Ankle/Foot Exam - PPT Flashcards
exostosis
found at insertion of achilles at calcaneus
– excessive tensile loading from triceps surae
– excessive shearing force from footwear via high arches
bunion cause
medial migration of 1st metatarsal
abduction of 1st phalanx
“tailors” bunion
lateral migration of 5th metatarsal head
adduction of 5th phalanx
explain relationship between rearfoot and forefoot varus/valgus
typically forefoot is opposite of rear foot
rearfoot valgus = forefoot varus
what is too many toes related to
rearfoot valgus
forefoot varus
severs disease
like osgoods but in the ankle
at the insertion of achilles tendon at calcaneus
most common in puberty aged populations
ankle ROM
DF - 20
PF - 50
Inv - 20
Ev - 10
what are ways to measure dorsiflexion?
weight bearing lunge
A/PROM goniometer
qualifications for weight bearing lunge test
perform half kneeling forward lunge
–measure distance from wall to tip of big toe
must have heel planted and knee touching wall
MDC for weightbearing lunge test
4.6/7 degrees
1.6-1.9 cm
what muscle group weakness can result in ankle instability
hip abductors
– causes fibularis longus to over activate and increase peak INV/ENV moments
ottawa foot and ankle rules
pain in posterior tip of medial/lateral malleoli
- ankle
pain at base of 5th metatarsal/navicular
- foot
syndesmosis
high ankle sprain
motion at the subtalar joint
eversion
inversion
motion at the talocrural joint
dorsi/plantarflexion
anterior drawer test
- indication
- perform
- positive
MCD - ligament sprain
pt supine w heel off table in slight PF, anterior glide of calcaneus/talus on stabilized tibia
excessive anterior translation/reproduction of symptoms
arc sign
- indication
- perform
- positive
MPD - achilles tendinopathy
prone w ankle off table and locate max area of swelling, have pt actively PF and DF ankle
if swelling moves - tendinopathy is present
dorsiflexion eversion test
- indication
- perform
- positive
MCD - ligamentous injury
passively dorsiflex foot/toes with eversion (5-10 sec)
tap tarsal tunnel region
tinel sign or complaint of symptoms/tenderness
royal london test
- indication
- perform
- positive
MPD - achilles tendinopathy
prone with ankle off table and locate area of max tenderness, pt dorsiflex ankle
re-palpate the same location
if the pain moves from the identified location after DF = tendinopathy indicated
squeeze test
- indication
- perform
- positive
MCD - syndesmosis
palpate middle third of lower leg (base of gastroc)
squeeze tibia and fibula
reproduction of pain
windlass test
- indication
- perform
- positive
MD - plantar fasciitis
NWB - extend great toe at MTP
repeat in standing
reproduction of symptoms along plantar fascia
impingement sign dorsiflexion test
- indication
- perform
- positive
MD - anterior ankle impingement
supine, ankle off table, palpate anterolateral aspect of talus
apply dorsiflexion to ankle
reproduction of symptoms
talar tilt test
- indication
- perform
- positive
MCD
medial = ATFL/CFL bias
lateral = deltoid bias
supine ankle off table, stabilize talus
grab calcaneus and bring into PF
move calcaneus laterally/medially based upon ligament
reproduction of pain / increased laxity
thompson test
- indication
- perform
- positive
MPD - achilles rupture
pt prone with foot off table
squeeze calf muscle and looking for plantarflexion
abnormal = no plantarflexion
