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Advanced Orthopedics > Ankle/Foot > Flashcards

Ankle/Foot Flashcards

1
Q

What is tarsal tunnel syndrome?

A

compressive neuropathy of the posterior tibial nerve

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2
Q

Who usually gets tarsal tunnel syndrome?

A

25-50
women > men reported
Sports w/ jumping & sprinting
Flat feet, Pronated, Calcaneal Everted

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3
Q

How does tarsal tunnel syndrome present?

A

Burning, tingling, or pain in the medial portion of the ankle and or plantar aspect of the foot with potential tenderness on palpation along tarsal tunnel. Painful activities include walking, standing, dorsi/plantarflexion

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4
Q

What special tests can you do for tarsal tunnel syndrome?

A

tinel’s sign, tarsal compression test

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5
Q

What is Posterior Tibial Tendon Dysfunction?

A

Overuse of the Posterior Tib Tendon, can lead to flat foot

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6
Q

Who usually gets Posterior Tibial Tendon Dysfunction?

A

20-40
Women over 40-50 years
Prolonged standing or walking
Overuse w/ Flat Pronated Foot

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7
Q

How does Posterior Tibial Tendon Dysfunction present?

A

Medial foot pain in the region of medial malleolus to the navicular tuberosity, tender palpation. Painful activitivies include walking, running or jumping; heel raise.

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8
Q

what special tests can you do for Posterior Tibial Tendon Dysfunction?

A

Weakness with SLS up on toes
Pain with resisted Inversion especially w foot PF’d.
Pain with passive Eversion
Too many toes sign

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9
Q

Who usually gets Chronic Ankle Instability?

A

Younger (Active)

Both, Female athletes> male athletes
Sports & Loading; Sprain that does not heal

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10
Q

How does Chronic Ankle Instability present?

A

Pain and tenderness usually over the lateral ankle, laxity of ankle ligaments ecspecially ATFL and CFL

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11
Q

what special tests can you do for Chronic Ankle Instability?

A

Anterior draw test
Talar Tilt
Syndemosis squeeze
Single Leg balance test

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12
Q

What is Cuboid Syndrome?

A

Midfoot sprain usually from MOI of forced plantarflex+inversion

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13
Q

Who usually gets Cuboid Syndrome (Midfoot sprain)?

A

15-40
Athletes, professional ballet dancers
PF and INV injuries, overuse syndrome; pronated feet

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14
Q

How does Cuboid Syndrome (Midfoot sprain) present?

A

P! on the lateral side of the foot, increased P! in WB, swelling on lateral foot. Painful activities include AROM/PROM of ankle/foot or walking.

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15
Q

What special tests can you do for Cuboid Syndrome (Midfoot sprain)?

A

Midtarsal Adduction test
Midtarsal supination test
Xray

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16
Q

What is Metatarsalgia?

A

Pain in the metatarsal heads (ball of foot); Typically the 2nd to 4th MT heads

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17
Q

Who usually gets Metatarsalgia?

A

older adults
female >male

high impact sports without proper footwear, shoes too tight/loose, excess bodyweight, wearing high heels

shortened Achilles tendon, increased foot pronation, high arches, hammer toe or calluses on bottom of foot, prominent metatarsal head

Note Mortons neuroma can be a cause of metatarsalgia

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18
Q

How does Metatarsalgia present?

A

sharp, aching, burning pain in the ball of your foot & sharp shooting pain, numbness, tingling in toes. Painful activities include standing, running, flex feet, walk (esp barefoot on hardwood surface)

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19
Q

What special tests can you do for Metatarsalgia?

A

imaging (X-ray)

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20
Q

What is Calcaneal apophysitis (Sever’s disease)?

A

painful inflammation of heel’s growth plate

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21
Q

Who usually gets Calcaneal apophysitis (Sever’s disease)?

A

children 8-14 yo
either gender

sports; growth plate senstivie to repeated running/pounding on pavement; specific sports: soccer, track, basketball. Other causes: obesity, flatfoot

tight achilles tendon, flat foot or high arched foot

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22
Q

How does Calcaneal apophysitis (Sever’s disease) present?

A

pain in heel or bottom of foot, palpation pain on calcaneus TTP and lateral heel. Painful activities include walking on toes, prolonged walking; running or jumping

23
Q

What special tests can you do for Calcaneal apophysitis (Sever’s disease)?

A

Xray
Squeeze Test

24
Q

What are the ottawa ankle rules?

A

-Pain to Palpation Distal 6cm of the posterior aspect or tip of medial or lateral malleolus
-Pain to Palpation of Navicular
-Pain to Palpation of base of the 5th Metatarsal

Obtain XR if any of the following

25
What is open packed and close packed position of Talocural Joint?
Close packed: Max DF Open packed: 5-10 PF
26
What is the open and closed packed position of Subtalar Joint?
Close packed: Max supination Open packed: 0-5 pronation
27
what is the open and closed packed position of the Midtarsal Joint?
close packed: ADD, InV of Subtalar open packed: ABD, EV of Subtalar
28
what is the open and close packed position of the 1st MTP Joint?
close packed: Full ext open packed: 10-20 ext
29
Where can soleus muscle pain refer to?
Ipsi SI joint
30
How do you differienate between the different branches of the sciatic nerve?
TED = Tibial (EV+DF) SID = Sural (InV + DF) PIP = Peroneal (InV + PF)
31
Thrust & Nonthrust Manipulation and Exercise in Patients Post Inversion Ankle Sprain (CPR)
Symptoms worse when standing, Symptoms worse in evening, Navicular drop > 5.5 mm, Distal tibiofibular joint hypomobility 3 of 4 variables +LR = 5.9
32
How do you perform Anterior Drawer Test for ATFL?
10-15 degrees of PF, push anteriorly
33
How do you perform Talar Tilt for ATFL & CFL?
Grab calcaneus and invert the foot. POS if there is pain or excessive mobility
34
How do you perform the Anteriolateral Ankle Impingement test?
Compress Talar Head and DF + EV; POS if Pain
35
What is the windlass test?
For plantar facititis, extend great toe, pos if there is pain
36
How do you perform Squeeze Test for High Ankle Sprain (Syndesmotic)?
Squeezing tibia and fibula together, POS if pain
37
How do you perform the Royal London Hospital Test?
Identify the mid-Achilles tendon part that is maximally painful by palpation Ask patient to max DF Re-palpate the same area as prior POS test for Achilles Tendinopathy if substantial decrease or absence of pain with palpation during maximal dorsiflexion
38
How do you perform the Arc sign for Achilles Tendinitis?
First observation to locate the thickened or swollen region of the Achilles tendon Have the patient move actively into DF / PF If the swollen area of the Achilles tendon moves along with the foot movement = POS test
39
What are the best interventions for lateral ankle sprain?
Progressive WB and Use of external support (Grade A) Structured Rehab – Protective AROM, Stretching & Neuromuscular (A) Manual Therapy (Joint) Talus (A)
40
What are the best interventions for chronic ankle instability?
Exercise: Proprioceptive & Neuromuscular (Grade A) WB exs, SLS, Balance Manual Therapy (A) Mobs & Manips MWM
41
How does Peronal Nerve Entrapment present?
Persistent pain, numbness, and tingling. Foot drop --> abnormal gait mechanics and other motor dysfunction (damage of the nerve/myelin around the nerve) - can have difficulty walking/running due to tripping over the foot. Localized pain at fibular head.
42
What is a haglund deformity?
also known as a "pump bump," is a bony enlargement on the back of the heel, where the Achilles tendon attaches. This enlargement can rub against shoes, causing irritation, pain, and inflammation, often leading to bursitis
43
What is Sinus Tarsi Syndrome?
condition causing pain and instability on the outside of the ankle, specifically in the sinus tarsi, a small tunnel between the ankle and heel bones. It often arises from ankle sprains or other injuries, but can also be triggered by foot shape, walking style, or underlying conditions like flat feet. Symptoms include pain, swelling, and a feeling of weakness or instability in the ankle
44
What is charcot foot?
a serious condition primarily caused by diabetes, where nerve damage leads to loss of sensation in the feet, resulting in the bones and joints of the foot and ankle breaking down and collapsing, often causing a distinctive "rocker-bottom" appearance.
45
What is the scoring for foot posture index (FPI-6)?
Normal Foot 0 to +5 Pronated +6 to +9 Highly Pronated +10 or more Supinated -1 to -4 Highly Supinated -5 to -12
46
Describe the anterolateral ankle impingement sign
Compress Talar Head and DF + EV; POS if Pain
47
Describe the Royal London Hospital Test
Identify the mid-Achilles tendon part that is maximally painful by palpation Ask patient to max DF Re-palpate the same area as prior POS test for Achilles Tendinopathy if substantial decrease or absence of pain with palpation during maximal dorsiflexion
48
describe the Arc sign for Achilles Tendinitis
First observation to locate the thickened or swollen region of the Achilles tendon Have the patient move actively into DF / PF If the swollen area of the Achilles tendon moves along with the foot movement = POS test
49
How do you perform distal fibular mobilizations?
For all AFC Mobilizations -Stabilize Proximal -Achieve Skin Lock -Mobilize along line of forearm Posterior Distal Fibular Glide Arthokinematics suggest would improve PF
50
What would a talocrural posterior glide improve?
dorsiflexion
51
What would talocrural anterior glide improve?
Plantarflexion
52
What would Talonavicular & Calcaneocuboid
Dorsal for DF / Plantar for PF
53
What are the components of the beighton scale for hypermobility?
1. Passive Ext of 5th MCP: Positive if > 90 2. Passive Ext of Elbow (Shd at 90): Positive if > 10 hyper-extension 3. Passive Ext of Knee (supine): Positive if > 10 Hyper-Ext 4. Thumb to flexor side of forearm: Positive if whole thumb touches side of forearm on flexor side 5. Trunk flexion: Criteria: Forward Flexion with the knees straight so the hands rest easily on the floor Hypermobile if 7 or >

Advanced Orthopedics (8 decks)

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