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ECOS > Approach to Ankle and Foot Complaint > Flashcards

Approach to Ankle and Foot Complaint Flashcards

1
Q

When testing muscle strength, if a patient has active movement against gravity, how would you grade it?

A

3/5

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2
Q

when testing muscle strength, if a patient has a flicker or trace of contraction, how would you grade it?

A

1/5

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3
Q

when grading muscle strength, if a patient has active motion against gravity and full resistance without evidence of fatigue, how would you grade it?

A

5/5

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4
Q

when testing muscle strength, if a patient has active motion of the body part achieved with gravity eliminated, how would you grade it?

A

2/5

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5
Q

when testing muscle strength, if no contraction is detected, how would you grade it?

A

0/5

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6
Q

when testing muscle strength, if a patient has active motion against gravity and some resistance, how would you grade it?

A

4/5

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7
Q

what is the talar tilt test used for?

A

to test for lateral ankle sprains, calcaneofibular ligament or anterior tabofibular ligament injury

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8
Q

what is the anterior drawer test in the ankle/foot used for?

A

to test for a lateral ankle sprain

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9
Q

what is the eversion test used for?

A

medial ankle sprain or a deltoid ligament injury

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10
Q

what is the squeeze test used for?

A

to test for a high ankle sprain or a distal tibiofibular syndesmosis injury

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11
Q

what is Homan’s sign used for?

A

to test for a DVT

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12
Q

What are the three main types of ankle sprains?

A

lateral ankle sprain, medial ankle sprain, syndesmotic ankle sprain (aka high ankle sprain)

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13
Q

What is the most common ankle sprain?

A

lateral ankle sprain

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14
Q

what is the mechanism of injury of of a lateral ankle sprain?

A

foot inversion and/or plantar flexion

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15
Q

what is the most likely ligaments injured in a lateral ankle sprain

A

anterior talofibular ligament*** and calcaneofibular ligament

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16
Q

if there is a lateral ankle sprain, which tests are positive?

A

talar tilt test (aka inversion test) and anterior drawer test

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17
Q

what is the mechanism of injury of a medial ankle sprain?

A

forced eversion

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18
Q

what is the most likely ligament injured in a medial ankle sprain?

A

deltoid ligament

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19
Q

what test is positive if there is a medial ankle sprain?

A

eversion test

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20
Q

how are ankle sprains graded?

A

grading scale 1-3; 3 most severe

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21
Q

What is the mechanism of injury of a syndesmotic or high ankle sprain?

A

forced external rotation of a dorsiflexed ankle

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22
Q

what is the most likely ligament involved in a syndesmotic/ high ankle sprain?

A

tibiofibular syndesmosis

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23
Q

what test is positive if there is a high ankle sprain?

A

squeeze test

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24
Q

What are 3 common pathologies of the achilles tendon?

A

tendonitis, achilles rupture, Sever’s disease

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25
Q

what are the signs and symptoms of achilles tendonitis?

A

pain/stiffness at tendon insertion, recent increase in exercise/activity, pain is worse with activity and goes away with rest

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26
Q

what test is used for achilles tendonitis?

A

thompson test

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27
Q

how is achilles tendonitis diagnosed

A

by a NEGATIVE thompson test

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28
Q

symptoms of an achilles tendon rupture?

A

patients report a popping sensation at their heel

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29
Q

what test is used to diagnose an achilles tendon rupture?

A

thompson test

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30
Q

how is an achilles tendon rupture diagnosed?

A

a POSITIVE thompson test

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31
Q

an inflammation or stress injury to the areas on and around an apophysis (growth plate) near the calcaneus

A

Sever’s disease

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32
Q

who gets sever’s disease?

A

active children going through growth spurts

33
Q

What are the signs and symptoms of sever’s disease?

A

chronic heel pain in growing children, pain with increased activity, pain is reproduced with direct palpation over the apophysis

34
Q

a loss of the longitudinal arch of the foot

A

pes planus

35
Q

an exaggeration of the longitudinal arch of the foot

A

pes cavus

36
Q

What is the common sign/symptom of plantar fasciitis?

A

pain is worse with first few steps in the morning and then improves

37
Q

inflammation and thickening of tissue that surrounds the nerve between toes

A

morton’s neuroma

38
Q

how does morton’s neuroma present?

A

the patient will most likely report feeling like they are walking on a marble

39
Q

what is the relevant special test used for morton’s neuroma?

A

Mulder’s sign

40
Q

How is morton’s neuroma diagnosed?

A

Positive Mulder’s sign: a palpable clicking sensation between the third web space as the transverse arch is compressed

41
Q

what causes steppage gait or foot drop?

A

fibular nerve compression

42
Q

what are the common signs of fibular nerve compression?

A

weakness of dorsiflexion and eversion, steppage gait, sensory loss over dorsal foot/lateral shin

43
Q

a consequence of chronic foot inflammation that ultimately results in mid foot deformities and a collapse of the longitudinal arch

A

Charcot foot

44
Q

who typically gets charcot foot?

A

diabetic neuropathy patients

45
Q

gout is an inflammatory arthropathy caused by what?

A

deposition of monosodium urate crystals in joints

46
Q

what types of foods may lead to gout flare up?

A

diet high in purines (meat, shellfish, and alcohol)

47
Q

joint aspirations in gout patients reveal what?

A

negatively birefringent needle shaped crystals

48
Q

ankle injuries will frequently cause dysfunction in the knee due to what?

A

the linked motion at the fibular head

49
Q

what causes the fibular head to glide anteriorly?

A

foot pronation

50
Q

what causes the fibular head to glide posteriorly?

A

foot supination

51
Q

what causes supination of the foot?

A

plantar flexion+inversion+adduction

52
Q

what causes pronation of the foot?

A

dorsiflexion+eversion+abduction

53
Q

What is the normal range of motion of dorsiflexion of the foot?

A

15-20 degrees

54
Q

what is the normal plantar flexion of the foot?

A

55-65 degrees

55
Q

what is the minor motion associated with dorsiflexion?

A

posterior glide

56
Q

what is the minor motion associated with plantar flexion?

A

anterior glide

57
Q

does dorsiflexion or plantar flexion make the ankle more stable?

A

dorsiflexion

58
Q

what is the normal range of motion of eversion of the tibiotalar joint?

A

10-20 degrees

59
Q

what is the normal range of motion of inversion of the tibiotalar joint?

A

20 degrees

60
Q

what is the minor motion associated with eversion?

A

anteromedial glide of the talus

61
Q

what is the minor motion associated with inversion?

A

posterolateral glide of the talus

62
Q

What is the normal range of motion of the talocalcaneal joint eversion/anteromedial glide?

A

5-10 degrees

63
Q

what is the normal range of motion of the talocalcaneal joint inversion/posterolateral glide?

A

5-10 degrees

64
Q

As the calcaneus moves into eversion, the talus will glide?

A

anteriorly and medially

65
Q

as the calcaneus moves into inversion, the talus will glide?

A

posteriorly and laterally

66
Q

a sliding motion (along an axis) of a tarsal bone toward the plantar surface in relation to surrounding bones

A

plantar glide

67
Q

a sliding motion (along an axis) of tarsal bones toward the dorsum of the foot in relation to the surrounding bones

A

dorsal glide

68
Q

the plantar glide of the cuboid and navicular bones are couples with?

A

rotation about an AP axis

69
Q

rotation of the cuboid and navicular bones creates what?

A

eversion of the cuboid and inversion of the navicular during plantar glide

70
Q

most likely preferences of the cuboid bone

A

eversion glide with plantar glide

71
Q

most likely preferences of the navicular bone

A

inversion glide with plantar glide

72
Q

most likely preferences of the cuneiforms

A

plantar glide only

73
Q

how is motion of the metatarsals named?

A

for the direction of the metatarsal head

74
Q

what are the motions that we evaluate at the metatarsals?

A

dorsal glide and plantar glide

75
Q

what are the motions that we evaluate at the MTPs, PIPs, and DIPs?

A

dorsal/plantar glide, rotatory glide, abduction/adduction

76
Q

what is the name of the guidelines for when to order X-rays on a patient with an ankle injury?

A

Ottawa Ankle Rules

77
Q

If a patient has pain in the malleolar zone, they must have at least one of?

A
  1. bone tenderness at the posterior tip of the medial or lateral malleolus or 2. Unable to bear weight immediately after injury AND unable to walk 4 steps in the doctor’s office or ER
78
Q

if a patient has pain in the midfoot region, they must have at least one of?

A
  1. bone tenderness at the FIFTH metatarsal or the NAVICULAR 2. Unable to bear weight immediately after injury AND unable to walk 4 steps in the doctor’s office/ER

ECOS (32 decks)

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