Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lower test 3 > Ankle & Foot Dysfunctions (Lecture 2) > Flashcards

Ankle & Foot Dysfunctions (Lecture 2) Flashcards

1
Q

Where is the sesamoid bone?

A

Plantar surface of distal part of 1st Metatarsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain the windlas effect?

A

With toe extension the plantar fascia is pulled taut (makes it more rigid and larger)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens to the medial longitudinal arch in great toe extension?

A

The fascia tightens and causes the metatarsal heads to be depressed and the longitudinal arch to rise (windlass effect)
* causes the metatarsal heads to drop down which increases the distance of the bottom of the metatarsal from the navicular - which in turn increases the angle between the two which creates a larger arch (do it yourself)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does plantar fascitis feel like?

A

First few steps feel like a sharp pain in the heel and then the fascia starts to loosen up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

KNOW: hindfoot excessive motion (going into excessive proantion / supination) may cause plantar fascitis

Excessive loading can cause this

Heel spur

reptitive loading

High BMI

Limited ankle DF (makes the foot cominsate w/ that. excessive motion)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where does the plantar fascia insert?

A

Medial tuberical of the calcenous (where pain is often felt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What time of day is plantar fascitits pain felt?

A

In the AM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

KNOW: More likely to get plantar fascitis if they have pes cavus or pes planus (note this is basically the same as them having increased supination or pronation as stated before)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why would someone w/ plantar fascitits have pain w/ toe extension?

A

Windlas effect

Because as the toes are put into extension the plantar fascia is stretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which 2 muscles being tight could lead to plantar fascitits? Why?

A

Gastroc / Soleus

Decreases foot DF which leads to needing more mobility at the foot which irritates that plantar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

KNOW: someone w/ plantar fascitits might have decreased intrinsic foot muscle strength thats causing that plantar fascia to have to compinsate causing their pain

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What phase of gait would someone w/ plantar fascitits avoid? Why?

What position of gait might be early?

A

Heel strike

because thats where the pain is coming from

may also have decreased stance time on that limb

They would also have early toe off because they don’t want to stretch that plantar fascia (so their weight wouldnt be forward yet and those toes come off before that plantar fascia is taut)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does surgery work well for plantar fascitits pts?

A

No

(they do a plantar fascia release but it is often not effective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What 4 things do we do to treat plantar fascitits?

A

1) Stretching –> however, we don’t actually change the tissue but we get those psycological effects (neurlogic response which reduces pain)

2) Massage

3) Shoe modification

4) Strengthening

can also do taping / dry needling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

there is a strong link between plantar fascities and ____

A

posterior tibia tendinopathies (often dry needle here)

Achilies tendinopathy also affects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a midportion achilies tendinopathies?

A

Just distal to the mid portion of the gastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is insertional achillies tendonpathy?

A

2-6 cm proximal to the achilies insertion on the calcaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

KNOW: A midportion achilies tendonopathy is going to be treated more like a muscular issue than a tendonis issus (muscleular loading mechancis)

A proximal tendonpathy is treated more like a tendon issue (tendon loading mechanis)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does the achillies tendon insert?

A

Posterior gastroc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pt has posterior foot pain, what kind of tendonpathy is most likely

A

Achilies tendonpathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pt is having medial foot pain. What tendonpathy am I thinking

A

posterior tibialis tendinopathy

22
Q

Lateral foot pain caused by a tendinopathy is most likely

A

fibularis

23
Q

Anterior foot pain linked to a tendinopathy is most likely

A

anterior tibialis (this is more shin splints / medial tibial stress syndome)

24
Q

Who is most likely to get an achilles tendonopathy

A

athletic pop

25
Q

Intrinsic factors that make a pt more likely to have an achillies tendonopathy

A

Decreased dorsiflexion

Adnormal subtalar ROM
* increased inversion
* Decreased total inversion/ecersion ROM

Decreased PF strength

Excessive rearfoot pronation

Hallux rigidus (big toe is stiff) - means they arent going to have great plyobility of metatarsals which means they won’t have foot push off which means the gastroc/soleus are what are going to be utilized = overuse

26
Q

Extrinsic risk factors for achilles tendonpathy (2)

A

Training errors

Footwear w/ insufficient rearfoot control, hard soles or high heels (excessive plantar flexion = tighter gastroc/soleus

27
Q

abnormal boney growth on the calcaneous from wearing high heels

A

haglunds deformation

28
Q

KNOW: VISA-A / TENDINS-A = achilles specific questionaires

A
29
Q

What age group is most likely to have an achilles tendonopathy?

A

30-50

NOTE: you can also get this younger. Normally basketball players that have that rapid DF/PF
* Running / jumping sports
* Normally happens in landing phase where the gastroc is having to slow the heel down from hitting the floor (going into DF and eccentrically lengthening gastroc/soleus)

30
Q

KNOW: Continuous thickkening of the tendons will happen w/ over stress

A
31
Q

What movement would not have as much strength w/ an achilies tendonpathy?

A

PF

Note: this movement will normally be very strong in most people due to it being a type 2 lever

Will also have decreased PF endurance

32
Q

What happens to achilies tendonopathy after activity

What happens during actvity

A

After = stiffness

During = less stiffness
* movement makes it feel better

33
Q

Would walking up or down stairs be worse for an achilles pt?

A

Down

Its eccentrically lengthening which causes the most stress on the tendon

34
Q

Protocal for achilies:
* Increase strength and flexibility
* Decrease inflammation
* Normalize ROM
* Eccentric Loading

Protocal 2:
* Unlatearl heel raises w/ no concentric component (up with both down with 1)
* 3 sets of 15 reps 2x/day for 12 weeks (getting more into that endurance phase)
* For tendons healing takes a long time

A
35
Q

Who normally gets achilles ruptures?
* Age
* active?
* sports?

A

Older 40-50

Usually sedentary adult

Sudden onset of increased activity “weekend warrior”

People make the common mistake of getting fit by playing sports instead of getting fit to play sports

Younger patients - usually an athletic or sports injury

36
Q

What is the MOI for an achilles tendon rupture? (4)

A

Extra little stretch to a fully streched tendon

forced DF when ankle is related / unprepared (eccentric)

Forceful contraction of gastroc/soleus against resistance (concentric)

Direct trauma to tendon when its taut

37
Q

Ruptured achilles

A
38
Q

Which motion is weak (non existent) w/ an achilles tendon rupture

A

Lack of PF

39
Q

Special test for achilies tendon rupture?

A

Positive thomson test

*squeeze the achilies and theres no motion at the foot (PF)

40
Q

What do they use to reconstruct the achilies tendon?

A

Plantaris graft

41
Q

How long do tenons take to fully heal?

A

8-12 weeks

42
Q

Achilles rupture post OP

Tendons take 8-12 weeks to heal to it makes sense that were doing strenghtening at the 9-12week mark

A
43
Q

Can achilies pts weight bear in phase 1?

A

No

44
Q

In phase 1 of an achiles rupture what EX are we doing

A

Hip / knee OKC stregnthening

were also doing muscle setting (pushing ito either side of muscle) just to get the muscle moving (isometric)

45
Q

Do we do scar mobilization in phase 1?

A

No

46
Q

What happens in phase 2 of achilies rupture?
* Weight bearing?
* ROM?
* What motion do we avoid?
* Scar?
* Mobilizations
* cardio?
* Strengthening?

A

Partial weight bearing

Start wedge system here (to take off pressure) (do this until weight bearing as tolerated because addding wedges = shifting weight off that limb)

ROM - ALL MOTIONS EXCEPT AVOIDING DF PASSED 0

Scar mobilization

Foot / ankle mobilizations (grade 1 and 2)

Avoid using machines for mobilization

Bike

Hip/Knee/Core strengthening

47
Q

Achilles rupture phase 3

A

Normalize gait pattern w/o wedges

WBAT/FWB

week 8 = shoot for FWB in boot

DF ROM no longer restricted, but continue to gently progress

No longer restrictions in DF

Ankle strengthening

48
Q

For these phases we need to know for test:
* general time frames for weight bearing status
* General time frames for progression of ankle
* Know ROM resitrctions
* Know tendon heal times (8-12 wks)

A
49
Q

Phase 4

A

Standing calf raise program

Standing ankle DF stretch on step

Stationary bike

Pool therapy (if inscision fully healed)

50
Q

Phase 5 = advanced rehab (think plyo) might not be in clinic in this phase

A

Lower test 3 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions