EEO FOOT & ANKLE Flashcards
1
Q
self report outcome measures for foot and ankle (3)
A
Functional foot index (FFI)
foot and ankle disability Index (FADI)
foot and ankle OA outcome scale (FAOS)
others - AIMS (arthritis), WOMAC, LEAP/LEFS/LEAS
2
Q
performance outcome measures
A
TUG
Timed LE Chair Rise Test
Wall Sit
Vertical Jump
LE Agility
Hop Test
Heel Raise Test
LQ YBT
3
Q
90% of lower extremity weightbearing is through what bone?
A
tibia
4
Q
what passive structures help dissipate forces and keep the tibia and fibula together?
A
anterior/posterior ligament of fibular head
interosseous membrane
anterior/posterior tibiofibular ligament
5
Q
where is the mortise joint in the lower leg? what does it do?
A
distal tibia, receives the talus to give stability
6
Q
A
A
navicular
7
Q
B
A
medial cuneiform
8
Q
C
A
intermediate cuneiform
9
Q
D
A
lateral cuneiform
10
Q
E
A
cuboid
11
Q
1
A
tibia
12
Q
2
A
talus
13
Q
3
A
fibula
14
Q
4
A
calcaneus
15
Q
what tendon attaches to the base of 5th MT
A
fibularis brevis
16
Q
what calcaneal foot position is this?
A
valgus
17
Q
what calcaneal foot position is this?
A
varus
18
Q
what is the first ray important for?
A
creating the medial longitudinal arch
19
Q
ray 2-4 guides _____
ray 5 guides ______
A
DF/PF
Sup/Pro
20
Q
windlass effect is involved with which ray?
A
1st ray!
tells you that the plantar fascia is there!
passive extension of first two (WB or NWB), should reproduce pain at heal
21
Q
what muscle counteracts the dorsiflexion moment
A
soleus (does PF)
22
Q
line of gravity is ______ to lat mal, so at the _____________ joint
A
line of gravity is anterior to lat mal,
at the calcaneo-cuboid joint
23
Q
foot posture index: what to look at
A
Calcaneal position (supinated/pronated neutral?)
forefoot position
gastroc atrophy,
swelling,
tibial rotation,
amount of toes visible (more = over pronation)
24
Q
a supinated ankle would stretch the ____ aspect and compress the ____ aspect, and leads to a ____ arch
A
stretches lateral
compressed medial
High arch
25
a pronated ankle would stretch the ____ aspect and compress the ____ aspect, and leads to a ____ arch
stretch medial
compress/tight lateral
26
tibial IR would cause what at the foot?
tibial ER would cause what at the foot?
IR = pronation (flat arch)
ER = supination, higher arch
27
too many toes - how many is too many
should only see two from behind
28
a medial cave around the medial malleoli may indicate ____
whereas a bulge would indicate ____
Concave - supination, high arches
bulge - pronated, so flat arches
29
looking anteriorly, the tibial center should be aligned with the __ ray
2nd
30
pronation of the foot is what 3 movements
eversion
abduction
dorsiflexion
31
supination of the foot is what 3 movements
inversion
adduction
plantarflexion
32
the talus articular surface is narrow ______ and wide ________
narrow posteriorly
wide anteriorly
33
the biomechanics for DF and PF are
DF - roll ant, slide post
PF - roll post, slide ant
34
dorsiflexion/plantarflexion happens at what joint? what are the norms?
talocrural joint
DF - 20
PF - 50
35
when performing DF, a tight gastroc might cause movement compensation??
forefoot abduction
36
main component of pronation is
dorsiflexion
37
main component of supination is
plantarflexion
38
hindfoot inversion and eversion happens at what joint
subtalar (5 and 5 degrees)
39
pronation and supination happens at what joint
midtarsal and metatarsal joints
40
is normal position, calcaneus should be
vertical or slight valgus
41
hindfoot varus leads to
calcaneal inversion
and the HINDFOOT DRIVES THE POSITION OF THE MIDFOOT AND FOREFOOT SO = foot supination
42
hingfoot valgus leads to
calcaneal eversion and the HINDFOOT DRIVES THE POSITION OF THE MIDFOOT AND FOREFOOT SO = foot pronation
43
Spring ligament
plantar clacaneonavicular ligament
medial side, supports medial longitudinal arch
44
in lateral ankle sprains, overplantarflexion and inversion leads to sprain of the
ATFL
"TALO" be carerful
45
in lateral ankle sprains, overdorsiflexion and inversion leads to sprain of the
CFL
46
in lateral ankle sprains, full dorsiflexion and inversion leads to sprain of the
PTFL
47
pt presentation of Lateral ankle sprain
brusing/swelling
pain
feeling of instability
may progress to chronic ankle instability
48
OTTAWA RULES
need x ray of ankel if pain in malleolar zone or bone tenderness at lat/med mall, or inability to WB/walk 4 steps
need x ray of foot if pain in midfoot zone or bone tenderness at navicular or base of 5th or inability to WB/walk 4 steps
49
Out of the FFI, FADI AND FAOS, which have a limitation due to being too long
FADI, FAOS
50
Which of the FFI, FADI, FAOS, which asks about work and sleep?
FADI
51
subjective measures of lateral ankle sprain
MOI
previous episode
joint noises
Ottawa ankle rules!
52
outcome measures of lateral ankle sprain
FFI
FADI
FAOS
LEFS- general
single leg heel raise
SLB
SLS
YBT
53
objective measures for lateral ankle sprain
clear the spine!
ankle AROM/PROM- check the other motions before doing the motion of injury
palpation
ankle girth
MMT
hop tests- not in acute phase
54
A lateral ankle sprain causes lack of ____ which is critical for gait
dorsiflexion
55
medial ankle sprain causes
forceful eversion of foot throughout a range of DF
56
what ligament is injured in a medial ankle sprain
deltoid ligament
also maybe plantar calcaneoclavicular
57
patient presentation of medial ankle sprain
swelling, pain, bruising
58
high ankle sprain cause
forceful talar external rotation with the ankle planted in DF
talus forces the fibula to separate from the tibia
poor prognosis
59
posterior tibialis tendinopathy causes
faulty foot biomechanics or overuse injury
age- lower arches, more stretch
WEAK FOOT INTRINSICS = POOR MIDFOOT STABLILITY AND EXCESSIVE PRONATION
60
pt presentation fo posterior tibialis tendinopathy
AND COMPENSATION - what do they lose??
tenderness on course of tendon
pain with contraction
pain with stretch- severe cases
they lose DF AND MEDIAL LONGITUDINAL ARCH
61
CPG of posterior tibialis tendinopathy: 4 clinical tests
**pain** with palpation
**swelling** around tendon
pain/weakness with **contraction**
inability/pain with **SLR** (most reliable!!)
62
subjective questions for posterior tibial tendinopathy
recent change in training, footwear, or terrain?
age changes in arch height
63
outcome measures for posterior tibial tendinopathy
FFI
FADI
LEFS
SLHR
SLB/SLS
64
objective measures for posterior tibial tendinopathy
CTS
ankle AROM/PROM
**feiss line (arch) **- navicular drop?
palpation
girth
MMT
YBT
65
when performing MMT/AROM/PROM for a patient with an injury, what motion/measurement should be performed last?
the one that is most painful based off of Dx!
ex: post tib does plantarflexion and Inv, so for posterior tibial tendinopathy do PF + INV last
66
achilles' tendinopathy causes
faulty foot biomechanics
overuse injury- wringing to the "watershed" area
67
insertional achilles' tendinopathy
pain/issue at the heel bone
due to compression, DF/closed packed positioning
68
mid tendon achilles' tendinopathy
issue at the watershed area, mid tendon
tensile forces, increased training activity, repetitive loading in running
69
achilles' tendinopathy pt presentation
pain along tendon
pain with palpation- variable
pain with contraction
pain with muscle stretch- severe cases
70
achilles' tendinopathy subjective questions
change in training, footwear, or incile?
age- changes in arch height
71
outcome measures for achilles' tendinopathy
**VISA-A**
FAAM
LEFS
SLHR
SLB
hop tests
single leg reach
72
objective measures for achilles tendinopathy
CTS
AROM/PROM- DF- knee straight/bent
Feiss line
static arch height
posture
palpation
MMT
73
Feiss line
clinical test for medial longitudinal arch height
74
T or F: achilles tendon rupture frequently occurs in a normal healthy tendon
T
75
If patient says they felt like they had been kicked or shot in the back of the ankle, and you feel a gap in the back tendon of their ankle, its likely a
Achilles tendon rupture
76
causes of tarsal tunnel syndrome
over pronation
rolling ankle medially
77
what runs through the tarsal tunnel medial to lateral?
tibialis posterior
flexor digitorum longus
tibial artery
tibial vein
tibial nerve
flexor hallucis longus
78
what causes plantar fascitis
forceful plantarflexion of foot with great toe extension
repeated microtrauma- overpronation or heel spur
79
pt presentation plantar fascitis - when would they feel pain?
pain at medial arch, distal to calcaneus
pain with initial steps, worse after prolonged WB
MORNING STEPS ARE WORSE ** Q
80
differential Diagnosis for plantar fascitis
can be irritation of medial or lateral plantar n
spondyloarthritis- bone spur in the back
81
what spinal nerve level associated with the back of the heel
S1
82
subjective questions for heel pain
change in training or footwear, how old are your shoes?
how are your first steps in the AM?
age and changes in arch height
83
outcome measures for heel pain
FFI
FAAM
LEFS
SLHR
SLB/SLS
84
objective measures for heel pain
CTS (!!)
BMI
AROM/PROM - (DF/PF & great toe F/E)
Feiss line
palpation of medial calcaneal
windlass test
girth
MMT
anterior single leg reach
85
2 types of heel pain
overweight OR
overtrainers
86
great toe needs __ degrees of extension for normal walking. what happens if they dont have that?
70 degrees
will overpronate, creating adduction of the big toe
87
an angle between MT and proximal phalanxe greater than __ degrees is abnormal
15 degrees
88
hallux rigidus is what?
great toe joint is rigid
joint inflammation and swelling of 1st MTP
89
hallux rigidus may be a cause of result of
plantar fascitis
90
what is a precursor to hallux rigidus
hallux limitus
91
all end feel of foot/ankle ROM is
firm
92
the first ray includes the
talus
navicular
medial cuneiform
1st MT
1st phalanx- distal and proximal
sesamoids
arch!
