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MSK SM > Adult foot and ankle disorders > Flashcards

Adult foot and ankle disorders Flashcards

1
Q

What does a larger calcaneous allow us to do

A

Propel ourselves away

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2
Q

what are the anatomical structures in the lateral and hindfoot

A 
distal fibula and fibula shaft
ankle lateral gutter and syndesmosis
lateral wall calcaneous 
perpnei
CFL and ATFL
sural nerve
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3
Q

What is the most commonly sprained ligament in the ankle

A

AFTL

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4
Q

What anatomical structures are in the medial and hindfoot

A 
Medial malleolus 
Anteriomedial tibiotalar joint 
Deltoid ligament 
PTT (tom), FDL (dick), FHL (harry)
Posterior tibial artery
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5
Q

What anatomical structures are found in the posterior ankle and hindfoot

A 
Achilles tendon
Calcaneal insertion
Retrocalcaneal space 
Peroneal tendons 
FHL
EDL 
Saphenous Nerve
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6
Q

What anatomical structures are located in the plantar topography

A 
2nd MT Base 
5th MT Base 
Tibialis P. Insertion
Master knot of Henry 
Cuboid tunnel
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7
Q

How exposed should a patient be when examining the foot and ankle

A

Bare to the knee

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8
Q

What is Pes Planus more commonly known as

A

Flat Feet

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9
Q

Describe the Jack’s test

A

Push the child’s big toe up. If a nice arch is formed, the test is positive

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10
Q

What is the most common cause of acquired flatfoot deformity in adults

A

Tibialis Posterior Dysfunction

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11
Q

How do you test for Tibialis Posterior Dysfunction

A

Get the patient to go up on their tiptoes

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12
Q

Where does the tibialis posterior lie

A

Immediately posterior to the medial malleolus attaching on the navicular tuberosity and plantar aspect of medial and middle cuneiforms

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13
Q

What is the main function of tibialis posterior

A

To elevate the arch

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14
Q

What group of patients are a higher risk of developing tubialis posterior

A

Obese middle aged females

Increases with age

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15
Q

What is the common presentation of tibias posterior dysfunction

A

Pain and / or swelling posterior to medial malleolus

They may notice the foot has begun to change shape

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16
Q

What are some of the treatment options for TPD

A

Physiotherapy
Insole to support the arch
NO STEROID INJECTIONS
surgery

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17
Q

What is Pes Cavus more commonly known as

A

High arches

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18
Q

What is the common cause for Pes Cavus

A

Idiopathic

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19
Q

What is the best treatment for Pes Cavus

A

Surgery

20
Q

What type of injuries are common in Pes Cavus

A

Ankle sprains

21
Q

Describe the pain caused by plantar fasciitis

A

Pain after rest
Can be worse after exercise
Tenderness over the plantar aspect of heel
EXTREMELY PAINFUL

22
Q

Plantar fasciitis has what test positive and what is this test for

A

Tinel’s test for Baxter’s nerve

23
Q

What are some of the causes of plantar fasciitis

A 
Physical overload 
excessive exercise or weight 
Seronegative arthropahy
Diabetes 
Abnormal foot shape 
Improper foot wear
24
Q

What is the treatment for plantar fasciitis

A

NSAIDS
Night splints
Taping/ resting
Usually self management

25
Q

Describe Hallux Valgus

A

The great toe points laterally and has subsequent effects of the rest of the forefoot

26
Q

Describe the incidence of Hallux Valgus

A

Increases with age
Usually bilateral
Females more than males
Adolescent subgroup

27
Q

Describe the aetiology of Hallux Valgus

A 
Some familial
Shoes 
General joint laxity 
Rheumatoid 
Splayed forefoot associated with loss of muscle tone and age
28
Q

What are the non-operative options for Hallux Valgus

A

shoe modification and padding

29
Q

What is the aim in operating on Hallux Valgus

A

Aim to realign the hallux and decreased the HV angle

Correct any lesser toe deformities at same time

30
Q

Describe the operation for Hallux Valgus

A

Break the bone and move the head laterally

31
Q

What is Morton’s neuroma

A

Degenerative fibrosis of digital nerve near its bifurcation

32
Q

Describe the presenting complaint from a patient with Morton’s neuroma

A

Burning and tingling in the toes

33
Q

What is tendinosis

A

A tendonopathy

34
Q

What is the management of Tendo-Achilles Tendinosis

A 
Activity modifications/ analgesia 
NSAIDs
Shockwave therapy 
Orthotics 
Physio
Surgery
35
Q

What age group are at a higher risk of Tendo-Achilles Rupture

A

Usually over 40s

36
Q

Describe the clinical presentation of Tendo-Achilles Rupture

A

Unable to bear weight
Weak plantar flexion
Palpable painful gap
Positive calf squeeze (Simmonds) test)

37
Q

Describe how the Simmonds test is performed

A

The patient kneels on a chair and you squeeze their calf. If the foot does not move this is a positive Simmonds test

38
Q

What is the management for Tendo-Achilles Rupture

A

Operative
Non operative
Both involve an extended recovery/ cast time
Functional outcome normally good

39
Q

What are the 4 different type of deformed toes that you can get

A

Hammer
Claw
Curly
Mallet

40
Q

In all 4 toe deformities, what is the underlying problem

A

Slight hyperextension of PTJ

41
Q

What are the common presentations of ankle sprains

A

Pain, bruising and tenderness

42
Q

What is the management for a sprained ankle

A 
Analgesia 
Rest 
Ice
Compression
Elevation
43
Q

What does the Weber Classification show

A

The location of the fracture

44
Q

What is the problem with the Weber Classification

A

It does not take the Malleolus into account

45
Q

When do we operate on a Pilon Fracture

A

Rarely straight away - usually wait 1 week

MSK SM (42 decks)

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