Ankle Exam and Eval Flashcards
1
Q
Gastroc is innervated by the
A
Tibial nerve
2
Q
Soles is innervated by the
A
tibial nerve
3
Q
Planters is innervated by the
A
tibial nerve
4
Q
Action of gastroc
A
PF
5
Q
Action of soleus
A
PF
6
Q
Action of Planters
A
PF
7
Q
Myotome for PF
A
S1-S2
8
Q
Tibialis Posterior is innervated by the
A
Tibial
9
Q
Peroneus Longus is innervated by the
A
superficial peroneal
10
Q
Peroneus Brevis is innervated by the
A
superficial peroneal
11
Q
Peroneus Tertius is innervated by the
A
deep peroneal
12
Q
Flexor Hallucis Longus is innervated by the
A
Medial plantar
13
Q
Flexor Digitorum Longus is innervated by teh
A
medial plantar
14
Q
Extensor Hallucis Longus is innervated by the
A
deep peroneal
15
Q
Extensor digitorum longus is innervated by the
A
deep peroneal
16
Q
Action of the tibialis post
A
PF
17
Q
Action of the peroneals
A
Longus and brevis = PF
Tertius = DF
18
Q
Action of FHL and FDL
A
PF
19
Q
Action of EHL and EDL
A
DF
20
Q
Myotome for DF
A
L4-L5
21
Q
Myotome for inversion
A
L4
22
Q
Myotome for eversion
A
L5-S1
23
Q
L1-L4 dermatome
A
ant and inner surfaces of LE
24
Q
L4-S1 dermatome
A
foot
25
L4 dermatome
Medial side of the foot
26
L5 dermatome
dorsum and plantar
27
L5-S2 dermatome
post and outer surfaces of LE
28
S1 dermatome
lateral side of the foot
29
Front of the knee dermatome
L4
30
Inf tibia fibular joint
Close packed
Open packed
Capsular pattern
```
Closed = DF with ER
Open = PF
Capsular = pain with WB DF of ankle
```
31
Talocrural join
Close packed
Open packed
Capsular pattern
```
Closed = DF with ER
Open = 20 degrees PF
Capsular = PF > DF
```
32
Subtlar joint
Close packed
Open packed
Capsular pattern
```
Closed = eversion (heel strike)
Open = neutral
Capsular = Varus > Valgus
```
33
Midtarsal/Tarsal Metatarsal Joint
Close packed
Open Packed
Capsular
Closed = Supination (push off)
Open - neutral
Capsular = DF, PF, Add, IR
34
Metatarsal phalangeal joint
Close packed
Open packed
Capsular
```
Closed = full extension
Open = slight extension
Capsular = 1st toe extension
```
35
Interphalangeal joint
Close packed
Open packed
Capsular
```
Closed = full extension
Open = slight flexion
Capsular = flex and ext
```
36
Edema test - figure of 8
```
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
Anterior Drawer test
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
Calcaneofibular ligament test
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
Posterior talofibular ligament test
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
Deltoid ligament test AKA Kleiger
Patient sitting
Stabilize lower leg and grab foot with other hand
Rotate everything laterally - stressing medial structures
Sort of everted and PF
41
Posterior Drawer test
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
Squeeze test
Syndesmosis lesion
Squeeze them proximally so that the distal part opens up
Pain is positive
43
Thompson test
Achilles tendon rupture
Last resort or to document
Squeeze gastric and should PF if intact
44
Windlass test - NWB
ankle in neutral and 1st MT head stabilized - extend first toe at MTP and let IP flex
Extend until end range or pain
45
Windlass test - WB
patient on step stool with toes hanging over edge - extend first MTP while letting IP flex - will produce pain if positive
46
Homans
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
Wells clinical prediction rules for DVT - major criteria
```
Active CA
Paralysis
Recently bedridden
Localized tenderness
Thigh and calf swelling
Family hx of DVT
```
48
Wells clinical predication rules for DVT - minor criteria
```
Hx of recent trauma
Pitting edema
Dilated superficial veins
Hospitalized within last 6 months
Erythema
```
49
What suggests DVT
> 3 major and > 2 minor
50
Neurological
Tinels at post tibial nerve
DF-eversion with tinels over tarsal tunnel
Mortons - sqeeze metatarsals together
Sensation testing
51
Foot position
get them into subtler neutral and then assess
52
How to get one in subtler neutral
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
What happens once you are in subtler neutral
assess - look at rear and forefoot varus/valgus
54
What position will the tibia be in with WB if foot is position in forefoot varus? What stress will be on the knee? hip?
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
What position will the forefoot be during WB if calc is positioned in rear foot valgus? What position will tibia be in?
valgus = eversion
Forefoot will compensate by supinating
Tibia IR
56
What position will the forefoot be in if the rear foot (calc) is in rear foot varus
varus = inversion
| forefoot will pronate to compensate
57
Outcome measures
Ankle joint function assessment tool
Foot and ankle ability measure
LEFS
PSFS (patient specific)
58
Open chain - what to check
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
Closed chain - what to check
Rise up on toes
Squat
Twisting trunk rotation R and L
