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AET 273 > foot and toes > Flashcards

foot and toes Flashcards

1
Q
  1. what bones are in the rear foot?
  2. what bones are in the mid foot?
  3. what bones are in the forefoot? MT
A
  1. Talus and calcaneus
  2. navicular, cuboid, and medical, intermediate, lateral cuneiform bones.
  3. metatarsals and phalanges.
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2
Q

what are the 3 regions of the foot?

A

rear, mid, forefoot

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3
Q

what is the function of the ankle?? MT

A
  • shock absorption
  • adaptation to uneven terrain
  • propulsion of our body through space.
  • stability for keeping body upright.
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4
Q

what are the 6 classifications of joints in the foot? MT

A
  1. subtler joint (talocalcaneonavicular joint)
  2. talonavicular joint.
  3. calcaneocuboid joint
  4. tarsometatarsal joint
  5. metatarsophalangeal join
  6. interphalangeal joint
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5
Q

what are the 3 arches of the foot and which bone is the point of reference for them? MT

A

medial longitudinal arch
- navicular bone
lateral longitudinal arch
transverse arch
- 2nd metatarsal

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6
Q

what are 4 main passive supporting structures of the foot? MT

A
  1. plantar fascia
  2. spring ligament (plantar calcaneonavicular)
  3. long plantar (long plantar calcaneocuboid)
  4. short plantar (short plantar calcaneocuboid)
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7
Q

what is the difference between extrinsic and intrinsic foot muscle?

A

extrinsic
- muscles in the lower leg that cross the ankle into the foot because of their muscle bellies, and exit on the outside of the foot.

intrinsic
- have both attachments that are contained within the ankle. muscles do not cross the talaco joint.

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8
Q

what is an overview of a fracture of the talus? MT

A
  • cause by acute hyper-dorsiflexion with inversion.
  • fracture of the lateral process and neck of the talus.
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9
Q

s/s for fracture of the talus? MT

A
  • severe posterior pain when jumping, running, or kicking.
  • pain is increased on force of plantar or dorsiflexion.
  • increased pain with resisted flexion of the great toe, bc of insertion point of flexor hallucinations longs tendon.
  • mod to sev swelling, tenderness, and dicoloration.
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10
Q

what is management for a fractured talus?

A

immediate immobilization of the talus and refer to a physician.

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11
Q

what is the overview of a calcaneus fracture? MT

A
  • they are high-energy axial loads. (failing from a height and landing on the bottom (flat feet))
  • factures occire at the anterior process by forceful plantar flexion or compression.
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12
Q

list the s/s of a calcaneus fracture? MT

A

-severe heel pain
- inability to walk or weight bear.
- palpable intense pain over the process of the calcaneus.

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13
Q

how do you manage a calcaneus fracture?

A
  • immobilization
  • ice and elevation to control edema.
  • short leg cast or walking boot for 6 weeks.
  • repair by surgery, patient experiences stiffness of the subtalar joint.
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14
Q

how can stress fractures develop? MT

A
  • running and jumping activities.
  • increase in training mileage
  • change in surface, hard to soft to uneven.
  • change in intensity.
  • change in shoe type.
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15
Q

what is the difference between non-critical and critical stress fracture?

A

non-critical
- fracture of medial tibia, fibula, 2,3,4 metatarsal.

critical
- fracture of anterior tibia, medial malleolus, talus, navicular, 5th metatarsal, sesamoids.

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16
Q

what are the s/s of stress fractures? MT

A
  • pain begins insidiously, and progressively gets worse over time.
  • pain limited to the fracture site.
  • prolonged pain.
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17
Q

which bones can be irritated in a stress fracture, and with which movements. MT

A

talus
- excessive pronation
calcareous
- excessive heel strikes
navicular
- jumping, ballet dancers.

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18
Q

how do you manage a stress fracture?

A
  • x-rays
  • bone scans and MRI
  • person needs to go through the full process of doing weight bearing actives as per to how the bone is healing.
  • rest, stretching, strengthening.
  • protected weight bearing, stiff shoe or walking cast.
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19
Q

what is severs disease?

A
  • seen in 7-10 yr olds
  • associated with growth spurts, decreased flexibility of hamstrings and tricep surae.
  • open growth plates
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20
Q

what causes sever disease?

A

hards surfaces
poor shoes
kicked in the region or landing off balance.

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21
Q

what are s/s of severs disease?

A
  • unilateral, bilateral, intermittent or continuous posterior heel pain.
  • pain worsen during and after activity.
  • pain improves with rest.
  • point tenderness anterior to the insertion of the achilles tendon along the posterior boarder of the calcareous.
22
Q

how does someone manage severs disease?

A
  • Rice
  • modify training
  • donut pad (taping)
  • increased strength and flexibility in tricep surae group.
23
Q

what is retrocalcaneal bursitis?

A
  • someone over the age of 7-10.
  • irritation of the retrocalcaneal bursa located between the achilles tendon and calcaneus.
  • excessive pronation.
24
Q

s/s of retrocalcaneal bursitis?

A
  • pain on palpation of the soft tissue just ANTERIOR to Achilles tendon.
  • increased pain during plantar flexion when athlete pushes off.
  • inflamed bursa can lead to a large mass referred to as pump bump.
25
Q

how do you manage retrocalcaneal bursitis?

A
  • consider tendinopathys if necessary.
  • shoe modification.
  • standard acute care.
  • stretching exercise that associate with achilles tendon.
26
Q

what is a cuboid subluxation?

A

happen with plantar-flexion and inversion injuries.
- this is when a strong reflex contraction occurs of the peroneus longs muscle. bc of the contraction the cuboid bone acts as a fulcrum and the tendon applies a force on the cuboid causing infer-medial displacement

27
Q

what is tarsal tunnel syndrome?

  1. what causes tarsal tunnel syndrome? MT
A
  • entrapment of the posterior tibial nerve or one of its medial or lateral branches.
  1. tarsal fracture or dislocation
    - hyperplantar flexion or excessive eversion.
28
Q

what are the s/s of tarsal tunnel syndrome? MT

A
  • diffuse pain
  • burning, numbness, pin and needles (along plantar and medial aspect of the foot)
29
Q

what is an lisfranc injury?

A
  • disruption of the tarsometatarsal joint (with or without an associated fracture.)
  • occurs along all 3 cuneiform bones. (medial to lateral)
30
Q

what is a MOI for a lisfranc injury?

A
  • severe twisting of the first metatarsal
    axial load along the first metatarsal.
31
Q

what are s/s for a lisfranc injury?

A
  • dislocation of the first cuneiform.
  • severe mid foot pain
  • pins and needles
  • swelling along mid foot region.
32
Q

how is lisfranc injuries managed?

A
  • short leg, non-walking cast for 6 weeks.
  • short leg, walking cast for 6 weeks.
  • surgery required.
33
Q

how does a longitudinal arch strain work?

A
  • flattening of the foot during mid-support phase causing the arch to be strained.
  • can be associated with a calcaneonavicular lig. sprain and flexor hallucis longs strain.
34
Q

s/s of longitudinal arch strain?

  1. what is treatment for longitudinal arch strain?
A
  • pain with running and jumping.
  • pain and swelling below the posterior tibalis tendon.
  1. RICE
    - reduce weight bearing (pain free)
    - arch taping.
35
Q

what is plantar fasciitis?

A
  • this is when the fascia on the plantar side of the foot thickens.
  • pain is normally worse in the morning, and decreases in pain over time, 5-10 minutes.
  • their are 3 fascia muscles in the foot.
  • pain increases with weight bearing
36
Q

what are in and extrinsic factors of plantar fasciitis?

A

Intrinsic factoria
- pes cavus or planes
- decreased plantar flexion
- reduced flexibility of plantar flexors
- excessive pronation.

Extrinsic factors
- improper footwear
- playing on uneven surfaces

37
Q

how do you treat plantar fasciitis?

A
  • standard acute care
  • Ice
  • deep friction massage
  • strengthen of the posterior chain, ex. hamstrings and glutes.
38
Q

what is a jones fracture?

A
  • a avulsion fracture at the BASE of the 5th metatarsal
  • is overlooked bc it is often seen as a severe ankle sprain where the foot goes into plantar flexion and adduction.
  • lateral ankle sprain can cause a jones fracture.
39
Q

what is treatment for jones fracture?

A
  • refer to physical
  • NWB 6-10 weeks, fallowed by walking cast for 4 weeks.
40
Q
  1. what is metatarsalgia?
  2. what are s/s of metatarsalgia? MT
A
  1. general discomfort of the metatarsal heads.
    - factors of metatarsalgia are: age, arthritic disease, gout, diabetes.
  2. flattening of the transverse arch
    - callus formation over the middle of the 3 metatarsals
    - increase of pain intensity and duration
41
Q

what are in and extrinsic factors of metatarsalgia? MT

A

intrinsic
- excessive weight bearing
- fallen transverse arch
- valgus collages of the knee.
- overpronation

Extrinsic
- narrow toe box
- improper shoe cleats
- repetitive jumping, or excessive running without proper rest.

42
Q

how do you manage metatarsalgia? MT

A
  • strengthen metatarsal muscles
  • activity modification
  • footwear examination
  • metatarsal pads or bars.
43
Q

what is Mortons neuroma? MT

A
  • entrapment of the nerve inside the foot between 2 metatarsal heads, normally 3 and 4 MTs
  • stress fracture must be ruled out.
44
Q
  1. what are treatments for Mortons neuroma?
  2. what are s/s of Mortons neuroma? MT
A
  1. modify footwear,
    - orthotics to decrease pressure
    - NSAIDSs
  2. dull and achy pain
    - squeeze the toes together which will irratate the nerve.
    - specific and point tender.
45
Q

what is turf toe? MT

A
  • sprain of the plantar capsular ligament of the 1st MTP joint.
  • results from a hyperextension of the great first toe.
46
Q

s/s of turf toe? MT

A
  • pain
  • tenderness
  • swelling on plantar aspect.
  • great toe extension is painful
  • sometimes associated with tearing flexor tendons
47
Q

management for turf toe?

A
  • standard acute care
  • taping to limit motion
  • use of a metatarsal pad
  • if severe restrictions activity for 3-6 weeks.
48
Q
  1. what can cause fractures or dislocations of the phalanges?
  2. s/s of fractures and dislocations of the phalanges?
  3. management for fractures and dislocation of the toes?
A
  1. kicking on an uneven surface.
    - stubbing toe
    - being stepped on.
  2. immediate and intense pain
    - obvious deformity with dislocation
  3. casting may be required with great big toe or multiple toe fractures.
    - buddy tapping taping is generally sufficient.
49
Q

what is the difference between hammer, mallet, and claw toe? MT

A

HAMMER TOE
- extension at the MTP joint
- flexed at PIP joint
- hyperextension at the DIP joint

MALLET TOE
- neutral at the MTP and PIP joint
- flexed at the DIP

CLAW TOE
- hyperextension oat the MTP joint
- flexion at the DIP and PIP joint.

50
Q

management for hammer, mallet and claw toe? MT

A
  • wearing footwear with more room for toes.
  • padding or tapping to prevent irritation
  • shave calluses
  • extreme case, surgery

AET 273 (8 decks)

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