Foot and Ankle - Assessment Flashcards

1
Q

Talocrural Snapshot: ROM and End Feel

  1. Dorsiflexion =
  2. Plantarflexion =
  3. Inversion =
  4. Eversion =
A

Dorsiflexion = 0 – 20 / Firm
Plantarflexion = 0-50 / Firm
Inversion = 0-35 / Firm
Eversion = 0-20 / Firm

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2
Q

Talocrural Snapshot:

Talocrural loose and close pack postions?

A

Loose pack = 10 degrees plantarflexion, midway between maximum inversion and eversion.

Close pack = Maximum dorsiflexion

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3
Q

Talocrural Snapshot:

Talocrural capsular pattern

A

Plantarflexion > dorsiflexion

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4
Q

Talocrural Snapshot:

Talocrural athrokinematics

A

Convex on concave; rolling and sliding occur in opposite directions.

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5
Q

Subtalar Snapshot: ROM and End Feel

  1. Inversion =
  2. Eversion =
A
  1. Inversion = 5 / Firm
  2. Eversion = 5 / Firm
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6
Q

Subtalar Snapshot:

Subtalar loose and close pack positions?

A
  1. Loose pack = midway between extreme ranges of motion
  2. Close pack = supination
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7
Q

Subtalar Snapshot:

Subtalar capular pattern?

A

Limitation of varus ROM

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8
Q

Subtalar Snapshot:

Subtalar athrokinematics

A

Triplanar movement into pronation and supination.

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9
Q

Midtarsal Snapshot: ROM and End feel

  1. Inversion =
  2. Eversion =
A
  1. Inversion = Minimal / Firm
  2. Eversion = Minimal / Firm
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10
Q

Midtarsal Snapshot:

Midtarsal Loose and Close pack positions?

A
  1. Loose pack = Midway between extreme ranges of motion (accommodating uneven surfaces during gait).
  2. Close pack = supination (rigid lever for push-off during gait)
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11
Q

Midtarsal Snapshot:

Midtarsal Arthrokinematics

A
  1. Talonavicular joint: concave navicular moving on convex talus.
  2. Calcaneocuboid joint: both articulating surfaces have convexity and concavity
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12
Q

1st Metatarsophalangeal Snapshot: ROM and End Feel

  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
A
  1. Flexion = 0-45 / Firm
  2. Extension = 0-70 / Firm
  3. Abduction = n/a , n/a
  4. Adduction = n/a , n/a
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13
Q

1st Metatarsophalangeal Snapshot:

1st MTP Loose and Close pack positions.

A
  1. Loose pack = 10 degrees extension
  2. Close pack = full extension
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14
Q

1st Metatarsophalangeal Snapshot:

1st MTP capsular pattern

A

Extension > flexion

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15
Q

1st Metatarsophalangeal Snapshot:

1st MTP Arthrokinematics

A

Concave on convex; roll and glide occur in the same direction

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16
Q

Surface Anatomy:

Dorsal Anatomy

A
  1. Metatarsals
  2. Cuneiforms
  3. Navicular
  4. Phalanges
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17
Q

Surface Anatomy:

Anterior lower leg and foot

A
  1. Talus = Identify medial and lateral malleolus and feel for the dome that lies between them
  2. Anterior Tibialis = Large tendon anteromedially; attaches to base of 1st MT
  3. Metatarsals = Locate the MTP joint and move proximally for each of the 5 MT
  4. Extensor Digitorum Longus = Follow all tendons from digits 2 – 5 proximally to the lower leg.
  5. Extensor Hallucis Longus = Follow the tendon from the great toe proximally to the lower leg
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18
Q

Surface Anatomy:

Medial Lower Leg and Foot

A
  1. Medial Malleolus = Bony prominence of the distal tibia
  2. Deltoid Ligament = Distal to medial malleolus; evert the ankle
  3. Tibialis Posterior = Muscle belly on the distal 1/3 of tibia; tendon is immediately posterior to medial malleolus; follow to navicular tubercle
  4. Flexor Digitorum Longus = Immediately posterior to tibialis posterior; have patient flex digits 2-5 to assist in identifying
  5. Flexor Hallucis Longus = Posterior to FDL; have patient flex great toe against resistance to assist in identifying
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19
Q

Surface Anatomy:

Posterior Lower Leg and Foot

A
  1. Gastrocnemius = Medial and lateral heads can be palpated on the proximal ½ of the lower leg
  2. Soleus = Deep to gastrocnemius and can be palpated on either side; have patient plantarflex in prone with knee flexed
  3. Calcaneal (Achilles) Tendon = Wide band connecting posterior leg muscles to calcaneus
  4. Calcaneus = Move distal from calcaneal tendon; identify medial and lateral borders, as well as the base.
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20
Q

Surface Anatomy:

Lateral Lower Leg and Foot

A
  1. Lateral Malleolus = Prominent bony structure of the distal fibula
  2. Lateral Ligaments of the Ankle = Calcaneofibular: just distal to the lateral malleolus; Posterior talofibular: posterior and inferior surface of lateral malleolus to the talus; Anterior talofibular: anterior lateral malleolus to talus
  3. Tuberosity of 5th Metatarsal = Locate 5th MT and palpate proximally until you feel a “step off”
  4. Fibularis (Peroneus) Brevis = Distal 2/3 of fibula, traveling posterior to lateral
    malleolus, attaches at tuberosity of 5th MT.
  5. Fibularis (Peroneus) Longus = Proximally attaches to fibular head, tendon palpated posterior to lateral malleolus and lateral aspect of the foot
  6. Cuboid = From the tuberosity of 5th MT, move proximally
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21
Q

Assessing ROM: Goniometer and ROM

Ankle Dorsiflexion

A
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22
Q

Assessing ROM: Goniometer and ROM

Ankle Plantarflexion

A
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23
Q

Assessing ROM: Goniometer and ROM

Ankle Inversion

A
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24
Q

Assessing ROM: Goniometer and ROM

Ankle Eversion

A
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25
Q

Assessing ROM: Goniometer and ROM

Subtalar Inversion

A
26
Q

Assessing ROM: Goniometer and ROM

Subtalar Eversion

A
27
Q

Assessing ROM: Goniometer and ROM

1st MTP Flexion

A
28
Q

Assessing ROM: Goniometer and ROM

1st MTP Extension

A
29
Q

Assessing MMT:

Grading Plantarflexion 0-5

A
30
Q

Assessing MMT:

Plantarflexion 3 – 5

A
31
Q

Assessing MMT:

Plantarflexion 3 – 5: Soleus Bias

A
32
Q

Assessing MMT:

Plantarflexion 0 – 2

A
33
Q

Assessing MMT:

Dorsiflexion: Anterior Tibialis 3 – 5

A
34
Q

Assessing MMT:

Dorsiflexion: Anterior Tibialis 0 – 2

A
35
Q

Assessing MMT:

Subtalar Inversion: Posterior Tibialis 0 – 2

A
36
Q

Assessing MMT:

Subtalar Eversion: Fibularis/Peroneals 3 – 5

A
37
Q

Assessing MMT:

Subtalar Eversion: Fibularis/Peroneals 0 – 2

A
38
Q

Assessing MMT:

MTP Flexion 0 – 5

A
39
Q

Assessing MMT:

IP Flexion 0 – 5

A
40
Q

Assessing MMT:

MTP Extension

A
41
Q

Assessing MMT:

MTP/IP Extension

A
42
Q

Assessing Joint Play:

Proximal Tibiofibular Joint - Posterior Glide

A
43
Q

Assessing Joint Play:

Distal Tibiofibular Joint - Posterior Glide

A
44
Q

Assessing Joint Play:

Proximal Tibiofibular Joint - Anterior Glide

A
45
Q

Assessing Joint Play:

Distal Tibiofibular Joint - Anterior Glide

A
46
Q

Assessing Joint Play:

Talocrural Joint Distraction

A
47
Q

Assessing Joint Play:

Talocrural Joint - Posterior Glide

A
48
Q

Assessing Joint Play:

Talocrural Joint - Anterior Glide

A
49
Q

Assessing Joint Play:

Subtalar Joint Distraction

A
50
Q

Assessing Joint Play:

Subtalar Joint Lateral Glide

A
51
Q

Assessing Joint Play:

Subtalar Joint Medial Glide

A
52
Q

Assessing Joint Play:

Metatarsalphalangeal Joint Anterior (Dorsal) Glide

A
53
Q

Assessing Joint Play:

Metatarsalphalangeal Joint Posterior (Plantar) Glide

A
54
Q

Special Test:

Tibial Torsion

A
55
Q

Special Test:

Forefoot Varus/Valgus

A
56
Q

Special Test:

Thompson Test of Calf Squeeze Test

A
57
Q

Special Test:

Anterior Drawer

A
58
Q

Special Test:

Talar Tilt (Varus) Stress Test (Lateral Ligaments)

A
59
Q

Special Test:

Talar Tilt (Valgus) Stress Test (Medial Ligaments)

A
60
Q

Special Test:

Subtalar Joint Neutral in Weightbearing

A
61
Q

Special Test:

Figure 8 Girth

A