PC Clinical Procedures & Protocols 2 — Questions and Answers
Question 1: When performing a digital block for a toe, which nerve must be anesthetized on BOTH the medial and lateral aspects?
- Sural nerve
- Digital nerve (Correct answer)
- Saphenous nerve
- Superficial peroneal nerve
Correct answer: Digital nerve
Digital blocks anesthetize the proper digital nerves on both medial and lateral sides of the toe to achieve complete anesthesia.
Question 2: Which debridement technique is most appropriate for a heavily infected wound with necrotic tissue in a podiatric patient?
- Autolytic debridement
- Enzymatic debridement
- Sharp surgical debridement (Correct answer)
- Mechanical wet-to-dry debridement
Correct answer: Sharp surgical debridement
Sharp surgical debridement is the fastest and most effective method for removing large amounts of necrotic and infected tissue.
Question 3: A patient presents with an ingrown toenail. The Winograd procedure involves removal of which structure in addition to the nail border?
- The nail matrix only
- A wedge of nail matrix and adjacent nail fold (Correct answer)
- The entire nail plate
- The distal phalanx periosteum
Correct answer: A wedge of nail matrix and adjacent nail fold
The Winograd procedure removes a longitudinal wedge of the offending nail border along with the underlying matrix and adjacent soft tissue.
Question 4: What is the primary purpose of using a fenestrated drape during podiatric surgery?
- To improve visualization of the operative field
- To maintain a sterile field around the operative site (Correct answer)
- To reduce tourniquet pressure
- To prevent post-operative swelling
Correct answer: To maintain a sterile field around the operative site
Fenestrated drapes create a sterile barrier around the operative site while exposing only the area being treated.
Question 5: During a nail avulsion procedure, phenol is applied after nail removal primarily to:
- Reduce post-operative bleeding
- Destroy the nail matrix to prevent regrowth (Correct answer)
- Sterilize the nail bed
- Anesthetize residual nerve endings
Correct answer: Destroy the nail matrix to prevent regrowth
Phenolization chemically ablates the nail matrix cells to permanently prevent regrowth of the treated nail border.
Question 6: Which casting technique is considered the gold standard for capturing a neutral subtalar joint position for custom orthotic fabrication?
- Weight-bearing foam impression
- Non-weight-bearing plaster slab cast (Correct answer)
- Semi-weight-bearing scan
- Weight-bearing plaster slipper cast
Correct answer: Non-weight-bearing plaster slab cast
The non-weight-bearing plaster slab cast with the subtalar joint held in neutral is the gold standard for custom functional orthotic fabrication.
Question 7: When applying a Jones compression dressing post-operatively, the primary goal is to:
- Immobilize the surgical site rigidly
- Provide even circumferential pressure to minimize edema (Correct answer)
- Protect the wound from contamination
- Maintain skin graft adherence
Correct answer: Provide even circumferential pressure to minimize edema
A Jones dressing uses multiple layers of padding and elastic bandaging to apply even compression that reduces post-operative swelling.
PC Clinical Procedures & Protocols 2
When performing a digital block for a toe, which nerve must be anesthetized on BOTH the medial and lateral aspects?