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MSKJaz > Foot and ankle > Flashcards

Foot and ankle Flashcards

1
Q

tests to see if pes planus is flexible

A

form arch on tiptoe

Jack’s test ( form arch when extend big toes)

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2
Q

tibialis posterior courses immediately posterior to __
attachments =
function =

A

medial malleolus
navicular tuberosity + plantar aspect of medial and middle cuneiforms
elevates arch, invertor and plantar-flexor

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3
Q

most common cause of acquired pes planus =

A

tibialis posterior dysfunction

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4
Q

tibialis posterior dysfunction is common in which group of patients

A

obese middle age women and increasing incidence with age

hbp and diabetes

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5
Q

causes of tibialis posterior dysfunction =

A

steroid injection
sero-ve arthropathies
idiopathic tendinosis (most common)

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6
Q

sign of pes planus on observation

A

from back can see too many toes (poke out laterally)

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7
Q

Type 1 pes planus

A

swelling tender and slightly weak power

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8
Q

type 2 pes planus =

A

planovalgus
midfoot abduction
passively correctable

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9
Q

type 3 pes planus =

A

fixity and mortise signs

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10
Q

Rx of pes planus

A

physio
insole
steroid injection only if florid synovitis
Sx - fuse if stage 4 (FDL replaces tib post tendon)

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11
Q

pes cavus causes

A

commonest - idiopathic

neuro - HSMN, CP, polio, spina bifida, club foot

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12
Q

plantar fasciitis:
worst = ___ and eases off, worse with ___
__ pain
++_ at plantarmedial heel

A

first step in the morning
activity
stabbing
fullness, swelling and tender

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13
Q

plantar fasciitis: ___ test +ve for Baxter’s nerve

A

Tinnel’s test

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14
Q

heel spurs are present in __ of population

=

A

1/4

calcification of insertion at calcaneus

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15
Q

causes of plantar fasciitis

A 
excessive exercise / wt
sero -ve arthropathy
diabetes
planovalgus / cavovarus
footwear
hypothyroid
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16
Q

Rx of plantar fasciitis

A 
NSAIDs
night splints (v painful, in dorsiflexion)
tape
physio
steroid injection
usually self-limiting 18-24mnths
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17
Q

Hallux valgus
usually uni/bilateral
M:F
causes =

A 
bilateral
F3:1M
familial (laxity/alignment)
shoes
CT disease
rheumatoid
splayed forefoot ass with loss of muscle tone and age
18
Q

possible sequelae of hallux valgus

A 
transfer metatarsalgia (as 2nd MTP takes over wt bearing)
lesser toe impingement (usually PIPJ)
bunion
neuralgia
shoe difficulties
19
Q

Rx of hallux valgus

A

shoe modifications
padding
Sx if not managed / deformities = osteotomies to realign

20
Q

OA of 1st MTPJ =

Rx (3) =

A

Hallux rigidus
non op
joint replace
arthrodesis

21
Q

feet features of RA

A

subluxed MTPJ
hallux valgus
clawed toes
painful plantar calluses

22
Q

Morton’s neuroma =

s+s =

A 
degenerative fibrosis (maybe due to traction/bursitis) of digital nerve near bifurcation
metatarsalgia, burning and tingling in toes
23
Q

mortons neuroma
age
F:M

A

45-50yo

F>M

24
Q

management of mortons neuroma

A

examine and US

insoles injections / exercise

25
Q

achilles tendonitis is due to repetitive microtrauma at ___

eg of causes =

A 
hypovascular region 2-6cm proximal to insertion
overtrain
ciprofloxacin
steroids 
CT diseases
26
Q

Ix for achilles tendonitis

A

examine
US
MRI

27
Q

treatment of achilles tendonitis

A 
activity modification
NSAIDs 
orthotics
physio
Sx
28
Q

Achilles rupture:
mechanism =
age =
s+s =

A 
sudden deceleration with resisted calf contraction
>40yo
cant wt bear 
weak plantarflex
painful gap
\+ve calf squueze (Simmond's) test
29
Q

acquired imbalances between flexors and extensors in toes => (4)

A

claw
mallet
hammer toes

30
Q

mechanism of ankle sprain

A

inversion on planted foot

31
Q

typical ligaments that are sprained in a sprained ankle

A

ATFL and CFL

32
Q

management of ankle sprain =

A

RICE and physio

Sx - Brostrum Gould - direct repair

33
Q

Weber A ankle # =

Rx =

A

below syndesmoses - stable and no ligament rupture

moon boot

34
Q

Weber B ankle # =

Rx =

A

at syndesmoses - can be stable/unstable

if talar shift needs fixed to prevent OA

35
Q

Wever C ankle # =

A

unstable

36
Q

Pilon # =

A

distal tibial #

high E and causes sig soft tissue problems

37
Q

5th MT common # mechanism =

A

inversion injury

38
Q

3 types of MT #

A 
avulsion by peroneus brevis tendon
Jones #
prox shaft (stress #)
39
Q

tarsoMT dislocation # =
high/low E
can sometimes dislocate __ from __

A

Lisfranc
high
hindfoot from forefoot

40
Q

calcaneal fracture => __+__ foot

A

broad and flat (bone explodes outwards)

41
Q

talus fracture mechanism = __/___

has a __ blood supply and so may lead to __

A

dorsiflexion/rapid deceleration
reversed
AVN

MSKJaz (28 decks)

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