foot and ankle.

Question 1

anatomical area where dorsal surface of leg ends and dorsal surface of foot begins?

Answer 1

subtalar joint line.

Question 2

Serious Dx of foot and ankle?

Answer 2

Fractures
Bone tumore
POSTop sepsis/DVT

Question 3

How to rule out Fx with what appears to be lateral ankle sprain?

Answer 3

-pain in lateral malleolus
AND
-unable to WB after injury or in ER
-Tenderness on posterior edge of malleolus.

Question 4

observations for foot/ankle?

Answer 4

-skin breakdown
-corn/callus
-excessive dryness/moisture
-edema
-color change of foot/toenail
-shoes
pes planus/cavus

Question 5

Pes planus vs. Cavus?

Answer 5

flat feet (pronated)
vs 
high arch (supinated)

Question 6

skin color change indicative of

Answer 6

loss of circulation to foot

Question 7

corns/callus indicative of?

what about over 1st metatarsal head?

Answer 7

increased friction

hyperpronating.

Question 8

accessory motions of proximal tib fib?

distal?

Answer 8

Proximal: ant/post glide.

Distal: Ant/post glide. Sup/inf glide.

Question 9

Talocrural jt accessory motion?

Answer 9

compression/distraction test

post glide/ 2 ant glides

Question 10

Subtalar jt acc motion

Answer 10

compress/distract

med/lateral gap/glide

Question 11

MTP accessory motion

IP

Answer 11

dorsal/plantar/med/lateral glide.

dorsal/plantar.

Question 12

ST of ankle/foot?

Answer 12

Anterior drawer
Talar Tilt
Talar neutral (prone and WB)
Navicular Drop Test
Feiss's Line
Windlass Test

Question 13

Flexion contracture of PIP and DIP of toe?

What is it due to?

where is pain?

Answer 13

Hammer Toe

capsular restriction

on pressure areas.

Question 14

An extension contracture of MTP jt accompanied by flexion contracture of IP jt?

due to what?

where is pain?

Answer 14

Claw toe

Pes Cavus alignment creating windlass effect

pressure area.

Question 15

Condition where second toe is longer than 1st toe .

what does it affect?

Answer 15

moron’s toe

Affects push off during gait.

Question 16

alignment impairment of 1st MTP where MT joint positions farther toward midline of body than what is considered normal?

Answer 16

Hallux Valgus.

pain on MTP/ pressure area.

Question 17

Pain in first or 2nd Metatarsal head after long period of WB?

what is it caused by

Answer 17

Metatarsalgia

• from hyperpronation
• collapse of transverse arch
• tight achilles.

Question 18

Congenital condition where tarsal bones fuse together.

what is result of this?

Answer 18

tarsal coalition

causes rigid flat foot.

Question 19

lateral ankle sprain is combination of what?

at how many days post injury?

Answer 19

+anterior drawer test
Tenderness over ATFL
Presence of ecchymosis

5 days post injury.

Question 20

Treatments of Lateral ankle sprain?

Answer 20

PRICE for first 48 hrs
Mobs for DF/ mobility of talus/pain
strengthen/stretch/proprioception.

Question 21

Pain at mortise.

ankle DF and tibial ER on talus with foot planted on ground?

Answer 21

High ankle sprain.

Question 22

What do you look for in high ankle sprain?

Answer 22

hypermobile distal tib/fib

Question 23

Tx for high ankle sprain?

Answer 23

cast/ORIF

limit WB and DF

Question 24

Diagnostic criteria of plantar fasciitis?

Answer 24

• medial heel pain with initial steps or prolonged WB.
• pain with palp of insertion
• Positive Windlass test
• neg. tarsal tunnel syndrome
• limited act/pass DF ROM
• abnormal foot posture index
• high BMI
• increase in WB activity.

Question 25

Tx of plantar fasciitis

Answer 25

- Manual PT to jt and calves and for pain - stretching - antipronation taping. - orthotics - night splint for 1-3 months - laser - strengthen intrinsics - rocker bottoms - lose weight.

Question 26

common stress fracture sites? cause?

Answer 26

metatarsals/tibia/fibula overuse or biomechanical factors.

Question 27

Dx of stress fractures? why is X ray not effective?

Answer 27

Bone scan/MRI. point tenderness only shows up on Xray after 10 days.

Question 28

Entrapment of deep perineal nerve between metatarsal shafts? cause? Dx?

Answer 28

Mortons neuroma. tight shoes/heels. tapping on nerve (tinels sign)

Question 29

Entrapment of posterior tibial nerve at medial mal? Dx?

Answer 29

Tarsal tunnel syndrome Tinels sign

Question 30

tendinopathy of soleus/tib post caused by excessive pronation. Tx? strengthen tib post and provide arch support

Answer 30

Post shin splints/ Medial Tibial Stress Syndrome strengthen tib post and provide arch support and education.

Question 31

tendinopathy of tib ant. possibly from compartment syndrome? Tx?

Answer 31

Anterior shin splints. strengthen tib ant. and arch support.edu.

Question 32

tendinopathy of gastroc? how is it Dx if muscle is torn?

Answer 32

Achilles tendinopathy Thompson test.

Question 33

inflammation of bursa common site?

Answer 33

Bursitis calcaneal

Question 34

Common OA sites?

Answer 34

Talocrural Jt. 1st MTP (Hallux rigid) IP

Question 35

hyperpronation can cause:

Answer 35

- pain at 1+2 MT heads - Hallux Valgus - Plantar Fasciitis - Navicular Tuberosity - Shin splint - knee pain

Question 36

common reason for hyperpronation?

Answer 36

``` Forefoot and rear foot varus. tight gastric congenital flat feet mid foot ligament laxity. leg length discrepancy ```

Question 37

How is mid foot laxity and congenital flat feet tested?

Answer 37

location of navicular tuberosity in relation to Feiss's line Navicular Drop Test

Question 38

With tight gastrocs, when trying to go to DF foot will likely go to

Answer 38

eversion/abd.

Question 39

Interventions for ankle strength.

Answer 39

``` Ankle pumps Toe curls AROM calve raises balance Plyos. ```

Question 40

functional tests of foot?

Answer 40

stand on hee;s/toes/lateral/medial foot/flex and extend toes.