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Management of MS Disorders > Exam 2: Foot & Ankle Evaluation > Flashcards

Exam 2: Foot & Ankle Evaluation Flashcards

1
Q

What are 4 management options when looking at foot and ankle dysfunctions

A

Exercise
Mobilization/Manipulation
Shoes
Orthotics

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2
Q

What are 6 hindfoot conditions

A 
Ankle sprains
Heel/arch pain syndromes
Sever's Disease
Subtalar/ankle pain
Tendon injuries
Retrocalcaneal exostosis
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3
Q

What is the most common injury of the ankle and foot in the US

A

ankle sprains

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4
Q

__% of ankle sprains are athletic related

A

50

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5
Q

50% of ankle sprains are _____ related

A

athletic

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6
Q

Put the following conditions in order from most occurrent to least occurrent:

Foot fractures, ankle fractures, foot sprain, and ankle sprains

A
  1. ankle sprains (2 million a year)
  2. Foot fractures (590,000)
  3. Ankle fractures (436,000)
  4. Foot sprains (265,000)
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7
Q

If an ankle sprain didn’t occur due to an athletic injury, what is the next likely cause

A

a fall from stairs

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8
Q

Walking puts up to ____ times your body weight on your foot

A

1.5

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9
Q

Your feet log ____ miles a year

A

1000

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10
Q

As shock absorbers, feet cushion up to __ ____ pounds of pressure during one hour of strenuous exercise

A

1 million

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11
Q

(lateral/medial) ankle sprains are more common

A

lateral

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12
Q

What position are lateral ligaments least stable in

A

The loose pack position of PF and inversion

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13
Q

Why are medial ankle sprains less common

A

The medial side is protected due to bony architecture and has decreased eversion

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14
Q

True or False:

Proximal/syndesmotic ankle sprains are usually caught early on and have quicker recoveries

A

False, they are usually unrecognized and prolong rehab

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15
Q

____% of ankle sprains can potentially progress to chronic problems

A

40

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16
Q

According to the Ottawa Ankle Rules, when is an ankle x-ray required

A

If there is bone tenderness in the malleolar zone, bone tenderness over the navicular or base of the 5th metatarsal, or the inability to weight bear

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17
Q

When are percussion and compression tests used

A

when a fracture is suspected

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18
Q

A (percussion/compression) test is a blow to the tibia, fibular, or heel to create vibratory force that resonates in fracture causing pain

A

percussion

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19
Q

A (percussion/compression) test involves compression of tibia and fibula either above or below the site of concern

A

compression

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20
Q

Which ligaments are usually involved in a syndesmotic ankle sprain

A

ATFL and PTFL

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21
Q

List the ligaments and their sequence of injury with increasing stress of an ankle injury

A
  1. Anterior talofibular (ATFL)
  2. Calcaneofibular (CFL_
  3. Posterior talofibular (PTFL)
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22
Q

What is a common MOI for an inversion ankle sprain injuring the ATFL followed by the CFL

A

Coming down after rebound (the foot in PF) and landing on another players foot (foot is inverted)

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23
Q

What is a common MIO for an inversion ankle sprain injuring the CFL by itself

A

When the foot is planted with inversion like cutting in soccer and field sports

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24
Q

Use the ____ principle for immediate care of an ankle sprain

A

RICE

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25
Q

There are 5 lateral ankle sprain sequela (injuries that occur after an initial injury). List what they are

A
  1. Impingement of the medial joint capsule
  2. Peroneal tendon strain/rupture
  3. Avulsion fracture of 5th metatarsal or lateral malleolus
  4. Talus/ankle mortise chondral lesions
  5. Superficial branch of the fibular nerve injury
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26
Q

How many grades are there to describe lateral ligament injuries

A

3

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27
Q

Grade (1/2/3) describes a minor tear with pain and only the ATFL involved

A

1

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28
Q

Grade (1/2/3) describes some degree of laxity with a firm end point

A

2

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29
Q

Grade (1/2/3) describes gross laxity without an endpoint

A

3

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30
Q

If a patient has a grade 1 sprain and anterior drawer and talar tilt test are both negative, how long until they can return to sport

A

1-10 days

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31
Q

If a patient has a grade 2 sprain, anterior drawer reports with increased laxity, and a negative talar tilt test - How long until they can return to sport

A

2-4 weeks

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32
Q

If a patient has a grade 3 sprain, a positive anterior drawer, and a positive talar tilt test - How long until they can return to sport

A

5-8 weeks with rehab

33
Q

Which ligament controls anterior shift of the talus on the tib/fib or a posterior shift of the tib/fib on the talus

A

ATFL

34
Q

Which ligament blocks IR of the talus on the tib/fiv or ER of the tib/fib on the talus

A

ATFL

35
Q

The ATFL prevents (IR/ER) of the (talus/tib-fib) on the (talus/tib-fib)

A
  1. IR of the talus on tib/fib

2. ER of the tib/fib on talus

36
Q

Which special test is used to test the integrity of the ATFL

A

anterior drawer test

37
Q

What is the anterior drawer test testing

A

ATFL integrity

38
Q

What is a positive sign of the anterior drawer test

A

If the foot slides forward and/or makes a clunking sound as it reaches the end point

39
Q

Out of these three ligaments, which one is the strongest:

ATFL, PTFL, CFL

A

PTFL

40
Q

What is a common MOI for the PTFL

A

deceleration with a quick stop

41
Q

Which special tests is used to test the integrity of the PTFL

A

posterior drawer test or ER test

42
Q

What is the posterior drawer test testing

A

PTFL integrity

43
Q

What position of the foot makes the CFL tight and what position makes the CFL slack

A

Tight in DF

Slack in PF

44
Q

The CFL checks (inversion/eversion) in (DF/PF)

A

inversion in PF

45
Q

A tear of the CFL will allow movement of the ____ on the ____

A

talus on calcaneus

46
Q

Which special test is used to test the integrity of the CFL

A

Talar tilt test

47
Q

How is the talar tilt test performed and what is it testing

A

It tests the integrity of the CFL by inverting the calcaneus with the ankle in neutral

48
Q

What are the signs and symptoms of a 1st degree sprain

A

acute ankle pain, maybe a pop
Little loss of function or ROM, no laxity
mild tenderness
little or no bruising/swelling

49
Q

What are the types of management for a 1st degree sprain

A

RICE for 1-2 days
limit weight bearing initially then hard rehab
Taping may help
Return to play in 7-10 days

50
Q

What are signs and symptoms of a second degree sprain

A 
severe ankle pain/tenderness
popping
loss of function/painful ROM
Increased laxity but has an end point
general swelling/bruising
limited WB
51
Q

What are the types of management for a 2nd degree sprain

A

RICE for 72 hours
boot/crutches for 5-10 days
Taping will help early stages
Retrain proprioception to prevent re-injury

52
Q

What are signs and symptoms of a 3rd degree sprain

A 
Severe or no ankle pain
popping/joint dislocation
severe tenderness
loss of function
immediate swelling/bruising 
Positive anterior drawer and talar tilt tests
53
Q

Ankle sprains are an example of what type of pain

A

nociceptive

54
Q

What are the types of management for a 3rd degree sprain

A 
RICE
X-RAY per ottawa rules
isometrics
ROM, PRE, and balance exercises
Maybe surgery
55
Q

What sport is medial/eversion ankle sprains commonly seen in

A

wrestling

56
Q

Which ligament is at risk during a medial ankle sprain

A

deltoid

57
Q

75% of ankle fractures occur on the (medial/lateral) side

A

medial

58
Q

What are the 3 types of fractures that are seen on the medial side

A
  1. Avulsion fracture of medial malleolus
  2. Pott’s - a Bimalleolar fracture
  3. Ankle mortise chondral lesions
59
Q

What special test is done to test the integrity of the deltoid ligament

A

Lateral talar tilt test done in neutral, PF, and DF

60
Q

A foot that is (supinated/pronated), (hypermobile/hypomobile) and has a depressed medial longitudinal arch is more predisposed to eversion sprains

A

pronated and hypermobile

61
Q

If a patient has localized point tenderness and swelling over the the deltoid ligament, what would you expect

A

a medial ankle sprain

62
Q

A positive talar tilt test eludes to what condition

A

medial ankle sprain

63
Q

What are the signs and symptoms of a syndesmotic sprain

A

Pain with passive ER and DF
loss of function
severe anterolateral pain

64
Q

What is a typical MOI of a syndesmotic sprain

A

A torsion force - The foot is planted and the leg moves on the foot

65
Q

A syndesmotic sprain is (easy/difficult) to treat and may take _____ of treatment

A

difficult; months

66
Q

If a patient has a syndesmotic ankle sprain, what would your course of treatment look like

A

The same as other ankle sprains, but immobilization and total rehab will be longer

67
Q

Which ligaments are affected during a syndesmotic ankle sprain

A

anterior and posterior tibiofibular ligaments

68
Q

What are the four structures that can be affected with a syndesmotic sprain

A

Posterior tibiofibular ligament
Anterior tibiofibular ligament
Interosseous membrane
Posterior talofibular ligament

69
Q

A taped ankle starts losing stability after ___ minutes of activity

A

30

70
Q

Ankle distraction is good for stiff _____ and ___ joints after being immobilized

A

TCJ and STJ

71
Q

A posterior glide of the tibia on the talus will increase (DF/PF)

A

PF

72
Q

A posterior glide of the talus on the tibia will increase (DF/PF)

A

DF

73
Q

During a stance stretch to the gastroc increase DF, make sure the individual does not (supinate/pronate) during the stretching

A

pronate

74
Q

What are 5 risk factors for developing a lateral ankle sprain

A
  1. History of ankle sprains
  2. No external support
  3. No warm up
  4. Limited DF
  5. No balance/proprioception exercises after old ankle sprain
75
Q

To evaluate activity and participation limitations, what are activities you can do post acute stage

A

single limb hop for lateral and diagonal movements

76
Q

If a patient has an acute ankle sprain, what types of manual therapy can be done

A

lymphatic drainage
joint mobs
AP talar mobs

77
Q

For an acute ankle sprain, what in one modality you should definitely use and one modality you definitely should not use

A

use ice

do not use ultrasound

78
Q

What are three MOI of nerve injuries

A

compression
tension
inflammation

Management of MS Disorders (18 decks)

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