Foot And Ankle Exam Tests Flashcards
1
Q
Circulation/sensation
A
- L4, L5, S1 dermatomes
- capillary refill (compress digit cause blanching, release pressure and note how long takes for blood to come back and regain color–>normal=less than 3 sec)
- take dorsalis pedis and posterior tibial pulse
- monofilament test
2
Q
What is the monofilament test?
A
- important for diabetic foot exam
- performed on plantar aspect with pt closing eyes
- place monofilament on 1st and 4th pads of toes
- place filament on 1/3/5th plantar MTP joint w/enough pressure to slightly bend the filament
- positive test= pt cannot feel monofilament
3
Q
ROM/strength testing dorsiflexion/plantarflexion, inversion/eversion, flexion/extension, pronate/supinate
A
- dorsiflexion= 15-20
- plantarflexion= 55-65
- inversion=20-30
- eversion= 10-20
- pronation=5
- supination=20 (plantarflex, adduct, invert)
4
Q
Achilles tendon reflex
A
- s1 dermatome
- hang foot off table and tap Achilles tendon to look for plantar flexion
5
Q
What is the anterior drawer test?
A
- grab posterior calcaneous w/1 hand and cup distal tib/fib w/other hand
- provide anterior force on calcaneous while stabilizing tib/fib
- normal springing calcaneous back to neutral should occur
- positive= pain, no springing, excessive motion
- indicates= anterior laxity–> ATFL tear/pathology
6
Q
What is the alar tilt test?
A
- grab distal tib/fib and inferior calcaneous w/other hand blocking motion of calcaneous on talus
- INVERT talus to evaluate ROM
- positive= laxity, increased ROM, pain
- indicates= calcaneofibular ligament pathology and ATFL
7
Q
What is the eversion test?
A
- grab distal tib/fib w/1hand and grasp midfoot from plantar surface of foot with other hand
- EVERT foot to evaluate ROM
- positive=laxity, increased ROM, pain
- indicates= deltoid ligament pathology
8
Q
What is the squeeze test (high ankle sprain)
A
- wrap hands around leg proximal to ankle
- contact distal tib/fib w/thenar eminence and squeeze 2-3 seconds, release rapidly
- positive= pain at syndesmosis
- indicates= syndesmosis pathology/high ankle sprain
9
Q
What is the cross leg test?
A
- for eval of high ankle sprain
- pt seated, crossed affected leg over opposite knee, apply pressure to proximal fibular of affected leg
- positive= pain at distal ankle
- indicates= syndesmosis injury
10
Q
What is the thompson test?
A
- pt prone w/foot off the table
- doc squeezes calf, should plantarflex
- positive=absence of plantarflexion
- indicates= achilles tendon rupture
11
Q
What is the homans sign?
A
- indicates thrombophlebitis or acute DVT
- pt. Lying or seated w/knee extended
- doc dorsiflexed the foot
- positive= pain with dorsiflexion
- indicates DVT w/edema, erythema, warm skin
- order venous doppler
12
Q
What is moses sign?
A
- indicates DVT of POSTERIOR TIBIAL VEINS
- pt seated or supine
- doc induces anterior compression on gastrocnemius muscle into posterior aspect of the tibia (compress calf toward tibia)
- positive= pain with anterior compression NOT lateral
- indicates- posterior tibial vein DVT
13
Q
What is a lateral ankle sprain?
A
- inversion ankle sprain with inversion and plantar flexion
- 85% of all sprains
- swelling/ecchymosis over involved area
- ligaments involved= ATFL, CFL, PTFL
14
Q
What is a high ankle sprain?
A
- 10% of all sprains
- ankle eversion adn rotation (some dorsiflexion)
- pain common on medial aspect
- minimal swelling, worse with weight bearing
- ligaments involed= anterior inferior tibiofibular, syndesmosis
15
Q
What is plantar fasciitis?
A
- inflammation of the origin of plantar aponeurosis
- worse with first steps in the morning, improve throughout the day
- point tenderness of calcaneous
- causes= tight calves, repetative impact activites, high arches, obesity, new changes to activities
