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msk > foot and ankle > Flashcards

foot and ankle Flashcards

1
Q

what is the first rocker of gait

A

heel strike to flat foot

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2
Q

what is the second rocker of gait

A

mid stance

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3
Q

what is the third rocker of gait

A

heel rise

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4
Q

name some muscles that power the foot

A
  • tibialis posterior
  • tibialis anterior
  • peroneus longus
  • peroneus brevis
  • EHL, FHL
  • EDL, FDL
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5
Q

what is simmonds test for

A

TA rupture

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6
Q

what is anterior draw test for

A

ankle stability

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7
Q

what is mulder’s click test for

A

morton’s neuroma

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8
Q

causes of hallux valgus

A
  • family
  • hypermobility
  • rheumatoid, pes planus
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9
Q

presentation of hallux valgus

A
  • unable to wear closed shoes
  • joint pain
  • transfer metatarsalgia - feel like pebble in shoe
  • falls risk/balance
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10
Q

management of hallux valgus

A
  • analgesia
  • orthotics/splints/toe-spacers/bunion pads
  • physio
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11
Q

indication for operation on hallux valgus

A
  • failure of non-op
  • pain
  • lesser toe deformity
  • overlapping
  • ulceration
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12
Q

presentation of funny looking toes

A
  • ulceration
  • callosities
  • corns
  • nail problems
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13
Q

4 types of funny toes

A
  • claw
  • hammer
  • mallet
  • curly toes
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14
Q

what is morton’s neuroma

A

benign fibrotic thickening of a plantar digital nerve due to irritation
-degenerative process

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15
Q

symptoms of morton’s neuroma

A
  • burning
  • tingling
  • numbness
  • pain on palpitation
  • pain relieved by removal of shoe
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16
Q

treatment for Morton’s neuroma

A
  • weight loss
  • stretch calf muscles
  • RICE
  • metatarsal padding
  • biomechanical assessment and orthosis
  • corticosteroid injection
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17
Q

indications for surgery

A

symptoms persistent after footwear modification and metatarsal pads
inadequate response to steroid injection

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18
Q

what is pes planus

A

flat feet

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19
Q

will an arch form in flexible flat feet when a patient tip toes?

A

yes

20
Q

what is tibialis posterior dysfunction

A

most common cause of acquired flatfoot deformity in adult

21
Q

presentation of tibialis posterior dysfunction

A
  • pain
  • swelling
  • change in foot shape
  • diminished walking ability
  • dislike of uneven surfaces
  • more noticeable hallux valgus
  • lateral wall impingement pain
  • midfoot and ankle pain
22
Q

what are the risk factors for tibialis posterior dysfunction

A
  • obese middle aged females
  • increases with age
  • hypertension
  • diabetes
  • steroid injection
  • seronegative arthropathies
  • idiopathic tendonosis
23
Q

presentation of type 1 TPD

A
  • swelling
  • tenderness
  • weak muscle power
24
Q

presentation of type 2 TPD

A
  • planovalgus
  • midfoot abduction
  • passively correctable
25
Q

treatment for TPD

A
  • physio
  • insole
  • NO steroid injections
  • orthoses to accommodate foot shape
  • bespoke footwear
  • surgery
26
Q

what is Pes Cavus

A

high arched feet

27
Q

what is plantar fasciitis

A

tenderness over plantar aspect of heel and/or plantarmedial aspect of heel

28
Q

presentation of plantar fasciitis

A
  • start up pain after rest
  • can be worse after exercise
  • fullness and swelling
  • Tinel’s test positive for baxter’s nerve
29
Q

causes of plantar fasciitis

A
  • physical overload
  • seronegative arthropathies
  • diabetes
  • abnormal foot shape
30
Q

treatment for plantar fasciitis

A
  • NSAIDs
  • night splints
  • taping
  • heel cups or medial arch support
  • physio
  • steroid injection
  • surgery
31
Q

what is achilles tendonopathy

A

repetitive microtrauma, failure of collagen repair with loss of fibre alignment

32
Q

management of achilles tendonopathy

A
  • analgesia
  • NSAIDs
  • shockwave therapy
  • orthotics
  • physio
  • surgery
33
Q

symptoms of achilles tendonopathy

A
  • pain
  • morning stiffness
  • eases with heat/walking
34
Q

what is a TA rupture

A

sudden deceleration with resisted calf contraction

35
Q

presentation of TA rupture

A
  • unable to bear weight
  • weak plantar flexion
  • palpable painful gap
  • positive calf squeeze
36
Q

management of TA rupture

A
  • operative
  • non-operative
  • rest tendon using crutches
  • analgesia
  • long recovery
  • cast
37
Q

management of ankle instability

A
  • physio
  • arthroscopy for pain
  • brostrom is gold standard
38
Q

treatment for ankle arthritis

A

first line

  • weight loss
  • PRICE
  • analgesia - NSAIDs

second line

  • biomechanical assessment and foot orthosis
  • footwear adaptations
39
Q

what is hallux rigidus

A

painful first MTP joint

40
Q

presentation of hallux rigidus

A
  • stiffness
  • pain increases with activity/aggravated by shoes
  • dorsal exostosis
  • IPJ hyperextension
41
Q

management for hallux rigidus

A

first line

  • weight loss
  • PRICE
  • footwear advice
  • analgesia - NSAIDs

second line

  • biomechanical assessment and foot orthosis
  • footwear adaptations
42
Q

what is the type of classification for ankle fractures

A

weber

43
Q

what is Talipes Equinovarus (club foot)

A

congenital deformity due to in utero abnormal alignment of the joints between the talus, calcaneus and navicular

44
Q

presentation of talipes equinovarus

A
  • ankle equinus
  • supination of the forefoot
  • varus alignment of forefoot
45
Q

splintage technique for talipes equinovarus

A

ponseti technique

46
Q

what is tarsal calition

A

condition where an abnormal bridge between the calcaneus and navicular or between the talus and calcaneous

can lead to flat foot in older children

msk (45 decks)

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