quickster2008's version from 2015-06-01 10:52


Question Answer
What nerves are you blocking in P&A?1) Dorsal proper digital branch of the medial dorsal cutaneous nerve 2) Medial terminal branch of the deep peroneal nerve 3) Plantar proper digital branch of the medial plantar nerve 4) Plantar proper digital branch of the 1st plantar common digital branch of the medial plantar nerve
purpose of TQBlood in the field will neutralize the phenol and make the procedure less effective
what type of phenol do you use89%carboxylicacid
how do u do a P&A(steps)• TQ – Blood in the field will neutralize the phenol and make the procedure less effective • Prep • Lift nail • Remove nail with hemostat • Check for spicules with curette • Apply phenol 3 applications 30 sec each – 89%carboxylicacid • Irrigate with Etoh – Phenol is soluble in etoh and helps to lavage the acid
Benefits of Phenol for Matrixectomy Proceduresprotein coagulation(controlles necrosis), disinfectant(reduces infection); anesthetic(reduces pain)
Alternative to Using Phenol10-20% sodium hydroxide
Irrigate with ? for sodium hydroxideacetic acid
Nail Surgery in Diabetic Patients? safe?yes
Posterior Splint indicationsfracture, sprain, dislocation, post-operative dressing
Posterior Splint purposeImmobilizes injured limb, Maintains corrected position after reduction, Prevents further injury, Decreases pain and bleeding
Posterior Splint- Supplieswebroll(6-8 rolls) plaster(10 sheets) ace wrap, tape
posterior splint application, webroll start atlevel of MPJS
posterior splint application, additional padding overplantar heel and achilles
why would u use additional padding in posterior splint worried about swelling
posterior splint application, webroll stop 2 fingers below fibular neck
posterior splint application, orderwebroll, posterior plaster splint, ace wrap
posterior plaster splint application, start___ stop___start distal to plantar MPJs and proximal to end of webroll, NO PLASTER ON SKIN
why do you use minimal tension for ace wrapto allow for swelling
Sugar tongueadditional 10 pieces of plaster that wraps from medial aspect of leg around plantar calcaneus to lateral aspect of leg
when would u use sugar tongueankle dislocations
unna boot indicationsulcers, lymphedema, sprains
Unna boot suppliesunna boot, 4" coban
do you have to keep foot 90 deg to leg for both posterior splint and unna boot?yes
what kind of radio frequency is ultrasoundsound waves
echogenicityability to bounce an echo
hyperechogeniclighter colors/white
hypoechogenicdarker colors/grays/black
anechogeniccomplete dark
Ultrasound usestendon(tenosynovitis, tendinosis, tear) Ligament injury, foreign body, masses(ganglion cyst, plantar fibroma, morton neuroma)
Echogenicity of bonehyperechoic with hypo echoic shadow
Echogenicity of tendonhyperechoic
Echogenicity of fathypoechogenic with irregular hyper echoic lines
Echogenicity of arteriesanechoic
Echogenicity of veinsanechoic
Echogenicity of nerveshyperechogenic
Echogenicity of fluidanechoic
Echogenicity of hardwarehyperechogenic
Synovial fluid analysishelps diagnose the cause of jt inflammation, pain swelling and fluid accumulation
How is synovial fluid performedprepare skin(alcohol), locate needle insertion site, inject 2-5 cc local anesthetic with 25 gauge needle, attach an 18 gauge need to a 10-20 cc syringe, insert needle into joint space, pull back plunger to aspirate 1-2 cc synovial fluid
4 categories of synovial fluid analysisinfectious, hemorrhagic, inflammatory and degenerative dz.'s
How would gout appear under polarized light microscopy examneedle shaped, negative birefringence, urate crystals
how would pseudogout appear under polarized light microscopy examrhomboid shaped, calcium pyrophosphate crystals, weak + birefringence
When would u inject local anesthetic and steroid combo for symptom relief and pin pointing areas for painplantar fascia, tarsal tunnel, sinus tarsi, ankle jt, interdigital space(neuroma)
What color would hemorrhagic appear on synovial fluid analysisred
What color would inflammatory appear on synovial fluid analysisyellow
What color would noninflammatory appear on synovial fluid analysisyellow
What color would septic(infectious) appear on synovial fluid analysisdirty yellow
What color would degenerative(noninflammatory) appear on synovial fluid analysisyellow
What color would normal synovial fluid appear on synovial fluid analysisclear
what would the viscosity(thickness) be for each category in the synovial fluid analysisnormal-moderate, degenerative-high, inflammatory-low, septic-variable, hemorrhagic-variable
what would the WBCs be for each category in the synovial fluid analysisnormal <200 mm^3, degenerative 200-2,000, hemorrhagic 200-2,000 inflammatory 2,000-10,000, septic >80,000,
what would the PMNs be for each category in the synovial fluid analysisnormal <25%, degenerative <25% hemorrhagic 50-75% inflammatory >50%, septic >75%
what would the clarity be for each category in the synovial fluid analysisnormal transparent(see thr), degenerative transparent, inflammatory transluent(some light passes thr eg plastic, glass), septic opaque(no light passes thr e.g. wood) hemorrhagic bloody


Question Answer
why would u use an ultrasound over MRI, xray, etcsafer(no radiation or anesthesia), simple(no discomfort to pt) effective
ultrasound equipmenttransducer, conducting gel, monitor
which is bigger on ultrasound artery or veinvein
how do u tell difference btw artery and veinvein is collapsible
is vein hyperechogenic, hypoechogenic or anechogenic?anechogenic
is a nerve hyperechogenic, hypoechogenic or anechogenic?hyperechoic
indications for biopsyABCD, asymmetric or irregular borders,
topical used for tx of onychomycosisciclopirox, jublia
which has a better cure rate ciclopirox or jubliajublia
creams for onychomycosisterbinafine, clotrimazole 1%