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SCS > SCS Study Guide- Ankle and Foot > Flashcards

SCS Study Guide- Ankle and Foot Flashcards

1
Q

what muscles are innervated by the deep peroneal nerve

A

the anterior compartment
tib ant, EHL, EDL, fibularis tertius

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2
Q

what muscles does the tibial nerve innervate

A

superficial layer of posterior compartment : gastroc, soleus, plantaris

deep posterior compartment: popliteus, FHL, FDL, tibialis posterior

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3
Q

what muscles does the superficial peroneal innervate

A

lateral compartment: peroneal (fib) longus, Peroneal (fib) brevis

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4
Q

what are the ligaments of the lateral ankle

A

anterior talofibular, calcaneofibular and posterior talofibular

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5
Q

what are the ligaments of the medial ankle

A

anterior and posterior tibiotalar, tibiocalcaneal, tibionavicaular

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6
Q

some additional support ligaments of the ankle

A

inferior and posterior tibiofibular ligament and interosseous membrane

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7
Q

which two ligaments are the most commonly injured in a syndesmotic injury

A

inferior anterior and posterior tibiofibular ligaments

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8
Q

most medial edge of foot, starting with metatarsals and working posteriorly, what are the bones on the medial aspect of the foot

A

metatarsals
medial cuneiform
navicular
talus
calcaneus

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9
Q

what are the ankle rules

A

pain in malleolar zone, and bony tenderness at the posterior half distal tib/fib
tip of medial/lateral malleolus
inabiltiy to walk 4 steps

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10
Q

what are common views for ankle pathology

A

internal oblique, mortise and lat view, AP view

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11
Q

what are the foot rules

A

pain in mid foot, and tender over navicular, 5th met, inability to walk 4 steps

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12
Q

common foot views

A

AP/LAT/oblique

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13
Q

morton’s test

A

metatarsalgia or neuroma

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14
Q

achilles tendon reflex

A

S1 nerve root

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15
Q

tinel sign

A

tarsal tunnel

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16
Q

anterior drawer test

A

anterior talofibular ligament

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17
Q

calf squeeze,

A

achilles rupture

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18
Q

ER test

A

syndesmotic, high ankle sprain

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19
Q

impingment test

A

impingment to the talocrural joint

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20
Q

navicular drop test

A

medial longitudinal arch by looking at navicular height

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21
Q

squeeze test lower let

A

tibiofibular syndesmotic injury

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22
Q

squeeze test calcaneous

A

stress fracture

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23
Q

windlass test

A

fascial and ligamentous impairments

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24
Q

Maisonnuerve fracture cause, exam

A

cause: tearing of interosseous and fx of prox fibula: ER force
palpate prox fibula!

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25
Q

tillaux fracture (SH type) cause and imaging

A

type: SH 3 of anterior lateral tibial epiphysis (avulsion)
cause: avulsion of ATFL from ER injury
x-ray then CT if needed

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26
Q

jones fracture
cause, exam and treatment and imaging

A

cause: forefoot adduction with PF, fx at base 5th metatarsal
exam: swelling and pain over the 5th met
imaging: ant/post/lat and mortise view, or oblique view
treatment: non op 6-8 weeks cast, crutches and immob, WB as pain subsides

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27
Q

jones fractures are at risk of what

A

mal/non union

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28
Q

lisfranc fracture cause, exam, imaging

A

TMT fx/dislocation with dorsal displacement of the proximal end of metatarsals
cause: crush to midfoot, sudden rotation force with PF foot
exam: alignment, medial plantar bruising, swelling/tenderness at dorsum of foot
imaging: MRI (missed on x-ray)

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29
Q

fracture of the talar dome cause, exam and treatment

A

cause: severe INV/DF or INV with PF force
exam: pain with WB, catching, swelling after activity
treatment: NWB, immob, conservative fails, surgery

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30
Q

severs disease cause, exam and treatment

A

calcaneal apophysitis
cause: 8-14y/o, traction injury
exam: pain at posterior heel below Achilles, swelling at calcaneus
treatment: RTS 2-8 weeks

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31
Q

what is the most common MT to stress fracture

A

2nd (AKA MARCH FX)

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32
Q

cause, exam, imaging and treatment of metatarsal stress fracture

A

cause: change in training, milage, surface, forefoot varus, hallux valgus, flat foot
exam: dull pain with gradual onset progressing to pain at rest. Diffuse at first then localizes
imaging: bone scan
treatment: rest, boot, restricted WB, orthotics

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33
Q

what are the 6 critical areas for stress fractrues

A

anterior tibialis, medial metatarsal, talus, 5th MET, navicular, seasmoids

34
Q

what is the difference in treatment between non-critical stress fx and critical stress fx

A

non-critical can have rest and immob, critical may need surgery

35
Q

calcaneal fracture cause exam and treatment

A

cause: landing after jump or fall
exam: swelling, inability to WB
treatment: non-displaced, immob and early ROM

36
Q

cuboid sublux cause, exam and treatment

A

cause: pronation with trauma, often with INV
exam: pain along 4th MT and over cuboid, inc pain with standing after prolonged sitting
treatment: manip of cuboid and orthotics

37
Q

hallux rigidus cause, exam and treatment

A

cause: loss of DF due to degenerative process and changes in articular cartilage
exam: restricted, causes foot to roll laterally, great toe cannot DF and forced DF causes pain
treatment: stiffer shoe with larger toe box, orthotics, osteotomy

38
Q

1st MTP joint sprain: AKA
cause, exam and treatment

A

turf toe
cause: forced DF of MTP player hit from behind during plant
exam: pain with DF< pain at met head of one, antalgic gait
treatment: stiffer shoe, steel/graphite insert, taping to prevent DF

39
Q

metatarsalgia cause, exam and treatment

A

general term for ball of foot pain
cause: restricted DF, shortened midstance phase of gait
exam: possible callous formation in forefoot
treatment: rule out stress fx, metatarsal pad and alleviate restricted DF.

40
Q

MOI of lateral ankle sprain

A

PF and IVN

41
Q

how do you asses for a lateral ankle sprain

A

lateral swelling and bruising, antalgic gait, tenderness at ATFL, PTFL and CFL and talar tilt, and anterior drawer

42
Q

medial ankle sprain MOI

A

eversion

43
Q

signs and symptoms of medial ankle sprain

A

medial swelling and bruising, tenderness at deltoid ligament, pain lateral due to compression, and talar tilt and Kleiger’s

44
Q

a deltoid ligament injury may cause… and why

A

increased pronation or decreased arch due to deltoid ligament contribution to supporting the arch

45
Q

MOI of syndesmotic injury

A

ER/Forced DF

46
Q

signs and symptoms of syndesmotic tear

A

decreased PF, TTP at ant and post tibiofib ligament, pain between bones, posteromedial pain at ankle joint
Squeeze test, ER test, crossed leg test and cotton test

47
Q

what might an x-ray show that is indicative of a syndesmotic tear

A

increased tibiofib space, decreased tibiofib overlap and inc medial clear space

48
Q

achilles rupture cause, exam and treatment

A

cause: pushing off WB foot with knee ext, unexpected DF
exan: pop “felt like shot”
(+) Thompson test and MRI

49
Q

retrocalcaneal bursitis cause, exam and treatment

A

cause: inflammation of the bursa between achilles and calcaneus from rubbing against a shoe, Haglund’s deformity
exam: RRP, bump, swelling
treatment: RICE, NSAIDs, stretching and heel lift

50
Q

sublungal hematoma cause, exam and treatment

A

blood under toenail from getting stepped on, repeated shear like kicking and running
treatment: drilling a small hole IF NO FX PRESENT

51
Q

hammer toe is a contraction of what joing in what position

A

flexion contracture to PIP

52
Q

mallet toe is a ____ contracture of what joint

A

flexion of DIP

53
Q

claw toe is a ___ contracture of what joint

A

flex contracture at DIP, and hyperextended MP

54
Q

joggers foot: what is it, cause and exam

A

local nerve entrapment of medial plantar nerve at tunnel of abd hallicus and navicular tuberosity
cause: running induced nerve pain
exam: pain medial arch into medial toes

55
Q

joggers foot is associated with _____ hindfoot deformity, and what activity

A

valgus, long distance running

56
Q

Haglund’s Deformity

A

bony enlargement of back of heel “pump bump”

57
Q

Morton’s neuroma between what met heads

A

3rd and 4th

58
Q

morton neuroma is associated with excessive…

A

pronation

59
Q

medial tibial stress syndrome AKA

A

shin splints
cause: repetitive micro trauma (running and jumping)

60
Q

imaging for MTSS

A

3 phase x-ray, may look cloudy and an MRI

61
Q

classification of acute, acute exertional and chronic compartment syndrome

A

acute is trauma and emergency
acute exertional is when you have min to mod activity
chronic, consistently with activity

62
Q

exam to dx MTSS

A

deep aching, swelling and tightness in compartment and pain with stretching

63
Q

what are the mmHG of pressures for pre, 1 min and 5 min post exercise

A

pre <15
1 min post: >30
5 min post> 20

64
Q

RTP after fasciectomy

A

2-4 months

65
Q

what kind of orthotic for turf toe

A

total contact orthotic, with carbon fiber plate and a rocker sole
extended heel shank

66
Q

what kind of orthotic for mortons neuroma

A

total contact orthotic with MT pad prox to 2nd met head

67
Q

what kind of orthotic for bunion

A

larger toe box, stretch shoe and total contact orthotic with medial posting

68
Q

what kind of orthotic for sesamoiditis

A

custom total contact with met pad, viscoelastic polymer under sesamoids, full length steel sheath and ant rocker bottom

69
Q

what kind of orthotic pes cavus

A

OTC with shock abosorption and total contact with lateral forefoot posting

70
Q

what kind of orthotic pes planus

A

OTC full insoles with medial posting

71
Q

what kind of orthotic achilles tendinopathy

A

firm heel cushion, heel elevation and TCO with medial posting and heel cup

72
Q

what kind of orthotic for sever’s

A

OTC insole with good arch support and absorption

73
Q

modified brostrom WB status

A

initially WBAT in boot (D/C at 4-6 weeks)

74
Q

RTS for brostrum

A

8-12 weeks

75
Q

avoid what two movements for 6 weeks post op Brostrum

A

adduction and inversion

76
Q

non-op achilles casting/bracing and ROM and strengthening

A

2 week cast with DF block and NWB
then boot with 20 degrees PF WBAT

week 6, remove 1 wedge and gentle NWB strengthening

77
Q

how long do you need a 1cm heel wedge for non op achilles care

A

at 10 week mark wtih boot is d/c, the 1cm wedge is kept for 3 months

78
Q

Achilles tendon debridement WB, strengthening, running RTP

A

WB when pain and swelling decrease
strengthening at 2-3 weeks
running 6-10 weeks
RTS: 3-6 months

79
Q

initially post op Achilles tendon repair, how is the leg placed

A

in a post splint with stirrup

80
Q

post op achilles repair, when can you do unilateral heel raises

A

3 months

81
Q

RTP when ___% and at what time

A

6-12 months, when 80%

SCS (26 decks)

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