10-5. Clinical Cases

Question 1

how many potential locations for joint deformity (in the lesser toes)?

Answer 1

3 potential locations;

can occur in any of the 3 cardinal planes

Question 2

What are the 3 major joint deformities that occur in the SAGITTAL PLANE?

Answer 2

• *CLAWFOOT occurs at MTPJ
• hammer toe occurs at PIPJ
• mallet toe at DIPJ

Question 3

primary and secondary deformity in:

CLAW TOE

Answer 3

• primary: MTPJ hyperextension/ hyperdorsiflexion
• secondary: PIP flexion/ plantarflexion

Question 4

mallet toe:

location of abnormality, and deformity

Answer 4

• DIPJ
• plantarflexed

Question 5

hammer toe:

location and deformity

Answer 5

• PIPJ
• plantarflex

Question 6

claw toe:

location, deformity

Answer 6

• MTPJ (PIP secondary)
• dorsiflexed (plantarflex secondary)

Question 7

Flexor pull and Extensor pull of:

MTP?

Answer 7

Question 8

Flexor pull and Extensor pull of:

PIP

Answer 8

Question 9

Flexor and Extensor pull of:

DIP joint

Answer 9

Question 10

What are the four common pulse points in the lower extremity?

Answer 10

• femoral triange
• popliteal fossa
• tarsal tunnel
• dorsum of the foot

Question 11

When feeling for the posterior tibial pulse:

describe the patient positioning and your finger placement.

Answer 11

Patient positioning: invert patient’s foot to relax the flexor retinaculum

Finger placement: posterior to medial malleolus @ 1 finger breadth

Question 12

What are potential causes of a reduced or absent posterior tibial pulse in a patient?

Answer 12

• pulse can be absent in young patients
• an absent pulse in individuals over 60yo can be a sign of arterial occlusion