Module #2-Foot, Ankle, Lower Leg Flashcards
Foot, Ankle, Lower Leg
Are the Deltoid Ligaments on the on the medial or lateral side of the foot?
Medial
How are the tarsal bones named?
Medial -Lateral, First, second, third
What does the distal tibiofibular joint (tibia and fibula) Form?
Ankle Mortise
What three movements are “Pronation” of the foot
Dorsiflexion, Eversion, Abduction of the foot
What three movements are “Supination” of the foot
Plantarflexion, Inversion, Adduction of the foot
What four ligaments make up the deltoid ligaments?
Anterior Tibiotalar
Posterior Tibiotalar
Tibiocalcanean
Tibionavicular
What is the most common type of ankle sprain?
Lateral ankle sprain at the anterior talofibular
What stabilizes the medial longitudinal arch?
Spring Ligament-Plantar Calcaneofibular
Without this, tendons would not be safe!
Retinaculum
how many compartments is the lower leg divided into?
4
What are compartments separated by?
Strong Fascia Walls
___________ is not a true arch
Transverse arch
Which muscle plays a huge role in supporting the medial arch of the foot?
Tibialis Posterior
Tibial Nerve entrapment syndrome
Tarsal Tunnel Syndrome
Most common affected compartment in the leg
Anterior
A fracture affecting one or more of the malleoli
POTT’S FRACTURE
How long does the first stage of healing take for fractures?
72 Hours
How are lateral ankle sprains measured?
Grade 1: mild, Grade 2: Moderate, Grade 3: Severe or total
Floating matter in the space where blood travels through
Embolus
Normal heart rate
60-100 Beats per minute
irregular heart beat
arrythmias
Avoid pacemaker side for how many weeks
6 weeks. Avoid entire area surrounding it
If a client is having an angina attack, you can administer how many nitro doses?
3
Why is the head of the fibular an endangerment site?
it doesn’t have a lot of fat or muscle to protect it
What structure goes around the head of the fibula?
Common Fibular Nerve
What is an easy test for Plantar Fasciitis?
Windless Test
Where is the tarsal tunnel located?
Find Medial Malleoli and go posterior then inferior to it.
What structures are involved in the tarsal tunnel ?
Tibial Nerve, Posterior Tibial Nerve, TDH muscles, medial Malleoli, Anterior Retinaculum
The sciatic nerve splits into what sections in the popliteal region?
Tibial nerve which innervates gastroc and soleus and the common fibular nerve which innervates the peroneals
What structure acts as the primary shock absorber for the foot?
Plantar Fascia
What structures are involved with mortons Neuroma?
Plantar nerves between 3rd and 4th toes
What structures are involved with bunions (Hallux Valgus)?
Medial part of the 1st metatarsophalangeal joint of the first big toe
What structures are involved with hammar toes?
toes 2-4 stuck in flex position
What structures are involved with a medial ankle sprain?
Deltiod Ligaments: Anterior Tiobiotalar, Posterior tibiotalar, tibionavicular, tibiocancaneal
What is mortons neuroma?
enlarged or irritated nerve tissue in distal region of the foot usually between the 3rd and 4th metatarsal
How would you treat mortons neuroma?
metatarsa;l spreading, deep stripping, avoid direct compression in area, nueral stretching
What is closed pack position?
When a synovial joint is under maximum tension
What is Capsular pattern of restriction?
predictable pattern of restriction,
Describe Convex v.s Concave rule
When a convex surface moves on a concave surface the roll and glide occur in opposite direction. Concave on convex, roll and glide happen in the same direction
where does a high ankle sprain occur?
Distal Tibiofibular sydemosis
What are TOM, DICK, HARRY muscles?
Tib Post, Flexor Digitorum Longus, Flexor Hallicus Longus
what causes hallux valgus?
pointed shoes, genetics, lax ligaments
What tom dick harry muscle lies closest to the medial Mellelous of the tibia?
Tibialis Posterior
Most superficial TOM DICK HARRY MUSCLE
Flexor Digitorum Longus
Which muscle is superficial to TOM DICK HARRY
SOLEUS
Which four muscles are located in the deep posterior compartment of the leg?
Popliteus, Flexor Digitorum Longus, Flexor Hallicus longus, Tibialis Posterior
Where are the TOM, DICK, HARRY muscles most superficial?
Medial side of the leg between the tibia and the calcaneus
What is classified at shin splints and what can cause them?
Periostitis, compartment syndrome: Overuse, Over Pronation, swelling, running
Why is the head of the fibula an endangerment site? What passes through it?
It doesn’t have a lot of adipose tissue. Common Fibular Nerve
What Bursae is between the calcaneal tendon and the skin?
Subcutaneous Calcaneal Bursa
This arch is very tall and is extremely resilient due to its large number of bones
Medial longtiudinal arch
——— is swelling caused by excess fluid trapped in body’s tissue
Edema
What type of edema is bad and is not to be treated common with pregnant women,liver, and kidney problems
Pitting edema
What are blood clots also called and how long do you have to wait?
Thrombi’s, 8-12 weeks
If anything is found in the flood stream it is called _______
Embolus
Terms for any changes to any normal heart beat (slower or faster)
Arrhythmias
Bunions (Hallux Valgus) is a condition that affects what joint?
1st MTP
What are the two types of hammer toes?
Flexible hammer toes
Rigid hammer toes
What toes does hammer toes affect?
The three middle toes
What is tarsal tunnel syndrome ? What are some symptoms of tarsal tunnel syndrome?
It is nerve entrapment syndrome and pain on the planter surface.sharp shooting pains in medial ankle. Numbness in muscles of foot.pain after walking or running
Treatment of tarsal tunnel syndrome
Treat posterior legs
Active engagement lengthening
Gentle deep friction
Deep stripping plantar surface of foot
How do you treat periostitis?
Excessive flushing due to restricts nature of compartment, reduce HT in anterior and posterior leg compartment. Stretch and lengthen all muscles that at HT
Compartment syndrome can occur within any compartment but most common in___
Anterior compartment
How do you treat plantar fasciitis?
Lengthen the plantar fascia, break down adhesions,lengthen posterior leg muscles, strengthen anterior muscles, ice massage .
What is Potts fracture?
A fracture affecting one or more of the mallei (lateral , medial) . Damage to deltoid ligaments may happen .
What are the 4 lower leg compartments?
Deep Posterior
Superficial Posterior
Lateral
Anterior
Name some different types of Bone Fractures
-Transverse
-Open
-Segmental
-Oblique
How do you want to treat ankle sprains?
Deep Friction to ligaments
Deep stripping to lower leg/ankle
ice in acute stage
heat in chronic stage for 10 minutes
lymphatic Drainage
Why are Lateral ankle sprains more common than medial?
The deltoid ligaments are strong and require a greater force to produce stretching or tearing. The Medial malleolus is further inferior, limiting eversion
What ankle conditions can lead to avulsions?
Lateral Ankle Sprain
What is contraindicated for ankle sprains?
Ankle Sprains (Lateral and Medial)
What is Hypertension also known as and why?
“Silent Killer” because of its asymptomatic presence.
What is hypertension?
Consistent High blood pressure (140/90 mm) for a long time. greater risk of having a stroke or heart attack
How often should measuring BP be taken with someone who has hypertension?
Beginning of treatment, usually first visit and periodically throughout treatment plan
What is deep Vein Thrombosis?
Inflammation of a deep vein causing blood platelets to collect forming a clot or thrombus, restrictiong blood. Major concern is a blood clot being disrupted and becoming an embolism.
What are some signs and symptoms of deep vein thrombosis?
Leg Swelling, heat, redness, tenderness, possibly chills and fever. massage contraindicated
What are Varicose Veins?
Dilation in the veins due to weak valves.
What are the three arches of the foot?
- medial longitudinal Arch
- Lateral Longitudinal Arch
- Transverse Arch
What are some things about the medial longitudinal arch of the foot?
The arch is very tall and resilitent due to its large number of bones. Normal space between inner sole and ground is two fingers
If someone has hind foot Varus, what are they prone to?
Lateral ankle sprains ( lateral collateral ligament)
What is hind foot cancaneal valgus?
Distal calcaneal deviates laterally at subtiles joint (reversion/overpronation)
Pes plants is also known as :
“Flat foot”
Pes cavus is also known as
High arch exaggerated longitudinal arch. Observe from medial side , standing.
Explain bunions (hallucinations Valgus)
A condition that affects the 1st MTP joint and means the deformity goes in a direction away from the midline of the body.
What is the bunion actually referred to?
The bump that sweeps medically on the side of the first MTP joint. Made up of irritated swollen tissue that is constantly rubbed between the shoe and pressure beneath the skin.
What is hammer toes?
The tendons in the toe become rigid, moving the joint out of alignment and the toe can’t be moved
What is Gout usually accompanied by?
Acute arthritis attacks
What is Gout?
Group of disorders where monosodium urate crystals are deposited in joints. Metatarsal joint of big toe commonly attacked , tarsals and ankle may be involved with progression
What is treatment of tarsal tunnel syndrome?
Deep posterior stripping leg
Active engagement lengthening
Gentle deep friction
Deep stripping plantar surface of foot
What is periostitis?
Pain along inner edge of the tibia due to repeated trauma of connective tissue surrounding the tibia. Common with athletes doing running or jumping sportd
What is Plantar Fasciitis?
Plantar fascia is chronically inflamed,possibly swollen or tears, heel spurs may be present
Varicose veins are most common in:
Women ages 40-50
End feel definition:
The quality of movement perceived by the therapist at the very end of the available ROM in PROM
