Brainscape's Knowledge GenomeTM

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


See full index

Year 2 MSK > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

Hallux Valgus

A

Big toe deformity.

Medial deviation of 1st metatarsal and lateral movement of the toe.

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

Who is most affected by hallux Valgus?

A

Women 4:1 with some familial tendency.

Seems to be more common in show wearing countries.

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

What conditions are associated with hallux Valgus?

A

Rheumatoid arthritis
Inflammatory arthropathies
Multiple sclerosis
Cerebral Palsy

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

What is main complaint of patients with hallux Valgus?

A

Pain

Cosmetic appearance

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

What causes the pain in hallux valgus?

A

Widened forefoot causes rubbing resulting in an inflamed bursae (bunion) and frequent ulceration.
1st and 2nd toe rub together resulting in skin breakdown.

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

What is used in the non surgical treatment of hallux Valgus?

A

Wearing wider accommodating shoes.

Spacer between 1st and 2nd toe to prevent ulcers.

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

What is the main reason for surgical treatment of hallux Valgus ?

A

generally for cosmetic reasons, however 30% are dissatisfied with the result due to pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is hallux rigidus?

A

Osteoarthritis of the 1st Metatarsophalangeal joint

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

Two types of hallux rigidus

A

Primary (degenerative)

Secondary (osteochondral injury etc)

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

What is the conservative treatment of hallux rigidus?

A

Use of stiff soled shoes to limit movement.

Removal of dorsal osteophytes which can impinge movement.

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

What is the removal of osteophytes called?

A

Cheilectomy

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

What is the gold standard surgical treatment of hallux rigidus?

A

Arthrodesis, fusion of MTPJ joint.

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

Benefits of arthrodesis of the MTPJ joint?

A

Alleviate all pain
MTPJ is a stiff joint anyway no real sacrifice in movement.
More successful than joint replacement.

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

Drawback of arthrodesis in hallux rigidus?

A

Unable to wear heals

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

Mortons neuroma

A

Irritated and swollen digital nerve leads to degenerative fibroma.

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

Clinical signs of Mortons neuroma

A

Burning and tingling pin radiating from affected toes.

Loss if sensation in web space.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the Mulder’s click test?

A

Mortons neuroma

Mediolateral compression of metatarsal ellicits a click

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What imaging is used for diagnosis of Mortons neuroma?

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the conservative management used in Mortons neuroma?

A

Injections of local anaesthetic and steroids.

Insoles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What us the surgical management of a Mortons neuroma?

A

Excision- some patients complain of continued pain.

Small risk of recurrence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some common stories for metatarsal stress fractures?

A

Runners, soldiers on long marches, dancers, of poorly conditioned people walking long distances.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which are the most common metatarsals to present with stress fractures?

A

2nd and 3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for a metatarsal stress fracture?

A

Prolonged rest in rigid soled boot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

On X-ray when are the metatarsal fractures most visible?

A

3 weeks post injury as resorption of the fracture causes gap to open up or callus forms.

25
Q

Where on the achilles tendon does tendonitis or rupture originate from?

A

Hypovascular region 2-6 cm from the origin.

26
Q

Pathology of achilles tendonitis

A

Repetitive microtrauma and collagen repair dysfunction resulting in misalignment.

27
Q

Predisposing factors for achilles tendontitis

A 
Quinolone antibiotics (ciprofloxacin)
Over training
Rheumatoid arthritis
Gout
Inflammatory athropathies
Steroids
CTD
28
Q

In achilles tendonitis where can the pain occur?

A

Within the tendon

On its insertion on the calcaneous.

29
Q

Treatment for achilles tendonitis?

A

Activity modification (heel raising)
NSAIDs
Physiotherapy

30
Q

What treatment is last line for achilles tendonitis?

A

Surgical decompression, wound healing and scars are often problematic.

31
Q

What treatment is never used in achilles tendonitis?

A

Steroid injections

32
Q

Method of injury in achilles rupture?

A

Sudden deceleration with calf contraction.

Lunging in badminton

33
Q

What do patients often say with an achilles rupture?

A

Feel like they’d been kicked in the back of the leg.

34
Q

What is clinical appearance of an achilles rupture?

A

Unable to bear weight.
Weak plantar flexion
Palpable painful gap

35
Q

Predisposing factors for an achilles tendon rupture

A 
Old age (degenerative)
Existing tendonitis
Steroid injections
36
Q

Surgical repair of achilles tendon rupture.

A

Suture damaged tendon to restore tension.

Cast for 8 weeks

37
Q

Non surgical repair of achilles tendon rupture.

A

Serial casts with ankle plantar flexed.

Early weightbearing whilst preventing dorsiflexio

38
Q

Benefits of serial casting over surgery for achilles rupture repair?

A

Serial casting avoids common wound problems and has as good functional output.

39
Q

Plantar Facsiits

A

Self limiting
Repetitive stress/ degenerative condition.
Pain whilst walking

40
Q

Where is the pain in plantar fasciitis.

A

Heel of the foot

Origin of plantar aponeurosis on distal plantar aspect of calcaneal tuberosity.

41
Q

What are some predisposing factors for plantar fasciitis?

A

Diabetes
Obesity
Frequent walking on hard floor or poorly cushioned shoes.

42
Q

Treatment for plantar fasciitis

A 
Rest
Physiotherapy
NSAIDs
Steroid injection
Night splints
Heel cups in shoes.
43
Q

Is surgery used in plantar faciitis?

A

Surgical release is used however 50% success rate and risk of damaging plantar nerves.

44
Q

Tibialis Posterior route and insertion in the foot.

A

Passes posterior to the medial malleolus.

Inserts onto medial aspect of the navicular , and plantar aspect of medial and middle cuneiform.

45
Q

What is the function of the tibias posterior?

A

Raises and stabilises the posterior arch.

Invertor and plantar flexor.

46
Q

Predisposing factors for developing tibialis posterior dysfunction.

A 
Rheumatoid arthitis
Hypertension
Diabetes
Obesity 
Seronegative arthropathies
47
Q

Treatment for tibialis posterior tendonitis

A

Splinting with medial arch support.
NO steroid injection
Surgical decompression if symptoms unresolving

48
Q

How does tibias posterior dysfunction present?

A

Pain posterior to medial malleolus
Diminished balance dislikes uneven surfaces
Flat Feet
Valgus of the heel

49
Q

What is likely to occur if tibias posterior ruptures?

A

Osteoarthritis of hind and mid foot.

50
Q

Surgery if no OA present in tibalis posterior rupture?

A

Tendon transfer and calcaneal osteotomy

51
Q

Surgery if OA is present in tibialis posterior rupture?

A

Arthrodesis

52
Q

Pes Cavus

A

Abnormally high arched foot

Often with clawed toes

53
Q

What is pes cavus often associated with?

A

Polio unilateral
Cerebral palsy
Hererditary sensory and motor neuropathy
Spina Bifida occulta

54
Q

What is treatment if pain is present?

A 
Surgical
Soft tissue release
Tendon transfer 
Calcaneal osteotomy
Arthrodesis (severe)
55
Q

What is the dysfunction in claw toes?

A

Hyperextension at MTPJ

Hyperflexion at PIP and DIP

56
Q

What is the dysfunction in hammer toes?

A

Hyperextension and MTPJ and DIP

Hyperflexion at PIPJ

57
Q

Issues with claw and hammer toes?

A

Painful and often rub against shoes and or each other resulting in ulceration and skin breakdown.

58
Q

What are the non surgical options in claw or hammer toes?

A

Toe sleeves and corn plasters can prevent skin issues

59
Q

Surgical options for claw or hammer toes.

A

Tenotomy (devotion of overactive tendon)
Tendon transfer
Arthrodesis or amputation in severe cases.

Year 2 MSK (19 decks)

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