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Semester 2 PM Exam 9 > Ankle Exam and Eval > Flashcards

Ankle Exam and Eval Flashcards

1
Q

Gastroc is innervated by the

A

Tibial nerve

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2
Q

Soles is innervated by the

A

tibial nerve

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3
Q

Planters is innervated by the

A

tibial nerve

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4
Q

Action of gastroc

A

PF

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5
Q

Action of soleus

A

PF

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6
Q

Action of Planters

A

PF

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7
Q

Myotome for PF

A

S1-S2

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8
Q

Tibialis Posterior is innervated by the

A

Tibial

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9
Q

Peroneus Longus is innervated by the

A

superficial peroneal

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10
Q

Peroneus Brevis is innervated by the

A

superficial peroneal

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11
Q

Peroneus Tertius is innervated by the

A

deep peroneal

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12
Q

Flexor Hallucis Longus is innervated by the

A

Medial plantar

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13
Q

Flexor Digitorum Longus is innervated by teh

A

medial plantar

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14
Q

Extensor Hallucis Longus is innervated by the

A

deep peroneal

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15
Q

Extensor digitorum longus is innervated by the

A

deep peroneal

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16
Q

Action of the tibialis post

A

PF

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17
Q

Action of the peroneals

A

Longus and brevis = PF

Tertius = DF

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18
Q

Action of FHL and FDL

A

PF

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19
Q

Action of EHL and EDL

A

DF

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20
Q

Myotome for DF

A

L4-L5

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21
Q

Myotome for inversion

A

L4

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22
Q

Myotome for eversion

A

L5-S1

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23
Q

L1-L4 dermatome

A

ant and inner surfaces of LE

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24
Q

L4-S1 dermatome

A

foot

25
Q

L4 dermatome

A

Medial side of the foot

26
Q

L5 dermatome

A

dorsum and plantar

27
Q

L5-S2 dermatome

A

post and outer surfaces of LE

28
Q

S1 dermatome

A

lateral side of the foot

29
Q

Front of the knee dermatome

A

L4

30
Q

Inf tibia fibular joint
Close packed
Open packed
Capsular pattern

A 
Closed = DF with ER
Open = PF
Capsular = pain with WB DF of ankle
31
Q

Talocrural join
Close packed
Open packed
Capsular pattern

A 
Closed = DF with ER
Open = 20 degrees PF
Capsular = PF > DF
32
Q

Subtlar joint
Close packed
Open packed
Capsular pattern

A 
Closed = eversion (heel strike)
Open = neutral
Capsular = Varus > Valgus
33
Q

Midtarsal/Tarsal Metatarsal Joint
Close packed
Open Packed
Capsular

A

Closed = Supination (push off)
Open - neutral
Capsular = DF, PF, Add, IR

34
Q

Metatarsal phalangeal joint
Close packed
Open packed
Capsular

A 
Closed = full extension
Open = slight extension
Capsular = 1st toe extension
35
Q

Interphalangeal joint
Close packed
Open packed
Capsular

A 
Closed = full extension 
Open = slight flexion
Capsular = flex and ext
36
Q

Edema test - figure of 8

A 
midway btw TA tendon and lateral malleolus 
distal to navicular
base of 5th MT
distal to medial malleolus
distal to lateral malleolus 
Measure in cm
37
Q

Anterior Drawer test

A

Looking at ant talofibular ligament
Patient supine
Stabilize tibia and fibula - place ankle in 10-15 degrees of PF and then draw heel gently forward

38
Q

Calcaneofibular ligament test

A

If anterior drawer is neg no reason to do this
Patient supine - one hand stabilize at tip-fib and other cups under calcaneus
DF ankle to 90 and invert
Apply force into inversion

39
Q

Posterior talofibular ligament test

A

If calcaneofibular is neg no reason to do this
Patient supine, stabilize tip/fib
DF foot while cupping talus and calc
Rotate heel medially moving talus away from lateral malleolus

40
Q

Deltoid ligament test AKA Kleiger

A

Patient sitting
Stabilize lower leg and grab foot with other hand
Rotate everything laterally - stressing medial structures
Sort of everted and PF

41
Q

Posterior Drawer test

A

assessing anterior tibiofibular ligament
Supine with knee and hip flexed putting foot into DF
Hold tip-fib with one hand and then push foot and talus post with the other

42
Q

Squeeze test

A

Syndesmosis lesion
Squeeze them proximally so that the distal part opens up
Pain is positive

43
Q

Thompson test

A

Achilles tendon rupture
Last resort or to document
Squeeze gastric and should PF if intact

44
Q

Windlass test - NWB

A

ankle in neutral and 1st MT head stabilized - extend first toe at MTP and let IP flex
Extend until end range or pain

45
Q

Windlass test - WB

A

patient on step stool with toes hanging over edge - extend first MTP while letting IP flex - will produce pain if positive

46
Q

Homans

A

patient supine, passively DF ankle - if pain is positive for DVT
correlate with parlor, swelling and loss of dorsals pedis pulse but doesn’t have to

47
Q

Wells clinical prediction rules for DVT - major criteria

A 
Active CA
Paralysis
Recently bedridden
Localized tenderness
Thigh and calf swelling
Family hx of DVT
48
Q

Wells clinical predication rules for DVT - minor criteria

A 
Hx of recent trauma
Pitting edema
Dilated superficial veins
Hospitalized within last 6 months
Erythema
49
Q

What suggests DVT

A

> 3 major and > 2 minor

50
Q

Neurological

A

Tinels at post tibial nerve
DF-eversion with tinels over tarsal tunnel
Mortons - sqeeze metatarsals together
Sensation testing

51
Q

Foot position

A

get them into subtler neutral and then assess

52
Q

How to get one in subtler neutral

A

NWB - have patient lay prone
palpate the neck of the talus with one hand and use the other to grab the 4th/5th metatarsals and then move foot until feel even distribution of talus in index and thumb
WB have them stand first NWB and then WB

53
Q

What happens once you are in subtler neutral

A

assess - look at rear and forefoot varus/valgus

54
Q

What position will the tibia be in with WB if foot is position in forefoot varus? What stress will be on the knee? hip?

A

forefoot varus and calc normally aligned - so forefoot will pronate to get foot on floor - calc might evert and then tibia would IR
Inc flexion at knee and IR at hip

55
Q

What position will the forefoot be during WB if calc is positioned in rear foot valgus? What position will tibia be in?

A

valgus = eversion
Forefoot will compensate by supinating
Tibia IR

56
Q

What position will the forefoot be in if the rear foot (calc) is in rear foot varus

A

varus = inversion

forefoot will pronate to compensate

57
Q

Outcome measures

A

Ankle joint function assessment tool
Foot and ankle ability measure
LEFS
PSFS (patient specific)

58
Q

Open chain - what to check

A

can they move ankle and toes - AROM DF, PF, Inv, Ev, and flexion, extension, and abduction of the toes
Might combine motion - DF with Inv and Ev, PF with Inv and Ev

59
Q

Closed chain - what to check

A

Rise up on toes
Squat
Twisting trunk rotation R and L

Semester 2 PM Exam 9 (3 decks)

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