Foot and Ankle Flashcards
1
Q
the podiatric model focuses on…
A
alignment and biomechanics
2
Q
functions of the foot
A
1 - absorb rotation
2 - loose adaptor
3 - base of support
4 - rigid lever
3
Q
which muscles attach to the talus
A
none of them
4
Q
what muscle controls foot pronation
A
posterior tib
5
Q
how much DF do you need for normal walking
A
10
20 for running
6
Q
for stress fractures, how do you decide if they should be non-weight bearing
A
if they have pain with normal everyday activities they should probably be NWB for a period of time
7
Q
what is chronic compartment syndrome usually due to
A
overuse of a muscle in that compartment
8
Q
can we treat chronic compartment syndrome
A
sometimes but it often still becomes a surgical issue
9
Q
the talocrural joint is approx __ degrees varus and about ______ degrees externally rotated
A
2-3
23
10
Q
talocrural DF range of motion
A
10-25
11
Q
DF arthrokinematics
A
anterior roll
posterior glide
12
Q
what could limit DF ROM
A
1 - posterior capsule
2 - gastroc/soleus
3 - deltoid ligament
4 - posterior tib-tib ligament
13
Q
PF range of motion
A
40-65 degrees
14
Q
what could limit PF
A
anterior capsule
anterior tib-fib ligament
15
Q
PF arthrokinematics
A
posterior roll
anterior glide
16
Q
ligamnets of the ankle mortise
A
interosseous membrane
ant tibio-fibular
post tibio-fibular
17
Q
how long does it typically take for a high ankle sprain to heal
A
6-8 weeks
18
Q
typical MOI for high ankle sprain
A
ER
19
Q
is immobilization common with a high ankle sprain
A
yes
20
Q
what are the ligs of the medial ankle
A
ant tibio-talar
ant tibio-navicular
calcaneo-tibio
post tibio-talar
21
Q
what are the ligs of the lateral ankle
A
ant talo-fibular
calcaneo-fibular
post talo-fibular
22
Q
most commonly sprained ligament
A
anterior talofibular ligament
23
Q
is ultrasound affective for acute ankle sprains
A
no
24
Q
are bracing and manual therapy supported for acute ankle sprains
A
yes
25
is manual therapy supported for chronic sprains
yes
26
should pts with chronic ankle sprains wear an ankle sprains
not usually, b/c they need to work on strength instead of relying on the support of the brace
27
ottawa ankle rules
- tenderness at lateral/medial malleoli, base of 5th metatarsal or navicular
- inability to walk 4 steps at site of injury or in ER
28
3 parts of the foot
rearfoot
midfoot
forefoot
29
there is 1 posterior ___ facet and 2 anterior _____ facets on the superior surface of the calcaneus. this is where the talus articulates
convex
concave
30
T or F: fractures of the calcaneus are often complex and long-term dysfuction is common
T
31
supination calcaneal motion and arthrokinematics in the OCK
inversion
PF
adduction
medial roll, lateral glide
32
what happens in the entire LE w/ supination in the CKC
calcaneus inverts
talus DF
talus abducts
tibia ER
kee ext/varus
femur ER
hip ext
posterior pelvic tilt
33
ankle inversion ROM is OKC? CKC?
20
10
34
pronation calcaneal motion and arthrokinematics in the OCK
calcaneus everts
talus PF
talus adductus
tibia IR
knee flex/valgus
femur IR
hip flex
anterior pelvic tilt
35
ankle eversion ROM in OCK? CKC?
10
8
36
ligs of subtalar joint
interosseus talo-calcaneal
cervical
37
two parts of the midtarsal joint
calcaneus-cuboid
talus-navicular
38
at the talo-navicular joint, the talus is _____ and the navicular is _______
convex
concave
39
supination creates a _____ foot while pronation creates a ______ foot
rigid
supple
40
during pronation the oblique and longitudinal axes become more ____ while during supination they become more ______
parallel
perpendicular
41
3 joints of the midfoot
navicular-cuneiforms
cuneiforms-met
cuboid - met
42
at the navicular-cuneiform articulation, the cuneiforms are _______ and the navicular is _______
concave
convex
43
at the cuneiform-met articulation and cuboid-met articulation the arthrokinematics are ______ on ________
convex on concave
44
lisfranc joint
1st cuneiform and 1st metatarsal
45
what is usually the MOI for a lisfranc injury
plantarflexion
46
what happens to the midfoot with a lisfranc injury
it becomes hypermobile
47
should you get imaging with a possible lisfranc injury
yes, immobilization and/or surgery is needed
48
what muscle helps control the medial longitudinal arch
posterior tib
49
what muscles help support the transverse arch
intrinsic foot muscles
50
what do patient's often complain of feeling with a cuboid sublux? what does a cuboid sublux often come from
- it feels like they are walking on a rock
- comes from chronic ankle sprains
51
what can you do for a cuboid sublux
- manipulations
- intrinsic foot and peroneal strength for stability
52
the metatarsophalangeal joints are _______ on _______
convex on concave
53
what can you do for hallux valgus
offload pain and prevent further valgus by controlling abnormal motion
54
metatarsalgia often comes from a lack of _____ or over____
dorsiflexion
pronation
55
plantar fascia tightens during ankle/toe
dorsiflexion
56
people with plantar fascitis usually have the most pain when
they first stand up in the mornings
57
is dry needling recommended for plantar fascitis
no
58
what is recommended for plantar fascitis
manual therapy, stretching, taping, orthotics, night splints, ther-ex, footwear, patient ed
59
how long should you try night splints for plantar fascitis
1-3 months
60
T or F: some achilles tendon ruptures are now treated non-surgically
T
61
is early mobilization beneficial for achilees tendon ruptures
yes
62
too much _____ stresses the post tib while too much _____ stresses the achilles tendon
pronation
dorsiflexion
63
treatment approach for tendinopathies
- protect healing tendon (soft tissue treatment)
- restore ROM
- strengthen (esp eccentrics)
64
should you wear night splints for tendinopathies
no
65
Orthoses, heel lifts, and laser therapy have __________ evidence when it comes to treating tendinopathies.
conflicting
66
most common LE tendinopathies
Achilles tendon
posterior tib
peroneals
67
anterior tib OIA innervation
O: upper 2/3 lateral tibia
I: 1st cuneiform/1st metatarsal
A: DF/inversion
N: deep fibular
68
extensor hallicus longus OIA innervation
O: middle of fibula
I: distal 1st ray
A: great toe ext/DF
N: deep fib
69
gastrocnemius OIA innervation
O: femoral condyles
I: calcaneal tuberosity
A: plantar flexion, knee flexion
N: tibial
70
posterior tibialis OIA innervation
O: posterior lateral tibia
I: navicular, cuneiforms, cuboid, base of 2,3,4
A: inversion, PF
N: tibial
71
fibularis longus/brevis OIA innervation
O: lateral tibia, proximal 2/3 fibula
I: base of 5th, 1st metatarsal, 1st cuneiform
A: eversion, PF
N: superficial fibular
72
three phase approach for foot/ankle rehab
1) protection (acute)
2) ROM (subacute)
3) return to activity (advanced training/maintenance)
73
What kind of strength training is appropriate (if any) during protection phase?
sub-max isometrics
74
By the end of the ROM phase the goal is to have full ROM and be fully...
weightbearing
*also want to return to full ADLs
75
What kind of strength training during ROM phase?
endurance and balance
76
The goal is for _____% of strength to be regained by the end of ROM phase.
80
77
During the return to activity the tissue is able to withstand full stress and the goal by the end of this phase is to return to...
athletics or occupation/daily activity
78
What kind of strength training during return to activity phase?
strength, balance, and agility
79
The goal is for _____% of strength to be regained by the end of return to activity phase.
90
80
What do foot orthotics do?
control abnormal motion or change abnormal position
81
Are soft orthotics used for rigid or hypermobile feet? What is the goal of soft orthotics?
rigid
goal is to rest/off load
82
What population are soft orthotics often seen in?
older adults
those with wounds
post-operative/trauma
83
Are semi-rigid orthotics for rigid or hypermobile feet? What is the goal?
hypermobile
forefoot control
84
What population are semi-rigid orthotics often seen in?
overpronators
heavier or more active individuals
85
T or F: orthotics have shown to be very useful for treating back pain
F: they have the most impact where you put them (foot/ankle)
86
T or F: orthotics can improve balance in older adults
T
87
Best position to measure PF and DF
prone
*for DF measure in both knee extension and flexion
88
How to control pronation during standing gastroc stretch
put a towel under medial arch and first two toes
89
How to stretch plantar fascia during gastroc stretch
towel under big toe
90
posterior glides improve...
dorsiflexion
91
What can cause the fibula to move forward? What can you do for this?
ankle sprains (the ATFL gets stretched out and pulls on it)
posterior glide
92
How many single leg calf raises should you be about to do for running?
30
