Foot & Ankle

Question 1

Foot and Ankle

Bony Palpation

Answer 1

1) Calcaneus “heel”
2) Sustentaculum tali “Under medial malleolus”
3) Medial malleolus “Above web of opposite hand”
4) Lateral malleolus
5) Talus “Pointer finger”
6) Navicular “Middle finger proximal”
7) Cuboid “Middle finger tip”
8) 3 Cuneiforms “Ring finger 1,2,3”
9) 5 Metatarsals “Pinky 1,2,3,4,5”
10) Metatarsophalangeal joints

Question 2

Foot and Ankle

Soft Tissue Palpation

Answer 2

1) Tibialis posterior tendon
2) Spring ligament
3) Tibialis anterior tendon
4) Deltoid ligament
5) Peroneus brevis “Tendon”
6) Achilles tendon
7) Plantar aponeurosis
8) Anterior talofibular ligament
9) Posterior tibial artery
10) Dorsal pedal artery

Question 3

Foot and Ankle

Ranges of Motion

Answer 3

Active and Passive

1) Ankle Dorsiflexion 20°
2) Ankle plantarflexion 50°
3) Subtalar Inversion 5°
4) Subtalar Eversion 5°
5) 1st MTP Joint Flexion “Big Toe”
6) 1st MTP Joint Extension “Big Toe”

Question 4

Drawer Sign

Anterior Drawer Sign of the Ankle

Answer 4

Positive:
Translation with the talus moving away from or toward the tibia

Indicates:

1) With tibia pushed/foot pulled; a tear/instability of the anterior talofibular ligament.
2) With tibia pulled/foot pushed; a tear/instability of the posterior talofibular ligament.

Question 5

Ankle Dorsiflexion Test

Answer 5

Positive:

1) The foot cannot dorsiflex with knee extended, but is able to with knee flexed.
2) The foot cannot dorsiflex in either knee position.

Indicates:

1) Contracture of the gastrocnemius muscle
2) Contracture of the soleus muscle

Question 6

Rigid or Supple Flat Feet Test

Answer 6

“Patient performs sitting then sanding”

Positive:

1) Absence of medial longitudinal arch in both positions.
2) Presence of medial longitudinal arch while seated with a loss of medial longitudinal arch while standing.

Indicates:

1) Rigid flat feet “No, No”
2) Supple flat feet “Yes, No”

Question 7

Homans Sign

12”

Answer 7

Positive:
Deep pain in the calf.

Indicates:
Deep vien thrombophlebitis

Question 8

Thompson Test

Answer 8

“Patient is Prone”

Positive:
Absence of foot plantarflexion motion

Indicates:
Achilles tendon rupture

Question 9

Morton Test

Answer 9

Positive:
Sharp pain in the forefoot

Indicates:
Metatarsalgia or neuroma (usually at the 3rd and 4th metatarsal interspace)