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MSK: LQ > lecture 8b: foot/ ankle examination > Flashcards

lecture 8b: foot/ ankle examination Flashcards

1
Q

what are 7 injuries associated with pronatory foot types (flat)

A

• Plantar fasciitis
• Interdigital neuroma
• Shin-splint
• Sesamoiditis
• Tarsal tunnel syndrome
• Patellofemoral dysfunction
• Posterior Tibialis Tendon Dysfunction

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2
Q

what are 7 injuries associated with supinatory foot types (high arch)

A

• Metatarsalgia or stress fracture
• Peroneal tendinitis
• IT band friction syndrome
• Lateral ankle sprain
• Lower back pain
• Sesamoiditis
• Plantar fasciitis

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3
Q

most studies for lateral ankle sprains support ____ and/or ___ over immobilization , ultrasound , RICE alone and RICE + meds

A

manual therapy and/or manipulation

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4
Q

is functinal treatment or immbolization better for acute ankle sprains

A

functional treatment

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5
Q

t/f: as BMI increases so does the risk for no contact ankle sprains in HS FB players

A

true

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6
Q

the balance program made by McGuine , included both ___ and ___ balance activities for ankle sprains

A

static and dynamic

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7
Q

what are teh variables for doing manipulations post inversion ankle sprains (lateral)

A
  • symptoms worse when standing
  • symptoms worse in evening
  • navicular drop > or even to 5 mm
  • distal tibiofubular joint hypomobility

if 3 are presents then probability to do manip is high

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8
Q

does adding myofascial therapy with manipulations add help with management of acute inversion ankle sprain (lateral)

A

no it does not help by adding myofascial release

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9
Q

the study where they looked at the effects of mobilization with movement on DF range of motion , dynamic balance and self reported function individuals with chronic amkel instability what did they find a positive change in

A

sport specific function but no change in DF ROM

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10
Q

what is the moderate evidence (B) for risk factors for acute lateral ankle sprain

A

• Pt age
• BMI
• Pain coping strategies
• Report of instability
• Hx of ankle sprain
• Ability to WB/pain w/ WB
• Ankle DF ROM
• Balance
• Ability to jump and land

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11
Q

what is considered weak evidence (C) for chronic ankle instability for risk factors

A
  • Previous tx
  • Number of previous ankle sprains
  • Pain level
  • Self reported function
  • Dynamic postural control
  • Balance systems
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12
Q

what clinical measures from strong evidence (A) for lateral ankle sprains

A
  • ankle swelling
  • ankle ROM (particularly DF in open and closed chain)
  • talar translation/Inversion
    -SL balance ( star excursion balance test )

** Need to measure >2 times during episode of care

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13
Q

what** self report measures** for lateral ankle sprains are consider strong evidence (A)

A
  • Foot and Ankle Ability Measure (FAAM)
  • Lower Extremity Functional Scale (LEFS
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14
Q

what pain/self efficacy outcome measure for lateral ankle sprain is weak evidence (C)

A
  • Tampa Scale of Kinesiophobia
  • FAB-Q
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15
Q

what physical performance test for lateral ankle sprain is moderate evidence (B)

A
  • Single limb hop tests
  • Timed when appropriate
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16
Q

what PT interventions for lateral ankle sprain is considered strong evidence (A)

A
  • external support and AD
  • manual therapy
  • ther ex exercise
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17
Q

what kind of evidence is Cryotherapy and diathermy for laterla ankle sprains

A

C weak

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18
Q

what is the strong evidence against the use of ___ for lateral ankle sprains

A

ultrasound

19
Q

what is the first thing u do for ankle fx? and then what

A

1st see if ankle is broken or if imagin is needed with the ottawa ankle or foot rules

if (-) then treat as needed as sprain
if (+) then immobilization and clearance by MD

20
Q

what are the ottawa ankle and foot rules

A

ankle:
- bone tenderness of lateral malleolus
- bone tenderness of medial malleolus
- inability to WB in ER and after injury

foot:
- bone tenderness at base of 5th MT
- bone tenderness of navicular tubercle
- inability to WB in ER or after injury

just need 1 to be true to need imagine

21
Q

how does compartment syndrome occur

A

when tissue pressure within a closed mm compartment exceeds perfusion pressure

22
Q

when does compartment syndrome occur

A

w high velocity injuries , bone fx , penetrating injuries , snake bite and vigorous exertion

23
Q

what does a pt complain of w compartment syndrome

A

complain of “burning”, and worsens w/ stretching involved tissue

24
Q

what are the similar findings of achilles tendinopathy as w patellar tendinopathy

A

vasculo-neural in growth and lack of inflammatory markers

25
achilles tendinopathy is suggest that neovascularization and neural in growth in ____ tendinosis related to pain
midsubstqnace
26
for achilles tendinopathy … ___ training program appears to enhance more normal tendon structure and eradicate neovascularization … however, consider your pt’s starting point
Eccentric
27
what exercise for **achilles tendinopathy** is considered **strong evidence (A)**
* Eccentric loading * Heavy load, slow speed (concentric/eccentric
28
what **stretching** for **achilles tendinopathy** is considered **weak evidence (A)**
* Ankle PFs w/ knee flexed and extended * Improve ankle DF ROM
29
what is Posterior Tibialis Tendon Dysfunction
degenerative and progressive condition of the posterior tibialias tendon
30
what is the observation and mobility for **Posterior Tibialis Tendon Dysfunction**
- Observation: Loss of arch height, forefoot abduction, rearfoot valgus - Mobility: limited and/or painful plantarflexion
31
what is the function and strength for Posterior Tibialis Tendon Dysfunction
- Function: abnormal gait mechanics: decreased push off, pain with WB or single leg balance - Strength: weak and painful single leg heel raise, asymmetrical bilateral heel raise, **weakness** with **inversion** and plantarflexion
32
what is the mechanics of dysfucntion of **cuboid subluxation**
almost always plantar subluxation
33
what is the treatment for cuboid subluxation
• Cuboid whip • Cuboid squeeze
34
how do u want to customize the orthotics for plantar fasciitis
subtalar neutral
35
how should the shoe wear be from plantar faciitis
improved CUSHIONING for supination foot improved SUPPORT (rear foot) for pronator foot
36
the cochrane review from plantar heel pain says there is ____ evidence supporting corticosteroids injections for short term relief of pain and ___ evidence supporting night splints for reducing pain in chronic conditions
limited 2x
37
the study for plantar heel pain (young et al) used manual therapy techniques targeting the ___ , ___ and ____ joints and all 4 patients reported _____ pain at discharge
talocrural , subtalar , and tarsometatarsal joints 0/10
38
according to the study (roos et al) did orthoses help with plantar faciitis
slight higher functional scores in orthotics groups but not difference in out come measures at 1 year
39
what is considered **strong eviednce** for **interventions** for **heel pain**
- manual therapy - stretching - taping - night splints
40
what is considered strong eviednce on what NOT to do for heel pain interventions
ultrasound
41
what is considered moderate evidence for interventions for heel pain
- do not use isolated foot orthoses - low lever laser therapy - therapeutic exercises/ NM re ed - dry needling
42
what is the ROM of the hallux during gait
65-70°
43
what is the etiology for hallux rigidus
trauma and degenerative changes
44
what is the wells criteria for PE/DVT
-clinical signs of DVT - HR > 100 BPM - immobilization for 3 days or longer - previous ex of PE or DVT - hemotysis - pts w cancer receiving treatment - alternative dx less likely then PE > 6 pints is high 2-6 is mod <2 is low

MSK: LQ (22 decks)

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