DSA 20 Stockard LE

Question 1

Tibiotalar Joint

1. Axis of motion
2. Major and minor motions

Answer 1

1. Primarily horizontal through talus

2. Dorsiflexion (major) and Plantar flexion (minor)

Question 2

Talocalcaneal joint

1. Axis of motion
2. Major and minor motions

Answer 2

1. primarily 42 degrees inferoposterior through calcaneus

2. inversion and eversion

Question 3

What ligament prevents forward displace of the ankle?

Answer 3

ATFL - anterior talofibular ligament

Question 4

What ligament prevents backward displacement of the ankle?

Answer 4

PTFL- posterior talofibular ligament

Question 5

What ligament prevents inversion of the ankle?

Answer 5

Calcaneofibular ligament

Question 6

What 3 motions occur with supination of the ankle?

Answer 6

1. inversion
2. adduction
3. plantar flexion

Question 7

What 3 motions occur with pronation of the ankle?

Answer 7

1. eversion
2. abudction
3. dorsiflexion

Question 8

With dorsiflexion the talus glides anterior or posterior?

Answer 8

posterior

Question 9

with plantar flexion, the talus glides anterior or posterior?

Answer 9

anterior

Question 10

What are the normal degrees of motion for the following motions?

1. Plantar flexion
2. Dorsiflexion
3. Adduction
4. Abduction
5. Inversion
6. Eversion

Answer 10

Please Don’t Add Abs In Exercise

1. 55-65
2. 15-20
3. 20
4. 10
5. 5
6. 5

Question 11

Classify a Grade I strain/sprain

Answer 11

generally intact tensile strength, NO gapping, TTP

Question 12

Classify a Grade III strain/sprain

Answer 12

complete disruption with no tensile strength, sloppy end feel with gapping/indentation

Question 13

What is the treatment for a Grade I ankle sprain

Answer 13

conservative care, weight bearing with brace immediately

Question 14

What is the treatment for a grade II ankle sprain

Answer 14

bracing, protected weight bearing, early rehab

Question 15

What is the treatment for a Grade III ankle sprain

Answer 15

immobilize for 3-4 wk, rehab (rarely surgery)

Question 16

If pt has point tenderness over base of 5th metatarsal what imaging do you order?

Answer 16

foot xray

Question 17

if you suspect a high ankle sprain in pt what imaging do you order?

Answer 17

weight bearing AP xray

Question 18

if you suspect a Fibular head fx and pt has tenderness over fibular head what imaging do you order?

Answer 18

Knee xray

Question 19

List Ottawa Rule for foot/ankle xray (4)

Answer 19

1. tenderness ove rinferior or posterior ppole of either malleolus
2. Inability to bear weight (4 steps taken independently, even if limping)
3. Tenderness along base of 5th metatarsal or navicular bone
4. Pediatric population

Question 20

What is the difference between an Avulsion fx of the 5th metatarsal and a Jone’s fx?

Answer 20

An avulsion fx is more proximal to the cuboid joint whereas a Jone fx is about 1.5cm distal to the tuberosity of the 5th metatarsal

Question 21

What causes an avulsion fx?

Answer 21

contraction of the peroneus brevis tendon

Question 22

The squeeze test and side to side test are positive in what type of ankle sprains?

Answer 22

syndesmosis sprains (distal tibiofibular joint)

Question 23

What is a Grade I Classification for Overuse?

Answer 23

pain after activity only

Question 24

What is a Grade II Classification for Overuse?

Answer 24

Pain with activity but does not significantly restrict performance

Question 25

What is a Grade III Classification for Overuse?

Answer 25

Pain with activity with significant performance restriction

Question 26

What is a Grade IV Classification for Overuse

Answer 26

Pain with activity and rest

Question 27

Stress fx are most frequent in which bones in the foot?

Answer 27

metatarsals and calcaneus

Question 28

What is the difference between an achilles' tear/rupture from tendonitis/retrocalcaneal bursitis?

Answer 28

Tear/rupture: hx of acute pain with explosive movement | Tendonitis: gradual onset, usually with repetitive jumping

Question 29

List 4 treatment options for achilles tendonitis and 1 that you do not do.

Answer 29

1. Heel lift 1/4 inch 2. decrease running/jumping 3. arch support 4. NSAIDs and ice NO STEROID INJECTIONS

Question 30

Lateral ankle pain from overuse results in...

Answer 30

peroneal tendonitis

Question 31

Medial ankle pain from overuse results from irritation of what tendon?

Answer 31

posterior tibialis tendon, and you will have swelling posterior to medial malleolus

Question 32

Inferior calcaneal heel pain from overuse results in....

Answer 32

plantar fasciitis

Question 33

A pt with the following hx makes you think of what? "Pain with first steps out of bed that gets better as the day goes on"

Answer 33

plantar fasciitis

Question 34

Morton's Neuroma

Answer 34

palpation of the interspace produces sharp pain that often radiates into toes (most commonly 3rd then 2nd)

Question 35

What is the most common deformity of the MTP joint?

Answer 35

Bunions, Hallux valgus

Question 36

What is the normal hallux angle?

Answer 36

less than 15 degrees

Question 37

This is a keratotic lesion over a bony prominence on less toes due to increases pressure on skin

Answer 37

corn

Question 38

Where is a Hard Corn usually found?

Answer 38

5th toe laterally or dorsally

Question 39

Where is a soft corn usually found?

Answer 39

in web spaces

Question 40

What bones make up the Transverse Arch? (4)

Answer 40

1. cuboid 2. cuneiforms 3. navicular 4. proximal ends of metatarsals