Brainscape's Knowledge GenomeTM

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


See full index

Pathology AT 531 > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

Regions of foot

A

Hindfoot (rear foot)
Midfoot (arch)
Forefoot

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

Hindfoot

A

Distal tib-fib: syndesmotic joint (High ankle)–little mvmt
Talcocrural-true ankle jt (DF/PF)
Subtalar-articulation of talus and calcaneus (in/ev)

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

Midfoot

A

Calc-cub (lateral)
Talo-navic (nautical shaped-medial midfoot)
Cuneiforms (above the nautical 3)

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

Forefoot

A

metatarsal and phalangeal joints
interphalangeal jts
PIP/MTP

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

Distal Tibiofibular Joint

A

syndesmosis

Can spread/separate a little bit-good thing if it stays b/w 1-2mm

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

Ligaments of Ankle anatomy

A

Interrosseous-
Anterior Tib-fib
Posterior Tib-fib-push in a PA direction to irritate it

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

Ankle Joint: Talocrural

A

Uniaxial, Modified Hinge, synovial (has capsule around it)
Designed for stability
Capsular pattern= if inflammed motion will be lost in one direction or another
PF: PA glide of Talus
DF: AP glide of Talus

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

Ligaments of Talocrural Jt

A

Deltoid or MCL: checks eversion
Anterior talo-fib: checks talar inversion (most commonly torn-lateral side)
Posterior talo-fib: checks ankle DF
Calcaneal fib: checks ankle and STJ inversion

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

Subtalar Jt

A

Synovial Jt with 3 DOF

  • Supination/Pronation
  • Primarily eversion/inversion
  • can work in transverse plane for Rotation
  • Can DF/PF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ligaments of Subtalar Jt

A

Lateral Talocalcanean
Medial Talocalcanean
Interosseous talocalcanean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Subtalar Jt movements

A

Half of joint mvmt is inversion/eversion: frontal plane
Rotation is other half: transverse plane
Transverse plane mvmt: horizontal ADD (medial rotation) and ABD***so this is the “rotation”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Subtalar Joint Packed Positions

A

open pack=pronation (shock absorption) loading response

close pack= Supination

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

Close Chain Pronation: SubTalar JT

A

Calcaneal Eversion**
Talar ADD & PF
Tibial IR**
Piriformis Syndrome

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

Close Chain Supination SubTalar Jt

A

Calcaneal Inversion
Talar ABD and DF
Tibial ER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heel Strike

A

Rear foot in supination
Midfoot will do what rear foot does so it is also in supination
*However abnormalities occur so they could do separate actions=problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Loading Response

A

Rear & Midfoot in Pronation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pronation

A

loose packed position
gives shock absorption
6-8 degrees normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Talonavicular Joint

A

Synovial, 3 DOF
Open pack: eversion
Close pack: inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Feiss Line Test

A

draw dot on medial mallelous
find most prominent part on navicular bone: navicular tuberosity mark it
find first metatarsal and mark it and if they lie in straight plan they would line up (helps determine level of arch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

LMJA

A

Longitudinal Midtarsal Joint Axis

axis of mvmt through your talonavicular joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Calcaneocuboid Joint

A

Synovial, 3 DOF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

OMJA

A

Oblique Midtarsal Joint Axis
axis of mvmt through your calcaneocuboid jt
Moves in a combo of DF with eversion and PF with inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

OMJA

A

Oblique Midtarsal Joint Axis
axis of mvmt through your calcaneocuboid jt
Moves in a combo of DF with eversion and PF with inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Calcaneocuboid Joint Packed Positions

A

Open pack=pronation

Close pack=supination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Windlass Mechanism

A

coordinated action of the layers of muscle, tendon, ligament, and bony architecture to maintain arch height and foot rigidity.

-w/o this being correct=not efficient lever/no effective push off power

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

1st MTP dorsiflexion

A

65 degrees= this tightens the fascia and lifts the arch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Tarso-metatarsals Liss Franc Sprain

A

cuboids dislocate or fracture (long healing time); tarsals can sublux on each other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Intermetatarsals

A

too much friction b/w these can pinch the nerve b/w them (neuromas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

MT-P which one has most fractures

A

second metatarsal has most fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which sprain is most common in ankle

A

ATF (85%)

MCL=5-7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Grades of Sprains

A

Grade I=week off
Grade II=2-6 weeks
Grade III=might require surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

MOI for ATF tear

A

forceful inversion, plantarflexion, adduction of foot and ankle; swelling in sinus tarsi, pain with palpation and (+) anterior drawer & talar tilt test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

S&S for Grade 1: ATF sprain

A

pain with mild disability, minimal loss of weight bearing, ATFL tender with palpation, some swelling none to mild laxity with ant. drawer test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

S&S Grade 2: Lateral Ankle sprain

A

athlete hears a pop or snap at time of injury, moderate pain, and disability, moderate swelling (hemarthrosis), echhymosis present. (+) ant. drawer and talar tilt. CF ligament outstretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

S&S Grade 3: latreral ankle sprain

A

involves tearing of ATFL; CF and possibly PTF ligaments. Severe pain and swelling, can’t weight bear (+) ant. drawer and talar tilt test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Talocrural joint packed positions

A

OPP=10-20 PF

CPP= full DF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Positive Talar Tilt

A

lots of inversion; should be ~25 degrees, you would see more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Medial Ankle Sprains MOI

A

hypereversion force; Post. Capsule would be stretched—you would look for posterior instability (landing in a lot of DF) would show a (+) posterior drawer test that could have to do with medial ankle sprain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

S&S Medial ankle sprain

A 
painful with palpation over deltoid ligament
(+) Kleiger's test
may have (+) anterior drawer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Syndesmotic (high ankle) sprain MOI

A

excessive DF force and or foot ER force-in CC (foot on ground)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

S&S for High ankle sprain

A

Severe DEEP pain, DEEP anterolateral pain-esp. about their tib fib ligament
(+) Mortice Spring test/Fibular translation
(+) squeeze test
(+) Kleiger’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Rehab for High ankle sprain

A

challenging rehab; may take months to heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Arch Sprain MOI

A

repeated stress, obesity, traumatic landing on foot from a height

42
Q

S&S arch sprain

A

pain along spring ligament and plantar fascia, decreased weight bearing fxn

43
Q

Tests for Arch sprain

A

(+) Feiss line or navicular drop test, (+) palpation over spring ligament or fascia

44
Q

Lisfranc Sprain (midfoot) 2 major causes

A

1) low-energy loading observed in sports related injuries

2) high-energy loading observed in motor vehicle and industrial accidents

45
Q

Lisfranc Dislocation

A

5 TMT jts=lisfranc jt

serves as dividing line b/w rigid midfoot and more flexible weightbearing forefoot

46
Q

Lisfranc clincial presentation

A

plantar midfoot ecchymosis
pain along the TMT joints w/ palpation, motion, and/or weight bearing
midfoot instability

47
Q

Lisfranc Tx

A

rigid immobilization in a non-weightbearing posture at least 8 weeks
screws are left in place for 5-6 months post-surgery

48
Q

Great toe sprain (turf toe) MOI

A

forceful hyperflexion or hyperextension of 1st MTP jt

49
Q

S&S of Great toe sprain

A

EHL stretched-hyperextension
FHL painful-overstretched in hyperflexion
Broken toe-squeeze test, tapping test on toes

50
Q

Clinical tests for turf toe

A

No special test, palpate, listen to history, do passive ROM (curl toe under will hurt) MMT to EHL will hurt….send if you think possible fracture rest from weight bearing and treat with modalities if you R/O fracture

51
Q

Talar Osteochondral Fx MOI

A

Talar Dome Fx (talar cyst, osteochondritis dissecans)

hyperinversion or other force that could cause a sprain, compression injury-landing from a jump or fall

52
Q

S&S of Talar Dome fx

A

athlete presents like they have a sprain
slow improvement during ankle rehab or ankle getting worse during normal healing process post sprain
—first thought would be high ankle sprain, if all those tests are (-) and hurts at night you need to screen for talar dome

53
Q

Management of Talar Dome fx

A

casting up to 3 months; possible osteotomy

54
Q

Unimalleolar Ankle fx

A

medical management: closed reduction
ORIF
MOI: classic is on tibia-but could have it on the fibula; could happen with inversion sprain–talus could give an impacting force on the tibia and break it

55
Q

Bimalleolar Ankle Fx

A

Medical management: closed reduction
ORIF: open reduction internal fixation
MOI: break on both sides typically tibia & fibula
also known as Pott’s fx

56
Q

Trimalleolar Ankle Fx

A

Medical Management: closed reduction
ORIF
The tri comes from tibia, fibula, and posterior aspect of medial malleolus coming off the fib and tib

57
Q

Leg fxs

A

tibial shaft; fibular shaft

closed reduction, ORIF, external fixation

58
Q

Tarsal Tunnel Syndrome

A

Entrapment of the posterior tibial nerve or one of its branches within the tarsal tunnel
Tunnel= posterior to medial malleolus, has osseous floor covered by flexor retinaculum

59
Q

Complaints of Tarsal Tunnel Syndrome

A

burning on plantar aspect of foot particularly at night
FWB increases symptoms
(+) Tinel’s
Not tender to touch on plantar aspect of foot
Rx: orthotics or surgery

60
Q

Cause of TTS

A

chronic tendinosis resulting in fibrosis, excessive pronation, RA, myxedema (swelling from thyroid deficiency)

61
Q

Achilles tendonitis.osis treatment

A 
RICE
Heel lift
Shoe fit
US, phono, ionto
Ice massage, WPL
Stretching
62
Q

Retrocalcaneal Bursitis

A 
Pump bump-exostosis
Tx: RICE
Heel lift
Shoe fit
US, phono, ionto
Ice massage, WPL
Stretching
63
Q

Achilles Tendon Rupture

A

Most common b/w 30-50 yrs old
Forefoot pushoff while knee is extending
“pop” heard at time of injury

64
Q

S&S of Achilles Tendon Rupture

A

visible defect in tendon, inability to PF

CC: swelling;bruising around malleoli, excessive passive DF, (+) Thompson test

65
Q

Rehab for ATR

A

acute-compression wrap, ice, immobilization splint, get pt to orthopedist
surgery or non-surgical healing
6 month progression to full ROM and strength

66
Q

Calf Strains MOI

A

MOI: over stretching it, running, not having good length in the calf

67
Q

Peroneal Tendon retinaculum Injuries

A

Tearing the lateral retinaculum–snapping peroneals it will snap in front of the malleolus. Peroneus Longus is important for stabilizing the first toe.

68
Q

Peroneal Sublux/Dislocation injuries

A

Mechanism Injury-sports requiring sudden turning and sharp cutting (wrestling, football, ice skating) Also direct blow to lateral malleolus or hyerinversion force

Watch them walk, and palpate

69
Q

Peroneal Tendon Injury S&S

A

During running or jumping the athlete hears and feels the tendon snapping and coming out of its groove. May have lateral pain, ecchymosis, and swelling

70
Q

Peroneal Tendon Injury Tx

A

Conservative approach: horseshoe pad laterally around the malleolus with splinting 4-6 weeks followed by rehab program.

Operative-if conservative approach fails.

71
Q

Peroneal Spasms-dropped cuboid S&S

A

Unstable cuboid
Too much motion around OMJA
Painful Cuboid palpation
Painful PF in Weight bearing

72
Q

Manioulate cuboid

A

Cuboid whip
RE-check palpation
Try PF and see if pain is reduced
Give arch strengthening exs

73
Q

Sever’s Disease

A

Osgood Schlatter’s of the ankle.
“Calcaneal Apophysitis”
Age: 10-15
Cause: repetitive jumping or direct trauma.

74
Q

S&S of Sever’s Disease

A

heel pain, PM

75
Q

Sever’s Disease Rx

A

NSAIDS, rest, heel lift, walking cast or splint.

76
Q

Anterior Compartment Syndrome MOI

A

Direct trauma such as by being kicked

77
Q

ACS S&S

A

possible loss of ankle DF and toe extension, pain at end range PF, swelling, discoloration

Severe pain, Tingling-burning pain (nerve compression), inability to DF, lower foot will feel cold and blue

Can result in dropped foot b/c they have lost nerve supply to anterior compartment muscles

78
Q

Treatment of ACS

A

fascial release, deep massage to break up myofascial tightness before surgery, live with it if they feel that they can do without what caused it hence running 10 miles

79
Q

Clinical tests for ACS

A

MMT, sensory testing, Dorsal pedal pulse

80
Q

Antero-lateral shin splints

A

involve either the anterior tib, EHL, EDL

81
Q

Cause of antero-lateral shin splints

A

overexertion of the muscle, too hard of heel, hard surface, tight gastroc/soleus; overuse of anterior tib

82
Q

S&S of anterior shin splints

A

heat, redness, swelling, tenderness at site of lesion

83
Q

rehab Ant. shin splints

A

Rest them, address tightness to gastroc/soleus, strengthen the DF and calf more lengthened then reintroduce running

if you don’t stress fx can result
Rest, ice, proper shoe fit, restore normal gastroc/soleus length, improve pretibial muscle strength, change running surface. Gradual return to running

84
Q

Posteromedial Shin Splint (medial tibial stress syndrome)

A

Involves mechanical inflammation of posterior tib, FHL or FDL.

85
Q

Causes of Post shin splint

A

overexertion of muscles during loading response. High correlation with excessive pronation.

86
Q

S&S Post

A

heat, redness, swelling, tenderness at site of lesion

87
Q

Intervention Postmed shin splints

A

Rest, ice, proper shoe fit, restore normal gastroc/soleus length, orthotics to control pronation, gradual running return.

Invertor controls pronation PRONATORS PROBLEM: especially posterior tibialis

Correct for extra pronation, get appropriate running shoe, tape arch, get orthotic to block pronation, stretch gastroc out

88
Q

Rearfoot Varus Deformity

A

> 3 degrees RF varus when in STJN

89
Q

Non-compensated rearfoot varus deformity

A

Mobilize
Stretching
Soft orthotic
Curved last shoe

90
Q

Compensated Rearfoot Varus Deformity

A

Determine where the compensation is coming from
Rearfoot
Midfoot
Forefoot

91
Q

Forefoot Varus

A

Forefoot is inverted when RF is in STJN.
Determine amount
Post forefoot medial up to 50% or the problem, never more than a 6 degree post.

92
Q

Forefoot Valgus

A

Forefoot is everted when in STJN.

Post laterally up to 50% of the deformity, not more than 6 degrees.

93
Q

Pes Cavus

A

Abnormally high arch that remains in open and closed chain.

94
Q

Pes Cavus associated dysfunctions

A

person can’t achieve normal pronation during the gait cycle and increased pressure on metatarsal heads.

95
Q

Equinus Foot

A

In STJN ankle cannot come to a neutral DF position.
Contracture of Gastrocnemius

Congenital malalignment, post-trauma, Neurological disorder. Common with cerebral palsy

96
Q

Pes Planus

A

Foot with an abnormally low medial-longitudinal arch in open and closed chain.

97
Q

“Convex Pes Valgus”

A

Congenital vertical talus with a dislocated navicular. DF occurs as a result of this at the midtarsals. This deformity is often surgically corrected with foot fusion.

98
Q

Hallux Limitus

A

Gradual loss of 1st MTP DF ROM due to joint inflammation, scarring, cartilage degeneration, osteophytes

99
Q

Hallux Rigidus

A

Severe loss of DF ROM 1st MTP due to arthritis

100
Q

What do both Hallux Limitus and Rigidus do

A

reduce Windlass mechanism may result in plantar fasciitis or stress fractures

101
Q

treatment for Hallux limitus and rigidus

A

joint mobilization, toe wedge, surgery

102
Q

Plantar Fasciitis Causes:

A 
Disrupted Windlass mechanism from
Hallux limitus/rigidus
Excessive pronation
Repetitive loads on foot
Training error
Weight gain
Pes Cavus/supinated foot
103
Q

Plantar Fasciitis S&S

A

very painful first step in AM. Diminishes in 5-10 minutes, slowly worsens throughout day. Point tenderness over medial tubercle.
May lead to onset of heel spurs.

104
Q

Interventions for Plantar Fasciitis/osis

A 
Correct the biomechanical dysfunction
Orthotic
Joint mobilizations
Stretching
Weight loss
NSAIDs, ice, friction massage, ultrasound, phonophoresis, iontophoresis, heel lift

Pathology AT 531 (3 decks)

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