Quiz 8 Flashcards

1
Q

What special test is used to implicate the deltoid ligament?

A

Valgus stress test or Kleigers

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2
Q

Where should your thumb be placed for the anterior impingement test?

A

Sinus Tarsi

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3
Q

What special test is used for a high ankle sprain?

A

External rotation test

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4
Q

What is another special test that can be used for diastasis or syndesmos?

A

Compression/Distraction

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5
Q

Name two special tests that can be used to assess for a stress fracture.

A

Calcaneal Tap

Compression/Distraction

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6
Q

What is fractured in a Pott’s fracture?

A

Distal fibula

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7
Q

What is fractured in a Maisonneuve fracture?

A

Proximal fibula

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8
Q

What is fractured in a Jones’ fracture?

A

Styloid process of the 5th metatarsal

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9
Q

What is the close packed position of the ankle?

A

Dorsiflexion

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10
Q

What is the normal DF ROM?

A

20

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11
Q

Plantar flexion?

A

50

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12
Q

Inversion?

A

20

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13
Q

Eversion?

A

10

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14
Q

MTP Flexion

A

45

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15
Q

MTP Extension?

A

70

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16
Q

With the navicular drop test, what measurement is considered “normal”?

A

10 mm or less, otherwise pronator

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17
Q

When using the longitudinal arch angle test, what goniometric measurement is considered to be normal?

A

130-150 deg

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18
Q

What does the Helbing’s sign tell you?

A

Medial bowing of the achilles tendons = patient is a pronator

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19
Q

What is the name for the neutral resting position of the foot

A

Bergman’s position

20
Q

What is the position? (Bergman’s)

A

PF and Inversion

21
Q

What are the three biomechanical components of pronation?

A

Calcaneal valgus
Midfoot eversion/collapse
Forefoot abduction (combined with varus and dorsiflexion)

22
Q

What tests can you use to quantify the degree of pronation/supination that a patient has?

A

Feiss’ Line
Navicular Drop Test
Longitudinal Arch Angle

23
Q

What is the term used for someone with a smaller/lower medial longitudinal arch?

A

Pes planus

24
Q

What is the term used for someone with a higher/larger medial longitudinal arch?

A

Pes cavus

25
Q

How many ankle sprains occur everyday?

A

25,000

26
Q

What four areas should be palpated for tenderness when following the ottawa ankle rules?

A

Posterior lateral malleolus, posterior medial malleolus, navicular, and base of 5th metatarsal

27
Q

When tenderness is absent, what is the next step in the ottawa ankle rules?

A

Have patient take 4 steps forward

28
Q

Why do we use the ottawa ankle rules?

A

To see if they need a radiograph; reduce recommendations for radiograph

29
Q

What are the grades and general tissues that are implicated for ankle sprains?

A

Grade 1-slight stretching and microscopic tearing of ligament fibers (interstitial damage)
Grade 2- partial tear with ligamentous laxity
Grade 3- Full rupture

30
Q

Explain the importance of detecting a high ankle sprain.

A

It is a syndesmotic joint and tearing can create diastasis.

It can also lead to OA and instability.

31
Q

What might you see in your observation that would lead you to believe that the patient had a high ankle sprain?

A

Ecchymosis that is more proximal than the malleoli

32
Q

What are the arthrokinematics of the talocrural joint?

A

Convex on concave

33
Q

What are three mobilizations you can do to improve DF?

A

Eversion at STJ (Valgus tilt)
Posterior glide
Anterior glide of fibula
Mobilization with Movement (active DF with posterior glide)

34
Q

What are three mobilizations you can do to improve PF?

A

Inversion at STJ (Varus tilt)
Anterior glide
Posterior glide of fibula
Mobilization with Movement (active PF with anterior glide)

35
Q

What is the capsular pattern of the talocrural joint?

A

PF > DF

36
Q

What is a morton’s foot?

A

The 2nd ray is longer than the 1st ray (including not just the phalanges but also the metatarsal - the 2nd MTP will be passed the 1st MTP)

37
Q

What is the clinical significance of this?

A

Alters the toe-off during gait - all the force will be going through the 2nd MTP joint instead of the 1st MTP joint that is designed for toe-off

38
Q

What should be done for these patients?

A

Orthotic with a 1st ray extension

39
Q

What percentage of the population has this?

A

22%

40
Q

What are three aspects of the Well’s Criteria? (Keep in mind he may make us name 3 more…)

A

Paralysis, paresis or recent orthopedic casting of LE (1 pt)
Recently bedridden (> 3 days) or major surgery within past 4 weeks (1 pt)
Localized tenderness in deep vein system (1 pt)
Swelling of entire leg (1 pt)
Calf swelling 3 cm greater than other leg (measured 10 cm below tibial tuberosity (1 pt)
Pitting edema greater in symptomatic leg (1 pt)
Collateral non-varicose superficial veins (1 pt)
Active cancer or cancer treated within 6 months (1 pt)
Alternative diagnosis more likely than DVT (Baker’s cyst, cellulitis, external venous compression, etc.) (-2 pts)

41
Q

What score do you have to get in order to have a high likelihood of DVT? (well’s criteria)

A

> 3 points

42
Q

What’s another quick test you can do to screen for DVT?

A

Homan’s test

43
Q

In case he lets us choose another bonus…According to the Turner 2009 study, what is the strongest scapulothoracic muscle?

A

Upper trapezius

44
Q

What is the weakest scapulothoracic muscle?

If he makes us name them in order from strongest to weakest:

A

Lower trapezius

upper trap, serratus anterior, middle trapezius, rhomboids, lower trapezius

45
Q

Explain (he may make us draw it I think we had to last year) closed packed position

A

The talocrural joint resembles a mortise lock. The talus locks into the distal tibia and fibula when in dorsiflexion.

46
Q

What is the loose packed position of the ankle and how does this affect the integrity of the supporting ligaments?

A

The talus is out of the “mortise” in plantarflexion therefore making the ligaments more susceptible to strain and injury due to increased stress and tension put on them.