The ankle and lower leg

Question 1

subtaler joint

Answer 1

allows inversion and eversion

Question 2

talocrural

Answer 2

plantar flexion and dorsiflexion

Question 3

lateral collateral ligament

Answer 3

posterior talofibular, calcaneofibular, anterior talofibular

Question 4

muscles in the anterior compartment

Answer 4

innervation: dorsiflex and extend toes
tibialis anterior, extension halliucis longus, extensor digitorum

Question 5

muscles in the lateral compartment

Answer 5

innervation: evert and dorsiflex
fibulas longus, and breaks, peroneous

Question 6

muscles in the superficial posterior compartment

Answer 6

innervation: plantar flex
gastrocnemius, soleus

Question 7

muscles in deep posterior compartment

Answer 7

innervation: invert ankle
tibialis posterior, flexor digitorum longus, flexor hallucis

Question 8

Medial tibial stress syndrome (MTSS

Answer 8

E: catch for all stress fractures caused by repetitive micro trauma, pulling of the fascia
M: ultrasound can determine stress fracture

Question 9

syndesmotic sprain (high ankle sprain)

Answer 9

E: loss of function; passive ER and DF cause pain; pain is anterolaterally located
M: immobilization and total rehab maybe longer (grade 1 needs cruches)

Question 10

Inversion ankle sprain

Answer 10

Mechanism: PF and inversion
structures damaged: ATFL, PTFL, and CFL
SS: grade 1: able to bear weight, no joint laxity
grade 2: popping sound, edema discoloration
grade 3: impossible to bear weight, swelling
M: grade 1: POLICE 30-60 min every two hours for 1-2 days
grade 2: cruches for 5-10 days
grade 3: immobilization for 10 days and 3-6wks in boot
EAISER TO SPRAIN BECAUSE LATERAL MALLEOLUS IS LONGER THAN MIDEIAL MALLEOLUS

Question 11

Eversion ankle sprain

Answer 11

Mechanism: eversion
structures damages: deltoid ligamant
represent 5% of all ankle sprains

Question 12

Ottawa ankle rules

Answer 12

1: bony tenderness/pain at zone A-D
2: inability to bear weight for 4 steps

Question 13

osteochondritis dessecans

Answer 13

e: occurs in superior medial articular surface of taller dome
ss: catching, locking, giving way
m: diagnosis through x ray; if fragments are displaced, then surgery is needed

Question 14

achilles tendon rupture

Answer 14

e: forceful plantar flexion with knee moving into full extension; athletes >30y/o
ss: sudden snap (kick in the leg) and Pop sound; occurs 2-6 cm proximal the calcanea insertion
m: surgical repair for serious injuries
(+) Thompsons test = no movement at ankle after squeezing the muscle
(-)thompson test = movement

Question 15

Compartment syndrome Acute

Answer 15

E: occurs secondary to direct trauma; evolves with minimal to moderate activity
Anterior and deep posterior compartments are involved (tibialis anterior, extensor hallicus longus, extensor digitorum)
ss: shiny due to stretching of skin

Question 16

compartment syndrome chronic

Answer 16

symptoms arise consistently at certain pint during activity
ss: compression of nerve 9deep fibular nerve)

Question 17

stress fracture of tibia or fibula

Answer 17

E: osteoclast and osteoblast imbalance; runners tend to develop in lower third of lower leg; dancers middle third)
ss: pain more intense after exercise than before; difficult to decree bone and soft tissue pain

Question 18

talocrural joint

Answer 18

plantar flexion and dorsiflexion

Question 19

gastrocnemius action

Answer 19

plantar flexion of the ankle