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PHTH 565 - MSK > ANKLE AND FOOT > Flashcards

ANKLE AND FOOT Flashcards

1
Q

What information can you get from a squat test

A
  • Location of pain
  • talocrural wrinkles (indication of range compared side to side
  • Splay of mortice
  • DF/Compression test
  • Strength
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2
Q

During the sway test, what do you expect to occur?

A

Ipsilateral calcaneous to side rotated to should invert and contralateral should evert

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3
Q

What should happen in heel raise

A

Calcaneous should invert at the top of the heel raise

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4
Q

What is the MOI of a high ankle sprain

A

Talus getting driven between med and late malleoli by hyperdorsiflexion combined with ER of the foot

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5
Q

What are the 3 pain provocation tests for the ITF joint

A
  • Dorsiflexion/compression test (deep squat + compression)
  • Squeeze test (squeezing proximally)
  • Palpation or Point test
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6
Q

What are you looking for on the dorsiflexion/compression pain provocation test

A
  • Pain without compression

- Decreased pain or increased range with compression

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7
Q

What are you looking for with the squeeze test

A

Pain reproduction at inferior tib-fib joint

- And distraction at ITF joint?

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8
Q

Where do you palpate in the palpation or point test for the ITF joint

A

Proximal to t/c line and 2/3 lateral

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9
Q

What are the 3 stability tests for the ITF joint

A
  • anterior and/or posterior glide of fibula
  • Splay on squat
  • External rotation test
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10
Q

How do you conduct the anterior and/or posterior glide of the fibular

A

Stabilize tib in crook lying apply sustained hold for 10 seconds and compare to other side
SUSTAIN SUSTAIN SUSTAIN

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11
Q

What is a positive finding on the Splay on squat test

A
  • > 2mm with calipers

measure at most splayed point

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12
Q

What are you looking for and What is a positive test for the external rotation test of the ITF joint?

A

Looking for available ROM, end feel, and symptom reproduction

Pain reproduced over ITF joint when foot is passively taken into DF and ER

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13
Q

What are two tests for general talocrural stability

A
  • Talocrural distraction

- Talocrural compression

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14
Q

For talocrural compression where do you apply the force

A

through the plantar aspect of the calcaneus

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15
Q

What are the tests of inversion stability

A
  • ATFL
  • Calcaneofibular ligament
  • PTFL
  • Dorsal calcaneocuboid ligament
  • Lateral talocalcaneal ligament (subtalar)
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16
Q

Where are you hands positioned when testing the ATFL? What motion do you create?

A

Distal fibula and anterior talus

Inversion in a position of PF

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17
Q

Where are you hands positioned when testing the Calcaneofibular ligament? What motion do you create?

A

Distal fibula and calcaneus

Inversion in neutral foot position

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18
Q

Where are you hands positioned when testing the PTFL? What motion do you create?

A

Distal fibula and Posterior talus

External rotation in full DF

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19
Q

Where are you hands positioned when testing the Dorsal calcaneocuboid ligament? What motion do you create?

A

Calcaneus and cuboid (have thumbs side by side). your body is turned away for Pt

Invert and abduct cuboid (gaping it)

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20
Q

Where are you hands positioned when testing the lateral talocalcaneal (subtalar)? What motion do you create?

A

Stabilize annterior talus and move calcaneus

Invert and gap lateral side of calcaneus

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21
Q

What are the 3 eversion ligament stability tests

A
  • Deltoid
  • Medial talocalcaneal (subtalar)
  • Spring (plantar calcaneonavicular) ligament
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22
Q

What are the 4 fibres of the deltoid

A
  • Anterior talus
  • Navicular
  • Calcaneus
  • Posterior talus
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23
Q

What motion to you create for all fibres of the deltoid ligament

24
Q

In what position do you test the anterior talus fibres of the deltoid ligament

25
In what position do you test the navicular fibres of the deltoid ligament
Slight PF
26
In what position do you test the calcaneal fibres of the deltoid ligament
In neutral
27
In what position do you test the posterior talar fibres of the deltoid ligament
Full DF
28
Where are you hands positioned when testing the Medial talocalcaneal ligament? What motion do you create?
Stabilize talus and evert and gap medial side of calcaneus
29
How do you stress test the spring (plantar calcaneonavicular) ligament
Roll up two towels - one under navicular one under calcaneus (sustentacular tali) Using web of hand apply pressure directly down through neck of the talus May be a visual deformity even prior to testing
30
What are the accessory movements at the ankle
anterior and posterior glides
31
What are the accessory movements at the talocrural joint
anterior (PF) glide | Posterior (DF) glide
32
How do you conduct an anterior glide at the TC joint
- stabilize distal tib-fib - Pull talus anteriorly (avoid pulling through calcaneous) - Pull along curve of the joint
33
How do you conduct an posterior glide at the TC joint
- Stabilize distal TibFIb on posterior part of calf | - Push talus posteriorly along the curve of the joint
34
Posterior calcaneus in ______ and the anterior is _____ (at the joints with the talus)
Convex Concave
35
Where does the spring ligament run and what is its role
from the navicular to the sustentacular tali, keeps the medial head of the talus off the floor
36
Why is sustained pressure important when testing the spring ligament
because injury to this ligament is often due to overload
37
medial glide of the anterior calcaneus on the talus helps with what motions
Inversion and supination
38
What is the hand position for a medial glide of the anterior subtalar joint
- Stabilize anterior talus - Moving hand anterior to peroneal tubercle , posterior to calcaneocuboid joint line - elbows out
39
In what position do you assess movement of the anterior subtalar joint ? treat?
supine | side lying
40
Lateral glide of the anterior calcaneus on the talus helps with what motions
Eversion and pronatino
41
What is the hand position for a lateral glide at the anterior subtalar joint
- stabilize across anterior talus - moving hand is over the sustentaculum tali - Elbows out
42
What glides will you perform at the talonavicular joint
plantar and dorsal
43
For the talonavicular, navicular-medial cuneiform, and 1st TMT joints what are the two motions and the terms used to describe them
1. Fold: plantar glide with medial rotation | 2. Fan: dorsal glide with lateral rotation
44
For the calcanealcuboid joint what are the two motions and the terms used to describe them
1. Fold: plantar glide and lateral rotation | 2. Fan: Dorsal glide with medial rotation
45
What is mobilization with movement
Get them to do a motion where they feel pain or restriction, then apply glide while doing that same motion. GLIDE FIRST MOVE SECOND
46
What are the indications for a talocrural traction manipulation
1. To restore the end of range of ankle OF or DF when mobs are no longer effective 2. To gain the final few degrees of PF or DF when a non-capsular limitation of motion is present
47
Why should joint stability be retested after a manip
there may be an underlying hypermobility or instability causing the loss of end range ROM
48
What are the effects of a talocrural traction manipulation
- Possible tearing of post-traumatic adhesions | - Quick strethc to joint capsule and stimulation of mechanoreceptors - neurophysiological effect
49
What are the risks of a talocrural traction manipulation
- Tearing of soft tissues (unintentionally) - Post treatment soreness - Fracture (unlikelY)
50
What are the contraindications of a talocrural traction manipulation
- Fracture in area - Joint instability in direction of manip - Inflammatory joint disease - Malignancy - Bone disease - Open wounds - Poor circulation or sensory deficit in area - Spasm or increased pain on test pull - Unsure of general health or diagnosis - Anticoagulant use - Haemophiliacs - Inability of patient to relax - Physio factors
51
What are some additional cautions and contras for novice manipulators
- Pain or instability proximally in the lower kinetic chain - uncertainty about indication for technique - Children - Diabetics - The elderly - positive SLR on affected side
52
Is the pre-manipulative hold part of consent
yes
53
what are you looking for in the pre-manipulative hold
pain or spasm
54
What do you retest following a manip
Mobility and stability
55
What is the follow-up treatment after a manip?
- ROM exercises, assuming joint is stable - Post-treatment soreness can occur; warn patient, suggest the use of ice - Balance, proprioception, strength, protected function (in new ROM) - Taping, bracing if joint is unstable

PHTH 565 - MSK (8 decks)

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