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Musculo 515 > Ankle & Foot Examination > Flashcards

Ankle & Foot Examination Flashcards

1
Q

where is the L1 dermatome?

A

upper thigh

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2
Q

where is the L2 dermatome?

A

middle thigh

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3
Q

where is the L3 dermatome?

A

Lower Thigh
Knee Joint Region

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4
Q

where is the L4 dermatome?

A

Medial (and post med) Shin
Medial Malleolus

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5
Q

where is the L5 dermatome?

A

Lateral (and post lat) shin
Top of foot
Great toe

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6
Q

where is the S1 dermatome?

A

Lateral border of foot
Heel
Middle of posterior calf

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7
Q

where is the S2 dermatome?

A

Popliteal fossa
Posterior thigh

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8
Q

what is the L1-L2 myotome action?

A

Hip flexion

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9
Q

what is the L3 myotome action?

A

Knee extension

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10
Q

what is the L4 myotome action?

A

Ankle DF

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11
Q

what is the L5 myotome action?

A

Great toe extension

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12
Q

what is the S1 myotome action?

A

Ankle PF

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13
Q

what is the S2 myotome action?

A

knee flexion

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14
Q

what is the S3-4 myotome action?

A

Toe Flexion

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15
Q

what is the L3/4 reflex?

A

Patellar tendon

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16
Q

what is the S1 reflex?

A

Achilles tendon

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17
Q

what is Fawn’s beard?

A

Patch of hair on low back
Indicative of spina bifida

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18
Q

what is Cafe Au Last spot?

A

Neurofibromatosis
Birthmarks w/ focal region to lumbar spine
May be present w/ scoliosis

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19
Q

what are some red flags of CNS impairments?

A

Gait Deficits
Romberg Test
Babinski Sign
Clonus Test
Cauda Equina sequelae

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20
Q

what are some red flag musculoskeletal impairments?

A

Fracture: advanced age + corticosteroid use + trauma = consider serious risk

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21
Q

what are some red flags cardiovascular & pulmonary impairments?

A

Constitutional S/S
Intermittent Claudation
Anginal symtoms
SOB

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22
Q

what are some red flag integumentary impairment?

A

Skin changes, rashes, itching
Wounds

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23
Q

what nerve roots do heel walking/ toe walking?

A

L4/S1 involvement

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24
Q

what can the heel drop test, test for?

A

Appendicitis
Spinal
Peritonitis

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25
Q

what are Stoddard’s warning signs?

A

Previous Malignancy
Late onset in life
Serious LOF
Intense pain
Area other than cervical & lumbar
Constitutional Signs
Gross weakness
Loss of bowel/bladder
Continuous pain
Blood work

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26
Q

what are some reasons for a medical referral?

A

No apparent movement dysfunction exists
No causative factors can be identified
Finding are not consistent w/ neuromuscular or musculoskeletal dysfunction
Presentation of suspicious red-flag signs or symptoms

27
Q

pain at rest is usually indicative of?

A

Not usually mechanical

28
Q

pain with activity is normally?

A

structural

29
Q

pain after activity is normally?

A

inflammatory

30
Q

what is a finding of painless & strong after resisted isometric test indicative of?

A

contractile tissue not source

31
Q

what is a finding of painless & weak after resisted isometric movements indicative of?

A

contractile tissue denervated, ruptured or deconditioned

32
Q

what is a finding of painful & strong after resisted isometric movements indicative of?

A

inflammation

33
Q

when discussing symptoms what does the “when” establish?

A

timeframe

34
Q

when discussing symptoms the patterns of what makes it better/ worse establish?

A

Nature & Behavior

35
Q

what are the Figure 8 Steps?

A
  1. Begin Mid-Way b/w tibialis anterior tendon & lateral malleolus
  2. Draw tape medially across instep & placed distal to navicular tubercle
  3. Draw tape across plantar foot placing it proximal to styloid of 5th metatarsal
  4. Draw tape across talus towards distal medial malleolus
  5. Move tape posteriorly behind & aim for other distal lateral malleolus
  6. Return to start of tape to take measurement
36
Q

what is the order of an examination?

A
  1. History
  2. Observation & Inspection
  3. LQS prn
  4. Foot & Ankle ROM
  5. Muscle Performance
  6. Functional testing
  7. Special tests
  8. Joint Play
  9. Neurodynamic Testing
  10. Palpation
37
Q

What is pitting edema?

A

Apply pressure w/ thumb for at least 5 seconds & if pit develops

38
Q

Describe Claw Toe

A

Extend, Flex, Flex

39
Q

Describe Hammer Toe

A

Extend, Flex, Extend

40
Q

how much DF/PF at talocrural joint during gait?

A

DF:10
PF: 20

41
Q

how much DF/PF at talocrural joint going upstairs?

A

DF: 20-30
PF: 10-15

42
Q

how much DF/PF at talocrural joint during running?

A

DF: 25
PF: 25

43
Q

what are some common sites for fracture in foot & ankle?

A

Calcaneous
5th Metatarsal (Jones fx)
Stress Fx of metatarsals (March Fx)
Distal fibular avulsion fx (traumatic)
Fibular stress fx

44
Q

what are the special test for fractures of foot & ankle?

A

Ottawa Foot & ankle rules
Metatarsal Compression Test
Tuning fork

45
Q

what is a positive test for Metatarsal Compression Test

A

(+) pain w/ metatarsal fx or neuroma

46
Q

what is a positive test for tuning fork?

A

different sound in bilateral comparison

47
Q

what is a positive test for Thompson test?

A

if non responsive ankle PF during the test

48
Q

what special test for DVT?

A

Homan’s Sign
Calf Swelling
Well’s Critera

49
Q

what is a positive Homan’s Sign?

A

popliteal and/or calf pain when squeezed

50
Q

what is a positive test for calf swelling?

A

If bilateral comparison reveals difference of 15 mm for men or 12 mm for women

51
Q

describe Biomechanical examination in non-weight bearing & short-sitting?

A

Inspection of foot health
view transverse arch: most evident in this position
measure tibial torsion

52
Q

describe Biomechanical examination in non-weight bearing & prone?

A

Passive hip rotation
Subtalar Joint Neutral

53
Q

describe the Biomechanical examination in weight bearing, anterior?

A

Proximal <–> distal observation
Inspection of how arches change from NWB to WB - medial longitudinal arch change most evident

54
Q

describe the Biomechanical examination in weight bearing, posterior?

A

Calf Symmetry
Achilles Shape
Haglunds Deformity
Tibial Varum
Rearfoot varus/valgus

55
Q

what are the special tests for achilles tendonitis?

A

SLS Heel raises for PF strength & FTPO
Confirm Achilles Tendon Integrity
Foot/Ankle Biomechanical exam

56
Q

what is Grade A evidence for Achilles Tendonitis?

A

Eccentric exercise

57
Q

what is Grade B evidence for achilles tendonitis?

A

modalities

58
Q

what are some observations that may bee seen with posterior tibialis tendon dysfunction?

A

-No calcaneal inversion with heel raise
- Too many toe signs
- Medial talar buldge

59
Q

what are the signs/symptoms of musculotendionous injury?

A

pain w. active contraction of muscle & passive lengthening of muscle (STT testing)

(+) Biomechanical examination

60
Q

what is grade a evidence for heel pain/plantar fasciitis?

A
  • Plantar Fascia Stretching & Gastric/soleus stretching
  • Joint Mobilization to improve talocrurcal DF
  • STM to plantar fascial, gastric/soleus trigger points
  • Application of antipronation taping
  • Foot orthoses & night splints
61
Q

what is grade F evidence for heel pain/ plantar fasciitis?

A

Strengthening exercises & movement training for muscles that control pronation & attenuate forces during weight bearing

62
Q

what are the special test for lateral ankle sprain?

A

Anterior Draw
Reverse Anteriolateral Drawer Test
Posterior Draw

63
Q

what are types of insertional achilles tendonitis?

A

Haglund’s Deformity
Pretendon Bursitis
Retrocalcaneal Bursitis

Musculo 515 (6 decks)

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