Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathomechanics > Final Exam: Foot & Ankle > Flashcards

Final Exam: Foot & Ankle Flashcards

1
Q

What is the capsular pattern of the talocrural joint?

A

plantarflexion > dorsiflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Eversion

A

pronation, abduction, & dorsiflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Inversion

A

supination, adduction, & plantarflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Medial Longitudinal Arch

A

bony support: calcaneus, talus, navicular, cunieforms, and three medial MTs

ligamentous support: long plantar ligament, spring ligament, and plantar fascia

  • muscular support from ant and post tibialis, PL, FHL, FHB, FDL, FDB, abd hallucis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lateral Longitudinal Arch

A

bony support: calcaneus, cuboid, 4th and 5th MTs

ligament support: long and short plantar ligaments, plantar fascia

muscular support: peroneus longus brevis, abductor minimi, flexor digitorum longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Proximal Transverse Arch

A

supported by posterior tibialis, peroneus longus, and intertarsal ligamentous structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Distal Transverse Arch

A

supported by transverse head of adductor hallucis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the three ways to measure arch height in patients?

A

navicular height/foot length; dorsum height at 50% foot length; 1st ray angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Longitudinal Arch Angle

A

typical: 130˚ to 150˚
pes planus: <130˚
pes cavus: >150˚

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ottawa Ankle Rules

A

Ankle X-ray is only required if there is any pain in the malleolar zone and any one of the following:

  • Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, OR
  • Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus, OR
  • An inability to bear weight both immediately and in the emergency department for four steps.

Additionally, the Ottawa ankle rules indicate whether a foot X-ray series is required. It states that it is indicated if there is any pain in the midfoot zone and any one of the following:

  • Bone tenderness at the base of the fifth metatarsal (for foot injuries), OR
  • Bone tenderness at the navicular bone (for foot injuries), OR
  • An inability to bear weight both immediately and in the emergency department for four steps.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examination findings of ankle sprains

A
  • antalgic gait
  • ankle in loose packed
  • edema (sinus tarsi, malleoli, etc.)
  • ecchymosis
  • point tenderness
  • decreased ROM, strength
  • decreased position sense
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Jones Fx

A

fracture at base of 5th MT near insertion of peroneus brevis; high incidence of non-union and could require ORIF; MOI: inversion with plantarflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Avulsion Fx

A

distal attachment of the fibularis brevis; avulsion fracture occurs when FB avulses a piece of bone from the base of the 5th MT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Intervention Plan for Ankle Sprains

A
  • return to function through early mobilization
  • RICE
  • ambulation
  • weight bearing activities
  • modalities (ice, compression, e-stim)
  • stretching, ROM
  • strengthening
  • joint mobilizations w/ or w/o taping
  • address hip and entire kinetic chain
  • compression wrapping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Shin Splints

A
  • inadequate energy attenuation d/t decreased extensibility and/or weakness of lower leg muscles
  • rearfoot is varus or valgus
  • forcible use of musculature during activity
  • faulty lower kinetic chain alignment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Shin Splints may include:

A
  • tendinitis of ant. tibialis and/or post. tibialis
  • tibial periostitis
  • tibial stress fx.
  • acute or chronic compartment syndrome
  • now called medial tibial stress syndrome when post. tibialis is involved
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examination Findings of Shin Splints

A
  • pain with running/walking
  • point tenderness
  • pain with resisted inversion
  • edema over post. medial tibia or ant. lateral tibia
  • may develop into a stress fracture
  • limited gait (antalgic)
  • limited running
  • limited recreational and work activities dependent on weight bearing and surfaces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Intervention plan for shin splints

A
  • RICE
  • modalities (ionto, US, e-stim)
  • stretching: triceps surae, post/ant tibialis gently
  • strengthening: all the above, especially eccentrically
  • improve muscular endurance
  • modify activity: surface, tape, shoe, intensity
  • orthotics
  • biomechanical alterations as needed
19
Q

Plantar Fasciitis

A

degeneration/inflammation of plantar fascia at the calcaneal attachment; chronic more than acute; ST joint may be inverted or everted; prolonged weight bearing or substantial weight gain

20
Q

Examination findings of plantar fasciitis

A
  • plantar and medial heel pain after rest or in AM
  • palpable tenderness
  • possible numbness/Tinel’s sign
  • thin fat pad in heel
  • decreased navicular height
  • gait limitations
  • limited stance time
  • unable to ambulate barefooted
21
Q

Intervention plan for plantar fasciitis

A
  • RICE
  • education (Strasburg sock, stretching in AM)
  • strengthening intrinsic muscles
  • stretch plantar flexors and plantar fascia
  • modalities
  • alter biomechanics: orthotics, tape
22
Q

Achilles Tendinitis

A

inflammation of tendoachilles; MOI = overuse, overstretching, foot malalignment

23
Q

Examination findings of achilles tendinitis

A
  • swelling
  • crepitus
  • acute, local tenderness
  • antalgic gait with early heel rise
24
Q

“Tennis Leg”

A

tear of the medial head of the gastroc

25
Q

Intervention plan for achilles tendinitis

A
  • RICE
  • gentle ROM and stretching
  • strengthening when symptoms allow
  • eccentrics
  • phonophoresis, iontophoresis, US
  • heel lift
  • walking cast if severe
26
Q

Foot Strain

A

acute or chronic pain in the area of the medial longitudinal arch d/t:

  • incorrect shoes: narrow, compress, stiff leather leads to atrophy and
  • decreased support from muscles and ligaments
  • increased body weight
  • excessive exercise in poor shoes
27
Q

Examination findings of foot strain

A
  • diffuse pain and tenderness along arch
  • fatigue/aching from arch to calf progressively worse throughout day
  • swelling
  • tender under navicular
  • pronated (everted) ST joint
28
Q

Intervention plan for foot strain

A
  • RICE
  • external support: supportive shoes: 5-6 eyelets, supportive heel counter; metatarsal bar or Thomas heel; accommodative orthotics or tape
  • weight reduction
  • strengthening of intrinsics
29
Q

Stress Fractures

A
  • most commonly at tibial shaft, calcaneus, and metatarsals 2-4
  • pain: with activity and not with rest, as fracture worsens, pain remains longer
  • x-ray might be negative for 2-3 weeks, until callus forms on the bone
30
Q

Examination findings of Jones fracture

A
  • localized pain over base of 5th MT

- swelling in same area

31
Q

Intervention plan for Jones fracture

A
  • cast 4-6 weeks; ORIF if not healing
  • mobility
  • strength
  • stability
  • stability
32
Q

Freiberg’s Disease

A

avascular necrosis of 1st or 2nd MT head (osteochondrosis); more common in Egyptian and Morton’s foot; begins in adolescence, more common in girls, long 2nd MT or short 1st MT head present; high heels

33
Q

Examination findings of Freiberg’s disease

A
  • pain in forefoot with standing and walking
  • local thickening and tenderness
  • MTP painful and motion restricted
34
Q

Intervention plan for Freiberg’s disease

A
  • relieve pressure from MT head via low healed shoes, MT bar

- excision arthroplasty

35
Q

Metatarsalgia

A

not a disease, pain in metatarsal area; splay foot with narrow shoes yields intermittent compression of digital nerve yielding pain; more common in females

36
Q

Examination findings of metatarsalgia

A
  • intermittent pain
  • sometimes very sharp pain
  • may have decreased sensation in adjacent sides of affected toes
  • lateral compression of foot reproduces the pain
  • presence of Morton’s neuroma in later stages
37
Q

Intervention plan for metatarsalgia

A
  • larger shoes
  • MT pad or bar
  • excision of lesion
  • pain control through modalities
  • strengthen intrinsics
38
Q

Hallux Valgus

A

1st MT head prominence secondary to:

  • increased foot width
  • MT head develops a protective bursa
  • proximal phalanx of hallux deviates laterally
  • FHL tendon and sesamoids bowstring
39
Q

Examination findings of hallux valgus

A
  • deformity
  • pain, wide foot, accompanied by bunion
  • 50-60 year old women more often
  • increased MP angle: normal = 2-30˚; congruous = 2-30˚; pathologic = 20-60˚
40
Q

Intervention plan for hallux valgus

A
  • change footwear
  • stretch, mobilize 1st toe
  • separate toes with a pad
  • strengthen abductor hallucis
  • orthotics to better position 1st ray
  • bunionectomy, osteotomy, arthroplasty, arthrodesis/fusion
41
Q

Hallux Varus

A

medial angulation of great toe at MTP joint

intervention options: surgical release of contracted structures; osteotomy with EHB tendon used for tenodesis to maintain correct alignment

42
Q

Hallux Rigidus

A

DF of great toe is limited due to OA of 1st MTP

  • acute: young people with narrow pronated feet, males . females; tender, MT head elevated, weight distribution altered
  • chronic: men > women; result of repeated trauma; mobilization as early as possible
43
Q

Pes Planus

A

pathology: congenital, genu valgus, shortened achilles, postural in infants, decreased muscle tone with aging or neuropathy, ST eversion (pronation)
intervention: usually none, strengthen supportive mm, orthotics

44
Q

Pes Cavus

A

pathology: muscle imbalance; muscle fibrosis (Volkman’s); myopathy (Charcot Marie-Tooth disease); bony structure
intervention: strengthen intrinsics, low heel shoe, accommodative orthotic, stretch triceps surae

Pathomechanics (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions