Mod 6: Foot/Ankle/Bone Injury

Question 1

deep fibular nerve innervates which mm? (4)

Answer 1

anterior tib
ext hallucis longus
ext digitorum longus
fibularis tertius

Question 2

tibial nerve innervates which mm? (6)

Answer 2

gastroc, soleus, plantaris
tibialis post
flex digitorum longus
flex hallucis longus

Question 3

superficial fibular nerve innervates which mm? (2)

Answer 3

fibularis brevis
fibularis longus

Question 4

lateral ligaments (3)

Answer 4

anterior talofibular lig (ATFL)
posterior talofibular lig (PTFL)
calcaneal fibular lig (CFL)

Question 5

medial ligament of the ankle

Answer 5

deltoid ligamant

Question 6

joint of DF/PF with what 2 bones?
-open packed position?
-closed packed position?

Answer 6

talocrural jt
talus & tibia
OP: full PF
CP: full DF

Question 7

joint of inversion/eversion with what 2 bones?

Answer 7

subtalar joint
talus + calcaneus

Question 8

CKC supination:
calcaneal motion (1), talar motion (2), tibial motion (1)

Answer 8

calcaneal inversion
talus ABD & DF
tibial ER

Question 9

CKC pronation:
calcaneal motion (1), talar motion (2), tibial motion (1)

Answer 9

calcaneal eversion
talus ADD & PF
tibial IR

Question 10

3 arches of the foot
what purpose?

Answer 10

anterior transverse arch
medial & lateral longitudinal arch
for stability, like tripod

Question 11

gait deviations: mm problem?
foot slap, toe drag, excess hip/knee flexion

Answer 11

weak DF/ant tib

Question 12

gait deviations: mm problem?
lack of push-off/pre swing

Answer 12

weak PF/gastroc

Question 13

gait deviations: mm problem?
excess supination

Answer 13

weak evertors/fibularis

Question 14

gait deviations: mm problem?
excess pronation

Answer 14

weak invertors/post. tib

Question 15

ATFL & PTFL special tests

Answer 15

Anterior Drawer Test
Posterior Drawer Test

Question 16

CFL sprain special test

Answer 16

Talar Tilt Test

Question 17

special test for ruptured Achilles tendon/no PF

Answer 17

Thompson’s Test

Question 18

special test for DVT d/t calf pain/tenderness

Answer 18

Homan’s sign

Question 19

talocrural jt
anterior glide for?
posterior glide for?

Answer 19

ant: PF
post: DF

Question 20

subtalar jt
medial glide for?
lateral glide for?

Answer 20

med: eversion
lat: inversion

Question 21

distal tib/fib jt
anterior glide for?
posterior glide for?

Answer 21

ant: PF
post: DF

Question 22

collapse of ankle, midfoot & rearfoot
imbalance of fib brevis & post tib

Answer 22

pronated foot

Question 23

pes planus; little/no arch with WB

Answer 23

flatfoot

Question 24

pes cavus; abnormally supinated foot
- high arch, tibial ER, increased forefoot varus
-lost shock absorption

Answer 24

stiff foot

Question 25

high vs. low lateral ankle sprain ligaments?

Answer 25

high: Ant tibiofibular ligament low: ATFL, CFL, PTFL ligaments (tALOfibular)

Question 26

ankle sprains can progress to ____ d/t what types of instability? (2)

Answer 26

chronic ankle instability mechanical/structural instability & functional/strength instability

Question 27

surgery: Achilles lengthening, distal tib/fib fusion, sometimes subtalar fusion

Answer 27

total ankle arthroplasty

Question 28

valgus deviation of great toe w/ pain/stiff/red/swelling of 1st MTP jt -exostosis (benign bone tumor) on dorsomedial aspect of 1st MT

Answer 28

Hallux Valgus/Bunions

Question 29

what to stretch vs strengthen in bunions?

Answer 29

stretch Achilles strengthen intrinsic foot mm

Question 30

sprain of the 1st MTP jt

Answer 30

turf toe

Question 31

joint flexion involved with: claw toe hammer toe mallet toe

Answer 31

claw: DIP hammer: PIP, DIP mallet: PIP, DIP

Question 32

common locations of tendonitis/osis

Answer 32

achilles peroneals tib post & ant FHL

Question 33

causes for this injury: push w/ WB on forefoot w/ extended knee sudden DF w/ full WB violent DF w/ jump/fall from height and landing on PF foot

Answer 33

Achilles Tendon Rupture

Question 34

causes for this injury: prolonged standing/walking pes cavus/planus adaptive shortening of heel cord new fitness program acute injury

Answer 34

plantar fascitis/osis

Question 35

mm to strengthen w/ plantar fascitis (2)

Answer 35

FHL flex digitorum longus

Question 36

pain in forefoot w/ inc. stress over MT head region -d/t high pressure activity over MT heads w/ abnormal weight distribution or altered biomechanics

Answer 36

Metatarsalgia

Question 37

entrapment neuropathy of tibial nerve as it passes through tunnel between flexor retinaculum & medial malleolus -can involve terminal branches of tibial & med/lat plantar nerve

Answer 37

tarsal tunnel syndrome

Question 38

enlargement of interdigital nerve & thickening of surrounding tissues -discomfort between 3rd/4th MT heads

Answer 38

Interdigital Neuroma/Morton's

Question 39

acute/chronic elevated tissue pressure within closed fascial space which occludes vessels & compromises NM function lateral, anterior, superficial posterior, deep posterior

Answer 39

compartment syndrome

Question 40

5 P's of compartment syndrome:

Answer 40

pain, paralysis, parasthesia, pallor, pulses

Question 41

periosteal irritation along tibia -inflammation of posterior tib & soleus mm

Answer 41

Medial Tibia Stress Syndrome

Question 42

overuse/weakness of anterior tib, EDL or EDB -poor eccentric control of DF on heel strike

Answer 42

Anterior Shin Splints

Question 43

common fx locations

Answer 43

tibia fibula talus calcaneus MTs

Question 44

calcaneal apophysitis (growth plate inflamm) -apply traction at Achilles insertion -common with inc. activity w/ children

Answer 44

Sever's Disease

Question 45

bloot clot in LE than can dislodge & travel (embolus) -pos. Homan's sign

Answer 45

DVT

Question 46

amount of overlapping bone that's still in contact -fragments are shifted side/back/forward

Answer 46

apposition

Question 47

failed healing of bone: nonoptimal/unsatisfactory healing of bone: slowed healing of bone:

Answer 47

nonunion malunion delayed union

Question 48

variables for bone repair timeline

Answer 48

type of bone involved (& how many) type of fx state of blood supply (circulation, comorbities) general health age

Question 49

fracture tx: distal part of limb is pulled in line of the bone -fragments repositioned -not surgical

Answer 49

closed reduction

Question 50

fracture tx: operative reduction of fx w/ direct visualization -surgical

Answer 50

open reduction

Question 51

fracture tx: fragments fixed w/ screw/pins/metal plates, combo for stability

Answer 51

internal fixation (ORIF)

Question 52

complications of internal fixation

Answer 52

infection non-union implant failure: broken pieces, tissue unacceptance refracture: if removed too soon

Question 53

fracture tx: transfixing screws that pass through skin & bone and attached to external frame -uses tension to hold alignment

Answer 53

external fixation

Question 54

post immobilization PT tx ideas

Answer 54

inc. ROM & joint play inc flexibility inc. strength/mm endurance functional activity

Question 55

general foot/ankle rehab

Answer 55

inc. WB tolerance inc. NM control achieve full WB on even/uneven surfaces balance/proprio strength of entire LE footwear gait biomechanics