{"id":1257,"date":"2010-12-04T15:10:10","date_gmt":"2010-12-04T15:10:10","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/inspection-9\/"},"modified":"2023-11-22T17:09:31","modified_gmt":"2023-11-22T17:09:31","slug":"inspection-9","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-lower-extremities\/the-foot-and-the-ankle\/inspection-9\/","title":{"rendered":"Inspection"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient remove all clothing from the legs.<\/span><\/li>\n<li><span style=\"color: #003366;\">Assess the spontaneous position with the patient standing.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to stretch the knees and place the feet slightly apart.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Ventrolateral Side<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Stand in front of the patient and inspect the shape and position of the following structures.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Bones and Joints<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Toes (<em>hallux valgus, hammer toes, claw toes, curved toes<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Feet (<em>transverse arch, pes planotransversus, shifting of weight over the feet<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Lateral malleolus.<\/span><\/li>\n<li><span style=\"color: #003366;\">Lower leg (<em>rotation abnormalities<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Knees (<em>patella, genu valgum, genu varum<\/em>).<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\">To assess any <span style=\"color: #33cccc;\"><strong>genu valgum<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>varum<\/strong><\/span>, ask the patient to place their legs\/feet next to each other.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Soft Tissues<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Skin of toes, feet and lower legs (<em>callus, corn, ingrown toenail, mycosis between the toes<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Muscle contours of the:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">Extensors or dorsal flexors.<\/span><\/li>\n<li><span style=\"color: #003366;\">Eversions.<\/span><\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #003366;\">Tendons of the:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">Extensors.<\/span><\/li>\n<li><span style=\"color: #003366;\">Eversion muscles.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Medial Side<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Inspect the shape and the position of the following structures.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Bones and Joints<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Metatarsophalangeal joint I (<em>hallux valgus\/bunion<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Feet. <\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\">Assess longitudinal arch: Slide your fingers under the longitudinal arch, if possible. You should be able to slide your fingers at least 1.5 cm under the sole of the foot. If necessary, ask the patient to place their foot in front of the other and put weight on it <em><strong>[Figures 92a, 92b]<\/strong><\/em>.<\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1254\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92a.jpg\" width=\"400\" height=\"293\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92a.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92a-300x220.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 92a<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1255\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92b.jpg\" width=\"400\" height=\"293\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92b.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-92b-300x220.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 92b<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Navicular bone (<em>tuberosity of navicular bone<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Calcaneus (<em>sustentaculum tali<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Medial malleolus.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Soft Tissues<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Skin, in particular the inside of the feet and lower legs.<\/span><\/li>\n<li><span style=\"color: #003366;\">Tendons of the i<\/span><span style=\"color: #003366;\">nversion muscles.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Dorsal Side<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Inspect the posterior side. Ask the patient to make a 180\u00b0 turn or stand behind the patient. The patient stands with their feet slightly apart <em><strong>[Figure 93]<\/strong><\/em>.<\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1256\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-93.jpg\" width=\"400\" height=\"293\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-93.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-93-300x220.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 93<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Bones and Joints<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Lateral malleolus.<\/span><\/li>\n<li><span style=\"color: #003366;\">Medial malleolus.<\/span><\/li>\n<li><span style=\"color: #003366;\">Calcaneus (<em>varus or valgus position<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Knees (<em>genu valgum, genu varum, height of knee folds<\/em>).<em><br \/>\n<\/em><\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\">To assess any <span style=\"color: #33cccc;\"><strong>genu valgum<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>genu varum<\/strong><\/span>, ask the patient to place their legs\/feet next to each other.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Soft Tissues<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Skin, heels and lower legs.<\/span><\/li>\n<li><span style=\"color: #003366;\">Muscle contours of the <\/span><span style=\"color: #003366;\">flexors (<em>plantar flexors<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Tendons:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">Achilles tendon and grooves (<em>rupture, swelling<\/em>).<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Gait Pattern<\/em><\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Ask the patient to walk and note:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Symmetry\/asymmetry.<\/span><\/li>\n<li><span style=\"color: #003366;\">Stride length.<\/span><\/li>\n<li><span style=\"color: #003366;\">Distribution of body weight over the left and right leg and foot.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">Can the patient do the following without problems:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Walk on their toes (<em>plantar flexors<\/em>)?<\/span><\/li>\n<li><span style=\"color: #003366;\">Walk on their heels (<em>dorsal flexors<\/em>)?<\/span><\/li>\n<li><span style=\"color: #003366;\">Walk on the inside of their feet (<em>eversion muscles<\/em>)?<\/span><\/li>\n<li><span style=\"color: #003366;\">Walk on the outside of their feet (<em>inversion muscles<\/em>)?<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Plantar Side<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Ask the patient to sit on the examination table and inspect the shape and position of the following structures.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Bones and Joints<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Compare with standing position when body weight is distributed over feet.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong><em>Soft Tissues<\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Skin (<em>callous formation, hyperkeratosis, verrucas<\/em>).<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #003366;\">If there are clear abnormalities on the soles of the feet, the patient should lie in the prone position on the examination table with feet hanging over the edge so that the soles of the feet can be examined more carefully.<\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Procedure Ask the patient remove all clothing from the legs. Assess the spontaneous position with the patient standing. Ask the patient to stretch the knees and place the feet slightly apart. Ventrolateral Side Stand in front of the patient and inspect the shape and position of the following structures. Bones and Joints Toes (hallux valgus, [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[71],"tags":[144],"class_list":["post-1257","post","type-post","status-publish","format-standard","hentry","category-the-foot-and-the-ankle","tag-the-examination-of-the-lower-extremities"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Inspection - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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