Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sem 2 - MSK > Foot And Ankle > Flashcards

Foot And Ankle Flashcards

1
Q

How many bones, tendons, arteries, veins and nerves in the foot?

A

28 bones in the foot

12 tendons

2 major arteries and veins

5 nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why does the foot arch?

A

Because Tallis sits on top of cuneiform so higher and not in contact with the ground.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ankle joint

A

Tibular and fibula with Talus underneath it.

Held together with ring of ligaments.

Bones are held together by tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Functions of the foot?

A

Designed to move.

  1. Support body weight -shape of bones, tie inferior edges together, tie ends together, suspend arch from above.
  2. Propulsion (efficiently)

Adapt to different surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The mortise?

A

Supported by lateral, medial and syndesmotic ligaments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fracture mechanism?

A

Inversion / Eversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Medical co-morbidities of fractures?

A
  • Diabetes (double healing time)
  • Neuropathy
  • Vascular disease
  • Smoker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of stable ankle fractures?

A

Can weight bare safely

Need cast / boot only for comfort

Low rate of complications or arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of unstable ankle fractures?

A

Need surgical stabilisation

Can be high risk surgery in complicated diabetic / poor blood supply (6% amputaion rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ankle sprain?

A

Similar mechanism to ankle fractures by ligaments fail first

90% heal with rest and time

Those that do not cause ankle instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an avulsion fracture?

A

Bone pulled off by tendon or ligament.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Achilles’ tendon rupture?

A

Largest tendon in the body

Vascular “watershed” 6cm from insertion into calcaneum

Rupture typically in 30-50yr olds “weekend warriors”

Often complain of being ‘Kicked in the back of the heal”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thompsons test?

A

The patient lies face down with feet hanging off the edge of the bed. If the test is positive, there is no movement of the foot (normally plantarflexion) on squeezing the corresponding calf, signifying likely rupture of the Achilles tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of Achilles’ tendon rupture?

A

Most now treated conservatively

5-10% wound complications with surgery

12 months recovery

Re-repture rate 2-8%

90-95% function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bunions - Halllux (toe) Valgus (deformity)

A

Mostly middle aged females.

Presentation:

  • Don’t like look of feet
  • Pain over the bump
  • Difficulty with shoes.

Causes:

  • Genetic factors
  • Laxity
  • Shoewear (but not shoewear alone)

First metatarsal has deviated medically and hallux deviated laterally.

VaLgus: deviation of the distal limb away (Leaving) from the midline.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of bunions?

A

Change shoes

Operation

  • metatarsal osteotomy (surgical realignment of the big toe).

Recovery: Silmilar to if broken foot - Speical shoe for 6 weeks.

17
Q

Hallux Rigidus?

A

Arthritis of the big toe

Osteoarthritis 1st MTPJ (metatarsophalangeal joint)

Presentation:

  • Pain in MTPJ
  • Lump over joint.
18
Q

X-ray signs of arthritis?

A
  • Loss of joint space
  • Osteophytes (extra bone)
  • Cysts
  • Subchondral sclerosis (marble -appear whiter)
19
Q

Conservative arthritis treatment?

A

If symptoms not bad enough or unfit for surgery

  • Orthotics or aids (stick)
  • Painkillers
  • Activity modification
  • Steroid injections
20
Q

Surgical treatment for arthritis?

A

Replace = Arthroplasty

Fuse = Arthrodesis

Remove = Excision arthroplasty

Realign (to take weight off the joint) = osteotomy

21
Q

Surgical treatment of Hallux Rigidus?

A

Rigid sole orthotic

1st MTP joint fusion - Gold standard

1st MTP joint replacement

Create a “fracture” instead of the joint

Stabilise the “fracture”

Allow normal bone repir to fuse the joint

22
Q

Ankle arthritis?

A

Is usually secondary

Post traumatic 70-80%

Inflammatory 12%

Primary osteoarthritis 7%

23
Q

Why less primary ankle arthritis?

A

Don’t really know - undergoing research.

24
Q

What is the gold standard treatment for ankle arthritis?

A

Arthrodesis (fusion) - Because the results are very good.

Arthroplasty does give a better range of movement

BUT, bigger op and more previous complications.

25
Q

Toe deformities

A

Lesser toe:

Claw toe - inbalance due to neurological abnormalities

Hammer and Mallet toe - idiopathic imbalance / Hallux Valgus

Curly toe - congenital

26
Q

Achilles tendinopathy

A

Degenerative not inflammatory process.

Insertional vs Non-insertional

Causes:

  • Overuse syndrome
  • Poor training in athletes
  • Obesity

Treatment:

  • Physiotherapy
27
Q

Pes Planovalgus?

A

Flat foot.

It is NORMAL for toddlers and young children to have flat feet.

Arch begins to form in most, but not all, at school age.

Common cause of parental anxiety

Vary rare cause of symptoms.

Usain Bolt has flat feet.

28
Q

When is flat feet abnormal?

A

When flat feet are rigid.

This means that when stand on tip toes, arch does not reappear.

This is a cause for concern.

29
Q

Tarsal coalition?

A

Reason for rigid flat foot.

This is when there is a failure of the tarsal bones to separate.

30
Q

Adult aquired flat foot?

A

History:

  • Change in shape
  • Location of pain
  • Females
  • Middle aged
  • Pain behind medial malleolus.

Fibialis posterior dysfunction

Treatment:

  • Insoles - medial arch support
  • Physiotherapy 80% better

Operation:

  • Reconstruction if flexible foot
  • Arthrodesis if stiff foot.
31
Q

Diabetes and the foot

A

15% of diabetics experience foot problems.

25% of diabetic hospitalisation for the foot

50% of major amputations are in diabetics

66% probability of conta-lateral amputation within 5 years

50-70% mortality within 5 years after major amputation - worse than a lot of cancers.

32
Q

Why does diabetes affect the foot?

A

Diabetes affects nerves in the foot (neuropathy).

So, loss of protective sensation in the foot.

This can lead to severe infections. - Infection, poor blood supply and immunosuppression.

Thorough clean up is required.

33
Q

Charcot Arthpopathy?

A

Loss of sensation due to neuropathy leads to distructive arthritis.

Leads to Rocker-Bottom foot.

Leads to massive deformity and bone loss

Pathology is challenging - loss of bone stock, soft bone due to inflammation, lack of pain as a reminder

Patients are challenging - obese, immunocompromised, poor diabetic control

Sem 2 - MSK (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions