Exam 2 Review

Question 1

“You are so tall that you hit your head on the door frame. Your head is quite painful and you gently rub it to ease the pain. This is an example of which pain modulation theory?”

Answer 1

The answer is GATE CONTROL THEORY

Question 2

HOPS stands for

Answer 2

HOPS - History, observation, palpation, and special test, Order we use for evaluations

Question 3

anterior compartment of leg what is in it and movements?

Answer 3

tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius
dorsiflexion, inversion, eversion

Question 4

lateral compartment

Answer 4

peroneus longus and brevis (or fibularis longus and brevis)

perform plantar flexion and eversion

Question 5

posterior superficial compartment of leg

Answer 5

gastrocnemius, plantaris, and soleus

plantar flexion and knee flexion

Question 6

posterior deep compartment of leg

Answer 6

tibialis posterior
flexor hallucis longus
flexor digitorum longus
popliteus
plantar flexion and inversion

Question 7

what joint movements does the subtalar joint perform?

Answer 7

inversion and eversion

Question 8

what movements do the talocrural joints perform?

Answer 8

plantarflexion and dorsiflexion

Question 9

pronation movements

Answer 9

In pronation, the calcaneus moves through eversion, abduction, and dorsiflexion relative to the fixed talus.

Question 10

supination movements

Answer 10

calcaneus and foot move through a combination of inversion, adduction, and plantar flexion in relation to the fixed talus.

Question 11

high ankle sprain mechanism of injury and details

Answer 11

injury to distal tibiofibular joint, increased external rotation or dorsiflexion

severe pain and loss of function or pain with external rotation and dorsiflexion

may need surgery, difficult to treat, immobilization and rehab may be longer

Question 12

inversion sprains

Answer 12

Most common, and result in injury to the lateral ligaments (Up to 90%)
Anterior talofibular ligament is injured with an inversion, plantar flexion, and internal rotation.

Question 13

whirlpool

Answer 13

indications: combination of massage and water immersion, swelling muscle spasm and pain
contraindications: not for an acute injury, be careful with full body immersion (don’t exceed 104) as volume of body part immersion increases temperature should decrease, proper maintenance to avoid infection, safety (electrical outlet athlete not turning it on or off)

Question 14

ultrasounds

Answer 14

indications: for tissue heating thermal and non-thermal effects
increase tissue permeability and fluid movement
useful for acute injuries,
contraindications: anesthetized areas and areas with reduced circulation

Question 15

paraffin bath

Answer 15

indications: chronic injuries, effective for angular areas such as hands wrists elbows ankles and feet
contraindications: not for lesions, make sure body part is clean and dried

Question 16

Diathermy

Answer 16

indications: effective for bursitis, capsulitis, osteoarthritis, deep muscle spasms and strains
penetrates up to two inches
uses magnetic waves

Question 17

TENS

Answer 17

transcutaneous electrical nerve stimulators, used for pain control

Question 18

thermotherapy

Answer 18

ncreased collagen extensibility; 
- Decreased joint stiffness
- Reduce pain
- Relief from muscle spasm
- Reduction of edema and swelling
- Increased blood flow.
Overall Indications:
Sub-acute and chronic stage of healing
Warm up
Pre-stretch
Stiffness
Muscle spasm
Pain
Chronic injury
Overall Contraindications
Decreased sensation
Circulatory impairment
Acute trauma with inflammation
Malignant tumor
Eyes, genitals

Question 19

hot packs

Answer 19

indications: used for general muscle relaxation and reduction of pain and spasm
limitations: unable to heat deeper tissues effectively

Question 20

pes planus

Answer 20

flatfoot
associated with excessive pronation, being overweight, and excessive exercise placing undo stress on arch
sign and symptoms
pain and weakness fatigue in medial longitudinal arch
management: structural flatfoot nothing
if problem: taping or orthotic

Question 21

pes cavus

Answer 21

high arch
etiology: higher arch than normal, excessive supination, abnormal shortening of achilles tendon
signs and symptoms: poor shock absorption resulting in foot pain, forefoot valgus deformity
management: if asymptomatic no attempt to correct
orthotics should be used if problems develop (lateral wedge)
stretch Achilles and plantar fascia

Question 22

plantar fasciitis

Answer 22

etiology: increased tension and stress on fascia, change from rigid supportive footwear to flexible footwear, poor running technique, running environment (soft surfaces with poor support shoes)
signs/symptoms: pain in the anterior medial heel
increased pain in the morning lessens after the first few steps
increased pain with forefoot dorsiflexion
management: extended treatment, orthotic therapy, NSAIDS and occasionally steroidal injection

Question 23

Jones fracture

Answer 23

etiology: inversion and plantar flexion, direct force or repetitive stress
signs/symptoms: immediate swelling and pain over 5th metatarsal, high nonunion rate and course of healing is unpredictable
management: crutches w/ no immobilization, gradually progress to weight-bearing, may need surgery (internal fixation)

Question 24

bunion (hallux valgus deformity)

Answer 24

etiology: associated with forefoot varus
shoes that are too narrow
bursa becomes inflamed and thickens
signs / symptoms: tenderness swelling and enlargement of joint
tendinitis in great toe flexors may develop
management: early recognition and care is critical wear correctly fitting shoes, orthotics, engage in foot exercises for intrinsic and extrinsic muscles

Question 25

anterior talofibular

Answer 25

restraint anterior displacement of talus

Question 26

calcaneofibular

Answer 26

restrains inversion of calcaneus

Question 27

posterior talofibular

Answer 27

restrains posterior displacement of talus

Question 28

deltoid

Answer 28

prevents abduction and eversion of ankle and subtalar joint | prevent eversion and pronation and anterior displacement of talus

Question 29

Morton's | neuroma

Answer 29

Transverse pressure applied to heads of metatarsals causing pain in forefoot. Positive test may indicate neuroma or metatarsalgia. In a very specific spot bottom of foot between 2nd and 3rd toes nerves squished

Question 30

compartment syndrome

Answer 30

etiology: acute compartment syndrome: medical emergency, occurs secondary to direct trauma chronic: symptoms arise consistently at certain point during activity signs / symptoms: increased pressure within compartment, complain of deep aching pain, tightness due to pressure and swelling, reduced circulation and sensation of foot, must be recognized and treated early management: medical emergency: need surgery to reduce pressure or release fascia less severe: pressures will be monitored and surgical needs depend on findings chronic: management is conservative fasiotomy may be necessary if conservation measures fail

Question 31

achilles tendon rupture

Answer 31

etiology: occurs with sudden stop and go forceful plantarflexion with knee moving into extension generally history of chronic inflammation signs/symptoms: sudden snap (kick in leg) with immediate pain which rapidly subsides point tenderness swelling discoloration and decreased ROM, obvious indentation and positive thompson test occurs 1-2 inches proximal to the calcaneal insertion management: surgical repair for serious injuries (70-80% of function) non-operative RICE NSAIDS, analgesics, non-weight bearing case for six weeks walking cast for 2 rehabilitation about 6 months

Question 32

medial tibial stress syndrome (shin splints)

Answer 32

etiology: pain in anterior portion of shin, accounts for 10-15% running injuries, repetivie microtrauma, improper footwear, flatfeet can contribute signs / symptoms four grades 1 pain after activity 2 pain before and after activity not affecting performance 3 pain before during and after activity affecting performance pain so severe performance is impossible management: physician referral for X-rays and bone scan activity modification (rest and reduce intensity) correction of abnormal biomechanics or shoes, ice massage to reduce pain and inflammation, arch taping or orthotics surgery

Question 33

IT band synddrome (runners knee)

Answer 33

etiology: repetitive and overuse conditions signs / symptoms: irritation at band's insertion (commonly seen in those who have genu varum) positive Ober's test, often occurs due to running with one leg higher than other (on slope or crowned road) management: correction of malalignments, ice before and after, proper warm up and stretching techniques, avoid aggravating activities

Question 34

unhappy triad

Answer 34

prone to disruption through torsional and valgus forces MCL ACL and medial meniscus

Question 35

Lachman Drawer test

Answer 35

reduces hamstring involvement at 30 degrees of flexion an attempt is made to translate the tibia anteriorly on the femur positive test indicates damage to ACL

Question 36

anterior drawer test

Answer 36

used to determine damage to anterior talofibular ligament primarily and other lateral ligaments secondarily positive test occurs when foot slides forward and/or makes a clunking sound as it reaches the end point

Question 37

talar tilt test

Answer 37

performed to determine extent of inversion or eversion injuries with foot at 90 degrees calcaneus is inverted and excessive motion indicates injury to calcaneofibular ligament and possibly to anterior and posterior talofibular ligaments if calcaneus is everted the deltoid ligament is tested via this test

Question 38

Thompson test

Answer 38

squeeze calf muscle while the foot is extended off the table to test the integrity of Achilles tendon positive test results in no movement in the foot (could indicate Achilles tendon rupture)

Question 39

apley's compression test

Answer 39

hard downward pressure is applied with rotation | pain indicates a meniscal injury