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Lower Limb > Ankle and foot conditions > Flashcards

Ankle and foot conditions Flashcards

1
Q

What is achilles tendinitis?

A

Inflammation of the achilles tendon

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2
Q

What causes achilles tendinitis?

A

Small tears in collagen fibres in tendon

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3
Q

What factors contribute to achilles tendinitis?

A

Sudden increase in activity e.g. running

Poor footwear

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4
Q

What are the symptoms of achilles tendinitis?

A

Pain when walking

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5
Q

What causes achilles tendon rupture?

A

Forceful plantarflexion

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6
Q

What factors predispose to achilles tendon rupture?

A

Achilles tendinitis

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7
Q

What is felt immediately after achilles tendon rupture?

A

Calf pain

Sudden dorsiflexion, passive

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8
Q

Why does a lump appear in the calf with achilles tendon rupture?

A

Due to shortening of the
medial and lateral heads of gastrocnemius
soleus

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9
Q

How do you test for achilles tendon rupture?

A

Gap in achilles tendon is visible and palpable in posterior distal leg

Individuals cannot plantarflex against resistance

Thompson’s test

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10
Q

What is the Thompson’s test?

A

Patient kneeling on chair - knee is flexed 90degrees
Squeeze calf
Foot should plantar flex

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11
Q

How are the results of Thompson’s test interpreted?

A

If foot doesn’t plantarflex

means achilles tendon is ruptured

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12
Q

How is achilles tendon rupture treated?

A

Non-surgical repairs for most people

Surgical repairs for very active people e.g. athletes

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13
Q

Clawed toes tend to involve which toes of the foot?

A

Lateral four toes

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14
Q

What are the joints like with clawed toes?

A

Hyperextension at MTP joints

Flexion of DIP joints

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15
Q

What is the dorsal surface of the toes like with clawed toes? Why?

A

Callosities on dorsal surface

due to pressure from shoes

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16
Q

What is the plantar surface of the toes like with clawed toes? Why?

A

Callosities on metatarsal heads
and tip toes
because are having to bear more weight

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17
Q

What are the joints like with hammered toes?

A

Hyperextension at MTP
Flexion at PIP joints
Hyperextension at DIP joints

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18
Q

What causes the formation of hammer toes?

A

Weakness of lumbricals and interosseus muscles
which normally flex MTP joints
and extend IP joints
(don’t panic it’s the same as the hand)

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19
Q

What is the dorsal surface like with hammered toes?

A

Callosities on dorsal surface

due to pressure from shoes

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20
Q

What are the types of flatfoot?

A

Flexible

Rigid

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21
Q

What is flexible flatfoot?

A

Lack of medial arch of foot

but only when weight bearing

22
Q

When is flexible flatfoot normal?

A

In children

23
Q

Why is flexible flatfoot normal in children?

A

Thick subcutaneous fat in sole of foot

Ligaments of foot are not completely developed yet

24
Q

What causes flexible flatfoot in adults?

A

Weakened ligaments of foot

25
Q

What is rigid flatfoot?

A

Lack of medial arch of foot all the time

26
Q

What causes rigid flatfoot?

A

Bone deformity

Dysfunction of tibialis posterior muscle - supports arch usually

27
Q

What are the symptoms and signs of rigid flatfoot?

A

Pain behind medial malleolus, due to damage to tibialis posterior muscle

Heel protrudes laterally when walking

28
Q

Is flatfoot more common in males or females?

A

Females

29
Q

What causes ankle sprain?

A

Partial or complete tear in ligaments of ankle joint

30
Q

What is the mechanism of an ankle sprain?

A

Foot is plantarflexed
Weight bearing
Then is excessively inverted

31
Q

Which ligaments of the ankle joint are most commonly damaged?

A

Lateral ligament

  • anterior talofibular
  • posterior talofibular
  • calcaneofibular
32
Q

Why are the lateral ligaments most commonly damaged?

A

Resist excessive inversion, so become damaged by it

Weaker than medial ligaments

33
Q

Which lateral ligament is at most risk of irreversible damage in an ankle sprain?

A

Anterior talofibular ligament

34
Q

What is the mechanism of a 5th metatarsal fracture?

A

Sudden excessive inversion of foot

fibularis brevis muscle avulses base of metatarsal 5

35
Q

5th metatarsal fractures often occurs alongside with…?

Why?

A

Ankle sprains

Because they both involve excessive inversion

36
Q

What is a Pott’s fracture-dislocation of the ankle joint?

A

Fracture of medial malleolus
lateral malloelus

and in some cases distal tibia too

37
Q

What is the mechanism of a Pott’s fracture dislocation? - 3 stages to it

A

Forced eversion of foot
pulls of medial ligament
avulses medial malleolus

Talus moves laterally
breaks off lateral malleolus

Tibia forced anteriorly
breaks of distal tibia

38
Q

What is the medical term for a bunion?

A

Hallux valgus

39
Q

What does valgus mean?

A

Deviation away from midline

lateral deviation

40
Q

What causes hallux valgus?

A

Pressure from footwear

Degenerative joint disease

41
Q

What is the appearance of hallux valgus?

A

Lump at first MTP joint

42
Q

Why does the lump form?

A

Pressure and friction against head of metatarsal 1
causes subcutaneous bursa to form
become inflamed

43
Q

How do the bones displace in hallux valgus?

A

First metatarsal shifts medially

Phalanges of big toe shift laterally

44
Q

Hallux valgus is more common in males or females?

A

Females

45
Q

What is a complication of diabetes mellitus?

A

Diabetic neuropathy - damage to nerves

gives loss of peripheral nerve functiond

46
Q

Why are people with diabetes mellitus at increased risk of foot injuries?

A

Lose sensation of pain

Injuries in foot go unnoticed

47
Q

Which injuries in particular are people with diabetes mellitus at increased risk of?

A

Ulcers
Infections of wounds
Damage to joints

48
Q

Where is the common fibular nerve at most risk of injury? Why?

A

When it winds around the neck of the fibula

because it’s most superficial at this point

49
Q

How is the common fibular nerve often injured?

A

Fracture of neck of fibula

Injury of knee joint
causing stretching of nerve

50
Q

What are the consequences of common fibular nerve injury?

A

Motor function loss

  • anterior leg muscles - supplied by deep fibular nerve
  • lateral leg muscles - supplied by superficial fibular nerve

Sensory loss

  • anterior and lateral leg, dorsum of foot - supplied by superficial and deep fibular nerves
  • upper lateral leg - supplied by lateral sural nerve
51
Q

What is a characteristic sign of common fibular nerve injury? Why?

A

Foot drop
loss of dorsiflexion by anterior leg muscles
loss of eversion by lateral leg muscles
gives unopposed plantarflexion

Lower Limb (26 decks)

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