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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
FOOT AND ANKLE - CONDITIONS - TARSEL TUNNEL SYNDROME
Hx - medial or plantar foot pain of paraesthesia S&S - tenderness around tarsal tunnel, +ve Tinel’s test DDx - lumbar radiculopathy
26
FOOT AND ANKLE - CONDITIONS - MORTONS NEUROMA
Hx - burning pain between metatarsals S&S - local tenderness, +ve Morton’s neuroma test (metatarsal squeeze) DDx - lumbar radiculopathy, metatarsal stress fracture
27
FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES
Hx - insidious onset of pain, better with rest, overuse injury (repetitive stress) S&S - tender to palpation (common locations: tibia, calcaneus, metatarsals)
28
FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - TIBIAL STRESS FRACTURE
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
29
FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - METATARSAL STRESS FRACTURE
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
30
FOOT AND ANKLE - CONDITIONS - STRESS FRACTURES - CALCANEAL STRESS FRACTURE
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
31
FOOT AND ANKLE - ORTHO TESTS - ACHILLES SQUEEZE TEST
- Pt prone with legs straight - Examiner squeezes the Achilles tendons bilaterally 2cm above the insertion point on the calcaneus
32
FOOT AND ANKLE - ORTHO TESTS - ACHILLES SQUEEZE TEST - POSITIVE TEST
**Achilles tendinitis, peritendinitis compression** - Pain
33
FOOT AND ANKLE - ORTHO TESTS - ANTERIOR DRAWER TEST
- 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
34
FOOT AND ANKLE - ORTHO TESTS - ANTERIOR DRAWER TEST - POSITIVE TEST
**ATFL instability** - Anterior motion of the foot
35
FOOT AND ANKLE - ORTHO TESTS - SN & SP
**SN**: 78-95 **SP**: 74-84
36
FOOT AND ANKLE - ORTHO TESTS - POSTERIOR DRAWER TEST
- Pt seated or supine - Examiner places one hand on posterior tibia - Other hand on plantar surface of the heel - Examiner pushes the foot posteriorly
37
FOOT AND ANKLE - ORTHO TESTS - POSTERIOR DRAWER TEST - POSITIVE TEST
**PTFL instability** - Posterior motion of the foot
38
FOOT AND ANKLE - ORTHO TESTS - THOMPSON TEST
- 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
39
FOOT AND ANKLE - ORTHO TESTS - THOMPSON TEST - POSITIVE TEST
**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
40
FOOT AND ANKLE - ORTHO TESTS - HOFFA'S TEST
- 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
41
FOOT AND ANKLE - ORTHO TESTS - HOFFA'S TEST - POSITIVE TEST
**Fracture of the calcareous, retrocalcaneal bursitis, moderate Achilles tendon strain, Achilles tendon rupture** - Pain or guarded motion
42
FOOT AND ANKLE - ORTHO TESTS - HOMAN'S TEST
- 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
43
FOOT AND ANKLE - ORTHO TESTS - HOMAN'S TEST - POSITIVE TEST
**Thrombophlebitis** - Short duration ‘deep’ calf pain **Gastrosoleus strain** - Persistant ‘achy’ calf pain
44
FOOT AND ANKLE - ORTHO TESTS - HOMAN'S TEST - SN & SP
**SN**: 35-48 **SP**: 41
45
FOOT AND ANKLE - ORTHO TESTS - MORTON'S TEST
- Pt seated or supine - Examiner squeezes foot around the metatarsal heads - Observe the patient for signs of pain or discomfort
46
FOOT AND ANKLE - ORTHO TESTS - MORTON'S TEST - POSITIVE TEST
**Mortons neuroma, metatarsal joint arthritis, fracture of the metatarsal heads or stress fracture, metatarsalgia** - Pain
47
FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST
- Pt supine - Examiner stabilises talus and applies medial then lateral forces to the calcaneus
48
FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST - POSITIVE TEST
**Subtalar sprain or instability** - Pain or displacement calcaneus
49
FOOT AND ANKLE - ORTHO TESTS - SUBTALAR GLIDE TEST - SN & SP
**SN**: 78 **SP**: 75
50
FOOT AND ANKLE - ORTHO TESTS - TALAR TILT
- 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)
51
FOOT AND ANKLE - ORTHO TESTS - TALAR TILT - POSITIVE TEST
**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
52
FOOT AND ANKLE - ORTHO TEST - TALAR TILT - SN & SP
**SN**: 67 **SP**: 75
53
FOOT AND ANKLE - ORTHO TEST - TINEL'S FOOT TEST
- 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)
54
FOOT AND ANKLE - ORTHO TEST - TINEL'S FOOT TEST - POSITIVE TEST
**Supraspinatus impingement, subacromial bursitis** - Pain with internally rotated shoulder **Biceps long-head impingement** - Pain with externally rotated shoulder
55
FOOT AND ANKLE - ORTHO TEST - TINEL'S FOOT TEST - SP
**SP**: 58
56
FOOT AND ANKLE - ORTHO TEST - WINDLASS TEST
- Pt seated - Examiner stabilises ankle in neutral and extends big toe while allowing the IP joint to flex
57
FOOT AND ANKLE - ORTHO TEST - WINDLASS TEST - POSITIVE TEST
**Plantar fasciitis** - Pain - Symptom reproduction
58
FOOT AND ANKLE - ACHILLES TENDON INJURY
- 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”
59
FOOT AND ANKLE - ACHILLES TENDON INJURY - NONINSERTIONAL TENDINOSIS
- 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
60
FOOT AND ANKLE - ACHILLES TENDON INJURY - INSERTIONAL TENDINOSIS
- An inflammatory condition - Occurs at or around the Achilles tendon insertion into the calcaneus
61
FOOT AND ANKLE - ACHILLES TENDON INJURY - RUPTURE
- Most common tendinous rupture in the lower extremity - Peak incidence in the 3 to 5 decades 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
62
FOOT AND ANKLE - ACHILLES TENDON INJURY - RISK FACTORS
- Males **Noninsertional** - Repetitive microtrauma - Aging **Insertional** - Hill running - Interval workouts
63
FOOT AND ANKLE - ACHILLES TENDON INJURY - POPULATION AFFECTED
- 30-50 (For a rupture)
64
FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION
- 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
65
FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - NONINSERTIONAL
- 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
66
FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - INSERTIONAL
- 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
67
FOOT AND ANKLE - ACHILLES TENDON INJURY - CLINICAL PRESENTATION - RUPTURE
- 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
68
FOOT AND ANKLE - ACHILLES TENDON INJURY - PROGNOSIS
- 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
FOOT AND ANKLE - ROM - PLANTAR FLEXION - MUSCLES ACTIVATED
Soleus Gastrocnemius Tibialis posterior Flexor digitorum longus Flexor hallucis longus Plantaris
70
FOOT AND ANKLE - ROM - PLANTAR FLEXION - TISSUE STRETCHED
Tibialis anterior Extensor digitorum longus Anterior ankle joint capsule and ligaments
71
FOOT AND ANKLE - ROM - PLANTAR FLEXION - TISSUE COMPRESSED
Posterior ankle structures
72
FOOT AND ANKLE - ROM - DORSIFLEXION - MUSCLES ACTIVATED
Tibialis anterior Extensor digitorum longus
73
FOOT AND ANKLE - ROM - DORSIFLEXION - TISSUES STRETCHED
Soleus Gastrocnemius Tibialis posterior Flexor digitorum longus Flexor hallucis longus Achilles tendon
74
FOOT AND ANKLE - ROM - DORSIFLEXION - TISSUES COMPRESSED
Anterior ankle structure (joint capsule)
75
FOOT AND ANKLE - ROM - INVERSION - MUSCLES ACTIVATED
Tibialis anterior Tibialis posterior
76
FOOT AND ANKLE - ROM - INVERSION - TISSUES STRETCHED
Fibularis longus, bervis and tertius Lateral ankle ligaments (ATFL, CFL, PTFL)
77
FOOT AND ANKLE - ROM - INVERSION - TISSUES COMPRESSED
Medial ankle structures
78
FOOT AND ANKLE - ROM - EVERSION - MUSCLES ACTIVATED
Fibula's longus, brevis and tertius
79
FOOT AND ANKLE - ROM - EVERSION - TISSUES STRETCHED
Tibialis anterior Tibialis posterior Medial collateral (deltoid) ligament of ankle
80
FOOT AND ANKLE - ROM - EVERSION - TISSUES COMPRESSED
Lateral ankle structures
81
ANTERIOR LEG MUSCLES
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
LATERAL LEG MUSCLES
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
POSTERIOR LEG MUSCLES
SUPERFICIAL TO DEEP Plantaris Gastrocnemius Soleus Fibularis (peroneus) longus Fibularis (peroneus) brevis Flexor hallucis longus Achilles tendon Popliteus Tibialis posterior Flexor digitorum longus
84
TIBIALIS ANTERIOR - ORIGIN
Anterior proximal tibia (lateral tibial condyle, proximal 2/3 of anterolateral surface of tibia and interosseous membrane)
85
TIBIALIS ANTERIOR - INSERTION
Medial cuneiform Base of 1st metatarsal
86
TIBIALIS ANTERIOR - ACTION
Dorsiflexion and inversion of ankle
87
TIBIALIS ANTERIOR - INNERVATION
Deep peroneal (fibular) nerve (L4-S1)
88
TIBIALIS ANTERIOR - TRIGGER POINT REFERRAL
Generally pain is referred downward toward the anterior medial ankle and big toe
89
TIBIALIS ANTERIOR - STRETCH
Place dorsum of foot on ground and apply pressure into plantar flexion and eversion
90
TIBIALIS ANTERIOR - STRENGTHEN
Dorsiflexion with rubber band Walking/running on sand Wobble board
91
EXTENSOR DIGITORUM LONGUS - ORIGIN
Proximal 2/3 of fibula Interosseous membrane Lateral condyle of tibia
92
EXTENSOR DIGITORUM LONGUS - INSERTION
Dorsal surface of digits 2-5
93
EXTENSOR DIGITORUM LONGUS - ACTION
Extension of digits 2-5 Dorsiflexion and eversion of foot
94
EXTENSOR DIGITORUM LONGUS - INNERVATION
Deep peroneal (fibular) nerve (L4-S1)
95
EXTENSOR DIGITORUM LONGUS - TRIGGER POINT REFERRAL
Generally pain is referred downward toward the anterior ankle and toes 2 - 4
96
EXTENSOR DIGITORUM LONGUS - STRETCH
Place dorsum of toes on ground and apply pressure into flexion of digits 2-5
97
EXTENSOR DIGITORUM LONGUS - STRENGTHEN
Toe raises Dorsiflexion with rubber band Wobble board
98
EXTENSOR HALLUCIS LONGUS - ORIGIN
Anterior middle 1/3 of fibula Interosseous membrane
99
EXTENSOR HALLUCIS LONGUS - INSERTION
Base of distal phalanx of big toe
100
EXTENSOR HALLUCIS LONGUS - ACTION
Extension of big toe Dorsiflexion and inversion of foot
101
EXTENSOR HALLUCIS LONGUS - INNERVATION
Deep peroneal (fibular) nerve (L4-S1)
102
EXTENSOR HALLUCIS LONGUS - TRIGGER POINT REFERRAL
Pain is normally referred downward to the big toe
103
EXTENSOR HALLUCIS LONGUS - STRETCH
Place dorsum of big toe on ground and apply pressure onto flexion of big toe
104
EXTENSOR HALLUCIS LONGUS - STRENGTHEN
Toe raises Dorsiflexion with rubber band Wobble board
105
PERONEUS TERTIUS - ORIGIN
Distal 1/3 of anterior fibula
106
PERONEUS TERTIUS - INSERTION
Base of 5th metatarsal
107
PERONEUS TERTIUS - ACTION
Dorsiflexion and eversion of foot
108
PERONEUS TERTIUS - INNERVATION
Deep peroneal (fibular) nerve (L5-S1)
109
PERONEUS TERTIUS - TRIGGER POINT REFERRAL
Pain is referred downward over the dorsum of the foot and ankle Occasionally pain may also refer over the heel
110
PERONEUS TERTIUS - STRETCH
Pt seated, invert and plantar flex ankle with mild over pressure
111
PERONEUS TERTIUS - STRENGTHEN
Reverse calf raise Running on sand Wobble board movements
112
PERONEUS LONGUS - ORIGIN
Head and proximal lateral shaft of fibula
113
PERONEUS LONGUS - INSERTION
Medial cuneiform and base of 1st metatarsal
114
PERONEUS LONGUS - ACTION
Eversion and plantar flexion of foot
115
PERONEUS LONGUS - INNERVATION
Superficial peroneal (fibular) nerve (L5-S1)
116
PERONEUS LONGUS - TRIGGER POINT REFERRAL
Pain is referred downward over the lateral leg (over middle fibula)
117
PERONEUS LONGUS - STRETCH
Invert ankle with mild over pressure
118
PERONEUS LONGUS - STRENGTHEN
Reverse calf raise Running on sand Wobble board movements
119
PERONEUS BREVIS - ORIGIN
Distal lateral 1/2 of fibula
120
PERONEUS BREVIS - INSERTION
Base of 5th metatarsal
121
PERONEUS BREVIS - ACTION
Eversion and plantar flexion of foot
122
PERONEUS BREVIS - INNERVATION
Superficial peroneal (fibular) nerve (L5-S1)
123
PERONEUS BREVIS - TRIGGER POINT REFERRAL
Pain is referred downward over the distal leg and ankle
124
PERONEUS BREVIS - STRETCH
Invert ankle with mild over pressure
125
PERONEUS BREVIS - STRENGTHEN
Reverse calf raise Running on sand Wobble board movements
126
GASTROCNEMIUS - ORIGIN
Medial head - above medial condyle of femur Lateral head - above lateral condyle of femur
127
GASTROCNEMIUS - INSERTION
Calcaneus
128
GASTROCNEMIUS - ACTION
Plantar flexion of foot
129
GASTROCNEMIUS - INNERVATION
Tibial nerve (S1-S2)
130
GASTROCNEMIUS - TRIGGER POINT REFERRAL
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
GASTROCNEMIUS - STRETCH
With posterior knee straight, lean body forward Internally or externally rotate leg to stretch medial and lateral fibres
132
GASTROCNEMIUS - STRENGTHEN
Calf raise Running on sand Wobble board
133
SOLEUS - ORIGIN
Soleal line of tibia and upper fibula
134
SOLEUS - INSERTION
Calcaneus
135
SOLEUS - ACTION
Plantar flexion of foot
136
SOLEUS - INNERVATION
Tibial nerve (S1-S2)
137
SOLEUS - TRIGGER POINT REFERRAL
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
SOLEUS - STRETCH
With posterior knee bent, lean body forward
139
SOLEUS - STRENGTHEN
Bent knee calf raises Running on sand Wobble board
140
PLANTARIS - ORIGIN
Distal posterolateral femur
141
PLANTARIS - INSERTION
Calcaneus
142
PLANTARIS - ACTION
Plantar flexion of foot
143
PLANTARIS - INNERVATION
Tibial nerve (S1-S2)
144
PLANTARIS - TRIGGER POINT REFERRAL
Refers pain over the back of the knee and upper half of the calf
145
PLANTARIS - STRETCH
With posterior knee straight, lean body forward
146
PLANTARIS - STRENGTHEN
Calf raise Running on sand Wobble board
147
TIBIALIS POSTERIOR - ORIGIN
Posterior proximal 2/3 of tibia Fibula Interosseous membrane
148
TIBIALIS POSTERIOR - INSERTION
Fans out over plantar surface of foot
149
TIBIALIS POSTERIOR - ACTION
Plantar flexion and inversion of foot
150
TIBIALIS POSTERIOR - INNERVATION
Tibial nerve (L4-S1)
151
TIBIALIS POSTERIOR - TRIGGER POINT REFERRAL
Refer pain over the back of the calf, achilles tendon and plantar surface of foot
152
TIBIALIS POSTERIOR - STRETCH
Pt seated with knee bent, dorsiflex and evert ankle, use ipsilateral hand to apply over pressure
153
TIBIALIS POSTERIOR - STRENGTHEN
Bent knee calf raise Running on sand Wobble board
154
FLEXOR DIGITORUM LONGUS - ORIGIN
Posterior middle 1/3 of tibia
155
FLEXOR DIGITORUM LONGUS - INSERTION
Base of distal phalanges 2-5
156
FLEXOR DIGITORUM LONGUS - ACTION
Flexion of toes 2-5
157
FLEXOR DIGITORUM LONGUS - INNERVATION
Tibial nerve (L5-S2)
158
FLEXOR DIGITORUM LONGUS - TRIGGER POINT REFERRAL
Refers pain over the medial back of the calf, achilles tendon and lateral plantar surface of the foot
159
FLEXOR DIGITORUM LONGUS - STRETCH
Pt seated with knee bent, dorsiflex ankle and extend toes 2-5, use ipsilateral hand to apply over pressure
160
FLEXOR DIGITORUM LONGUS - STRENGTHEN
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
FLEXOR HALLUCIS LONGUS - ORIGIN
Posterior inferior 2/3 of fibula Interosseous membrane
162
FLEXOR HALLUCIS LONGUS - INSERTION
Distal phalanx of big toe
163
FLEXOR HALLUCIS LONGUS - ACTION
Flexion of big toe
164
FLEXOR HALLUCIS LONGUS - INNERVATION
Tibial nerve (L5-S2)
165
FLEXOR HALLUCIS LONGUS - TRIGGER POINT REFERRAL
Refers pain over the medial plantar surface of the foot and big toe
166
FLEXOR HALLUCIS LONGUS - STRETCH
Pt seated with knee bent, dorsiflex ankle and extend 1st toe, use ipsilateral hand to apply over pressure
167
FLEXOR HALLUCIS LONGUS - STRENGTHEN
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
INTRINSIC FOOT MUSCLES
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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