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ECOS I Exam 1 > 20: Approach To Ankle And Foot Complaint > Flashcards

20: Approach To Ankle And Foot Complaint Flashcards

1
Q

Three possible injuries with a positive talar tilt test

A
  1. Lateral ankle sprain
  2. Calcaneofibular L injury
  3. Anterior talofibular L injury
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2
Q

What does a positive anterior drawer test signify?

A

Lateral ankle sprain

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3
Q

Possible injury with a positive eversion test

A

Medial ankle sprain (deltoid L)

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4
Q

Two possible injuries with a positive squeeze test

A
  1. High ankle sprain

2. Distal tibiofibular syndesmosis injury

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5
Q

Positive Homan’s sign signifies?

A

DVT

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6
Q

Three main types of ankle sprains

A
  1. Lateral
  2. Medial
  3. Syndesmotic
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7
Q

Most common type of ankle sprain

A

Lateral ankle sprain, Anterior talofibular L

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8
Q

Mechanism of injury for a lateral ankle sprain

A

Foot inversion and/or plantarflexed

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9
Q

Medial ankle sprain mechanism

A

Forced eversion

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10
Q

Ligament injured in medial ankle sprain

A

Deltoid L (but takes a lot of force to actually tear it)

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11
Q

Other name for syndesmotic ankle sprain

A

High ankle sprain

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12
Q

Most likely ligament torn in high ankle sprain

A

Tibiofibular syndesmosis

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13
Q

Mechanism for syndesmotic ankle sprain

A

Forced external rotation of a dorsiflexed ankle

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14
Q

Three “grades” of ankle sprains

A
  1. Grade 1: no laxity, minimal ligament damage
  2. Grade 2: Mild/moderate laxity
  3. Grade 3: complete ligament disruption
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15
Q

Treatment for the three grades of ankle sprains

A

All of them: manage conservatively with NSAIDs, RICE, PT. Grade 3 requires immobilization for 3 weeks, and surgery if unstable

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16
Q

Largest tendon in the body

A

Calcaneal tendon

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17
Q

Achilles tendinitis MOI

A

Repetitive motions -> microtears in tendon -> inflammation (common in athletes)

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18
Q

S/S of Achilles tendinitis

A

Pain/stiffness at tendon insertion, recent increase in activity level, worse with activity

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19
Q

Associated test with Achilles tendinitis

A

NEGative Thompson test

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20
Q

Achilles rupture MOI

A

80% occur during high impact sports

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21
Q

S/S of Achilles rupture

A

Popping sensation at the heel, +/- pain

22
Q

Associated test with Achilles rupture

A

Positive Thompson test

23
Q

Sever’s disease

A

Calcaneal apophysitis - inflammation/stress injury to area around apophysis in heel

24
Q

S/S of sever’s disease

A

Chronic heel pain related to increased activity and growth, pain reproduced over apophysis

25
Q

Four things that can cause a tibiotalar effusion

A

Injury, arthritis, infection, hemearthrosis

26
Q

Pes planus

A

Flat feet - loss of longitudinal arch

27
Q

Pes cavus

A

Exaggeration of longitudinal arch of foot

28
Q

Hammer toe vs claw toe

A

Hammer toe: flexion at PIP, extension at DIP

Claw toe: flexion at PIP and DIP

29
Q

Hallux valgus

A

Lateral deviation of big toe that can lead to a prominence on the medial aspect of the MP joint (bunion)

30
Q

What worsens the pain of plantar fasciitis?

A

First few steps in the morning, prolonged standing, forced dorsiflexion

31
Q

Morton’s neuroma

A

Inflammation/thickening of tissue surrounding nerves between toes

32
Q

S/S of Morton’s neuroma

A

Sensation of walking on a marble, palpable in web space -> replicates burning pain with radiation and numbness in toes

33
Q

Associated test with Morton’s neuroma

A

Mulder’s sign: palpable clicking sensation between third web space as transverse arch is compressed

34
Q

Where is fibular nerve most commonly compressed

A

Where it wraps around the lateral aspect of the fibular head

35
Q

What can cause fibular nerve compression?

A

Prolonged lying, crossing legs, ankle sprain, prolonged immobilization in a cast

36
Q

S/S of fibular nerve compression

A

Weak dorsiflexion and eversion, steppage gait, sensory loss of dorsal foot and lateral shin

37
Q

Charcot foot

A

Mid arch deformities and collapse of longitudinal arch due to chronic foot inflammation

38
Q

What causes Charcot foot?

A

Neuropathy, often diabetic

39
Q

What causes diabetic neuropathy

A

Chronic elevated blood sugar damages peripheral nerves

40
Q

S/S of Charcot foot

A

Visible collapse of longitudinal arch, warmth, redness, edema, Hx minor trauma

41
Q

What causes gout?

A

Monosodium urate crystals

42
Q

What joint is most susceptible to gout?

A

1st MTP

43
Q

What foods cause gout and why?

A

Meat, shellfish, alcohol -> high in purines, which breaks down to create uric acid

44
Q

What is seen upon joint aspiration of a gouty joint?

A

Negatively birefringent needle-shaped crystals

45
Q

Pronation vs supination of foot: three actions that create them

A

Pronation: dorsiflexion, eversion, abduction (Abed)
Supination: plantarflexion, inversion, adduction (AdPI)

46
Q

Where does the fibular head glide when the foot is pronated vs supinated

A

Pronated -> fibular head glides anteriorly

Supinated -> fibular head glides posteriorly

47
Q

When the calcaneus moves into eversion/inversion, where does the talus go?

A

Calcaneal eversion -> talus goes anterior + medial

Calcaneal inversion -> talus goes posterior + lateral

48
Q

Preference for glide for cuboid, navicular, and cuneiforms

A

Cuboid: eversion + plantar glide
Navicular: inversion + plantar glide
Cuneiforms: plantar glide

49
Q

What are the Ottawa Ankle Rules?

A

Guidelines for when to order X-rays on a pt with ankle pain

50
Q

Ottawa ankle rules: if patient has pain in the malleolar zone

A

Must have one of the following

  1. Bony tenderness at posterior tip of medial or lateral malleolus
  2. Unable to bear weight immediately after injury + unable to walk 4 steps in clinic
51
Q

Ottawa Ankle rules: if pt has pain in midfoot region

A

Must have at least one of the following for an x-ray

  1. Bony tenderness at fifth metatarsal or navicular
  2. Unable to bear weight immediately after injury + unable to walk 4 steps in clinic

ECOS I Exam 1 (22 decks)

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