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Advanced Physical Dx > Ankle and Foot Exam > Flashcards

Ankle and Foot Exam Flashcards

1
Q

What are the lateral ligaments of the ankle?

A

Anterior talofibular (ATF)
Calcaneofibular
Post.talofibular

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2
Q

What is the syndesmosis in the ankle?

A

Connection btw
tib/fib by Inter-
Osseous Ligament

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3
Q

What is the medial ligament in the ankle?

A

Deltoid ligament

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4
Q

What history questions need to be asked for ankle injuries?

A 
When and What happened?
Which way did it bend/twist?
Able to ambulate?
Swelling?
Previous injury and when?
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5
Q

What is the most common ankle injury? How is it caused?

A
  1. Lateral ligament sprains
  2. Plantar flexion and inversion
  3. > 40% can lead to chronic problems
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6
Q

What is another name for a high ankle sprain? What is the prevalence and how is it caused?

A
  1. Syndesmotic sprains
  2. 10%
  3. Dorsi-flexion and/or eversion, rotational injury
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7
Q

What is the prevalence of medial ankle sprains and how is it caused?

A
  1. 5%

2. Eversion

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8
Q

What needs to be assessed for an ankle injury pt?

A 
1. AROM & PROM
A. Inversion and eversion
B. Plantar and Dorsiflexion
2. Strength
A. Not very helpful following acute injury
3. Sensation
4. Vascular
5. Special testing
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9
Q

What are the normal ranges of motion for plantar flexion, dorsiflexion, inversion, and eversion of the heel?

A

Plantar Flexion: 50 degrees
Dorsiflexion: 20 degrees
Inversion of heel: 35 degrees
Eversion of heel: 15 degrees

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10
Q

What does the anterior drawer test of the ankle assess? How is it performed?

A
  1. Checks ATFL

2. Foot neutral pos, plantar flex 10 deg,stablize distal leg & pull heel anteriorly

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11
Q

What is an abnormal anterior drawer ankle test?

A

Abnormal Translation is 5-10 mm, or 3 mm > than other side

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12
Q

What does the Talar tilt test of the ankle assess? How is it performed?

A
  1. Checks the calcaneo-fibular ligament (CFL) and ATFL
  2. Ankle/foot unsupported in 10-20 deg of plantar flexion, stab. medial distal leg & apply inversion force slowly to hindfoot
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13
Q

What is an abnormal talar tilt ankle test?

A

Laxity (lack of endpoint)

-Most nl ankles have a tilt of approx 5 deg or<

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14
Q

What does the Thompson test of the ankle assess? How is it performed?

A
  1. Checks integrity of Achilles tendon
  2. Patient prone feet hanging off table
  3. Squeeze gastrocnemius muscle
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15
Q

What is an normal Thompson ankle test?

A

Should cause plantar flexion of foot if tendon is intact

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16
Q

What is a grade I ankle sprain?

A

Stretching, small tears

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17
Q

What is a grade II ankle sprain?

A

large but incomplete tear

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18
Q

What is a grade III ankle sprain?

A

Complete tear

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19
Q

What are the dx tests for ankle injuries?

A

X-ray
Lateral
Mortise
PA

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20
Q

What is the tx for ankle injuries?

A 
1. RICE:
A. Rest
B. Ice, Compression, and Elevation
2. Aircast
3. Crutches
4. NSAID’s
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21
Q

Define sesamoid bones

A

Most bones in the human body are connected to each other at joints.
There are a few bones that are not connected to anyother bone.
Instead, they are connected only to tendons or are embedded in muscle. These are the sesamoids.
A good example is the kneecap (patella), whichis the largest sesamoid.
Two other very small sesamoids, eachabout the size of a kernel of corn,are found in the underside of the forefoot near the big toe, one on the outer side of the foot and the other closer to the middle of the foot.

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22
Q

What are the sxs of sesamoid bone injury?

A

Pain under the big toe on the ball of the foot

Pain with bending or straightening the big toe

23
Q

What dx tests are used in sesamoid bone injuries?

24
Q

What is the treatment for a sesamoid bone injury?

A

Conservative first (RICE) if fails they remove the sesamoid bone

25
What 3 fractures are possible on the 5th metatarsal?
1. Stress fracture: most distal 2. Jones Fx: middle 3. Pseudo-Jones/Avulsion/Tennis Fx: most proximal
26
How is overpronation corrected?
Orthotics
27
What nerves control inversion?
L4, L5
28
What nerves control eversion?
L5, S1
29
What is a wet test of the foot?
Assessment of height of arch: high, normal, low
30
What is characteristic for pes planus?
Over-pronation
31
Define plantar fasciitis
1. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes. 2. Overuse injury of sole of foot
32
Describe the pain characteristic with plantar fasciitis
1. starts gradually with mild pain at the heel bone often referred to as a stone bruise. 2. The pain classically occurs right after getting up in the morning and after a period of sitting.
33
What are the complications of untreated plantar fasciitis?
1. Chronic pain 2. You may not be able to keep up your level of activity, and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk. 3. calcaneal spur
34
How is plantar fasciitis treated?
1. Stretching of Achilles tendon and plantar fascia, non-weight bearing exercise 2. Ice, 20 mins 3-4 times per day 3. NSAIDs
35
define calcaneal spur
When plantar fasciitis continues for a long time, a heel spur (calcium deposit) may form where the fascia tissue band connects to your heel bone.
36
What dx test are used for calcaneal spur?
Xray
37
What is the tx for calcaneal spur?
1. Stretching of Achilles tendon and plantar fascia, non-weight bearing exercise 2. Ice, 20 mins 3-4 times per day 3. NSAIDs 4. Heel pad shoe inserts 5. Surgery if chronic pain
38
What conditions affect the achilles tendon?
1. tendo-calcaneal bursitis 2. Tendonitis 3. Rupture
39
Define Morton's Neuroma
Morton's neuroma is a painful condition that affects the ball of your foot, most commonly the area between your third and fourth toes, or in the 2nd and 3rd webspace. Morton's neuroma may feel as if you are standing on a pebble in your shoe or on a fold in your sock.
40
What are the sxs of Morton's neuroma?
1. A feeling as if you're standing on a pebble in your shoe 2. A burning pain in the ball of your foot that may radiate into your toes 3. Tingling or numbness in your toes
41
What are the risk factors for Morton's neuroma?
1. High heels 2. Sports; jogging, snow skiing, rock climbing 3. Foot deformities; bunions, hammertoes, high arches
42
What are the dx studies for Morton's neuroma
1. X-rays | 2. Ultrasound
43
Define pes cavus
high arch
44
Define pes planus
flatfoot
45
What is the tx for Morton's neuroma?
``` 1. Conservative A. OTC Arch supports & foot pads B. Custom-made shoe inserts 2. Surgery A. Injections B. Decompression surgery C. Removal of the nerve ```
46
Define hallux valgus
bunion on big toe
47
Define bunionette/Tailor's bunion
bunion on the little toe joint and 5th metatarsal
48
Define hallux rigidus
bone spurs on the big toe proximal phalanx and the first metatarsal
49
What are the types of toe deformities?
1. Claw deformities 2. mallet toes 3. hammer toes Send them to a podiatrist!
50
Define tarsal tunnel syndrome
Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
51
What are the sxs of tarsal tunnel syndrome>
1. Tingling, burning, or a sensation similar to an electrical shock 2. Numbness 3. Pain, including shooting pain
52
What are the dx tests for tarsal tunnel syndrome?
1. Tinel’s at medial ankle | 2. EMG/NCV: nerve conduction
53
WHat is the tx for tarsal tunnel syndrome?
1. RICE 2. NSAIDs 3. Immobilization 4. PT 5. Orthotics/Shoes

Advanced Physical Dx (9 decks)

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