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BOC > Chapter 18 - The Foot > Flashcards

Chapter 18 - The Foot Flashcards

1
Q

function of foot sesamoid bones

A

reduce pressure in weight bearing

increase mechanical advantage of flexor tendon

act as sliding pulleys for tendon

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2
Q

plantar fascia attaches where posteriorly?

A

calcanea tuberosity

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3
Q

sustenaculum tali located on the…

A

calcaneus

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4
Q

shape of the talus

A

broader anteriorly than posteriorly

bony alignment limits dorsiflexion

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5
Q

cuboid is on which side of the foot

A

lateral aspect of the foot

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6
Q

cuboid articulates with which metatarsals?

A

4th and 5th

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7
Q

cuneiforms sit between

A

the navicular and bases of metatarsals 1-3

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8
Q

medial longitudinal arch formed by

A

calcaneus, navicular, talus, 1st cuneiform, 1st metatarsal

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9
Q

spring ligament

A

attaches from calcaneus to navicular

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10
Q

navicular is on the

A

medial side of the foot

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11
Q

what tendons run along the medial longitudinal arch

A

posterior and anterior tibialis

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12
Q

lateral longitudinal arch

A

calcaneus, cuboid, 5th metatarsal

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13
Q

what tendons run along the lateral longitudinal arch

A

peroneus longus

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14
Q

anterior metatarsal arch

A

metatarsal heads

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15
Q

transverse arch

A

across transverse tarsal bones

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16
Q

what tendons run across the transverse arch

A

peroneal longus, tibialis posterior

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17
Q

plantar fascia supports the foot…

A

against downward forces

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18
Q

sub-talar joint

A

talus and calcaneus

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19
Q

sub-talar movements

A

inver/ever pron/sup

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20
Q

mechanics of pronation

A

calcaneus everts, talus PF and ADD, flattens medial longitudinal arch

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21
Q

mechanics of supination

A

calcaneus inverts, talus DF and ABD, increases medial longitudinal arch

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22
Q

pronation

A

eversion +abduction of forefoot

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23
Q

supination

A

inversion + adduction of the forefoot

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24
Q

muscles that pronate

A

peroneus longus/brevis/tertius

extensor digitorum longus

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25
Q

muscles that supinate

A

tibialis posterior,

flexor digitorum longus,

flexor hallucis longus,

tibialis anterior,

extensor hallucis longus

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26
Q

tibial nerve

A

posterior leg, plantar foot

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27
Q

common perineal nerve

A

front of leg, foot

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28
Q

arteries of foot

A

A/P tibial arteries

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29
Q

forefoot consists of

A

metatarsals and phlanges

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30
Q

mid foot consists of

A

navicular, cuboid, cuneiforms

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31
Q

rear foot consists of

A

calcaneus, talus

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32
Q

stance phase

A

initial contact of heel to toe off (60% of total gait)

heel strike, mid stance, push-off

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33
Q

heel strike

A

contact on lateral calcaneus with subtler supination and tibial ER

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34
Q

midstance

A

subtler joint pronates, and tribal IR (20%)

pronation maintained to provide shock absorption by unlocking the midfoot

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35
Q

push off

A

foot begins to supinate and will approach neutral subtler position at 70-90% of stance phase

supination locks the mid foot back up to form a rigid lever

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36
Q

swing phase

A

time between toe off and initial contact (NWB)

initial swing, mid swing, terminal swing

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37
Q

pronation involves what structural deformities

A

pes planes, forefoot varus, forefoot valgus, rear foot vars (in NWB)

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38
Q

pronation causes increased medial tension of..

A

post tib. and gastroc/soleus

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39
Q

pronation causes increased lateral compression of what joints

A

subtler and talocrural

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40
Q

pronation cause what at the knee

A

valgus force at the knee

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41
Q

excessive pronation

A

loose foot ->increased forefoot motion

compromises 1st met and attachment of peroneus longus

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42
Q

supination involves what structural deformities

A

forefoot valgus, pes Cavus

tibial ER compensation

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43
Q

Excessive supination causes

A

insufficient GRF absorption

puts weight on 1st and 5th mets

limits IR: inversion sprains, MTSS, peroneal tendinitis, IT band friction syndrome, trochanteric bursitis

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44
Q

pump bump aka

A

Haglaund’s deformity

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45
Q

hallux valgus aka

A

bunion

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46
Q

sustenaculum tali located

A

medially

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47
Q

sinus tarsi located

A

laterally

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48
Q

pulses

A

posterior tibial (behind medial malleolus)

dorsal pedal

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49
Q

Longitudinal arch angle also known as

A

feiss line

50
Q

feiss line test

A

draw line from medial malleolus, to 1st MTP joint (plantar). mark navicular tubercle (NWB)

they stand WB, ft 12 in apart, note position of navicular tubercle from ground

(+) navicular drops >2/3 to floor

51
Q

NAvicualr drop test

A

sitting: mark navicular tuberosity, measure distance to ground

standing measure, looks or greater than 10 mm = (+) test

52
Q

Morton’s test

A

food in natural. apply transverse pressure to heads of metatarsals

(+) - sharp pain in forefoot

indicates: metarsalgia or neuroma

53
Q

achilles tendon reflex

A

S1

54
Q

talus fractures (etiology)

A

occurs in the dome

usually from severe INV/DF (medially) or INV/PF (laterally) with ER of tibia

55
Q

talus fx s/sx

A

hx of ankle trauma, pain, catching, snapping, swelling, talar dome is tender over anterior joint line

56
Q

talus fx management

A

x-ray, immobilize, protect, NWB progression

57
Q

calcaneus fx etiology

A

landing after a jump

58
Q

s/sx calcanea fx

A

swelling, pain, cannot WB, deformity

59
Q

calcanea stress fx etiology

A

receptive heel strike, see in runners

60
Q

management of calcanea stress fx

A

x-ray, bone scan, NWB

61
Q

apophysitis of calcaneus aka

A

sever’s disease

62
Q

apophysitis of calcaneus etiology

A

occurs in young, physical active athletes - traction injury at apophysis of calcaneus where achilles tendon attaches

63
Q

apophysitis of calcaneus s/sx

A

pain at posterior heel, pain during vigorous activity that is received with rest

64
Q

apophysitis of calcaneus management

A

Rest, ice, stretching, NSAIDS

65
Q

retrocalcaneal bursitis etiology

A

pressure from heel counter inflames bursa between achilles and calcaneus/

exostosis may develop

66
Q

exostosis

A

bony outgrowth or callus

67
Q

heel contusion etiology

A

sports demanding stop and go response or changes from horizontal to vertical movement.

68
Q

heel contusion s/sx

A

pain in heal, cannot WB, warmth/redness

69
Q

heel contusion management

A

RICE NSAIDS, heel cup, protective donut, wear shock absorbent footwear

70
Q

tarsal tunnel formed by

A

osseous floor and flexor retinaculum

71
Q

inside the tarsal tunnel

A

tibialis posterior, flexor hallucis longus, flexor digitorum muscles, tibial artery, tibial vein

72
Q

tarsal tunnel synodrome s/sx

A

pain, paresthesia (medial and plantar), (+) Tinel’s,

73
Q

tarsal tunnel management

A

surgery (if chronic), NSAIDS, orthotic

74
Q

Lisfranc Injury

A

Tarsometatarsal fx/Dislocation

75
Q

lisfranc etiology

A

ankle is PF with rear foot locked, sudden forceful hyper PF of forefoot results in dorsal displacement of proximal end of metatarsals

76
Q

lisfranc s/sx

A

subtle symptoms:

pain, swelling, tenderness on dorsum of foot, possible fx of metatarsals; disruption of supporting ligaments

77
Q

lisfranc management

A

restore alignment (ORIF);

78
Q

pes planus foot

A

flat foot

79
Q

pes planus etiology

A

fallen ML arch, excessive pronation,

caused by: tight shoes, forefoot varus, trauma, excessive exercise

80
Q

pes planus s/sx

A

pain, weakness/fatigue in arch, calcanea eversion, bulging navicular, flattening of arch,

81
Q

pes planus management

A

taping, orthotics (medial wedge)

82
Q

pes cavus foot

A

high arch, claw foot, hollow foot

83
Q

pes Cavus foot etiology

A

excessive supination, congenital or neuro disorder

84
Q

pes cavus foot s/sx

A

poor shock absorption, pain, metarsalgia, clawed/hammer toes,

forefoot valgus, shortened achilles, odd calluses on ball and heel of foot

85
Q

pes cavus management

A

orthotics with lateral wedges, stretching achilles tendon and plantar fascia

86
Q

plantar fasciitis etilogy

A

repeated tensile stress, hyperpronation, leg length discrepancy, toe running, limited DF

87
Q

plantar fasciitis s/sx

A

anteromedial heel pain, morning pain, decreased pain with movement, pain w/ toe walking and during DF

88
Q

plantar fasciitis management

A

RICE, NSAIDS, correct cause, arch support, taping, orthotics, walking boot, night splint,

89
Q

Jones Fx Etiology

A

most common acute fx is fx to the diaphysis at the base of the 5th met

90
Q

Jones Fx S/sx

A

swelling and p!, healing is slow; high non-union rate and healing course is unpredictable

91
Q

Jones Fx Management

A

crutches, no immobilization, progress to weight bearing; treat early with internal fixation

92
Q

metatarsal stress fracture etiology

A

most common - 2nd MT (marcher’s fx) - runner who changed training surfaces.

93
Q

metatarsal stress fx management

A

gradual return to activity, rest, orthotic to correct pronation

94
Q

Bunionettes aka

A

tailor’s bunions

95
Q

Bunions etiology

A

associated with structural forefoot varus

narrow shoes or short shoes also pointed shoes

bursa over 1st MTP joint becomes inflamed and thickens. Joint is enlarged and toe is malaligned

96
Q

Bunion S/sx

A

pain, swelling, joint enlargement; poorly fitting shoes increase irritations and pain; angulation of toe progresses

97
Q

bunion management

A

wear correctly fitting shoes, orthotics, tape splint along with wedge b/w great toe/ 2nd toe

98
Q

sesamoiditis etiology

A

caused by receptive hyperextension of the great toe (dancing/basketball)

99
Q

sesamoiditis s/sx

A

pain under great toe, esp during push-off. Palpable tenderness under 1st MT head

100
Q

sesamoiditis management

A

orthotics, metatarsal pads, arch supports, metatarsal bar

101
Q

metatarsalgia etiology

A

pain under 2-3rd metatarsal heads

heavy callus forms, causes inflexibility of gastroc/soleus

also could be caused by fallen metatarsal arch

102
Q

metatarsalgia s/sx

A

p! under met bones 2-4; caves deformity may cause metatarsalgia

103
Q

metatarsalgia management

A

pad to elevate depressed met heads; remove callus buildup; stretching of gastroc/soleus; strengthening of intrinsic foot musculature

104
Q

Morton’s neuroma etiology

A

neuroma is a mass in nerve sheath between 3 and 4 metatarsals;

predisposing factors: collapse of transverse arch, excessive pronation

105
Q

morton’s neuroma s/sx

A

burning paresthesia, severe p! that radiates to toes, hyperextension of toes increases sx

106
Q

morton’s neuroma management

A

bone scan to rule out stress fx; teardrop-shaped pad placed b/w 3rd and 4th MT heads; narrow shoes may exacerbate problems

107
Q

Turf Toes etiology

A

hyperextension injury resulting from sprain of the MTP joint of great toe

108
Q

Turf Toe s/sx

A

pain and swelling, p! increased in push-off during walking, running, jumping

109
Q

management of turf toe

A

stiffer forefoot of turf shoes, orthoplast under foot, tapping to prevent dorsiflexion, and rest

110
Q

Morton’s toe

A

1st toe is abnormally short

111
Q

management of morton’s toe

A

if painful use orthotic with medial wedge

112
Q

hallux rigidus etiology

A

bony spurs on dorsal aspect of 1st MTP joint that results in impingement and a loss of active and passive DF

degenerative arthritic process

113
Q

hallux rigidus s/sx

A

great toe unable to DF; forced DF increases pain, weight bearing on lateral foot when walking

114
Q

hallux rigidus management

A

stiffer she with larger toe box, NSAIDs,

115
Q

Hammertoe

A

flexible deformity that can become fixed; flexion contracture at PIP joint

116
Q

Mallet toe

A

flexion contracture at DIP joint (involving flexor digitorum longus tendon).

117
Q

Claw toe

A

flexion contracture at DIP joint and hyperextension at the MCP joint; callus develops over PIP joint and under metarsal head

118
Q

subungal hematoma etiology

A

large force applied to toe, kicking another object. receptive shearing

119
Q

subungal hematoma s/sx

A

bleeding may be immediate or slow, producing p!, bluish-purple color

120
Q

subungal hematoma management

A

ice, release pressure by drilling hole into nail bed

BOC (49 decks)

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