S3_L3: Examination of the Ankle and Foot

Question 1

which of the ff are true about the ankle & foot

A. 28 tarsal bones, 27 articulations, more than 100 ligaments and muscles

B. Provides enough mobility to adapt to different surfaces, attenuate shock, maintain sufficient stability for effective locomotion

C. Sustains the greatest load per surface area, 120% of BW when walking & 275% of BW when running

D. It is important for the ankle and foot complex to be stable and strong enough to attenuate and absorb the increase in body weight when doing different
activities

E. All of the above

Answer 1

E

Question 2

modified T/F on the ankle & foot

Walking on leveled surfaces or uneven
terrains, the ankle and foot will have to
accommodate the varying surfaces to be
able to ambulate or walk without difficulty

Ankle and foot distributes the entire weight of the body to avoid stressing the small bones, ligaments, and muscles supporting the complex

Answer 2

TT

Question 3

match the ff part of foot

1. Front part of the foot complex that has 14 bones of the toes, 5 metatarsals, medial and lateral sesamoid bones
2. Navicular, cuboid, 3 cuneiforms
3. Located on the back part of the foot that consists of Tibia, talus, calcaneus

A. HINDFOOT
B. MIDFOOT
C. FOREFOOT

Answer 3

1. C
2. B
3. A

Question 4

modified T/F on ligaments of the LATERAL ASPECT of the foot

3 major ligaments supporting the lateral aspect of the ankle and foot complex are
Posterior talofibular ligament, Calcaneofibular ligament, Anterior talofibular ligament

Affected in inversion ankle sprain which most commonly affects: posterior
talofibular ligament (abnormal inversion
movement when foot is plantarflexed)

Answer 4

TF

Affected in inversion ankle sprain which most commonly affects: ANTERIOR
talofibular ligament

Question 5

modified T/F

Calcaneofibular ligament is also sprained when the foot suffers from an excessive inversion when the foot is in a neutral position

Posterior talofibular ligament is sprained when the foot suffers from excessive inversion when the foot is in dorsiflexion

Answer 5

TT

Question 6

T/F

Ligaments are laxed in plantarflexed position (OPP position of the ankle joint)

Answer 6

T

Question 7

modified T/F on ligaments on the MEDIAL ASPECT of the foot

4 ligaments makes up the deltoid ligament like Posterior tibiotalar ligament, Tibiocalcaneal ligament, Tibionavicular ligament, Anterior tibiotalar ligament

Ligaments are placed closer to each other & is more stable than the lateral aspect

Answer 7

TT

Question 8

modified T/F on SUSTENTACULUM TALI

Palpable structure that houses the
proprioceptive center of the ankle and foot

Affectation of the sustentaculum tali and
proprioception center leads to problems in proprioception of the patient

Answer 8

TT

Question 9

which of the ff are true about PLANTAR FASCIA/PLANTAR APONEUROSIS

A. Thick structure which serves as a supportive and protective role

B. Intricately involved in the weight-bearing function of the foot

C. Load is estimated to be at 1000 N

D. Responsible for the windlass mechanism

E. All of the above

Answer 9

E

Question 10

modified T/F on Windlass mechanism

helps the foot become rigid for propulsion during the toe-off portion of the gait cycle

During the toe-off portion, it is at that point when the foot starts to clear off the ground, moving into the swing phase, if the foot does not become rigid, there will be no enough propulsion to proceed walking

Answer 10

TT

Question 11

which of the ff are true about plantar fasciitis

A. Patients with plantar fasciitis have inflamed plantar fascia

B. It cannot help the foot become rigid

C. During gait, they lose the toe-off subphase of gait

D. Instead of doing heel off and toe off, the patient just lifts the entire foot abruptly above the floor (antalgic gait)

E. All of the above

Answer 11

E

Question 12

which of the ff are true about Truss mechanism, EXCEPT:

A. triangular unit with the ankle joint as the apex of the triangle

B. Calcaneus and talus: posterior struts

C. First ray: anterior strut

D. Stabilized by 2 struts by limiting it to spread apart

E. None of the above

Answer 12

E

Question 13

modified T/F

During the first half of the gait cycle, when the toes are in neutral, the plantar fascia is relaxed to freely adapt to the terrain but while during heel strike, foot flat, and midstance, the foot will try to adapt on the terrain for better weight absorption

During the latter part of the gait cycle, when the toes are in DF, the fascia becomes tensed & during heel off (dorsiflexion) and toe off (increased dorsiflexion) to be able to propel the leg forward

Answer 13

TT

Question 14

modified T/F

Most ankle sprains occur when foot is in DF, EV, and ABD (also malleolar or talar
fracture)

Achilles tendinopathy is an overuse injury with posterior calcaneal pain

Answer 14

FT

Most ankle sprains occur when foot is in PF, INV, and ADD (also malleolar or talar
fracture)

Question 15

modified T/F

Increased sx when walking on uneven
terrain: ankle instability

Increased sx when walking on hard surfaces (vs softer surface): lack of shock absorbency of the foot

Answer 15

TT

Question 16

modified T/F

Pain during first few steps in the
morning and slowly disappears
overtime is the common sx of plantar
fasciitis

stress fx most commonly happen in Metatarsals d/t weight absorption

Answer 16

TT

Question 17

which of the ff are true about Compartment syndromes

A. diffused type of pain

B. Common in anterior compartment
of lower leg (tibialis anterior)

C. Begins with muscle strain then
inflammation then increased pressure
on the area

D. Common manifestation is pain on
the compartment during palpation
/muscle contraction

E. All of the above

Answer 17

E

Question 18

Determine which activities and positions aggravate the symptoms

A. Pain with forced DF and EV with squatting & cause ankle instability

B. Pain after activity suggests overuse or
chronic injury

C. Pain during activity d/t stress on the injured structure

D. All of the above

Answer 18

D

Question 19

the ff are Warning signs, EXCEPT:

A. Immediate and continuous inability to bear weight d/t fracture

B. Nocturnal pain that’s common among pts with malignancies

C. Gross pain during ankle valgus (eversion) and tenderness with pressure on distal fibula d/t fractured fibula

D. Pain and weakness during resisted eversion d/t fx of 5th MT bases

E. Inflamed calf: DVT (deep vein thrombosis)

F. None of the above

Answer 19

F

Question 20

match the ff postural deviations

1. abnormal abduction of the toe
2. high arched foot
3. result of imbalance in the muscle strength/tendon length/ligaments

A. Hallux valgus
B. Pes cavus
C. Hammer toe

Answer 20

1. A
2. B
3. C

Question 21

match the ff area of Tenderness

1. inversion ankle sprain
2. eversion ankle sprain
3. high ankle sprain
4. compartment syndrome
5. heel spurs that may also be present in plantar fasciitis
6. plantar fasciitis in the medial longitudinal arch

A. ATFL
B. Deltoid ligaments
C. Interosseous membrane & tibiotalar
ligament
D. Anterior aspect of leg
E. Heel
F. Plantar aponeurosis

Answer 21

1. A
2. B
3. C
4. D
5. E
6. F

Question 22

modified T/F

Plantar fascia should be relaxed in initial
contact (heel strike), loading response (foot flat), and midstance

During the last phase, (terminal stance/heel off and pre-swing/toe off) the plantar fascia should be tight so it can act as one unit for effective propulsion

Answer 22

TT

Question 23

which of the ff Outcome measure tools can be used

A. LEFS
B. BBS for balance assessment
C. FGA
D. AJFAT
E. All of the above

Answer 23

E

Question 24

modified T/F

Running tests include 40m run time & Figure of 8 run

Hopping tests include Single limb hop, Triple hop, Crossover hop, Stair hop, Side-to-side hop, 6M crossover hop & Square hop

Answer 24

TT