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MSK 1 > Ankle > Flashcards

Ankle Flashcards

1
Q

Posterior Tibial Tendon

A

behind medial malleolus attaching to navicular bone

gives support to medial longitudinal arch of foot

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2
Q

Posterior Tibial Tendon dysfunction

A

rupture or weakness of the tendon causing a flat foot/loss of the arch

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3
Q

Posterior Tibial Tendon dysfunction epidemiology

A

obese, middle aged women > 55

DM, HTN, steroid use/injections

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4
Q

Posterior Tibial Tendon dysfunction pt presentation

A

pain and swelling on MEDIAL ankle
“weak ankle”
pain moves to lateral as progression of disease

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5
Q

PE Posterior Tibial Tendon dysfunction

A

“Too many toes sign” / valgus of the heel

edema of medial ankle, tenderness, unable to stand on toes

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6
Q

Dx studies Posterior Tibial Tendon dysfunction

A

weight bearing AP and Lateral XR

MRI to asses tendon health

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7
Q

prevention Posterior Tibial Tendon dysfunction

A

control of RF (Weight, HTN, DM)

proper foot wear (medial arch support)

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8
Q

Tx Posterior Tibial Tendon dysfunction

A

SLWC for 4 weeks with RX (tendonitis)
Surgical repair if ruptured

NSAID (NO STEROIDS – increased rupture risk)

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9
Q

ganglion of ankle

A

herniation of synovial fluid from joint or tendon sheath

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10
Q

ganglion of ankle hx

A

non painful, 2/2 weakness of tissue or minor trauma

location on lateral side

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11
Q

PE ganglion of ankle

A

affected ankle and compare w/other 2-3 mm mass

not fixed with palpitation

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12
Q

dx study ganglion of ankle

A

AP and Lateral XR

r.o tumors and or bone loose bodies

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13
Q

ganglion of ankle tx

A

aspiration (3 times before sx)

fluid is straw colored, NSAIDs if needed

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14
Q

tibial nerve

A

posterior leg around medial malleolus and into medial arch of foot

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15
Q

tarsal tunnel syndrome

A

impinged tibial nerve by inflamed synovial shell of tibial tendon/flexor digitorium or hallucis longus

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16
Q

tarsal tunnel syndrome hx

A

burning type pain, tingling or numbness in distal tibial nerve distribution

worse after walking or exercise

MC idiopathic

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17
Q

PE tarsal tunnel syndrome

A

posterior malleolus edema and arch collapse
tenderness of tarsal tunnel
postive tines sign

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18
Q

dx study tarsal tunnel syndrome

A

EMG not effective
AP and lateral XR
MRI if mass found

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19
Q

tarsal tunnel syndrome prevention

A

proper foot wear, good arch support
avoid tightness around medial ankle

CRPS may develop

20
Q

tx of tarsal tunnel syndrome

A

relieve tension on tibial n., RICE, good foot wear and arch support
NSAID

NOT often go to sx

21
Q

Achilles tendon

A

attaches to gastroc-soleus complex to calcaneus of hind foot for powerful plantar flexion during jumping or walking

22
Q

Achilles tendon tear hx

A

“kicked me in heel”
stop and go sports
acute pain resolves within couple of hours

MC middle aged men

23
Q

PE Achilles tendon tear

A

edema of achilles tendon and ecchymosis

feel entire length of tendon from bell to heel for hap in tendon

+ Thompson (calf contraction w.o plantar flexion)

24
Q

Achilles tendon tear prevention

A

proper warm up and stretch

if untreated then weak plantar flexion and push off in sports or walking

25
Q

non sx tx Achilles tendon tear

A

Equinus (point down) cast x 6 weeks then progressive cast to neutral position (x 6 more weeks)

more likely to re rupture

26
Q

Achilles tendon tear sx tx

A

cast x 6 weeks

faster recovery

27
Q

rx tx Achilles tendon tear

A

AVOID NSAIDS

mild narcotic x 2-3 days post op

28
Q

which type of ankle sprain is MC?

A

lateral ankle sprain

anterior talofibular and calcaneofibular ligaments

29
Q

anterior tibiofibular ligament sprain

A

conjunction with others = high ankle sprain

takes longer to heal

30
Q

ankle sprain hx

A

sudden inversion of foot when weight bearing

immediate pain and pop

inversion with ER of body MOI for high sprain

31
Q

ankle sprain PE

A

ankle edema and antalgic gait

HIGH sprain suggested = squeeze test and external rotation test

32
Q

dx study of ankle sprain

A

tenderness over bone = need XR AP, Lateral, Mortise view

33
Q

mortise view ankle sprain for syndesmosis

A

med. mortis > 4 mm

tibial/fib space > 5 mm

34
Q

XR proximal leg to rule out in ankle sprain

A

rupture of intraosseous membrane and Maisonneuve fx

35
Q

ankle sprain prevention

A

ankle strengthening and proprioception

prophylactic bracing or taping prior to participation

36
Q

tx ankle sprain

A

NSAIDS

RICE, WBAT or crutches for short term

severe = 2-4 weeks of cast

brace for ligament protection and PT

37
Q

Ottawa criteria

only x ray if (ANKLE) (only need 1)

A
  1. bone tenderness at posterior edge or tip of lateral OR medial malleolus
  2. inability to weight bear both immediately and in ED
38
Q

ottawa criteria

only Xray if (FOOT) (only need 1)

A
  1. bone tenderness at base of 5th metatarsal
  2. bone tenderness at navicular
  3. inability to weight bear both immediately and in ED
39
Q

ankle fracture mc where?

A

lateral ankle (distal fibula)

40
Q

Bimalleolar ankle fx

A

medial malleolus and fibula

41
Q

trimalleolar fracture

A

posterior malleolus + medial malleolus + fibula

42
Q

dx studies ankle fx

A

AP, lateral, mortise of ankle

MAY need proximal fibula radiograph and for radiograph

43
Q

weber A ankle fx = what tx?

A

SLWC or boot x 4weeks

44
Q

weber B ankle fx = what tx?

A

Surgery

45
Q

weber C ankle fx = what tx?

A

surgery

46
Q

Maisonneuve fracture

A

spiral fracture of proximal third of fibula - tear of distal tibuolofibular sndesmosis and interosseous membrane

MSK 1 (9 decks)

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