Lecture 3 Flashcards Preview

P-2 Ortho 3 > Lecture 3 > Flashcards

Flashcards in Lecture 3 Deck (82)
Loading flashcards...
1

Corns vs callouses?

Corns are on the toe
Callouses are everywhere else

2

Callous definition?

Hyperkeratotic lesion of the skin that forms in response to excessive pressure over a bony prominencde

3

What is a persistent callous on the sole of the forefoot?

intractable plantar keratosis

4

What type of callouses get referred to ortho?

None, “don’t send these to me, I will not be happy”

5

Metatarsalgin?

Thickening of the tissue around a nerve leading to the toes

Callouses beneath the metatarsal heads cause this

6

What causes callouses to hurt?

The callus itself or some other manifestation of chronic overload of the metatarsal head

7

What will usually cause corns?

Toe deformities:
- hammer toe
- bunionette
- claw toe

And tight footwear

8

Heloma durum?

Hard corns occur over bony prominences

9

Heloma molle?

Soft corns between the toes (webbed space)

10

Where do plantar warts present?

In the soft tissue, Not over bony prominences

11

How are corns and calluses treated?

paring:
Shaving with a scalpel to remove enough avascular keratin to restore normal contour to skin w/o drawing blood

12

Treatment for metatarsalgia?

Paring of the callous and correcting the problem that caused it to grow in the first place

13

What is a later stage tx for corns and callouses?

You can do surgical tx to remove underlying bone

14

Tx for plantar warts?

Topical salicylic acid
or
liquid nitrogen

If that fails, surgery

15

What causes plantar warts?

They are hyperkeratotic lesions caused by human papillomavirus

16

Medical description of plantar warts?

Painful, slightly raised lesions on the sole of the foot.

17

What are clusters of plantar warts?

“Mosaic warts”

18

Differentiating plantar warts from callouses and corns?

Plantar warts:
- Non wt bearing areas
- Tender when pinched from sides

Corn:
- tender w direct pressure

19

What will superficial paring of a wart with a scalpel reveal?

Punctate hemorrhage and a fibrillated texture

20

What if i really want to know what the shit growing on the foot is?

Histopathologic examination

Seldom necessary

21

Why are aggressive tx of plantar warts not preferred?

Most spontaneously resolve w/in 6 months

22

What will improve the effectiveness of the keratolytic agents?

Occlusive tape (duct tape)

23

Besides tape what else will get rid of plantar warts?

Electrocautery
Cryotherapy
Laser ablation
Curettage

24

Necrosis of the deep dermis?

You were too aggressive with the wart tx and now your pt has intractable painful scarring of the sole of the foot

25

What are some other risks for plantar warts?

They can spread to other areas of the foot

Secondary infection from your ablation efforts

26

Who gets referrals for persistent or recurring warts?

NOT AN ORTHO PROBLEM

27

Common culprit causing onychomycosis?

Trichophyton rubrum
T. Mentagrophytes

Cause 90%

28

Why do we care about fungal infections of the toe?

Primarily cosmetic but sometimes nail becomes hypertrophic and interfers with foot wear

So we care because our pt cares

29

Common presentation of onchymycosis?

Discoloration, thickening and difficulty in trimming nail

Thickening and chalk yellow or white discoloration of the nail

30

What cements the nail fungus diagnosis?

Microscopic exam of the nail scrapping on KOH wet prep