Foot and Ankle

Question 1

Plantar Flexion

Answer 1

50-65
Gastrocnemius, Tibial N. S1/2
Fibularis longus/brevis, Superficial fibular N, L5
Flexor digitorum longus, Tibial N. L5
Tibialis Posterior, Tibial N. L5

Question 2

Achilles Reflex

Answer 2

S1

Question 3

Anterior Drawer Test

Answer 3

Doc grasps posterior calcaneus with one hand and cups distal tib/fib. Monitoring anteriorly at the anterior talus. Provide anterior force on calcaneus while stabilizing the distal tib/fib. Normal springing of calcaneus back to neutral should occur.
(+) test= pain, no springing, excessive motion
ATF ligament pathology

Question 4

Talar Tilt Test

Answer 4

Doc grasps distal tib/fib with one hand and the inferior calcaneus with the other, blocking motion of the calcaneus on the talus. Invert talus to evaluate ROM
(+) test= laxity, increased ROM or pain
Calcaneofibular ligament pathology/tear

Question 5

Eversion Test

Answer 5

Doc grasps distal tib/fib with one hand and grasps the midfoot from the plantar surface of the foot with the other hand. Doc everts foot to evaluate ROM
(+) test= laxity, increased ROM
Deltoid ligament

Question 6

Squeeze test

Answer 6

Doc wraps hands around leg proximal to the ankle. Contacting the distal tib/fib with both thenar eminences. Squeeze 2-3 seconds. Rapidly release.
(+) test= pain at syndesmosis
syndesmosis pathology

Question 7

Cross leg test

Answer 7

Evaluating high ankle sprains
Patient seated, cross affected leg over opposite knee
(+) test= pain at distal ankle
Syndesmotic injury

Question 8

Thompson test

Answer 8

Pt prone with foot off the table. Doc squeezes the calf
(+) test= absence of plantar flexion
Achilles tendon rupture

Question 9

Homan’s sign

Answer 9

Indicates DVT
Pt laying or seated with knee extended. Doc dorsiflexes foot.
(+) test= pain
Suggestive of DVT along with warmth, red, swelling
Need to get a venous doppler

Question 10

Moses Sign

Answer 10

indicates a DVT
Pt seated. Squeeze the calf
(+) test= pain with anterior compression but not with lateral compression

Question 11

Inversion Ankle sprain

Answer 11

80-85% of all ankle sprains
Ankle inversion with plantar flexion
ATF tears first
Swelling

Question 12

High ankle sprain

Answer 12

accounts for 10% of all ankle sprains
Ankle eversion and rotation
Ligaments involved: Anterior inferior tibiofibular, syndesmosis
Pain more common on medial aspect with minimal swelling
pain worse with weight bearing

Question 13

Plantar fasciitis

Answer 13

Inflammation of origin of plantar aponeurosis
Worse with first steps, improves through the day
Point tenderness of calcaneous
Tight calves, repetitive impact activities, high arches, obesit

Question 14

Morton’s neuroma

Answer 14

Inflammation and thickening of tissue that surrounds the nerve between the toes
Between the 3rd and 4th toes
Patient reports feeling like walking on a marble
Palpable in web space

Question 15

Turf Toe

Answer 15

Inflammation and pain at base of 1st MTP
Presents as pain and bruising at base of hallux
Hyperextension of great toe causing damage to the joint
Severe cases can damage sesamoids and flexor tendon
Common due to activities on hard surfaces

Question 16

Achilles tendonitis

Answer 16

Inflammation at Achilles tendon
PResents as sharp heel pain and stiffness at mid achilles tendon to insertion
Worse with strenuous exercise. Better with walking
Micro tears in tendon cause swelling and thickening
Causes tight calf muscles, sudden change in activity, poorly fitting shoes, incorrect running technique.

Question 17

Dorsiflexion

Answer 17

15-20
Tibialis Anterior, Deep Fibular L4/5
Extensor Hallucis Longus, Deep Fibular L5
Extensor digitorum longus, Deep Fibular L5