Lecture 14

Question 1

What type of lever is the calf/ankle?

Answer 1

2nd class lever

Question 2

1st MTP Extension ROM

Answer 2

heel supported to limit ankle motion

Axis: medial aspect of mid MTP joint
Stationary: medial midline of 1st metatarsal
Moving: medial midline of proximal phalanx

all toes cam extend

Question 3

1st MTP Flexion ROM

Answer 3

heel supported to limit ankle motion

axis: medial aspect of mid MTP joint
stationary: medial midline of 1st metatarsal
moving: medial midline of proximal phalanx

don’t let them plantarflex

Question 4

1st MTP abduction PROM

Answer 4

axis: dorsal aspect of 1st MTP
stationary: dorsal midline of 1st metatarsal
moving: dorsal midline of 1st proximal phalanx

measure starting position in order to get accurate PROM value

Question 5

Gastrocnemius muscle sterngth

Answer 5

1. hands on wall or just two fingers on table for balance
2. knee must stay in extension
3. movement must be vertical
4. must go through full ROM for reps to count
5. watch for change in UE support

goal of 25 reps and <10% difference from the other side

Question 6

Soleus muscle strength

Answer 6

1. standing with hands on wall for balance
2. knee flexed to approx 45°
3. goal of >15 reps and <10% difference from the other side

Question 7

Soleus muscle endurance test

Answer 7

wall sit, rise up onto toes, shift weight onto one leg and hold as long as you can.
quads should fatigue before calf

Question 8

anterior tibialis strength test

Answer 8

position is long or short sitting
force is down and out into eversion

toes should not be extended
pt is doing dorsiflexion with inversion

Question 9

Posterior tibialis strength test

Answer 9

long or short sitting with foot slightly plantar flexed
force is up and out (scooping motion)
pt is doing inversion and plantarflexion

watch for subs of toe flexors

Question 10

ankle eversion strength test

Answer 10

fibularis longus and brevis

pt should be in plantarflexion, long or short sitting
force is in and up, scooping motion
pt plantarflexes and everts

Question 11

extensor hallucis brevis strength test

Answer 11

pushing proximal 1st phalanx down into flexion, patient tries to move into extension

Question 12

extensor hallucis longus strength test

Answer 12

pushing distal 1st phalanx down into flexion
pt tries to move into extension

Question 13

extensor digitorum longus strength test

Answer 13

hallux is stabilized with one hand and other hand applies resistance into flexion of other digits

Question 14

hallux MP flexion strength test

Answer 14

flexor hallucis brevis

long sitting, stabilize foot into slight plantarflexion
action: flex 1st toe, bend your toe over my finger
resistance: applied at middle phalanx into extension with thumb

Question 15

hallux IP flexion strength test

Answer 15

flexor hallucis longus

long sitting, stabilize foot in slight plantarflexion
action: flex 1st toe, place the end of your toes into my finger
resistance applied at plantar distal phalanx into ext w/thumb or index finger

Question 16

lesser toe MP flexion strength test

Answer 16

lumbricals and interossei

sitting and stabilizing foot in slight plantar flexion
“curl your toes around my finger and hold”
force is across the MP joints into extension

Question 17

Lesser toe DIP flexion strength test

Answer 17

flexor digitorum longus

sitting and stabilizing foot in slight plantar flexion
curl your toes around my finger and hold
force is across the DIP joints into extension