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THER EX > Orthopedic Management of the Foot and Ankle PP > Flashcards

Orthopedic Management of the Foot and Ankle PP Flashcards

1
Q

Injuries to lateral ligament complex

What 3 ligaments make up the lateral ligament complex of the ankle?

MOST OFTEN SPRAINED

A
  1. ANTERIOR TALOFIBULAR LIG(inversion ankle sprain)

next most often

  1. FIBULOCALCANEAL LIG
  2. POSTERIOR TALOFIBULAR LIG
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2
Q

Most common injury –
Approximately 95% of all ankle sprains
Injury does not require high forces to occur

WHAT SHOULD YOU AVOID?

shank pg233 17-1

A

inversion sprain

MOI: avoid pf inver and add of the foot and akle

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3
Q

the leach class what 3 degrees

A

first degree- rupture of anteriro talofib

second degree - two are rupture anterior talofib and fibulocalcaneal

third degree- all 3 torn anteriro talofib,anterior talofib and fibulocalcaneal

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4
Q

s/s inversion sprain

depends on the severity of the sprain

A

swelling pain lof cardinal signs

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5
Q

Scarify

A

Scratching or cracking the hard outer coat of a seed to help it germinate. Can also be done with acid.

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6
Q

Understands how environmental print, pictures, and symbols contribute to literacy development

A

Reading environmental print assesses the students ability to read commonplace or “highly frequent” print accessible in their local and daily environment, such as signs in the school like STOP, EXIT, or NO SMOKING. Environmental print information can be used to assess the access a child has had or the attention given to printed language in the environment. It encourages beginning readers to develop and “I can read!” attitude. The purpose of reading environmental print is to give children an experience that allows them to read familiar print drawn from the world around them that they are likely to have seen. It not only brings the outside world of print closer to the classroom but also build children’s confidence in their ultimate ability to learn to read.

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7
Q

grade three precautions with surgery

KC 875 box 22.2

“activity-related precautions to reduce the risk of re-injury after lateral ligament reconstruciton of the ankle”

A
  • modify activities to low-impact
  • minimized or avoid participation in high impact
  • involve activities that associate with high risk ankle injuries
    • particiapate in pre-season injury prevention
    • wear prescribe orthodics
    • tape ankle or insert slight lateral lift in the shoe
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8
Q

name 2 Ankle tests and what they test for.

A
  • Talor Tilt
    • Testing for ligament resistance to inversion stress
  • Anterior Drawer
    • Assess integrity of anterior talofibular ligament
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9
Q

Treatment:

for ankle sprain

include ROM

A
  • RICE
  • Clinically, what education should be provided to the patient to ensure pt safety re: icing at home?
  • Limit movement/immobilization
  • Limit weight bearing with gradual increase
  • Avoid inversion with inversion sprains

ROM

  • Strength-iso at ankle can strengthen above injury
  • What type of exercises should be utilized in the acute stage?
  • Progress weight bearing
  • Progress to concentric and eccentric contractions and proprioception exercises
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10
Q

Clinically, remember that once a patient can bear weight on the ankle without crutches, demonstrates controlled swelling and can complete ROM and isometrics without excessive c/o pain, begin progressing to more challenging activities
Provide examples:

A
  1. wobble board
  2. bosu
  3. airX
  4. square pad
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11
Q

MOI: fo Achilles Tendinitis

A

Achilles Tendinitis

Intrinsic:

Extrinsic:

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12
Q

Achilles Tendinitis s/s

A

Signs & Symptoms
Pain
Swelling
Crepitus
What is crepitus? crunchy

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13
Q

Achilles Tendinitis:Treatment

A

Physical agents for inflammation/NSAIDS
Decrease stress
What could you do to improve aerobic endurance while avoiding stress? UBE
Progressive exercises as injury healing and pt pain tolerance allows: ROM,

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14
Q

If physician prescribes a rigid cast immobilization for a 10 day period, rehab progresses at a slower rate following removal of cast

A

rehab process is a lot slower do to cast

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15
Q

MOI: complete tear of tendon caused by sudden forceful PF
What type of impairments and functional limitations may be present?

A

suden forceful PF

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16
Q

Special Test for PTs to complete for achilles rupture
Thompson Test

A

like homens - no motion probably a rupture

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17
Q

Achilles Tendon Rupture 877 comp w/ repair kc

coventional tx 878

Whats the tx

A

Surgery to sew tendon back together, immobilize, then rehab to increase range, strength and more advance function
Conservative: Immobilize for as long as 8 weeks
Not typically very successful

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18
Q

General program suggestions for Achilles Tendon Rupture

A

General program suggestions:
Regain full ROM initially once immobilization has ended
Pt may be using heel-lift 3-4 weeks following immobilization
*If tendon is stressed too much, it could re-rupture

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19
Q

General program suggestions (cont’d):
Progressive exercises with latex band
Proprioception exercises
CKC exercises
Weight bearing PF is appropriate to begin once pt has completed ROM and strengthening exercises without complication

precautions and guidelines 881 kc

A

fix slide

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20
Q

Compartment Syndromes

Two types

A

Acute- serious with fluid build up after trauma

Chronic- exersional after working out

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21
Q

Inflammation of plantar aponeurosis
Heel spurs may be involved

because of pull Wolfs law may cause a heel spur

A

Plantar Fasciitis

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22
Q

Plantar Fasciitis

Signs & Symptoms

A
  • pain in the moring
  • pain in heel from spur
  • tightness
  • tends to warm up during day
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23
Q

Plantar Fasciitis

Treatment

A

Control inflammation
What types of modalities may be used? US, ICE
Deep massage
Basic strengthening of foot muscles
How can we strengthen the foot muscles? marble pick up or toe crunches
Orthotics

24
Q

What types of exercises may be appropriate for a patient suffering from plantar fasciitis?

Consider what motion(s) would put the most stress on the plantar fascia?

A

DF

25
Q

Morton’s Neuroma

What does neur- mean?

What does –oma mean?

A

Nerve

tumor

26
Q

Morton’s Neuroma:Signs and Symptoms

A
  • burning
  • cramping
  • catching sensation
  • usually unilateral
  • 15% of pt have bilateral
27
Q

Morton’s Neuroma

Special Tests completed by the PT

Mortons test

A

Squeeze MT heads together for 1-2 minutes
Tingling, pain, etc indicative of neuroma
If positive, symptoms are relieved once pressure is taken away

28
Q

Morton’s Neuroma: conservative tx

A

MT pad; change of footwear to wider, softer shoe; corticosteroid injections; avoid high heal wear

29
Q

Treatment:Surgical Excision Post-op Rehab

A
  • Early ROM to avoid stiffness and fibrosis
  • Compression bandages for inflammation and pain
  • Modalities
  • Progress to strengthening
30
Q

Lateral or valgus deviation of great toe

MOI
Genetic bony structure + improper footwear

15% or less is normal

A

Hallux Valgus

31
Q

Hallux Valgus: tx conservative

A

Change footwear, orthotics, modify activity temporarily (bike instead of run), strengthen foot muscles

32
Q

Hallux Valgus: Surgical

A

Bunionectomy

  • Post-op
    • Pads and special shoe to position toe in correct alignment
    • Modalities for inflammation and pain
33
Q

name3 Toe Deformities?

mrs t says know them

A
  1. Mallet toes
  2. Hammer toes
  3. Claw toes
34
Q

mallet toes

Hammer toes

claw

A

flexed DIP

like butiners

THe claw

35
Q

plesase look at

A
  • ankle fx
  • stress fx
  • medial tibial stress syndrome
  • arch deformities
  • TAA
36
Q

How would these toe deformities affect gait?

How would they affect balance?

What types of exercises may assist the patient?

A

effects hip knee and back

37
Q

what combined motions cause supination?

A

plantar flexion, inversion, and ADD

38
Q

what combined motion cause pronation?

A

dorsi, eversion, and ABD

39
Q

What ligament is most affected by medial or eversion ankle sprains?

A

deltiod ligament

40
Q

Most commonly ankle sprains occur with the foot in an ___________ or ____________ position before the injury.

A

unloaded or NWB

41
Q

what motions should you avoid during the MAX-protection phase of an inversion ankle sprain?

A

PF, inversion

42
Q

what is the MOI of a lateral ankle sprain?

A
43
Q

___________ instibility is defined as laxity of the ankle ligaments.

A

Mechanical

44
Q

___________ instability refers to a subjective feeling of giving way without affecting ligament laxity.

A

Functional

45
Q

what injury of the ankle is the Thompson test for

A

ruptured achilles

46
Q

what motions do you want to avoid in max protection phase of mechanical ankle ligament instability

A

excessive PF and inversion

47
Q

complete rupture of the achilles tendon can occur with sudden _______________ contraction of the gastroc-soleus.

A

eccentric-concentric

48
Q

approx _______ of achilles tendon ruptures are secondary to degenerative changes in the tendon

A

50%

49
Q

what test is used for a ruptured achilles tendon

A

thompson test

50
Q

surgical repaired achilles tendon have a much lower rate of rerupture (than non operative approch) and there is a significant increase in the ultimate recovery of muscle strenght, power and endurance

A

polo :)

51
Q

what motion needs to be avoided with pt’s that have an achilles rupture?

A

DF

52
Q

acute compartment syndome is treated with a surgical procedure called what?

A

fasciotomy

53
Q

if you have a pt with an ankel fracture that was repaired with an ORIF and they are experiencing increased pain, swelling, crepitus(that was not already present), and motion what is this a sign of and what should you do?

A

sign of possible hardware loosening, notify PT immediately

54
Q

there are certain stress fractures that pose a greater risk of delayed union, nonunion and displacement than others. these tend to be termed “at risk” stress fractures, where are the locations

A

5th metatarsal, navicular, sesamoid, and inraarticular fractures

55
Q

which “at risk” stress fracture is described as “no-man’s-land”?

A

5th metatarsal at the base or proximal diaphysis

56
Q

when can closed-chain activities be added to an intervention for a stress fracture pt?

A

when radiographic confirmation by a physician documents stable bone healing.

57
Q
A

THER EX (15 decks)

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