foot and ankle

Question 1

what muscles make up the lateral compartment and what nerve innervates them?

Answer 1

fibulas longus and brevis, superficial fibular nerve

Question 2

what muscles make up the deep posterior compartment and what nerve innervates them?

Answer 2

tib posterior, flexor hallucis longus, flexor digitorum, tibial nerve

Question 3

what muscles make up the anterior compartment and what nerve innervates them?

Answer 3

tib anterior, extensor hallucis longus, extensor digitorum longus, fibula’s Tertius, deep fibular nerve

Question 4

what muscles are a part of the superficial posterior compartment and what nerve innervates them?

Answer 4

gastroc, soleus, plantaris, tibial nerve

Question 5

a surgical release of the plantar fascia will likely lead to failure of which ligament?

Answer 5

spring ligament

Question 6

do passive or active structures support the medial longitudinal arch?

Answer 6

both! Research supports that both contribute but to what degree and when is still not established.

Question 7

if someone is weak in ankle plantar flexors how will they usually compensate during walking?

Answer 7

You will notice an increased hip pull with increased activity of the hip flexors

Question 8

is pes cavus flat foot or high arch?

Answer 8

high arch

Question 9

is pes planus flat foot or high arch?

Answer 9

flat foot

Question 10

how big of a difference on the navicular drop test is considered abnormal?

Answer 10

greater than 10mm

Question 11

what does decreased heel height possibly mean during heel raise?

Answer 11

decreased ability to lift weight, decreased length of plantar flexors, mid foot instability

Question 12

what angle is considered hallux limitus?

Answer 12

less than 40 degrees of DF of 1st met

Question 13

what are you assessing the integrity of with the anterior drawer test on the ankle?

Answer 13

ATFL

Question 14

how do you perform the cotton test? What does it test for?

Answer 14

hold tibia, move talus medially and laterally. Tests for syndesmotic instability

Question 15

what does the arc sign test for? How do you perform it?

Answer 15

test for achilles tendinopathy. Lay on stomach, look for bulge in tendon, DF and PF, if the bulge moves it is positive

Question 16

what does a Bohlers angle of less than 20 degrees on radiographs indicate?

Answer 16

a broken calcaneous

Question 17

what factors in women predispose them to hallux values?

Answer 17

low BMI, wearing high heels

Question 18

what factors in men predispose them to hallux values?

Answer 18

higher BMI, hx of pes planus

Question 19

what does current evidence support in relation to hallux valgus and conservative care?

Answer 19

the valgus will get worse unless corrected by surgery

Question 20

what are two treatment options for hammer toes?

Answer 20

larger toe box in the shoes, taping of the MTP joint into flexion

Question 21

what are the basic principles of high ankle sprains?

Answer 21

avoid DF, progress slowly

Question 22

what are the Bernese Ankle Rules?

Answer 22

one of the following has to be positive - indirect fibular stress (10cm proximal), direct medial malleolar pressure, compression of mid and forefoot

Question 23

what ligament is at risk of not healing properly after a lateral ankle sprain?

Answer 23

ATFL

Question 24

what is the only relevant prognostic factor at 4 weeks associated with outcome at 16 weeks

Answer 24

pain during weight bearing ankle DF and medial joint line pain

Question 25

what 5 factors put you at risk for re injury after a lateral ankle injury?

Answer 25

hx of ankle sprains, failure to use a brace, failure to warm up, lacking ankle DF, failure to participate in balance and proprioceptive prevention program after last injury

Question 26

is joint laxity or mechanical instability associated with the development of CAI?

Answer 26

no

Question 27

to return to sport after CAI what activity is very important to integrate?

Answer 27

plyometrics

Question 28

what movement indicates anterior ankle impingement?

Answer 28

forced DF

Question 29

what is the primary cause of ankle OA?

Answer 29

previous fx

Question 30

what is the main treatment for ankle osteoarthritis?

Answer 30

surgery

Question 31

what are three factors associated with plantar fasciopathy?

Answer 31

obesity, limited DF, time spent on feet at work

Question 32

what is the biggest risk factor for plantar fasciopathy?

Answer 32

limited DF

Question 33

what is the normal age range for plantar fasciopathy?

Answer 33

45-65 y/o

Question 34

are orthotics helpful in plantar fasciopathy?

Answer 34

yes, if they person has excessive pronation

Question 35

what surgery has shown some promise for plantar fasciopathy?

Answer 35

gastroc recession

Question 36

what is tarsal coalition?

Answer 36

when bones from the mid foot and hind foot fuse

Question 37

what are the symptoms of tarsal coalition?

Answer 37

vague hind foot pain, repeated ankle sprains, family hx of TC, hind foot valgus

Question 38

what is the MOI for a lisfranc injury?

Answer 38

axial load to a PF foot

Question 39

what is the mid foot squeeze test used to screen and haw is it performed?

Answer 39

used to screen for Lisfranc injuries, grab the dorsum of foot and squeeze

Question 40

what does severs disease effect?

Answer 40

the calcaneous where the achilles tendon inserts

Question 41

what is the prognosis for Severs?

Answer 41

2 - 8 weeks

Question 42

who is most at risk for Severs?

Answer 42

6-8 year old boys

Question 43

what two test combined have almost 100% sensitivity for severs?

Answer 43

one leg heel standing test, squeeze test

Question 44

what is kohlers disease?

Answer 44

osteochondritis of the navicular bone

Question 45

what is the prognosis for kohlers disease?

Answer 45

8 months

Question 46

who is usually affected by kohlers disease?

Answer 46

boys between 2-10 y/o

Question 47

how will kohlers disease present?

Answer 47

gradual onset, swelling over dorsum of foot, tender navicular

Question 48

what is the goal of conservative treatment for hallux rigidus?

Answer 48

limit first MTP joint motion

Question 49

who will you typically see a Morton neuroma in and what will they complain of?

Answer 49

45-50 y/o female, sharp burning pain between 3rd and 4th toe

Question 50

what is the typical treatment for a Morton neuroma?

Answer 50

steroid injection

Question 51

what is a primary risk factor for non insertional achilles tendinopathy?

Answer 51

obesity

Question 52

what 4 risk factors are present in runners for the development of non insertional achilles tendinopathy?

Answer 52

limited DF ROM, abnormal subtaler ROM, decreased PF strength, foot pronation

Question 53

patients who are frequently less active and overweight typically present with insertional or non insertional achilles tendinopathy?

Answer 53

insertional

Question 54

what is the typical patient you will see with an achilles tendon rupture?

Answer 54

40-60 y/o male

Question 55

what is the recommended treatment for subluxing peroneal tendons?

Answer 55

surgery

Question 56

do men or women have a worse outcome after ankle fracture?

Answer 56

men

Question 57

how often should shoes be replaced to avoid excessive loading and potential stress fractures?

Answer 57

300-500 miles

Question 58

what two things during running predispose someone to a stress fx?

Answer 58

excessive hip adduction and rear foot eversion

Question 59

what 4 characteristics are associated with MTSS?

Answer 59

previous injury, female gender, higher BMI, below average activity history