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ANATOMY > FOOT AND ANKLE > Flashcards

FOOT AND ANKLE Flashcards

1
Q

FOOT AND ANKLE - ROM

A

Talocrural (talotibial)

  • Plantar flexion - 40
  • Dorsiflexion - 20

Subtalar

  • Inversion - 20
  • Eversion - 10

Metatarsophalangeal

  • Flexion - 75
  • Extension - 35

Interphalangeal

  • Flexion - 60
  • Extension - 20
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2
Q

FOOT AND ANKLE - MYOTOMES

A
  • Hip flexion - L1, L2, L3 - femoral nerve
  • Knee extension - L3, L4 - femoral nerve
  • Knee flexion - L4, L5, S1, S2 - sciatic nerve
  • Ankle dorsiflexion - L4, L5 - deep peroneal nerve
  • Ankle inversion - L4, L5 - tibial nerve, deep peroneal nerve
  • Ankle eversion - L5, S1 - superior peroneal nerve
  • Big toe extension - L5, S1 - deep peroneal nerve
  • Big toe flexion - L5, S1 - tibial nerve
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3
Q

FOOT AND ANKLE - ORTHO TEST - SCREENING

A
  • SCREENING - Heel walk, toe walk
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4
Q

FOOT AND ANKLE - ORTHO TEST - INSTABILITY/LIGAMENT STRESS

A
  • INSTABILITY/LIGAMENT STRESS - Anterior drawer test, talar tilt, Subtalar glide test, rotational stress
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5
Q

FOOT AND ANKLE - ORTHO TEST - VASCULAR

A
  • VASCULAR - Claudication test, Homan’s test
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6
Q

FOOT AND ANKLE - ORTHO TEST - STRESS FRACTURE

A
  • STRESS FRACTURE - Calcanea squeeze test, Morton’s squeeze test
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7
Q

FOOT AND ANKLE - ORTHO TEST - ACHILLES TENDINOSIS/RUPTURE

A
  • ACHILLES TENDONOSIS/RUPTURE - Achilles tap test, achilles squeeze test, Hoffa’s/Simmond’s test
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8
Q

FOOT AND ANKLE - ORTHO TEST - NERVE COMPRESSION

A
  • NERVE COMPRESSION - Tinel’s test
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9
Q

FOOT AND ANKLE - JOINT TYPE

A
  • Hinge - talocural, metatarsophalangeal and interphalangeal
  • Gliding - subtalar, mid tarsal joints
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10
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - PLANTAR FLEXION

A
  • PLANTAR FLEXION - soleus, gastrocnemius, tibialis posterior, flexor digitorum longus, flexor hallucis longus
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11
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - DORSIFLEXION

A
  • DORSIFLEXION - tibialis anterior, extensor digitorum longus
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12
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - INVERSION

A
  • INVERSION - tibialis anterior, tibialis posterior
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13
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - EVERSION

A
  • EVERSION - fibula’s lobgus, brevis and tertius
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14
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - 1ST TOE FLEXION

A
  • 1ST TOE FLEXION - flexor hallucis longus and bervis
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15
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - TOE 2-5 FLEXION

A
  • TOE 2-5 FLEXION - flexor digitorum longus and brevis, lumbricals
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16
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - 1ST TOE EXTENSION

A
  • 1ST TOE EXTENSION - extensor hallucis longus and brevis
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17
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - TOE EXTENSION

A
  • TOE EXTENSION - extensor digitorum longus and brevis
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18
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - ABDUCTION

A
  • ABDUCTION - dorsal interossei
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19
Q

FOOT AND ANKLE - MAIN MUSCLE ACTIONS - ADDUCTION

A
  • ADDUCTION - palmar interossei
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20
Q

FOOT AND ANKLE - NORMAL END FEEL

A

TALOCURAL - firm ligamentous

SUBTALAR - firm ligamentous

TMT - elastic firm

MTP EXTENSION - elastic/ligamentous

MTP FLEXION - firm/ligamentous

MTP BIG TOE - firm/bony

PIP FLEXION - firm/bony

PIP EXTENSION - firm/ligamentous

DIP FLEXION - firm/ligamentous/elastic

DIP EXTENSION - firm/ligamentous/elastic

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21
Q

FOOT AND ANKLE - CONDITIONS - ACHILLES TENDINITIS

A

Hx - painful tendon, worse with running, jumping, stairs, better with rest
S&S - tender to palpation, +ve Achilles squeeze test, +ve Thompson test
DDx - Achilles strain

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22
Q

FOOT AND ANKLE - CONDITIONS - PLANTAR FASCIITIS

A

Hx - pain in moving worse with first few steps
S&S - tender to palpation, +ve calcaneal squeeze
DDx - canlaneal stress fracture

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23
Q

FOOT AND ANKLE - CONDITIONS - COMPARTMENT SYNDROME

A

Hx - symptoms exercise induced, better with rest, muscle weakness, foot drop gait
S&S - local swelling and tightness, +ve calf circumference test, muscle weakness
DDx - tibial stress fracture, tibialis anterior strain

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24
Q

FOOT AND ANKLE - CONDITIONS - ANKLE SPRAIN

A

Hx - significant trauma, mild-moderate pain
S&S - local swelling, +ve talar tilt test, +ve anterior/posterior drawer, +ve rotational stress test
DDx - avulsion fracture

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25
Q

FOOT AND ANKLE - CONDITIONS - TARSEL TUNNEL SYNDROME

A

Hx - medial or plantar foot pain of paraesthesia
S&S - tenderness around tarsal tunnel, +ve Tinel’s test
DDx - lumbar radiculopathy

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26
Q

FOOT AND ANKLE - CONDITIONS - MORTONS NEUROMA

A

Hx - burning pain between metatarsals
S&S - local tenderness, +ve Morton’s neuroma test (metatarsal squeeze)
DDx - lumbar radiculopathy, metatarsal stress fracture

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27
Q

FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES

A

Hx - insidious onset of pain, better with rest, overuse injury (repetitive stress)
S&S - tender to palpation (common locations: tibia, calcaneus, metatarsals)

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28
Q

FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - TIBIAL STRESS FRACTURE

A

most common stress fracture of body; usually involves dominant or long leg; repetitive trauma (long distance running/walking/marching, military recruits, ballet dancers); usually proximal posterior diaphysis region which is usually stable; less common in mid shaft where the ‘black line’ may be observed indicating more significant injury

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29
Q

FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - METATARSAL STRESS FRACTURE

A

common usually involve 2nd and 3rd; secondary to repetitive stress; tenderness with metatarsal/Morton’s squeeze test but no numbness or tingling unless there is nerve involvement

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30
Q

FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - CALCANEAL STRESS FRACTURE

A

common stable fracture; secondary to repetitive trauma; heel pain that may mimic plantar fasciitis or retrocalcaneal bursitis/achilles tendonitis; tenderness with calcaneal side squeeze and calcaneal percussion; may be painful with heel strike during gait - pt will often have an altered gait

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31
Q

FOOT AND ANKLE - ORTHO TESTS - ACHILLES SQUEEZE TEST

A
  • Pt prone with legs straight
  • Examiner squeezes the Achilles tendons bilaterally 2cm above the insertion point on the calcaneus
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32
Q

FOOT AND ANKLE - ORTHO TESTS - ACHILLES SQUEEZE TEST - POSITIVE TEST

A

Achilles tendinitis, peritendinitis compression

  • Pain
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33
Q

FOOT AND ANKLE - ORTHO TESTS - ANTERIOR DRAWER TEST

A
  • Pt seated or supine
  • Examiner places one hand on anterior tibia
  • Other hand on posterior calcaneus then pulls the foot anteriorly
  • First with the ankle in a neutral position (90 degrees)
  • Repeat with the ankle plantar flexed
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34
Q

FOOT AND ANKLE - ORTHO TESTS - ANTERIOR DRAWER TEST - POSITIVE TEST

A

ATFL instability

  • Anterior motion of the foot
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35
Q

FOOT AND ANKLE - ORTHO TESTS - SN & SP

A

SN: 78-95

SP: 74-84

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36
Q

FOOT AND ANKLE - ORTHO TESTS - POSTERIOR DRAWER TEST

A
  • Pt seated or supine
  • Examiner places one hand on posterior tibia
  • Other hand on plantar surface of the heel
  • Examiner pushes the foot posteriorly
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37
Q

FOOT AND ANKLE - ORTHO TESTS - POSTERIOR DRAWER TEST - POSITIVE TEST

A

PTFL instability

  • Posterior motion of the foot
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38
Q

FOOT AND ANKLE - ORTHO TESTS - THOMPSON TEST

A
  • Pt prone with leg straight
  • Examiner squeezes the calf over the widest point of the gasjrosoleus complex
  • Observe for the presence of plantar flexion with calf squeeze
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39
Q

FOOT AND ANKLE - ORTHO TESTS - THOMPSON TEST - POSITIVE TEST

A

Complete rupture of the Achilles tendon

  • No plantar flexion with calf squeeze
  • SN: 96
  • SP: 93

Gastrocnemius or coleus muscle strain or MFTPs

  • Local pain

Thrombophlebitis

  • Short duration of ‘deep’ calf pain
  • SP: 40
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40
Q

FOOT AND ANKLE - ORTHO TESTS - HOFFA’S TEST

A
  • Pt prone with ankles hanging over edge of table
  • Examiner palpates the Achilles tendon and instructs pt to actively plantar flex and dorsiflex the ankle
  • If heel pain or decreased tension is is present then the examiner may proceed to passively plantar flex and dorsiflex the ankle
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41
Q

FOOT AND ANKLE - ORTHO TESTS - HOFFA’S TEST - POSITIVE TEST

A

Fracture of the calcareous, retrocalcaneal bursitis, moderate Achilles tendon strain, Achilles tendon rupture

  • Pain or guarded motion
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42
Q

FOOT AND ANKLE - ORTHO TESTS - HOMAN’S TEST

A
  • Pt supine with leg straight
  • Examiner raises the pt straight leg to 10
  • Examiner forcefully dorsiflexes the foot and squeezes the calf with the other hand
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43
Q

FOOT AND ANKLE - ORTHO TESTS - HOMAN’S TEST - POSITIVE TEST

A

Thrombophlebitis

  • Short duration ‘deep’ calf pain

Gastrosoleus strain

  • Persistant ‘achy’ calf pain
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44
Q

FOOT AND ANKLE - ORTHO TESTS - HOMAN’S TEST - SN & SP

A

SN: 35-48

SP: 41

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45
Q

FOOT AND ANKLE - ORTHO TESTS - MORTON’S TEST

A
  • Pt seated or supine
  • Examiner squeezes foot around the metatarsal heads
  • Observe the patient for signs of pain or discomfort
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46
Q

FOOT AND ANKLE - ORTHO TESTS - MORTON’S TEST - POSITIVE TEST

A

Mortons neuroma, metatarsal joint arthritis, fracture of the metatarsal heads or stress fracture, metatarsalgia

  • Pain
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47
Q

FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST

A
  • Pt supine
  • Examiner stabilises talus and applies medial then lateral forces to the calcaneus
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48
Q

FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST - POSITIVE TEST

A

Subtalar sprain or instability

  • Pain or displacement calcaneus
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49
Q

FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST - SN & SP

A

SN: 78

SP: 75

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50
Q

FOOT AND ANKLE - ORTHO TESTS - TALAR TILT

A
  • Pt seated or supine
  • Examner stabilises the ankle joint over tibia and fibula
  • Examiner dorsiflexes and inverts the foot (for PTFL)
  • Examiner keeps ankle neutral and inverts the foot (for CFL)
  • Examiner plantar flexes and inverts the foor (for ATFL)
  • Examiner keeps ankle neutral and everts the foor (for deltoid ligament)
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51
Q

FOOT AND ANKLE - ORTHO TESTS - TALAR TILT - POSITIVE TEST

A

PTFL strain/rupture

  • Increased motion or pain with ankle dorsiflexion and inversion

CFL strain/rupture

  • Increased motion or pain with ankle neutral and inversion

ATFL strain/rupture

  • Increased motion or pain with ankle plantar flexion and inversion

Deltoid strain/rupture

  • Increased motion or pain with ankle neutral and eversion
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52
Q

FOOT AND ANKLE - ORTHO TEST - TALAR TILT - SN & SP

A

SN: 67

SP: 75

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53
Q

FOOT AND ANKLE - ORTHO TEST - TINEL’S FOOT TEST

A
  • Pt prone, supine or seated
  • Examiner percusses over the medial ankle behind the medial malleolus (posterior tibial nerve/medial plantar nerve) and over the dorsum of the ankle near the neck of the talus (deep peroneal nerve)
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54
Q

FOOT AND ANKLE - ORTHO TEST - TINEL’S FOOT TEST - POSITIVE TEST

A

Supraspinatus impingement, subacromial bursitis

  • Pain with internally rotated shoulder

Biceps long-head impingement

  • Pain with externally rotated shoulder
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55
Q

FOOT AND ANKLE - ORTHO TEST - TINEL’S FOOT TEST - SP

A

SP: 58

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56
Q

FOOT AND ANKLE - ORTHO TEST - WINDLASS TEST

A
  • Pt seated
  • Examiner stabilises ankle in neutral and extends big toe while allowing the IP joint to flex
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57
Q

FOOT AND ANKLE - ORTHO TEST - WINDLASS TEST - POSITIVE TEST

A

Plantar fasciitis

  • Pain
  • Symptom reproduction
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58
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY

A
  • Must decipher whether the tendon is ruptured or not ruptured
    • If it is not ruptured it is further classified as to whether the problem exists at the attachment site of the Achilles on the calcaneus “insertional” or if symptoms exist proximal to this area “noninsertional”
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59
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - NONINSERTIONAL TENDINOSIS

A
  • When there is actual intratendinous degeneration of the Achilles tendon proximal to its attachment on the calcaneus
  • Tendon is typically swollen
  • Onset of symptoms is insidious and located within the midsubstance of the tendon
  • Its not called ‘tendonitis’ because history reveals no true inflammatory component instead a fibromyxoid degenerative tissue with a high water content replaces normal tendon
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60
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - INSERTIONAL TENDINOSIS

A
  • An inflammatory condition
  • Occurs at or around the Achilles tendon insertion into the calcaneus
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61
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - RUPTURE

A
  • Most common tendinous rupture in the lower extremity
  • Peak incidence in the 3to 5decades and occurs 5 times more often in males
  • Described in middle-aged athletes who have experienced a sudden pain with an audible “pop” in the back of the heels
  • Many report a sensation of being hit even when they haven’t
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62
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - RISK FACTORS

A
  • Males

Noninsertional

  • Repetitive microtrauma
  • Aging

Insertional

  • Hill running
  • Interval workouts
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63
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - POPULATION AFFECTED

A
  • 30-50 (For a rupture)
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64
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION

A
  • Pain is the cardinal symptom of Achilles tendinopathy
  • In the early phase of insertional and noninsertional tendinopathy pt may complain mainly of pain following strenuous activity and if progressive can develop pain that accompanies routine activities
  • Decreased ankle dorsiflexion
  • Hamstring tightness
  • Note the contour of the tendon, any areas of widening and the presence or absence of nodules
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65
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - NONINSERTIONAL

A
  • Likely due to the tendon having a sparse cellularity and vascularity
    • Both of which impair the inflammatory process
  • As a result, the tendon becomes thicker, softer, and yellowish
  • Degeneration of the tendon is often insidious and asymptomatic
  • Swelling and pain typically 4cm proximal to the distal insertion of the Achilles
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66
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - INSERTIONAL

A
  • Often associated with the Haglund deformity
  • Posterior heel pain thought to be due to bony impingement from the calcaneus, local bursitis, or both
  • If the tendonitis becomes chronic the tendon can also become palpably thickened
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67
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - RUPTURE

A
  • Symptoms differ
  • Pt with partial tears will complain of more pain than those with complete ruptures
  • Pt with Achilles rupture will be unable to plantarflex the ankle
  • The Thompson test is sensitive in picking up a rupture
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68
Q

FOOT AND ANKLE - ACHILLES TENDON INJURY - PROGNOSIS

A
  • Good with treatment
  • For all insertional and noninsertional Achilles tendon disorders conservative treatment is initially started
  • Occasionally immobilisation in a boot is needed if symptoms are disabling
  • Physical therapy is often very helpful
69
Q

FOOT AND ANKLE - ROM - PLANTAR FLEXION - MUSCLES ACTIVATED

A

Soleus
Gastrocnemius
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Plantaris

70
Q

FOOT AND ANKLE - ROM - PLANTAR FLEXION - TISSUE STRETCHED

A

Tibialis anterior
Extensor digitorum longus
Anterior ankle joint capsule and ligaments

71
Q

FOOT AND ANKLE - ROM - PLANTAR FLEXION - TISSUE COMPRESSED

A

Posterior ankle structures

72
Q

FOOT AND ANKLE - ROM - DORSIFLEXION - MUSCLES ACTIVATED

A

Tibialis anterior
Extensor digitorum longus

73
Q

FOOT AND ANKLE - ROM - DORSIFLEXION - TISSUES STRETCHED

A

Soleus
Gastrocnemius
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Achilles tendon

74
Q

FOOT AND ANKLE - ROM - DORSIFLEXION - TISSUES COMPRESSED

A

Anterior ankle structure (joint capsule)

75
Q

FOOT AND ANKLE - ROM - INVERSION - MUSCLES ACTIVATED

A

Tibialis anterior
Tibialis posterior

76
Q

FOOT AND ANKLE - ROM - INVERSION - TISSUES STRETCHED

A

Fibularis longus, bervis and tertius
Lateral ankle ligaments (ATFL, CFL, PTFL)

77
Q

FOOT AND ANKLE - ROM - INVERSION - TISSUES COMPRESSED

A

Medial ankle structures

78
Q

FOOT AND ANKLE - ROM - EVERSION - MUSCLES ACTIVATED

A

Fibula’s longus, brevis and tertius

79
Q

FOOT AND ANKLE - ROM - EVERSION - TISSUES STRETCHED

A

Tibialis anterior
Tibialis posterior
Medial collateral (deltoid) ligament of ankle

80
Q

FOOT AND ANKLE - ROM - EVERSION - TISSUES COMPRESSED

A

Lateral ankle structures

81
Q

ANTERIOR LEG MUSCLES

A

SUPERFICIAL TO DEEP
Fibularis (peroneus) longus
Tibialis anterior
Extensor digitorum longus
Fibularis (peroneus) brevis
Extensor hallucis longus
Fibularis (peroneus) tertius
Extensor digitorum brevis
ITB (insertion)
Biceps femoris (insertion)
Sartorius (insertion)
Gracilis (insertion)
Semitendinosis (insertion)
Quadriceps femoris tendon

82
Q

LATERAL LEG MUSCLES

A

SUPERFICIAL TO DEEP
Gastrocnemius
Soleus
Fibularis (peroneus) longus
Tibialis anterior
Extensor digitorum longus
Fibularis (peroneus) brevis
Fibularis (peroneus) tertius
Extensor digitorum brevis
Biceps femoris (insertion)
Gluteus maximus (insertion via ITB)
Quadriceps femoris tendon

83
Q

POSTERIOR LEG MUSCLES

A

SUPERFICIAL TO DEEP
Plantaris
Gastrocnemius
Soleus
Fibularis (peroneus) longus
Fibularis (peroneus) brevis
Flexor hallucis longus
Achilles tendon
Popliteus
Tibialis posterior
Flexor digitorum longus

84
Q

TIBIALIS ANTERIOR - ORIGIN

A

Anterior proximal tibia (lateral tibial condyle, proximal 2/3 of anterolateral surface of tibia and interosseous membrane)

85
Q

TIBIALIS ANTERIOR - INSERTION

A

Medial cuneiform
Base of 1st metatarsal

86
Q

TIBIALIS ANTERIOR - ACTION

A

Dorsiflexion and inversion of ankle

87
Q

TIBIALIS ANTERIOR - INNERVATION

A

Deep peroneal (fibular) nerve (L4-S1)

88
Q

TIBIALIS ANTERIOR - TRIGGER POINT REFERRAL

A

Generally pain is referred downward toward the anterior medial ankle and big toe

89
Q

TIBIALIS ANTERIOR - STRETCH

A

Place dorsum of foot on ground and apply pressure into plantar flexion and eversion

90
Q

TIBIALIS ANTERIOR - STRENGTHEN

A

Dorsiflexion with rubber band
Walking/running on sand
Wobble board

91
Q

EXTENSOR DIGITORUM LONGUS - ORIGIN

A

Proximal 2/3 of fibula
Interosseous membrane
Lateral condyle of tibia

92
Q

EXTENSOR DIGITORUM LONGUS - INSERTION

A

Dorsal surface of digits 2-5

93
Q

EXTENSOR DIGITORUM LONGUS - ACTION

A

Extension of digits 2-5
Dorsiflexion and eversion of foot

94
Q

EXTENSOR DIGITORUM LONGUS - INNERVATION

A

Deep peroneal (fibular) nerve (L4-S1)

95
Q

EXTENSOR DIGITORUM LONGUS - TRIGGER POINT REFERRAL

A

Generally pain is referred downward toward the anterior ankle and toes 2 - 4

96
Q

EXTENSOR DIGITORUM LONGUS - STRETCH

A

Place dorsum of toes on ground and apply pressure into flexion of digits 2-5

97
Q

EXTENSOR DIGITORUM LONGUS - STRENGTHEN

A

Toe raises
Dorsiflexion with rubber band
Wobble board

98
Q

EXTENSOR HALLUCIS LONGUS - ORIGIN

A

Anterior middle 1/3 of fibula
Interosseous membrane

99
Q

EXTENSOR HALLUCIS LONGUS - INSERTION

A

Base of distal phalanx of big toe

100
Q

EXTENSOR HALLUCIS LONGUS - ACTION

A

Extension of big toe
Dorsiflexion and inversion of foot

101
Q

EXTENSOR HALLUCIS LONGUS - INNERVATION

A

Deep peroneal (fibular) nerve (L4-S1)

102
Q

EXTENSOR HALLUCIS LONGUS - TRIGGER POINT REFERRAL

A

Pain is normally referred downward to the big toe

103
Q

EXTENSOR HALLUCIS LONGUS - STRETCH

A

Place dorsum of big toe on ground and apply pressure onto flexion of big toe

104
Q

EXTENSOR HALLUCIS LONGUS - STRENGTHEN

A

Toe raises
Dorsiflexion with rubber band
Wobble board

105
Q

PERONEUS TERTIUS - ORIGIN

A

Distal 1/3 of anterior fibula

106
Q

PERONEUS TERTIUS - INSERTION

A

Base of 5th metatarsal

107
Q

PERONEUS TERTIUS - ACTION

A

Dorsiflexion and eversion of foot

108
Q

PERONEUS TERTIUS - INNERVATION

A

Deep peroneal (fibular) nerve (L5-S1)

109
Q

PERONEUS TERTIUS - TRIGGER POINT REFERRAL

A

Pain is referred downward over the dorsum of the foot and ankle
Occasionally pain may also refer over the heel

110
Q

PERONEUS TERTIUS - STRETCH

A

Pt seated, invert and plantar flex ankle with mild over pressure

111
Q

PERONEUS TERTIUS - STRENGTHEN

A

Reverse calf raise
Running on sand
Wobble board movements

112
Q

PERONEUS LONGUS - ORIGIN

A

Head and proximal lateral shaft of fibula

113
Q

PERONEUS LONGUS - INSERTION

A

Medial cuneiform and base of 1st metatarsal

114
Q

PERONEUS LONGUS - ACTION

A

Eversion and plantar flexion of foot

115
Q

PERONEUS LONGUS - INNERVATION

A

Superficial peroneal (fibular) nerve (L5-S1)

116
Q

PERONEUS LONGUS - TRIGGER POINT REFERRAL

A

Pain is referred downward over the lateral leg (over middle fibula)

117
Q

PERONEUS LONGUS - STRETCH

A

Invert ankle with mild over pressure

118
Q

PERONEUS LONGUS - STRENGTHEN

A

Reverse calf raise
Running on sand
Wobble board movements

119
Q

PERONEUS BREVIS - ORIGIN

A

Distal lateral 1/2 of fibula

120
Q

PERONEUS BREVIS - INSERTION

A

Base of 5th metatarsal

121
Q

PERONEUS BREVIS - ACTION

A

Eversion and plantar flexion of foot

122
Q

PERONEUS BREVIS - INNERVATION

A

Superficial peroneal (fibular) nerve (L5-S1)

123
Q

PERONEUS BREVIS - TRIGGER POINT REFERRAL

A

Pain is referred downward over the distal leg and ankle

124
Q

PERONEUS BREVIS - STRETCH

A

Invert ankle with mild over pressure

125
Q

PERONEUS BREVIS - STRENGTHEN

A

Reverse calf raise
Running on sand
Wobble board movements

126
Q

GASTROCNEMIUS - ORIGIN

A

Medial head - above medial condyle of femur
Lateral head - above lateral condyle of femur

127
Q

GASTROCNEMIUS - INSERTION

A

Calcaneus

128
Q

GASTROCNEMIUS - ACTION

A

Plantar flexion of foot

129
Q

GASTROCNEMIUS - INNERVATION

A

Tibial nerve (S1-S2)

130
Q

GASTROCNEMIUS - TRIGGER POINT REFERRAL

A

Upper medial head - refers pain over the medial calf and medial longitudinal arch of the foot
Medial and lateral head - refers pain over the local area superiorly and inferiorly on the ipsilateral side

131
Q

GASTROCNEMIUS - STRETCH

A

With posterior knee straight, lean body forward
Internally or externally rotate leg to stretch medial and lateral fibres

132
Q

GASTROCNEMIUS - STRENGTHEN

A

Calf raise
Running on sand
Wobble board

133
Q

SOLEUS - ORIGIN

A

Soleal line of tibia and upper fibula

134
Q

SOLEUS - INSERTION

A

Calcaneus

135
Q

SOLEUS - ACTION

A

Plantar flexion of foot

136
Q

SOLEUS - INNERVATION

A

Tibial nerve (S1-S2)

137
Q

SOLEUS - TRIGGER POINT REFERRAL

A

Mid belly - refers pain over the mid calf, heel and proximal sole of the foot
Lateral belly - refers pain over the local area superiorly and inferiorly on the ipsilateral side

138
Q

SOLEUS - STRETCH

A

With posterior knee bent, lean body forward

139
Q

SOLEUS - STRENGTHEN

A

Bent knee calf raises
Running on sand
Wobble board

140
Q

PLANTARIS - ORIGIN

A

Distal posterolateral femur

141
Q

PLANTARIS - INSERTION

A

Calcaneus

142
Q

PLANTARIS - ACTION

A

Plantar flexion of foot

143
Q

PLANTARIS - INNERVATION

A

Tibial nerve (S1-S2)

144
Q

PLANTARIS - TRIGGER POINT REFERRAL

A

Refers pain over the back of the knee and upper half of the calf

145
Q

PLANTARIS - STRETCH

A

With posterior knee straight, lean body forward

146
Q

PLANTARIS - STRENGTHEN

A

Calf raise
Running on sand
Wobble board

147
Q

TIBIALIS POSTERIOR - ORIGIN

A

Posterior proximal 2/3 of tibia
Fibula
Interosseous membrane

148
Q

TIBIALIS POSTERIOR - INSERTION

A

Fans out over plantar surface of foot

149
Q

TIBIALIS POSTERIOR - ACTION

A

Plantar flexion and inversion of foot

150
Q

TIBIALIS POSTERIOR - INNERVATION

A

Tibial nerve (L4-S1)

151
Q

TIBIALIS POSTERIOR - TRIGGER POINT REFERRAL

A

Refer pain over the back of the calf, achilles tendon and plantar surface of foot

152
Q

TIBIALIS POSTERIOR - STRETCH

A

Pt seated with knee bent, dorsiflex and evert ankle, use ipsilateral hand to apply over pressure

153
Q

TIBIALIS POSTERIOR - STRENGTHEN

A

Bent knee calf raise
Running on sand
Wobble board

154
Q

FLEXOR DIGITORUM LONGUS - ORIGIN

A

Posterior middle 1/3 of tibia

155
Q

FLEXOR DIGITORUM LONGUS - INSERTION

A

Base of distal phalanges 2-5

156
Q

FLEXOR DIGITORUM LONGUS - ACTION

A

Flexion of toes 2-5

157
Q

FLEXOR DIGITORUM LONGUS - INNERVATION

A

Tibial nerve (L5-S2)

158
Q

FLEXOR DIGITORUM LONGUS - TRIGGER POINT REFERRAL

A

Refers pain over the medial back of the calf, achilles tendon and lateral plantar surface of the foot

159
Q

FLEXOR DIGITORUM LONGUS - STRETCH

A

Pt seated with knee bent, dorsiflex ankle and extend toes 2-5, use ipsilateral hand to apply over pressure

160
Q

FLEXOR DIGITORUM LONGUS - STRENGTHEN

A

Calf raise pushing up on toes
Walking or running on sand
Short foot exercise (place foot on a small towel and pick it up off the floor)

161
Q

FLEXOR HALLUCIS LONGUS - ORIGIN

A

Posterior inferior 2/3 of fibula
Interosseous membrane

162
Q

FLEXOR HALLUCIS LONGUS - INSERTION

A

Distal phalanx of big toe

163
Q

FLEXOR HALLUCIS LONGUS - ACTION

A

Flexion of big toe

164
Q

FLEXOR HALLUCIS LONGUS - INNERVATION

A

Tibial nerve (L5-S2)

165
Q

FLEXOR HALLUCIS LONGUS - TRIGGER POINT REFERRAL

A

Refers pain over the medial plantar surface of the foot and big toe

166
Q

FLEXOR HALLUCIS LONGUS - STRETCH

A

Pt seated with knee bent, dorsiflex ankle and extend 1st toe, use ipsilateral hand to apply over pressure

167
Q

FLEXOR HALLUCIS LONGUS - STRENGTHEN

A

Calf raise pushing up on toes
Walking or running on sand
Short foot exercise (place foot on a small towel and pick it up off the floor)

168
Q

INTRINSIC FOOT MUSCLES

A

SUPERFICIAL TO DEEP
Extensor hallucis brevis
Extensor digitorum brevis
Abductor digiti minimi
Flexor digitorum brevis
Abductor hallucis
Lumbricals
Flexor digiti minimi
Flexor digitorum longus tendon
Quadratus plantae
Adductor hallucis
Flexor hallucis brevis
Interossei muscles

ANATOMY (10 decks)

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