clinical aspects lower leg

Question 1

compartment syndromes result from increased pressure within a myofascial compartment resulting in

Answer 1

ischemia and pain

Question 2

acute compartment syndrome occurs due to?

Answer 2

trauma (fractures, crush injuries, severe burns)

Question 3

chronic compartment syndrome is also referred to as? and what is usually the cause

Answer 3

external compartment syndrome from exercise related soreness- runners or walkers

Question 4

what areas of the leg are most commonly affected by chronic compartment syndrome?

Answer 4

anterior and deep posterior

Question 5

how is compartment syndrome usually diagnosed?

Answer 5

measuring the compartmental pressure before and during exercise
resting pressure more than 12 mm/hg
one minute exercise pressure more than 20 mm/hg

Question 6

pain along the medial aspect of the tibia, usually involving the tibialis anterior muscle is called?

Answer 6

shin splints or medial tibial stress syndrome

Question 7

ski boot syndrome is a term used to describe?

Answer 7

compression neuropathy of the deep fibular nerve as it leaves the anterior compartment- tight fitting ski boots or shoes

Question 8

what are the clinical features associated with compression of the deep fibular nerve?

Answer 8

motor- loss of dorsiflexion of foot and extension of toes, diminished inversion
sensory- loss of sensation to skin in webspace between digits 1-2

Question 9

what condition is due to microscopic tears in the collagen fibers of the tendons just prox to attachment of calcaneus?

Answer 9

achilles tendonitis

Question 10

what is the most common cause and symptoms of achilles tendonitis?

Answer 10

repetitive activities- baseball, tennis, runners and dancers; pain is most common symptom while running or walking

Question 11

what decreases the symptoms of achilles tendonitis?

Answer 11

heel lifts and stretching

Question 12

what is the usual cause of a rupture of the tendon calcaneus?

Answer 12

poorly conditioned people with history of tendonitis- forceful plantar flexion

Question 13

symptoms of a ruptured tendon calcaneus?

Answer 13

hear an audible snap and feel intense pain, have a palpable gap with greater dorsiflexion and less plantar flexion

surgery only required in extremely active individuals

Question 14

calcaneal tendon reflex tests for segmental innervation of?

Answer 14

S1 and S2

Question 15

what is a condition with narrowing or occlusion of the posterior tibial artery and its branches resulting in painful leg cramps and a diminished posterior tibial artery pulse?

Answer 15

peripheral arterial disease

Question 16

what is the most frequently injured major joint?

Answer 16

ankle- sprains most common

Question 17

which ligaments in a sprained ankle are most commonly damaged?

Answer 17

lateral ligaments because they aren’t as strong as deltoid,

anterior talofibular most vulnerable and calcaneofibular

Question 18

why does a sprained ankle usually occur?

Answer 18

inversion type injury or avulsion fracture of the lat malleolus of fibula

Question 19

what is another name for a sprain at the inferior tibiofibular joint?

Answer 19

high ankle sprain

Question 20

what is different about a high ankle sprain vs a classic ankle sprain?

Answer 20

usually more significant and severe and require longer rehabilitation time

Question 21

which fracture occurs when a foot is forcibly everted (externally rotated)?

Answer 21

Pott’s fracture

Question 22

Pott’s fracture can result in what other issues? (3)

Answer 22

1 tearing of deltoid ligament
2 fracture of shaft of fibula
3 fracture of lat malleolus

Question 23

a potts fracture has how many degrees of damage?

Answer 23

1st-3rd degrees

Question 24

what is the cause of plantar fascitis?

Answer 24

aponeurosis becomes stretched and tiny tears develop which become inflamed and painful

Question 25

when is plantar fascitis most commonly seen and what are the symptoms?

Answer 25

runners or high impact sports with overuse or bad footwear; pain is more severe after sitting or first thing in the morn (first step pain)

Question 26

if a bone spur develops on the medial aspect of the calcaneus from plantar fascitis individuals will notice

Answer 26

pain on that aspect of the foot when walking (due to bursae becoming inflamed)

Question 27

what is a condition where the tibial nerve and or the medial plantar nerve are compressed as they pass deep to flexor retinaculum?

Answer 27

Jogger's foot or tarsal tunnel syndrome

Question 28

what are symptoms of joggers foot/ tarsal tunnel syndrome?

Answer 28

- burning, sharp pain behind medial malleolus and may radiate to plantar surface of foot - intermittent symptoms, may become constant overtime - parasthesia and numbness may occur

Question 29

what are the causes of tarsal tunnel syndrome?

Answer 29

trauma hypertrophy of deep posterior leg muscles "flat feet"

Question 30

plantar nerve reflex tests?

Answer 30

L4, L5, S1 and S2 and results in flexion of digits

Question 31

if the response of the plantar nerve reflex is abnormal, digits 2-5 will abduct and digit 1 will extend, this is called?

Answer 31

positive babinski response

Question 32

babinski response is normal in infants until?

Answer 32

4 months after birth

Question 33

what is a condition in which plantar nerves are compressed between the heads of the metatarsals and the transverse metatarsal ligaments?

Answer 33

morton's neuroma- intermetatarsal neuroma or interdigital

Question 34

mortons neuroma usually affects what and is caused by what?

Answer 34

affects the nerves in the spaces between 3-4 digits and caused by a benign tumor on the nerve

Question 35

what are the symptoms of mortons neuroma?

Answer 35

dull cramping or burning sensation which becomes more pronounced and sharp; common in runners, dancers and tight shoes

Question 36

what is a foot deformity characterized by lateral deviation of MP joint of digit 1?

Answer 36

hallux valgus

Question 37

what is the cause of hallux valgus?

Answer 37

pressure of footwear or arthritis, can be congenital and more common in females and increased age

Question 38

when a sesamoid bone is displaced by deviation and ends up in the space between the heads of the 1st and 2nd metatarsals it causes the joint to lock and is called?

Answer 38

hallux rigidis

Question 39

if the first digit overlaps the second digit inferiorly it can cause the development of ____ on the 2nd digit where it rubs against shoe

Answer 39

corns

Question 40

when bursae of hallux becomes tender and inflamed its called a?

Answer 40

bunion

Question 41

what is a common deformity of digit 2-3 which can be congenital; the affected digits are hyperextended at the MP and DIP joints and flexed at PIP joints

Answer 41

hammer toe

Question 42

what is a condition with a hyperextension injury at the MP joint of digit 1 and is due to damage of the plantar capsular ligament?

Answer 42

turf toe

Question 43

a structural deformity of the talus bone usually from birth and cause shortening and contracture of muscles and ligaments

Answer 43

club foot (talipes equinovarus)

Question 44

club foot is more common in?

Answer 44

males than females and is genetic

Question 45

what is the term used for a normal foot with normal arches?

Answer 45

pes rectus

Question 46

what is the term used to describe a foot with inadequacy in medial longitudinal arch and arches become depressed and collapsed?

Answer 46

pes planus

Question 47

what is the term for an arch lacking in weight bearing but appears normal when not weight bearing?

Answer 47

flexible flat foot-usually due to loose or degenerative ligaments, common in childhood, usually resolves with age

Question 48

what is the term for an arch that lack even when not weight bearing?

Answer 48

rigid flat foot- usually due to bone deformities, can be congenital or acquired

Question 49

what describes a secondary consequence of damage to a ligament or atrophy of a muscle and changes arch?

Answer 49

acquired flat foot, fallen arch

Question 50

when the medial longitudinal arch is unduly high?

Answer 50

pes cavus or clawfoot- muscle imbalance (polio)