Ankle and Leg Flashcards
what are the two areas for which the ankle joint can be palpated?
medial to the anterior tibialis in the anteromedial recess, lateral to the peroneus tertius in the anterolateral recess
resisted inversion with the foot plantarflexed and everted isolates muscle strength testing of what muscle?
tibialis posterior
resisted ankle eversion tests the strength of what muscles
peroneals
during the anterior drawer test of the ankle, you should rotate the talus in what way to detect true ankle instability, which is a rotary phenomenon?
internal rotation of the talus during the anterior drawer
twisting injuries produce what pattern of fibula / tibia fracture?
spiral
what is the percentage of weightbearing from the fibula and tibia, respectively?
fibula - 20%
tibia - 80%
fibula shaft fractures can be associated with injury to what ligamentous structure?
syndesmosis
t/f a majority of fibular shaft fractures are treated non surgically
true
the common peroneal nerve traverses at the level of what portion of the fibula?
proximal fibular neck
a high fibula fracture with syndesmosis injury is usually associated with injury to what other area of the lower leg?
medial malleolus fracture or deltoid ligament rupture
t/f syndesmotic injury or disruption of the ankle mortise associated with ankle fracture require surgical repair
true
what is the pathophysiology of MTSS?
periostitis by traction from posterior lower leg muscles
a runner presents with bilateral shin pain. you are trying to differentiate MTSS from BSI. The MRI shows longitudinal edema of the periosteum. what is the diagnosis?
MTSS
what is the first line treatment for CECS?
activity modification
why is the region of the achilles tendon 6cm proximal to insertion in the calcaneus most prone to rupture?
relatively hypovascular area of tendon
what peripheral nerve can be injured during an achilles tendon repair?
sural nerve
in what general ankle position should immobilization occur if pursuing non operative management of achilles tendon rupture?
plantarflexion with progressively increased dorsiflexion during recovery/rehab
which area of the posterior tibialis tendon is the most hypovascular and most susceptible to injury?
area below and behind the medial malleolus
t/f steroid injections are considered a viable option for posterior tibialis tendinitis
false - this can lead to rupture of the tendon and should be avoided
describe the single heel raise test for posterior tibialis tendinopathy/ dysfunction ?
single leg heel raise should result in varus alignment, heel will remain valgus during heel lift in PTT dysfunction
which posterior ankle tendon is situated between the medial and lateral posterior tubercles of the talus?
FHL tendon
os trigonum can predispose to injury of what flexor tendon of the foot/ankle?
FHL tendon
a patient has pain with palpation in the retromalleolar region of the lateral ankle with pain upon resisted eversion. what is the most likely diagnosis?
peroneal tendon pathology
lateral talar osteochondral lesions are typically associated with what mechanism of injury?
inversion
t/f osteochondral autograft transplantation is an option for larger osteochondral lesions of the talus that have failed previous surgical treatment
true
which structure forms a labrum like structure at the posterior tibial plafond and can cause posterior ankle impingement if torn?
posterior tibiofibular ligament
test for posterior ankle impingement by moving the ankle into what position?
plantarflexion
