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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
Q

Talipes Equinovarus: PT

A

manipulation followed by casting or splinting for postural

Talipes requires surgical intervention to correct deformity followed by casting or splinting

26
Q

Equinus:

A

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
Q

Equinus: Dx

A

clinical exam

28
Q

Equinus: PT

A

flexibility exercises of shortened muscle structures within foot, joint mobilization and strengthening of intrinsic/extrinsic foot ms

29
Q

Hallux Valgus

A
  • 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
Q

Hallux Valgus DX

A

clinical exam

31
Q

Hallux Valgus PT

A

orthotic fitting and patient education

32
Q

Metatarsalgia

A
  • 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
Q

Metatarsalgia Dx

A

clinical exam

34
Q

Metatarsalgia meds

A

NSAIDs Acetaminophen and Neurontin

35
Q

Metatarsalgia PT

A

correction of biomechanical faults, impved flexibility of triceps sure and modalities to decrease pain prescription of orthotics and education regarding footwear

36
Q

Metatarsus Adductus

A
  • 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
Q

Metatarsus Adductus Dx

A

clinical exam

38
Q

Metatarsus Adductus PT

A

intervention includes strengthening and regaining proper alignment of foot (orthosis)

39
Q

Charcot-Marie-Tooth Disease

A

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
Q

Charcot-Marie-Tooth Disease Dx

A

electrodiagnostic testing and clinical exam

41
Q

Charcot-Marie-Tooth Disease Meds

A

NSAIDs Acetaminophen, Neurontin

42
Q

Charcot-Marie-Tooth Disease PT

A

no specific tx to prevent since it is genetic prevent contractors, skin breakdown, and maximize patients functional capacity Pt education and ambulation training

43
Q

Plantar Fasciitis

A
  • Etiology usually mechanical,
  • chronic irritation from overpronation,
  • limited ROM of 1st MTPand talocrural joint,
  • tight triceps surae,
  • acute injury,
  • rigid cavus foot
44
Q

Plantar Fasciitis Dx

A

clinical exam, differentiated from tarsal tunnel by negative tinels

45
Q

Plantar Fasciitis Meds

A

NSAIDs Acetaminophen and Corticosteriod injections

46
Q

Plantar Fasciitis PT

A
  • 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
Q

Rearfoot Varus

A

subtalar varus, calcaneal varus abnormal alignment of tibia, shortened soft tissues, or malunion of calcaneus = right inversion of calcaneus w/ STJ neutral

48
Q

Rearfoot Valgus

A

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
Q

Forefoot Varus

A

congenital abnormal deviation of head and neck of talus = inversion of forefoot when STJ in neutral

50
Q

Forefoot Vaglus

A

congenital abnormal development of head/neck of talus = eversion of forefoot when STJ in neutral

51
Q

Rearfoot/Forefoot Deformities Dx

A

Clinical Exam

52
Q

Rearfoot/Forefoot Deformities PT

A

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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