Ankle and Foot Exam Competency

Question 1

Differentiate between the structures in the Medial/Lateral Longitudinal Arches and the Transverse Distal Tarsal Arch in the foot.

Answer 1

Medial: Talus, Navicular, Cuneiforms 1-3, and Metatarsals 1-3

Lateral: Calcaneus, Cuboid, and Metatarsals 4-5

Transverse Distal Arch: Navicular, Cuboid, Cuneiforms 1-3 and Proximal Metatarsals

Question 2

Which Tendons pass through the Tarsal Tunnel?

Answer 2

“Tom, Dick, and Harry”

1. Posterior Tibialis
2. Flexor Digitorum Longus
3. Flexor Hallucis Longus

Question 3

When would you perform a Monofilament test?

Answer 3

When you have a Diabetic Patient!

Question 4

Describe the ranges of motion at the ankle joint in terms of degrees.

Answer 4

Dorsiflexion: 15-20 Degrees

Plantarflexion: 55-65 Degrees

Subtalar Inversion: 20-30 Degrees

Subtalar Eversion: 10-20 Degrees

Question 5

Differentiate between the movements of Pronation and Supination of the ankle joint.

Answer 5

Pronation: Dorsiflexion, ABduction, Eversion

Supination: Plantarflexion, ADduction, Inversion

Question 6

What are the primary muscles and their nerve roots when testing for strength in the ankle?

Answer 6

Tibialis Anterior (L5): Dorsiflexion

Gastrocnemius/Soleus (S1): Plantarflexion

Question 7

What are you testing for with the Anterior Drawer Test?

Answer 7

ATF Ligament

Question 8

What are you testing for with the Talar Tilt Test?

Answer 8

Calcaneofibular Ligament

Question 9

What are you testing for with the Eversion Test?

Answer 9

Deltoid Ligament

Question 10

What are you testing for with the Squeeze Test?

Answer 10

HIGH ankle Sprain (Syndesmosis Pathology)

Question 11

What are you testing for with the Cross Leg Test?

Answer 11

HIGH ankle Sprain (Syndesmosis Pathology)

Question 12

What are you testing for with the Thompson Test?

Answer 12

Rupture of the Achilles Tendon

Question 13

What are you testing for with the Homan’s Sign? What else might you need to order to rule out a blood clot?

Answer 13

Acute Deep Vein Thrombosis (Pt is lying supine and Doc is going to Dorsiflex the Pt’s foot; Positive Test with PAIN)

** NEED to get a Venous Doppler to rule out clot

Question 14

What are you testing for with the Moses Sign?

Answer 14

Deep Vein Thrombosis or Posterior Tibial Veins

Doc applies an ANTERIOR force to the Pt’s Gastrocnemius M. on the posterior aspect of the Tibia

Question 15

Which Ligament is going to tear first in an Inversion Ankle Sprain?

Answer 15

Anterior Tibiofibular Ligament

• Calcaneofibular L.
• Posterior Talofibular L.

Question 16

Describe the Clinical Presentation of Plantar Fascitis.

Answer 16

• Inflammation of the Plantar Aponeurosis
• Worse with first Steps and improves through Day
• Tight Calves

Question 17

What is Morton’s Neuroma?

Answer 17

Inflammation and thickening of tissue that surrounds the nerve between toes (Most commonly between 3rd and 4th toes)

Pt reports feeling like they are walking on a MARBLE

Question 18

What is Turf Toe?

Answer 18

Inflammation and Pain at the base of the 1st MTP

Caused by HYPEREXTESION of great toe causing damage to the joint capsule

Question 19

What is Achilles Tendonitis? What are some causes?

Answer 19

Inflammation at the Achilles Tendon

Causes: Tight Calf Muscles, Sudden change in activity, Poorly fitting shoes, Incorrect Running Technique