LE, knee, ankle, and foot Flashcards
What is the importance of the pelvis in posture?
Final common platform for postural alignment
True or false: the LE are linked to systemic clinical issues
True
Where does pain refer from when it presents in the legs?
- Lumbar
- Pelvic
- Abdominopelvic region
What are the six clinical goals for DOs? (SEMEN-P)
- Stability
- Energy efficient movement
- reduce Mechanical stress
- Eliminate nociception
- Neural balance
- Promote venous and lymphatic drainage
What is osgood-schlatter syndrome? What makes it worse?
An inflammation of the patellar ligament at the tibial tuberosity. It is characterized by a painful lump just below the knee and is most often seen in young adolescents.
Worse with extension of the knee.
Most of the joints of the LE are of what kind? What is the one exception to this?
Synovial capsule
Distal tibiofibular joint is a fibrous syndesmosis
Should AROM include weight bearing when there is a suspected joint injury?
Yes
What are the two reasons behind painless weakness?
- Neurological deficits
- Complete tear of a tendon
What is a first degree sprain? What is the clinical course of this?
Integrity of the ligament is undisturbed, but is TTP and painful to stretch
Self limiting
What is third degree ligament sprain? What is the clinical course of this?
Complete disruption of the ligament with no remaining tensile strength
Needs surgery
What is a grade I second degree ligament sprain?
Partial tear with slight laxity
What is grade II second degree ligament sprain?
More complete tearing and moderate laxity
How do you determine SDs of the lower limb (generally)?
If pattern of paired motions are free in one direction, but restricted in the other
Main motions of the joint of the LE are assessed how?
With PROM along with the minor motion glides
What is the order of the exam for a suspected ligament injury?
AROM
PROM
Resisted tests
Painful stretching of a muscle/tendon and painful ROM n is suspicious for what?
Muscle/tendon injury
If a joint is restricted secondary to pain in all planes of motion, what is this?
Capsular pattern
Treatment of SD improves bodily function how?
Reducing hyper-sympathetic activity
What is the ANS supply to the LE?
T11-L2
What are the 5 steps of improving LE vascular input and drainage?
- Opening fascial pathways
- Maximizing pressure gradients between thorax and abdomen produced by improving respiratory efficacy
- Improve muscular contraction
- Eliminate the tourniquet effect found in the hip, knee, and ankles
- Lymphatic pumping
What are the ottawa ankle rules? (4 areas of TTP, exam finding)
TTP over the medial malleolus or navicular bone
TTP over the lateral malleolus or styloid process of 5th metatarsal
Patient cannot weight bear
What are the four steps of the DMU sprained ankle protocol?
- Reset the talus in the mortise of the ankle
- Milk the peroneal muscles
- Correct the ipsilateral fibular head
- Correct the ipsilateral posterior 3rd rib
What is the cause of a high ankle sprain?
Tearing of the syndesmosis
True or false: when evaluating any issue with the lower extremity, you should alway assess the hip, knee, and ankle
True
What is the mechanism of the injury with a high ankle sprain?
Inversion injury
What information should be gathered with a history for a joint injury?
- Learn mechanism of injury
- Narrow the exam down to the smallest amount of tissue area
What is the order of the examination for a joint?
- Inspect
- ROM
- Resistance/strength
- Ligaments
- Joint surfaces
- Palpation
What are the components of the unhappy triad?
- Torn lateral meniscus
- ACL tear
- Medial meniscal tear
What is the treatment for a second degree ligament spain?
Rehabilitation or regenerative injection therapies
What are the two ways of improving muscular contraction?
- Remove SDs innervating the muscle
- Treating muscle strains and imbalances
