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Physical Exam Course > Ankle and Foot > Flashcards

Ankle and Foot Flashcards

1
Q

Special Tests: Ankle Sprain

A

AFL: Anterior drawer

AFL + CLF: Talar tilt

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2
Q

Special Tests: Maisonneuve fracture

A

Fibular head palpation

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3
Q

Special Tests: High ankle sprain

A
  • Squeeze test
  • External Rotation Test: Passivle DF + EROT of foot
  • Fibular Drawer test: Pt on side → Anterior/posterior force placed on fibular w/ increased translation
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4
Q

Special Tests: Tarsal Tunnel Syndrome

A

Tinel

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5
Q

Special Tests: Stress fracture

A

Hop Test

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6
Q

3 functional parts of foot

A
  • Hindfoot: Calcaneus, talus
  • Midfoot: Navicular, cuboid, cuneiform
  • Forefoot: Phalanges, metatarsals
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7
Q

Components of hindfoot

A
  • Hindfoot: Calcaneus, talus
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8
Q

Components of midfoot

A
  • Midfoot: Navicular, cuboid, cuneiform
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9
Q

Components of forefoot

A

Forefoot: Phalanges, metatarsals

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10
Q

3 ligament complexes of the ankle

A
  • Lateral: ATFL, CFL, PTFL
  • Medial: Deltoid
  • Interosseous: AITF, PITF, IO

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11
Q

Sign for pes planus

A

Too many toes sign

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12
Q

Special tests: Evaluates stability of ATFL

A

Anterior drawer test

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13
Q

Special tests: Positive anterior drawer

A

3-5 mm increased translation

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14
Q

Special tests: Evaluates ATFL and CFL

A

Talar tilt test

  • ATFL: Inversion of foot w/ ankle plantar flexed
  • CLF: Inversion w/ foot dorsiflexed
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15
Q

Special tests: Morton’s Neuroma

A

Metatarsal squeeze test

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16
Q

Moton’s neuroma

A

Neurofibroma of branch of tibial nerve between metatarsal heads

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17
Q

Special tests: Positive metatarsal squeeze test

A

Pain + Paresthesias radiating to toes + Palpable click

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18
Q

Special tests: Ruptured achilles tendon

A

Thompson

19
Q

Special tests: Peroneal subluxation test

A

Recurrent inversion ankle sprains

  • Subluxation of peroneal tendons over lateral malleolus w/ active dorsiflexion and eversion against resistance
20
Q

Special tests: Distinguish between MTSS and Tibial stress fracture

A

Hop test

21
Q

Special tests: Areas of palpation w/ inversion ankle sprains

A
  • Base of 5th Metatarsal: tuberostiy avulsion, jones fracture
22
Q

Special tests: Areas of palpation w/ eversion ankle sprains

A
  • Proximal fibular: Maisonneuve fracture
23
Q

Types of 5th metatarsal fractures

A
  • Avulsion Fracture
  • Jones Fracture
  • Stress Fracture

24
Q

Ottawa ankle rules (3)

A
  1. Unable to ambulate 4 steps immediately after injury or in ER
  2. Bony tenderness over distal 6 cm of tibia and fibula (includes malleoli)
  3. Tenderness over navicular bone or base of 5th metatarsal
25
Q

Maisonneuve fracture

A

medial malleolus fracture/medial ligament complex injury + Fracture of proximal fibula

26
Q

Mechanism of high ankle sprain

A

Hyperdorsiflexion +/- Eversion

27
Q
  • Burning/electrical pain on base of foot/heel
  • Paresthesia radiating to toes
  • Symptoms exacerbated w/ standing/walking/driving
  • (+) Tinel’s at tarsal tunnel
A

Tarsal tunnel syndrome

28
Q

Contents of tarsal tunne l

A
  • Tibial nerve
  • Tibialis posterior tendon
  • Flexor digitorum tendon
  • Flexor hallucis longus tendon
29
Q

Hallux rigidus

A

OA of 1st MTP

30
Q

Cause of turf toe

A

Hyperdorsiflexion injury to 1st MTP leading to stretching or tearing of soft tissue restraints on dorsal aspect

  • Soft shoes
  • Hard playing surfaces
31
Q

Lisfranc injury

A

Lisfrance ligament injury attaching medial cuneiform to 2nd metatarsal

32
Q

Causes of lisfranc injury

A
  • MVC
  • Falls
  • Contact sports
33
Q

Lisfranc injury exam

A
  • Swelling/tenderness over tarsal/metatarsal area
  • Inability to bear weight or stand on toes
  • Pain w/ passive abduction and pronation w/ hindfoot is stabilized
34
Q

Frieberg’s infarction

A

AVN of metaphysis of 2nd/3rd metatarsal heads

35
Q
  • Vague plantar foot pain w/ wt. bearing
  • pain/tenderness/decreased ROM of affected MTP joint
  • Woman
  • Younger
A

Freiberg infraction

36
Q

Common locations of foot arthritis

A
  • Posterior Heel: Achilles tendon
  • Media ankle: Posterior tibialis, Flexor digitorum longus, Flexor hallucis longus
  • Lateral Ankle: Peroneous longus/brevis
37
Q

Achilles tendon bursas

A
  • Retrocalcaneal bursa: between calcaneous and achilles
  • Subcutaneous bursa: between achilles tendon and skin
38
Q

Haglund’s deformity

A

Prominence of posterior superior aspect of calcaneous

39
Q

Most common stress fractures in lower leg

A

Tibua

metatarsal

40
Q

High risk stress fracture locations

A
  • Superior Femoral Neck (Tension)
  • Pars interoarticularis of lumbar spine
  • Femoral head
  • Proximal 5th metatarsal shaft
  • Base of 2nd metatarsal
  • Anterior cortex of tibia
  • Medial malleolus
  • Talus
  • Tarsal Navicualr
  • Patella
  • Great toe sesamoid
41
Q

Treatment: 5th metatarsal stress fracture

A

Surgical: Conservative treatment may be attempted in select pts but usually requries up to 20 wks protected wt bearing/NWB

42
Q
  • Young athlete/military recrute
  • Point tenderness over proximal 5th metatarsal
  • (+) Hop test
A

5th Metatarsal stress fracture: March Fracture

43
Q
  • Track and field athlete
  • Point tenderness over posterior navicular (N spot)
  • (+) Hop test
  • Pain w/ toe raises
A

Tarsal navicular stress fracture

44
Q

Periostitis of medial border of tibia

A

Medial Tibial Stress Syndrome: Shin splints

Physical Exam Course (7 decks)

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