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2 MSK > Adult Foot and Ankle > Flashcards

Adult Foot and Ankle Flashcards

1
Q

what region of the foot does the meidal malleolus lie in?

A

medial hindfoot

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2
Q

what region of the foot does the deltoid ligament lie in?

A

medial hindfoot

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3
Q

what region of the foot does the sural nerve lie in?

A

lateral hindfoot

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4
Q

another name for flat feet?

A

pes planus

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5
Q

most common cause of acquired flat foot deformity in adults?

A

tibialis posterior dysfunction

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6
Q

what does the tibialis posterior muscle run behind in the foot?

A

medial malleolus

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7
Q

where does the tibialis posterior insert

A

navicular tuberosity

plantar aspect of medial and middle cuneiforms

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8
Q

what does the tibialis posterior do

A

stabilises medial longitudinal arch
inversion
plantarflexion

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9
Q

who tends to get tibialis posterior dysfunction?

A

obese middle aged women

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10
Q

causes of tibialis posterior dysfunction?

A 
hypertension
diabetes
steroid injection
seronegative arthropathies
idiopathic tendonosis
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11
Q

clinical presentation of tibialis posterior dysfunction?

A 
pain +/- swelling posterior to medial malleolus with:
change in foot shape
struggling to walk
noticeable hallux valgus
midfoot/ankle pain
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12
Q

what would you see on examination of someone with type 1 TPD?

A

swelling
tenderness
slightly weak muscle power

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13
Q

what would you see on examination of someone with type 2 TPD?

A

planovalgus

midfoot abduction

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14
Q

treatment for TPD?

A

physiotherapy
NO steroids
orthoses
surgery

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15
Q

commonest cause of pes cavus?

A

idiopathic

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16
Q

other causes of pes cavus?

A 
HSMN
CP
polio
spina bifida
club foot
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17
Q

clinical presentation of pes cavus?

A

high arched foot with clawed toes

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18
Q

clinical presentation of plantar fasciitis?

A

pain after rest that is exacerbated by exercise
swelling on plantarmedial aspect of heel
positive tinel’s test for baxter’s nerve

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19
Q

causes of plantar fasciitis

A

physical overload eg exercise, obesity
seronegative arthritis
diabetes
planovalgus/cavovalgus

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20
Q

treatment for plantar fasciitis?

A 
NSAIDs
night splints
taping
physio
steroid injection
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21
Q

does hallux valgus commonly present bilaterally or unilaterally?

A

bilaterally

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22
Q

is hallux valgus more common in men or women?

A

women

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23
Q

causes of hallux valgus?

A 
familial
shoes
joint laxity
connective tissue disease
rheumatoid
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24
Q

treatment for hallux valgus?

A 
shoe modifications (non-op)
operative
25
Q

when would you consider surgery in someone with hallux valgus?

A 
failure of other treatment
pain
lesser toe deformities
lifestyle limititation
overlapping
ulceration
26
Q

how is the surgery for hallux valgus done?

A

osteotomy to break the bone and then move the head laterally

27
Q

what is hallux rigidus?

A

OA of 1st MTPJ

28
Q

surgical management of hallux rigidus?

A

joint replacement

fusion

29
Q

what causes rheumatoid foot?

A

synovitis increases proteinases and collagenases which impairs integrity of joint capsules and ligaments by destructing hyaline cartilage

30
Q

systemic effects of rheumatoid foot?

A 
vasculitis
ischaemia
ulceration
neuropathy
immunosuppression
anaemia
31
Q

why do you get flat feet in rheumatoid foot?

A

unstable subtalar joint causes the calcaneus to become valgus, this causes medial arch to collapse

32
Q

what is morton’s neuroma?

A

degenerative fibrosis of digital nerve near it’s bifurcation

33
Q

clinical presentation of mortons neuroma?

A

forefoot pain

burning and tingling in toes in middle aged people

34
Q

non surgical treatment of mortons neuroma?

A

insoles

injections

35
Q

surgical treatment of mortons neuroma?

A

excise

36
Q

how is mortons neuroma diagnosed?

A

USS

XR

37
Q

what happens when you excise the digital nerve?

A

no sensation in between toes

38
Q

what happens in achilles tendinosis?

A

repetitive microtrauma causes failure of collagen repair

39
Q

what drugs predispose you to achilles tendinosis?

A

ciprofloxacin

steroids

40
Q

clinical presentation of achilles tendinosis?

A

pain, morning stiffness, eases with heat/walking

41
Q

investigations for achilles tendinosis?

A

USS

MRI

42
Q

management for achilles tendinosis?

A 
analgesia
NSAIDs
NO steroids
orthotics
physio
maybe surgery
43
Q

what is the minimum age that you tend to see a tendo-achilles rupture in?

A

40

44
Q

most common cause of a tendo-achilles rupture?

A

pre-existing tendinosis

sudden deceleration with resisted calf contraction

45
Q

clinical presentation of a tendo-achilles rupture?

A 
unable to bear weight
weak plantar flexion
palpable painful gap
\+ve simmond's test
think someone has hit them
46
Q

what is simmond’s test?

A

test for achilles tendonitis by squeezing calf

47
Q

name the types of surgery conducted on claw, hammer and mallet toes?

A

tenotomy
tendon transfer
fusion
amputation

48
Q

most common movement causing an ankle sprain?

A

inversion on a planted foot

49
Q

does an ankle sprain or fracture take longer to heal?

A

sprain

50
Q

what ligaments are commonly affected in ankle sprain?

A 
anterior talofibular (ATFL)
calcaneofibular (CFL) lateral ligaments
51
Q

non-operative management for ankle sprain?

A

RICE

physio

52
Q

operative management for ankle sprain?

A

brostrum gould

chrisman snook

53
Q

when is an ankle fracture classed as unstable?

A

if it includes a medial malleolus fracture or deltoid ligament fracture

54
Q

treatment for an unstable fracture?

A

surgery

55
Q

treatment for a stable fracture?

A

cast and boot

56
Q

where does a pilon fracture happen?

A

distal tibia

57
Q

most common cause of a pilon fracture?

A

high energy fall/crash

58
Q

most common injury to the 5th metatarsal?

A

inversion

2 MSK (61 decks)

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