leg, ankle, foot Flashcards
talus
no musc attachment
wider ant than post, less stable in plantarflexion
talocrural joint
talus, tib, fib
creates mortise/dome
mvmnts = dorsiflex, plantarflex
hinge jt
subtalar jt
talus and calcaneus
inversion/eversion
- inc inversion bcs lateral malleolus more distal
dome of talus
talus slides posteriorly to allow full dorsiflexion
distal tibia and fibula joint
connected via syndesmosis/fibrous tissue
also connect via interosseous membrane
posterior inferior tibia fibula lig: connects tib/fib distal
- also ant version
sections of the foot
hindfoot = talus, calcaneus
midfoot = row to cuboid, cuneiforms
forefoot
- hallux = only 2 phalanges
- MTs 1-5, MTP jts
- tarsometatarsal jts, intermetatarsal jts
leg compartments
ant = tib ant, EDL, EHL
superficial post = gastroc/soleus/popliteus
deep post = tib post/flexors
lat = fibularis longus/brevis
aucte compartment syndome
common leg bcs in contusion
inextensible fascia, inc swelling compresses anterior tibial artery and nerve
- limb threatening
S/S = tight ant compartment, infection signs, musc hypertrophy
- skin is red/shiny/hot
- pain WORSENS w rest and stretch
- dec dorsal pedal pulse
treatment
- IER, no P
- fasciotomy
chronic exertional compartment syndrome
manage w rest
anterior and deep post compartments more common
- young athletes
MOI = anatomy, overdev muscles that cause temp compression w activity
S/S = tight, cramping, numbness
- NO red/hot/shiny
diagnose w needle in compartment plus exercise
“shin splints”
anterior shin pain
dull/aching over ant tibia, tender palp, bilateral
- aggro by jump/run/hard surfaces
causes i.e. change intensity, bad footwear, training surfaces
deep vein thrombosis
potenial shin splint
blood clot forms in leg causing pain/swelling
- can be asymptom
MOI = post op, birth control
can cause pulmonary embolism when breaks off and travels to lungs
homan’s sign
potential conditions shin splints
tib ant/post tendinopahy
medial tibial stress syndrome
stress fracture
deep vein thrombosis
chronic compartment
tibial ant/posterior tendinopathy
tib ant = anterolat, proximal
- test resisted dorsi
tib post = posterolat, distal
- test resisted plantar
- more likely bcs 7 attachments to foot
leg/foot stress fracture
inc likely tibia bcs more weightbearing, tibial border
consistent pain w walking and rest, throbbing, bone tenderness
lateral ankle sprain
MOI = inversion w plantarflexion i.e. jump landing, cutting/uneven ground
inversion inc bcs lateral malleolus
- lateral ligaments weaker
anterior talofibular lig/ATFL= most common injury, top of foot
calcaneofibular lig = most last
PTFL = more likely injured w dorsiflexion
talar tilt
- plantar = ATFL
- dorsi = PTFL
- neutral = CFL
fracture test = ottawa ankle rules
fibularis brevis tendon attaches to base of 5th MT, potential avulsion
medial ankle sprain
MOI = eversion, can be coupled w dorsiflexion
deltoid ligament, test w talar tilt in eversion
syndesmosis sprain
high ankle sprain
MOI = inversion, when foot plants hard and talus is driven into mortise
- dome of talus forced up, tib/fib separate
- joint splayed
- fixed foot w ext rot tibia i.e. ski boot
affected ligs
- interosseous membrane
- AITFL/anterior inf tibiofibular lig
anterior drawer test
key is palpation, more anterosuperior
- longer recovery, treat w boot
achilles tendon rupture
30-50y/o
MOI = push off foot when knee extended
S/S = snap, someone kicked me
thompson test = squeeze calf, pos = no plantarflexion
surgical intervention, also boot w wedge
toe mvmnts
adduction, abduction
toe extension = point to sky
toe flexion = curl
pes cavus vs pes planus
pes cavus = high arch
- plantar fasciitis, peroneal tedonitis, ITB syndrome, metatarsalgia, sesamoid disorders
- inc chance stress fracutres bcs dec shock absorption
pes planus = flat foot
- achilles tendonitis, plantar fasc, medial tibia stress syndrome, tib post tendonitis, sesamoid disorders
sesamoid disorders
sesamoids = p shaped bones embedded in FHL tendon, number varies
fracture
sesamoiditis = inflammation of surrounding tissue i..e tendons
metatarsalgia
discomfort of MT heads
constant overload –> flattening transverse arch
- inc callouses from weight bearing
predisposing factors
- diabetes
- gout = uric acid crystal buildup, swelling
- age
- phys active
morton’s neuroma = thickening around nerve –> paresthesia around MT head
- compress shoebox from shoes
toe deformities
claw toe = hyperext MTP, flexed PIP/DIP
mallet toe = neutral MTP/PIP, flexed DIP
hammer toe = ext MTP, flex PIP, hyperext DIP
can be chronic i.e. footwear
hallux rigidis vs hallux valgus
hallux rigidis = degenerative arthritis of 1st MTP jt
- S/S = tender, enlarged 1st MTP jt
- loss motion, dec toe extension
- diff wearing high heels
hallux valgus = bunions, thickening medial capsule and bursa
- S/S = pain MTP jt, diff wearing shoes
