Physical Exam-Ankle

Question 1

How do the muscles of the calf (soles and gastrocnemius) know when to fire to complete gait cycle?

Answer 1

The plantar fascia is stretched and makes them fire.

Question 2

Where do 85% of ankle sprains occur?

Answer 2

Anterior talofibular ligament on the lateral ankle.

Question 3

Why don’t medial ankle sprains occur as often as lateral ankle sprains?

Answer 3

The medial ankle has the deltoid ligament, which is very strong and difficult to tear.

Question 4

In what position do most ankle sprains occur?

Answer 4

Plantar flexion. The ankle is fairly stable in when flat.

Question 5

What things do you “inspect” during the physical exam of the ankle?

Answer 5

Gait, arches, swelling, ecchymosis, atrophy

Question 6

What are the key areas in the foot to palpate during the physical exam?

Answer 6

Metatarsal shafts and bases (Lis Franc = 2,3,4 and Jones = 5), anterior navicular, medial tubercle of calcaneus (plantar fasciitis) and achilles.

Question 7

What are the key areas in the lateral ankle to palpate during the physical exam?

Answer 7

Anterior talofibular ligament, calcaneofibular ligament, posterior talofibular ligament and the infero-posterior aspect of the lateral malleolus

Question 8

What are the key areas in the medial ankle to palpate during the physical exam?

Answer 8

Deloid ligament and infero-posterior aspect of the medial malleolus

Question 9

What are the key areas in the anterior ankle to palpate during the physical exam?

Answer 9

Anteior syndesmosis (between tibia and fibula)

Question 10

What are the ankle special tests?

Answer 10

Thompson’s Squeeze Test (achilles). Anterior Drawer Test (ATFL). Talar Tilt/Varus Stress Test (CFL).