Brainscape's Knowledge GenomeTM

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


See full index

USA PTMMD 2 > Ankle/Foot Radiating Pain > Flashcards

Ankle/Foot Radiating Pain Flashcards

1
Q

With Ankle/Foot pain with radiating pain, what will we hear in the Hx?

A
  • Sensory Changes
    -Shooting, burning, cramping, hyperestesia, paresthesia, anesthesia
  • Motor Changes
    -Weakness paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With Ankle/Foot pain with radiating pain, what is the MOI?

A
  • Direct Trauma
  • Insidious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

With Ankle/Foot pain with radiating pain, what will we find in the Physical Exam?

A

(+) Neuromuscular finding
- Segmental vs Peripheral sensation and/or motor changes
- Neural tension/provication

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

What are the Characteristics of Fibular Nerve Entrapment?

A

This is the most common compressive neuropathy of LE
- Sx can originate of the Common Fibular or either the Superficial/Deep after the split (Presentation differ)
- Fibular Nerve entrapment has been associated with Surgical interventions, including TKA and High Tibial/Fibula Osteotomies and Knee Dislocations
- Number 1 Cause of Foot Drop

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

What are the Risk Factors for Fibular Nerve Entrapment?

A
  • Prolonged Crossed Leg Posture
  • Recent Weight Loss (~24 lbs)
  • Diabetes Mellitus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

During the Hx, what may we hear with Patient that are sufforing from Sensory Disturbances from the Common Fibular Nerve?

A

Disturbances of the entire anterior and lateral leg, dorsum of foot, web spaces of 1st - 5th toes

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

During the Hx, what may we hear with Patient that are sufforing from Sensory Disturbances from the Superficial Fibular Nerve?

A

Disturbances of the Distal 1/3 of the lateral lower leg, dorsum of the foot, web spaces of 2nd - 4th toes

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

During the Hx, what may we hear with Patient that are sufforing from Sensory Disturbances from the Deep Fibular Nerve?

A

Disturbances of the web space between the 1st and 2nd toes

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

During the Hx, what may we hear with Patient that are sufforing from Motor Disturbances from Fibular Nerve Entrapment?

A
  • Drop Foot
  • Decreased Balance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Those patients with Fibular Nerve Entrapment, what may we find during the Muscle Performance Testing?

A

Mid-Range Isometric Testing
- Weak and Pain-free

MMT
- Weak to motor innervation

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

Those patients with Common Fibular Nerve Entrapment, what are common exam findings?

A
  • (+) Tinels at Fibula Neck
  • (+) SLR w/ PF and Inversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Those patients with Superficial Fibular Nerve Entrapment, what are common exam findings?

A

3 Tests
-Resisted DF and Eversion w/ palpation
-Passive PF and Inversion
-Passive Inversion w/ Tinel’s along course of nerve (5 in proximal to lateral malleolus)

  • SLR w/ PF and Inversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Those patients with Deep Fibular Nerve Entrapment, what are common exam findings?

A
  • Tinels at anterior Tarsal Tunnel w/ ankle in PF and Inversion
  • SLR w/ PF and Inversion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Prognosis with Fibular Nerve Entrapment?

A
  • Conservative Treatment First
    -Deep Fibular N. > Superficial Fibular N.
  • Surgery if conservative fails
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Tarsal Tunnel Syndrome?

A

This is Compression of the Tibial N. at Medial Ankle

2 Types:
- Proximal Tarsal Tunnel Syndrome
- Distal Tarsal Tunnel Syndrome

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

What are the Risk Factors for Tarsal Tunnel Syndrome?

A
  • Age 25-50
  • Trauma
  • Repetitive Stress
    -Pronation and Ankle DF
  • Rheumatoid Arthritis
  • DM
17
Q

With Tarsal Tunnel Syndrome, what are the DD that we must consider?

A
  • Plantar Fasciitis
  • Lumbosacral Radiculopathy
  • Morton’s Neuroma
  • Tendinopathies
    -Tib. Posterior
    -Flexor Hallucis Longus
  • Medial Tibial Stress Syndrome
  • Systemic Disease (Gout, RA)
  • Tumor
18
Q

With Tarsal Tunnel Syndrome, what is the most common site of Entrapment?

A

Beneath the Flexor Retinaculum, before it splits into its medial and lateral plantar branches

19
Q

What are the Primary Complains with those with Tarsal Tunnel Syndrome?

A

Vague pain and/or Neuropathic Sx to the regions of the Medial Malleolus; Medial Arch; Plantar foot and toes

20
Q

With Tarsal Tunnel Syndrome, what are the Exam Findings we’ll see?

A
  • (+) Dorsiflexion-Eversion Test
  • (+) Tinel’s Sign
21
Q

What is Distal Tarsal Tunnel Syndrome?

A

This is a compression syndrome of the Distal branches of the tibial nerve. Either the Medial or Lateral Plantar Nerves can become compressed
- When the Medial Plantar Nerve is implicated this is knowns as Joggers Foot
- When the Lateral Plantar Nerve is implicated this is known as Baxter’s Foot

22
Q

With Distal Tarsal Tunnel Syndrome, what is Joggers Foot?

A

Compression of the Medial Plantar Nerve

This occurs due to compression in 1 or 2 sites:
- 1st site: Between the Fascia of the Abductor Hallucis and Quadratus Plantae Muscles
- 2nd site: Within the Tarsal Tunnel, Under the Knot of Henry, which is the place that the tendons of Flexor Hallucis Longus and Flexor Digitorum Longus cross in the Flexor Retinaculum

23
Q

With Distal Tarsal Tunnel Syndrome, what is Baxter’s Nerve?

A

Compression of the Lateral Plantar Nerve, more specifically the first branch of the Lateral Plantar N.

  • This is Primarily a Motor Nerve (supplying innervation to Abd Digiti Minimi (Sensory to periosteum of the calcaneus and long plantar lig.)

Compression can occur at:
- 1st site: Between the Fascia of the Abductor Hallucis and Quadratus Plantae Muscles
- 2nd site: Between Flexor Digitorum Brevis and Calcaneus

24
Q

What are the Primary Complains with those with Joggers Foot (Med. Plantar N.)?

A

Vague pain worse with activity
- 1st - 3rd toes, medial heel, medial arch

25
What motions compress the Medial Plantar Nerve under Abductor Hallucis M?
Heel Raises and Ankle Eversion
26
With what population will you see Jogger's Foot (Med. Plantar N.) more often?
- Long Distance Runners or those individuals that perform a lot of repetitive loading through their heels -They may display abnormal pronated foot postures, like hyper-pronation, rearfoot valgus or pes planus with associated abnormal running mechanics
27
What are the Primary Exam Findings with Baxter's Nerve (Lateral Plantar N.)?
- Chronic medial heel pain **without** sensory disturbances (Due to compression of the 1st branch) - Pain to deep palpation to abductor hallucis, this radiates proximal and/or distal - (+) Tinel's sign at Abductor hallucis - Abductor Digiti Minimi weakness (In advanced cases)
28
With the Prognosis of Tarsal Tunnel Syndrome, what is the difference between Surgical Management with Proximal and Distal Tarsal Tunnel Syndrome?
**Proximal Tarsal Tunnel Syndrome** - Outcomes are best if they are provided before Sx have been present for a year - These have the best outcomes when the cause of the neuropathy is entrapment due to space-occupying lesion **Distal Tarsal Tunnel Syndrome** - Outcomes are not as good, therefore recommended to hold off of surgery as long as possible
29
What are the Risk Factors for Morton's Neuroma?
- Middle-aged women - Runners, dancers - Narrow shoes - Abnormal foot postures/mechanics
29
What is Morton's Neuroma?
This is a mechanical entrapment of one of the interdigital nerves in the foot - The nerves develop non-neoplastic fibrotic or degenerative lesions that results in forefoot pain and disability - Typically affects the 3rd digitial nerve (between 3rd and 4th toes); followed closely by the 2nd digital nerve (between the 2nd and 3rd toes)
30
Whats the DD for Mortons Neuroma we should consider?
- Lumbar, hip, knee referral - Tarsal Tunnel Syndrome - OA - MTP Strain - MTP Synovitis - Stress Fx
31
With Morton's Neuroma, what will we hear in the Hx?
- Plantar forefoot pain - Worse with activity; better with rest -P! with Weightbearing - Worse when wearing tight/narrow shoes
32
With Morton's Neuroma, what will we find in the Physical Examination?
**ROM** - P! MTP extension **Joint Integ. and Mobility** - MTP dorsal glide hypermobility **Muscle Performance** - Intrinsic Muscle strength deficits **Special Test** - (+) Squeeze test with Mulder's Sign
33
What are the Intervention Strateiges for Radiating Pain?
- Activity Modification - Braces, Orthotics, Taping, Footwear - Soft tissue mobilizations - Joint mobs/manipulations - Therapeutic exercise and/or neuromuscular re-educatoin -Address abnormal ankle/foot posture/mechanices -Improve ankle/foot stability
34
What are the Intervention Strateiges for Tarsal Tunnel?
Tarsal Tunnel has the largest cross section area when the ankle is in a neutral position (slight PF, midway bewteen inversion and eversion) - So braces and supports that help maintain an ankle neutral position are recommended strategies for Proximal Tarsal Tunnel Syndrome - For Distal Tarsal Tunnel Syndrome, Heel Pads may protect the medial and lateral plantar nerves from excessive compressive forces
35
What are the Intervention Strateiges for Morton's Neuroma?
- Changes to wider shoes with improved shock absoprtion - Metatarsal pads proximal to symptomatic area

USA PTMMD 2 (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions