foot care

Start Studying!

Terms

undefined, object

copy deck

what are the 4 Common foot disorders (4 categories)?: - Keratotic disorders
- Nail disorders
- Peripheral vascular disorders
- Structural disorders
What are the 2 main types of keratotic lesions?: o Calluses
o Corns
True or False Calluses are a broad based, diffused thickening of the stratum corneum: TRUE

Calluses are a broad based, diffused thickening of the stratum corneum
Where are Calluses most commonly located?: under the metatarsal heads
True or False Callus colour varies from black to grey to yellow occasionally appearing brown or red r/t: extravasation of blood in the underlying dermis: FALSE
Callus colour varies from WHITE to grey to yellow occasionally appearing brown or red r/t: extravasation of blood in the underlying dermis
TRUE or FALSE Corns are more discrete presenting with a thickened area of the skin with a central corn that may penetrate into the dermis: TRUE

Corns are more discrete presenting with a thickened area of the skin with a central corn that may penetrate into the dermis
Hard corns are called (heloma dura) (heloma molle) or (heloma millaire): Hard corns (heloma dura)

Soft corns (heloma molle)
Seed corns (heloma millaire)
Soft corns are called A (heloma dura) B (heloma molle) C (heloma millaire): Hard corns (heloma dura)

B Soft corns (heloma molle)

Seed corns (heloma millaire)
Seed corns are called A (heloma dura) B (heloma molle) C (heloma millaire): Seed corns are called

Hard corns (heloma dura)
Soft corns (heloma molle)

C Seed corns (heloma millaire)
What does this describe Hard, Soft or Seed Corns? - Most common - Appears on interphalangeal joints and metatarsal heads - They are firm, dry masses with a polished surface - May develop beneath the nail plate ( referred to as: Hard corns
- Most common
- Appears on interphalangeal joints and metatarsal heads
- They are firm, dry masses with a polished surface
- May develop beneath the nail plate ( referred to as subungual heloma) this is caused in response to pressure from foot wear
- Can become infiltrated with blood vessels and or nerve endings from the papillary dermis and are then referred to as vascular corns or neurovascular corns
What does this describe Hard, Soft or Seed Corns? - Most common - Appears on interphalangeal joints and metatarsal heads - They are firm, dry masses with a polished surface May develop beneath the nail plate ( referred to as su: Hard corns
- Most common
- Appears on interphalangeal joints and metatarsal heads
- They are firm, dry masses with a polished surface
May develop beneath the nail plate ( referred to as subungual heloma) this is caused in response to pressure from foot wear
- Can become infiltrated with blood vessels and or nerve endings from the papillary dermis and are then referred to as vascular corns or neurovascular corns
- If left untreated they can become surrounded by a meshwork of fibrous tissue known as a fibrous corn (heloma fascia)
What type of corn is described here? - Develop between the toes - Have a characteristic rubbery texture due to placement preventing adequate evaporation: Soft corns
- Develop between the toes
- Have a characteristic rubbery texture due to placement preventing adequate evaporation
What type of corn is described here? - Are typically smaller - Superficial clusters of porokeratotic cells found embedded in plantar calluses - Often scene scattered around the heel or non-weight bearing areas of the plantar surface - These ar: Seed corns
- Are typically smaller
- Superficial clusters of porokeratotic cells found embedded in plantar calluses
- Often scene scattered around the heel or non-weight bearing areas of the plantar surface
- These are generally not painful
True or False Keratotic Lesions are: - Mechanically induced lesions can be different from hyperkeratosis caused inherited dermatological diseases or chemical toxicity: TRUE

eratotic Lesions are:

- Mechanically induced lesions can be different from hyperkeratosis caused inherited dermatological diseases or chemical toxicity
TRUE or FALSE Keratotic Lesions are Determined through medical history and assessment observing distribution patterns: TRUE

Keratotic Lesions are

Determined through medical history and assessment observing distribution patterns
What type of lesions are described below? - Corns and calluses are mechanically induced - Appear on weight bearing areas or bony prominences - Subject to pressure from foot wear: Keratotic lesions/mechanical hyperkeratosis
- Corns and calluses are mechanically induced
- Appear on weight bearing areas or bony prominences
- Subject to pressure from foot wear
Pls answer true or false for each: Keratotic Lesions are caused by: Gait T or F Patient Weight T or F Footwear T or F ROM of joints T or F Toe deformities T or F Foot size T or F Posture of the foot (pronated, neutral, supi: Keratotic Lesions are caused by:

Gait T
Patient Weight F
Footwear T
ROM of joints T
Toe deformities T
Foot size F
Posture of the foot (pronated, neutral, supinated) T
What is the 1st step in Conservative lesion debridement?: 1st step in Conservative lesion debridement is sharp debridement or enucleation with a scalpel
Will Conservative lesion debridement provide relief?: Yes

- Provides immediate symptomatic relief
What are some underlying causes of Conservative lesion debridement?: - Underlying cause needs to be addressed
o Level of activity
o Bio-mechanics
o Foot wear
o Level of skin hydration
Which treatment does NOT belong when treating Heel calluses? - Emollient creams - Salicylic acid - Emollient or corticosteroid creams - Sharp debridement with scalpel or sanding - Injection therapy - Orthotics/ shoe modifications: Emollient or corticosteroid creams is for treatment of Exotic eczema

Heel calluses are treated with:

- Emollient creams
- Salicylic acid
- Sharp debridement with scalpel or sanding
- Injection therapy
- Orthotics/ shoe modifications
These symptoms describe what? - Dry scaling - Anterolateral aspect of legs - itchy - Due to excessive use of soaps - Frequently bathing in hot water: Atopic eczema
- Dry scaling
- Anterolateral aspect of legs
- itchy
- Due to excessive use of soaps
- Frequently bathing in hot water
True or False For each bullet below - choose TRUE or FALSE Treatment of Atopic Eczema can include: - Emollient or corticosteroid creams T or F - Education T or F - Injection therapy T or F - Purchase of a humidifier T or F<: Treatment of Atopic Eczema can include:

- Emollient or corticosteroid creams T
- Education T
- Injection therapy F (this is for heel calluses w associated fissuring)
- Purchase of a humidifier T or F
What condition is described below? - Fungal infection in the foot - Common in older people - Caused by a group of fungi known as dermatophytes - Causes karatin destruction - Itchy - Burning sensation Treatment: - Anti-f: Tinea Pedis ( athletes foot)
What is the treatment for an Acrochordon (skin tag)?: not necessary but;

- If painful it can easily be removed with a scalpel followed by electrocautery
What condition is described below - Keratotic lesion - Projects outward from skin in the shape of an animal horn - Commonly found on the ears, hands,and feet in older people - Develop from a wide range of pre-existing dermatological le: Cutaneous horns
- Keratotic lesion
- Projects outward from skin in the shape of an animal horn
- Commonly found on the ears, hands,and feet in older people
- Develop from a wide range of pre-existing dermatological lesions
- Frequently painful
- Risk of malignancy
What nail disorder is described below? - Fungal infection of the nail - Most common of all nail disorders - Affecting 2-13 % of the general population: Onychomycosis
- Fungal infection of the nail
- Most common of all nail disorders
- Affecting 2-13 % of the general population
what effects does Onychomycosis have on a patient?: Onychomycosis

Effect on Patients
- Pain
- Difficulty walking
- Footwear limitations
- Psychosocial
The following Three subtypes describe what condition? 1. Candida paronychia â€“ characterized by swelling and erythema of the proximal and lateral nail folds 2. Candida onycholyosis- characterized by separation of the nail plate from the nai: Candidal
When assessing Candidal, what conditions may mimic onychomyocosis?: - Rule out conditions that may mimic onychomyocosis
o Psoriatic nails
o Onychogryphosis (claw/ramâ€™s horn nail)
The following describes what condition? Risk factors - Ill fitting footwear - Tight socks - Hyperhidrosis (excess moisture) - Incurvated/involuted nails - Pronated foot type - Hallux valgus (bunion) - Incorrect cutting of n: Onychocryptosis â€“ ingrown toenail
- Usually effects younger children and our ageing population
- Decreased peripheral vascular supply increases the likely hood of infection in older people
- Potentially serious consequences
o Ulceration
o Cellulitis
- Develops when a specula of nail penetrates the nail sulcus, leading to erythema, swelling, and secondary infection
- Painful
The following are the 3 stages of Onychocryptosis Place them in order 1,2 and 3 Stage __ - Hypergranulation tissue has developed over the edge of the nail plate Stage __ - Toe appears red and swollen - Pain on direct pres: Three stages of Onychocryptosis
Stage 1
- Toe appears red and swollen
- Pain on direct pressure
Stage 2
- Evidence of infection
- Slight pressure to toe will cause considerable pain
- Patient has difficulty walking
Stage 3
- Hypergranulation tissue has developed over the edge of the nail plate
What syndrome is described below? - Uncommon condition - Characterized by the thickened, incurbated yellow nails - Can occur in toes or fingers nails - Nail dystrophy associated with the syndrome is thought to be due to lymphatic: Yellow nail syndrome
What is PVS short for?: Peripheral Vascular Disorders
What is PAD short for?: - Peripheral arterial disease (PAD)

- Peripheral arterial disease (PAD) is a chronic arterial occlusive disease of the lower limb caused by arthrosclerosis, the thickening of the intima of large arteries, which results in a reduction in the vessel diameter and subsequent reduction in peripheral blood flow
What Condition is characterised by the accumulation of fluid in the limbs, caused by the inability of lymphatic system to adequately drain lymph from interstitial spaces: Lymphoedema
What is Pes Pianus?: Pes Planus â€“ flat foot
- Painful
- Caused by the tibial posterior muscle weakening and elongating
- Most common biomechanical issue with the foot during the aging process
- Difficulty walking
What is Pes Caves: Pes Caves â€“ high arch (know this )
- High medial arch
- Structural abnormalities
How many joints in the foot? How many bones and sesmoinds in the foot?: 26 bones and 2 sesamoids
33 joints
T or F There are 500 ligaments, muscles, tendons that hold structure together: False,

There are Over 100 ligaments, muscles, tendons that hold structure together
What do the Tendons do?: - Transmit muscle force to skeletal system
What is described below? - Bands of fibrous connective tissue - Hold bone and joints together - Give strength and support, do not stretch - Are pliable and flexible - Limit action of joint beyond a fixed point: Ligaments

- Bands of fibrous connective tissue
- Hold bone and joints together
- Give strength and support, do not stretch
- Are pliable and flexible
- Limit action of joint beyond a fixed point
What are the 3 types of ligaments?: Spring ligaments
- Supports talus
- If dysfunctional â€“ pes plantus (flat foot)
Long plantar ligaments
- Connects plantar surface of cuboid with plantar surface of calcaneous
- Fastens to the base of the metatarsals
Short plantar ligament
- Lies deep in the foot
- Secures the calcaneum and cuboid
- Limits movement between the calcaneum and cuboid to a gliding motion
What role do muscles perform: - Controls movement
- Expands and contracts
- 20 different muscles in the foot
- May weaken or atrophy from lack of use
- Regular exercise will improve foot function
Describe Extrinsic muscles: Extrinsic muscles

- Controls leg and foot movement
- Visible on dorsal aspect of on plantar flexion
- Arises at the lower leg and extends into the foot as tendons
Describe Intrinsic muscles: Intrinsic
- Intrinsic maintains foot shape and support
- Supports toes
- Arise and insert within the foot itself
what are 3 types of arteries?: Intima
- Endothelial cells which provide smooth surface for passage of blood
Media
- Layer of large arteries
- Consisting of elastin
- Provides vessels with the ability to expand an contract in response to changes in blood volume
Adventitia
- Primarily loose connective tissue
- Assists in flexibility anchoring the vessels to surrounding structures
What does ABPI stand for? What does a low ABPI indicate?: Ankle Brachial pressure index

ABPI Values - ABPI normally >1.0 - ABPI < 0.9 indicates some arterial disease - ABPI > 0.5 and < 0.9 can be associated with claudication and if symptoms warrant a patient should be referred for further assessment - ABPI < 0.5 indicates severe arterial disease and may be associated with gangrene, ischemic ulceration or rest pain and warrants urgent referral for a vascular option.
What is PSS?: Peripheral Sensory System (PSS)
- Globrous skin on the sole of the foot contain large populations of mechanoreceptors capable of detecting the site, velocity and acceleration of mechanical stimuli
- A decrease in the size and number of axons and the myelin sheaths surrounding the axons causing a reduction in nerve conduction velocity
What are the functions of the skin? try for 5: Function of the skin
- Sensory
- Temperature regulation
- External protection
- Storage of fats, water and salts
- Excretion
- Largest organ in the body
- The skin on our feet is 15x thicker than the skin on our face
- Skin on our feet have more sweat glands than anywhere else on our body
- Can produce 500mls of moisture/day
What are the 2 layers of skin?: - Epidermis
- Dermis
which layer of skin has a rich blood supply?: Dermis
- Has a rich supply of blood vessels, lymph vessels and nerves
- Contain sebaceous glands, sweat glands, and sensory organs
- Subcutaneous fatty tissue lies just below the dermis. It is very fibrous and rough on the sole of the foot especially the heel
Which layer of skin is on the outside?: Epidermis
- Outer layer
- Contains 0 blood supply
- Very few nerve endings
- Feed nutrients from the underlying dermis by diffusion
- Protects against moisture leaving and entering the body as the cells of the epidermis contain keratin
A nail is comprised of densely packed ___ cells consists of ______ layers: - comprised of densely packed keratin cells

- consists of 3 layers
o dorsal
o intermediate
o ventral plates
What are the functions of nails? try for 4 Protection of ____ Assists in _____ Adds _____: - Protection of underlying distal phalanges
- Protection of nerve endings
o There are numerous nerve endings in the dermis underlying the nail making it very sensitive
- Assists in sensory perception
o Light touch
- Adds strength to digits
True or False The following affect Nail Growth - Aging T or F - Patient Weight T or F - Inadequate blood supply T or F - Trauma T or F - Infection T or F - Nutritional deficiencies T or F - Hair Colour T o: The following affect Nail Growth

- Aging T or F
- Patient Weight F
- Inadequate blood supply T or F
- Trauma T or F
- Infection T
- Nutritional deficiencies T
- Hair Colour F
- Skin disease T
- Congenital conditions T
- Inherited factors T
What are characteristics of an aging foot? think of 8: Characteristics of aging foot
- Diminished nerve supply resulting in reduced sensation
- Reduced arterial supply as a result of reduced integrity of the veins and semi-lunar valves
o Resulting in lower limb edema
o Results in decreased healing time
o The foot and lower limbs may have a bluish or reddish colour due to impaired circulation
- Atrophy of the fat pads on the sole of the foot
o Causing painful callusing to develop under the metatarsal heads
- Loss in hair growth on the dorsal aspect of the foot due to diminished circulation
- The foot may become wider and longer d/t collapsed arches
- Rate of nail growth slows
- Nails become brittle or thickened
- Nails may develop diseased or infection due to poor circulation and decreased ability to fight infection or disease

Start Studying!

Deck Info

Number of cards 57

Created By fewacres