assessment and conditions of the lower leg. Flashcards
what are the 4 compartments of the lower leg? MT
- superior posterior compartment.
- deep posterior compartment.
- lateral compartment.
- anterior compartment.
what structures are associated with the superior posterior compartment? MT
- gastrocnemius
- soelus
- plantarus
what structures are associated with the deep posterior compartment? MT
- fibula posterior
- tibial artery.
- flexor digitorum longus
- tibia posterior artery and nerve.
what structures are associated in the lateral compartment? MT
- protus longus
- brevis
what structures are associated with the anterior compartment? MT
- extensor digitorums
- tibia artery
- pronus tarsis.
what areas of the lower leg on bones do you palpate?
- fibular head and shaft
- medial and lateral malleolus
- tibial shaft
- tibial plateau (can’t really palp.)
what are soft issue structures to palpate?
(3 pern. + 2 flex +1)
- peroneus longus, brevis, tertius.
flexor hallicis, digitorum longus - posterior tibialis.
what are soft issue structures to palpate?
(exten +others)
- anterior tibialis
- extensor hallucis longus, digitorum
- gastrocnemius
- soleus
- Achilles tendon
what is peroneal tendon subluxation/ dislocation? MT
- dynamic force being applied to the ankle.
- dramatic blow to posterior lateral malleolus or moderate/ severe inversion ankle sprain resulting in tearing of perineal retinaculum.
- some cases tendon may rupture.
what are s/s of perineal sublet/dislocation? MT
- complain of snapping in and out of groove with activity.
- eversion against manual resistance replicates sublimation
- recurrent pain, snapping, instability.
- present w/ ecchymosis, edema, tenderness, crepitus over tendon.
what is management for peroneal sublex/dislocation? MT
- compression with felt horseshoe
- RICE, meds from MD
- conservative treatment time 5-6 weeks.
what is anterior tibialis tendinitis? MT
- occurs after extensive down hill running
- no MOI
- dorsiflexion + inversion actively will be painful.
s/s of anterior tibialis tendinitis? MT
- point tenderness over anterior tibialis tendon, and of the muscle.
how do you manage anterior tibialis tendinitis? MT
- rest/ decrease running time & distance, avoid hills.
- serious case, ice & before and after stretching.
- Dailey strengthen.
what is posterior tibialis tendinitis? MT
- common overuse condition in runner with foot hyper mobility or over pronation. (flat feet)
- repetitive microtrauma.
- active + resisted issues
- plantar flexion + inversion issues.
- on medial side.
s/s of posterior tibialis tendinitis? MT
pain & swelling in area of medial malleolus.
- edema, point tenderness, increase pain pain during resistive inversion and plantar flexion.
management of posterior tibialis tendinitis? MT
- RICE
- NWB cast w/ foot in inversion may be used.
- taping or orthotics
what is peroneal tendinitis? MT
- found in patients that have pes cavus (high Arch) due to excessive supination, placing stress on peroneal tendon
- issues with passive dorsiflexion.
- pain pushing off.
s/s of peroneal tendinitis? MT
- pain behind medial malleolus during push off.
- pain along distolateral aspect of calcaneus and beneath the cuboid.
management for peroneal tendinitis? MT
- Rice, elastic tape, warm-up and flexibility exercises.
- orthotics.
where is anterior, posterior tibialis tendinitis , peroneal and achilles tendinitis located?
- on top of the foot.
- behind medial mall.
- behind lateral mall.
- along Achilles tendon
what causes leg cramps and spasms?
- fatigue, loss of fluids, electrolyte imbalance.
what are 3 syndromes that make up compartment syndrome? MT
- acute compartment syndrome
- occurs secondary to direct trauma.
- medical emergency.
- acute exertion compartment syndrome
- evolves with minimal to moderate activity.
- chronic compartment syndrome.
- symptoms increase at a certain point during activity.
- pain, pale skin, numb and tingling, faint pulse.
s/s of compartment syndrome? MT
- deep aching pain and tightness due to pressure and swelling.
-reduced circulation and sensation.
what is management for compartment syndrome? MT
- severe acute or chronic may require a medical emergency that is surgery to reduce pressure or release fascia.
- rice
if surgery is required no activity for 2-4 months
what are stress fractures of tibia and fibula?
- muscles that are constantly pulling on the bone.
- tibia stress fractures are more common than fibula stress fractures.
- overuse conditions of people with structural and biomechanics insufficiencies.
- training errors
- shin splints can lead to stress fractures, constant dull ache should be x-rayed.
s/s of stress fractures?
- pain mire intense after exercise than before.
- point tenderness
management of stress fracture?
- reduce activity for 14 days.
- after 2 weeks of no pain, can gradually return to play.
- 6-8 wk recovery.
- cycle before running.
