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Boards: Musculoskeletal > Foot and Ankle Conditions > Flashcards

Foot and Ankle Conditions Flashcards

1
Q

Ligament Sprains: Grades

A
  • 95% of all lig sprains are lateral
  • Grade 1: no loss of fxn, min tearing of ATFL
  • Grade 2: some loss of fxn, partial disruption of ATFL, CFL
  • Grade 3: complete loss of fxn w/ complete tearing of ATFL, CFL & PTFL
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2
Q

Ligament Sprains: Dx

A

MRI if necessary

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3
Q

Ligament Sprains: PT

A

reduction of p! and inflammation w/ manual therapy and mod correction of biomechanical faults

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4
Q

Achilles’ Tendonosis/tendonopathy

A

degenerative condition of the achilles tendon.

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5
Q

Achilles’ Tendonosis/tendonopathy: Dx

A

(+) Thompsons test

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6
Q

Achilles’ Tendonosis/tendonopathy: Meds

A

Acetaminophen and NSAIDS, Corticosteriod injection or by mouth

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7
Q

Achilles’ Tendonosis/tendonopathy: PT

A

General Bursitis/Tendonopathy tx

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8
Q

Fractures of the Ankle: Type

A

Unimalleolar: med or lateral

Bimalleolar: med and lateral

Trimalleolar: med, lat & post tub of tibia

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9
Q

Fractures of the Ankle: Dx

A

plain film imaging - growth plate fractures are of concern, especially types III and IV

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10
Q

Fractures of the Ankle: PT

A

intervention emphasizes return of fxn w/o p!,

early PROM to prevent capsular adhesions and

funx training/restoration

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11
Q

Tarsal Tunnel Syndrome:

A
  • Entrapment of posterior tibial nerve/branch within tarsal tunnel
  • caused by overuse, excessive pronation, tendonitis of long flexor/post tib tendons
  • Symptoms include:
    • pain numbness tingling along medial ankle to plantar surface of the foot
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12
Q

Tarsal Tunnel Syndrome: Dx

A

electrodiagnostic tests, (+) tinels of tarsal tunnel

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13
Q

Tarsal Tunnel Syndrome: meds

A

NSAIDs, Acetominophen and Neurontin

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14
Q

Tarsal Tunnel Syndrome: PT

A

Use of orthoses to maintain neutral alignment of foot and possible neurodynamic mobilization

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15
Q

Flexor Hallucis Tendonopathy

A

commonly seen in ballet performers, tendonitis in acute stages may become chronic

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16
Q

Flexor Hallucis Tendonopathy Meds

A

NSAIDs Acetaminophen Corticosteriods

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17
Q

Pes Cavus:

A
  • “hollow foot” deformity observed includes
    • increased height of long arch,
    • dropping of ant arch,
    • metatarsal heads lower than hind foot,
    • plantar flexion and splaying of forefoot
    • claw toes
  • Fxn is limited due to altered arthokinematics reducing ability to absorb forces through foot
  • Etiology includes genetics, neurological disorders, contracture of soft tissues
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18
Q

Pes Cavus: dx

A

clinical exam and biomechanical screen of LE

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19
Q

Pes Cavus: PT

A

patient education, reduction of high impact sports, use of proper footwear and possibly orthoses

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20
Q

Pes Planus

A
  • deformity including reduction in heigh of medial longitudinal arch, normal in infants/toddlers
  • Results in decreased ability for foot to provide a rigid lever for push off during gait,
  • Etiology includes genetics, muscle weakness, ligament laxity, paralysis, excessive pronation, trauma or dx (RA)
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21
Q

Pes Planus Dx

A

clinical exam

22
Q

Pes Planus PT

A

intervention emphasizes patient education and appropriate footwear and orthotic fitting

23
Q

Talipes Equinovarus:

A
  • Postural: results from intrauterine malposition
    • Results in plantar flexed, adducted, and inverted foot (postural)
  • Talipes: abnormal development of head/neck of talus
    • PF at STJ, talocalcaneal, talonavicular, and calcaneocuboid joints & supination at mid tarsal joints
  • due to hereditary NMS disorders (myelomingocele)
24
Q

Talipes Equinovarus: DX

A

clinical exam

25
Talipes Equinovarus: PT
manipulation followed by casting or splinting for postural Talipes requires surgical intervention to correct deformity followed by casting or splinting
26
Equinus:
Plantar flexed foot, w/ compensatory STJ or mid tarsal pronation secondary to limited DF. Etiology includes congenital bone deformity, neurological disorders CP, contracture of gastric/soleus, trauma or dx
27
Equinus: Dx
clinical exam
28
Equinus: PT
flexibility exercises of shortened muscle structures within foot, joint mobilization and strengthening of intrinsic/extrinsic foot ms
29
Hallux Valgus
* Medial deviation of head of 1st MT from midline of body, * metatarsal and base of proximal 1st phalanx move medially while distal moves laterally. * Etiology varies: biomechanical malalignment (excessive pronation), ligament laxity, hereditary, weak ms, tight foot wear * Normal: 8-20 deg
30
Hallux Valgus DX
clinical exam
31
Hallux Valgus PT
orthotic fitting and patient education
32
Metatarsalgia
* Etiologies: * Mechanical (tight triceps surae and/or achilles tendon, collapse of transverse arch, short first ray, pronation of forefoot) or * Structural changes in transverse arch, possibly leading to vascular compromise in tissues of forefoot. * Changes in footwear * Complaint: p! at 1st/2nd MT heads after long WB
33
Metatarsalgia Dx
clinical exam
34
Metatarsalgia meds
NSAIDs Acetaminophen and Neurontin
35
Metatarsalgia PT
correction of biomechanical faults, impved flexibility of triceps sure and modalities to decrease pain prescription of orthotics and education regarding footwear
36
Metatarsus Adductus
* Etiology: congenital, muscle imbalance or neuromuscular disease such as polio. * Types: * Rigid: medial subluxation of tarsometatarsal its, hind foot is slightly in valgus w/ navicular lateral to head of talus * FLexible: adduction of all 5 metatarsals at the tarsometarsal joints
37
Metatarsus Adductus Dx
clinical exam
38
Metatarsus Adductus PT
intervention includes strengthening and regaining proper alignment of foot (orthosis)
39
Charcot-Marie-Tooth Disease
peroneal ms atrophy that affects motor and sensory nerves, may begin in child/adulthood and affects ms in lower leg/foot but eventually progresses to ms of hands and forearm Varies with degree of genetic dominance
40
Charcot-Marie-Tooth Disease Dx
electrodiagnostic testing and clinical exam
41
Charcot-Marie-Tooth Disease Meds
NSAIDs Acetaminophen, Neurontin
42
Charcot-Marie-Tooth Disease PT
no specific tx to prevent since it is genetic prevent contractors, skin breakdown, and maximize patients functional capacity Pt education and ambulation training
43
Plantar Fasciitis
* Etiology usually mechanical, * chronic irritation from overpronation, * limited ROM of 1st MTPand talocrural joint, * tight triceps surae, * acute injury, * rigid cavus foot
44
Plantar Fasciitis Dx
clinical exam, differentiated from tarsal tunnel by negative tinels
45
Plantar Fasciitis Meds
NSAIDs Acetaminophen and Corticosteriod injections
46
Plantar Fasciitis PT
* regain proper foot alignment * modalities to reduce inflammation * flexibility of plantar fascia (pes cavus) * careful flexibility of triceps surae * joint mobilizations * night splints * strengthen inverters of foot * pt education regarding footwear * orthotic fitting
47
Rearfoot Varus
subtalar varus, calcaneal varus abnormal alignment of tibia, shortened soft tissues, or malunion of calcaneus = **_right inversion of calcaneus w/ STJ neutral_**
48
Rearfoot Valgus
abnormal malalignment of knee (genu valgum) or tibial valgus = **_eversion of calcaneus w/ STJ neutral_** \*due to increased mobility of hind foot, fewer msk problems develop from this deformity than rear foot varus
49
Forefoot Varus
congenital abnormal deviation of head and neck of talus = **_inversion of forefoot when STJ in neutral_**
50
Forefoot Vaglus
congenital abnormal development of head/neck of talus = **_eversion of forefoot when STJ in neutral_**
51
Rearfoot/Forefoot Deformities Dx
Clinical Exam
52
Rearfoot/Forefoot Deformities PT
regain proper alignment improve flexibility of shortened soft tissues orthotic fitting and patient education regarding selection of footwear

Boards: Musculoskeletal (18 decks)

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