The Ankle Part 2: Exam 3 Flashcards

1
Q

MOI lateral ankle sprain

A

Inversion and plantar flexion

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2
Q

Lateral ankle sprain ligaments

A
  • ATFL

- CFL

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3
Q

How ATFL is injured

A

Plantar flexion and inversion

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4
Q

How CFL is injured

A

Inversion

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5
Q

Etiology of grade one ligament sprain

A
  • inversion and plantar flexion

- causes stretching of ATFL

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6
Q

Symptoms of grade 1 ligament sprain

A
  • mild pain and disability
  • minimally impaired weight bearing
  • point tenderness over ligament and no laxity
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7
Q

Management of grade 1 sprain

A
  • RICE 1-2 days
  • limited weight bearing initially and then agressive strengthening rehab
  • tape can provide additional support
  • return to activity in 7-10 days
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8
Q

Etiology of grade 2 sprain

A

-moderate inversion force causing great deal of disability with many days of lost time

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9
Q

Symptoms of grade 2 sprain

A
  • feel/ hear a pop or snap
  • moderate pain with difficulty bearing weight
  • tenderness and edema
  • special tests will be positive for laxity
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10
Q

Management of grade 2 sprain

A
  • RICE for 72 hours
  • x-ray to rule out fracture
  • crutches for 5-10 days
  • progress to weight bearing
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11
Q

Etiology of grade 3 sprain

A
  • relativity uncommon but extremely disabling
  • caused by significant force resulting in spontaneous subluxation and reduction
  • damages the anterior/ posterior talofibular and calcaneofibular ligaments as well as the capsule
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12
Q

Symptoms of grade 3 sprain

A
  • severe pain
  • swelling
  • hemarthosis
  • discoloration
  • unable to bear weight
  • grossly positive instability test
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13
Q

Management of grade 3 sprain

A
  • RICE
  • x-ray
  • possible dorsiflexion splint
  • progressive weight bearing
  • isometrics in cast
  • ROM exercises and balance exercises one out of cast
  • possibly surgery
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14
Q

Eversion ankle sprain etiology

A

-5-10%

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15
Q

What is injured with an eversion sprain?

A

-deltoid ligament and possible fib fracture

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16
Q

Who is more susceptible to eversion sprains?

A

-pronated and hypermobile

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17
Q

Symptoms of eversion sprain

A
  • severe pain

- unable to bear weight

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18
Q

Management of eversion sprain

A
  • RICE
  • xray
  • no weight bearing initially
  • posterior splint
  • NSAIDs
  • same course of treatment of grade 2 sprain
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19
Q

What can happen with grade 2 or higher sprain?

A

Considerable instability and may cause weakness in medial longitudinal arch resulting in excessive pronation or fallen arch

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20
Q

Etiology of high ankle sprain

A

-external rotation and or forced dorsiflexion

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21
Q

What is injured in high ankle sprain

A
  • anterior/posterior tibiofibular ligaments

- sydesmosis

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22
Q

Symptoms of high ankle sprain

A
  • Pain anterolaterally
  • loss of function
  • pain
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23
Q

Management of high ankle sprain

A
  • difficult and longer to treat

- modified weight bearing

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24
Q

Another name for high ankle sprain

A

Syndesmotic

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25
Q

Ankle fracture etiology

A

-blunt trauma and strong multidirectional forces

26
Q

Symptoms of ankle fracture

A
  • swelling
  • pain
  • crepitis
  • deformity
27
Q

Management of ankle fracture

A
  • RICE

- walking cast or brace with immobilization lasting 6-8 weeks

28
Q

Etiology of achilles tendon strain

A

Common and occurs with sprains or increased dorsiflexion

29
Q

Symptoms of Achilles strain

A
  • pain

- partial or complete rupture of achilles

30
Q

Management of achilles strain

A
  • RICE
  • conservative treatment should be used to avoid chronic tendinitis
  • elastic wrap
  • heel lift
  • stretching and strengthening
31
Q

Achilles tendinitis etiology

A
  • inflammatory condition

- overload due to extensive stress

32
Q

Symptoms of tendinitis

A
  • pain and stiffness
  • warm/ pain to touch
  • tendon thickening
33
Q

Management of tendinitis

A
  • RICE
  • NSAIDs
  • long term healing time
34
Q

Achilles rupture etiology

A
  • sudden stop and go

- more common in 30+ years

35
Q

Symptoms of achilles rupture

A
  • pain and rapidly subsides
  • decreased range of motion
  • swelling
  • discoloration
  • loss of function
  • point tenderness
36
Q

Management of achilles rupture

A
  • RICE
  • NSAID
  • NWB
37
Q

Peroneal tendon injuries

A
  • dislocation and subluxation
  • tendinitis
  • similar symptoms
38
Q

Peroneal tendon etiology

A

Direct blow to posterior lateral malleolus

39
Q

Symptoms of peroneal tendon injuries

A
  • pain
  • snapping and instability
  • discoloration
  • swelling
  • tenderness
  • crepitus
40
Q

Management of peroneal tendon injury

A
  • RICE
  • NSAID
  • analgesic
  • possible surgery
41
Q

Tendinopathy/ tendinitis

A

Can occur in any of the tendons that cross the joint and is usually due to overuse and poor biomechanics

42
Q

Muscle or shin contusions etiology

A

Direct blow

43
Q

M/s contusion symptoms

A
  • pain
  • weakness
  • swelling
  • discoloration
  • hard
  • rigid
  • inflexible
44
Q

M/S contusion management

A
  • RICE
  • Modalities
  • MAINTAIN ROM
  • wrap or tape
45
Q

Acute leg fractures etiology

A
  • most common in fibula (mid third)
  • tibial (lower third)
  • direct blow or indirect trauma
46
Q

Symptoms of acute leg fracture

A
  • pain
  • swelling
  • leg hard and swollen due to increased pressure
47
Q

Management of acute leg fractures

A
  • splint
  • xray
  • reduction
  • cast up to 6 weeks
48
Q

Another name for shin splint

A

Medial tibial stress syndrome

49
Q

Etiology of shin splint

A
  • stress fracture
  • repetitive micro-trauma
  • 10-15% running
50
Q

Four grades of shin splint pain

A
  • pain after activity
  • pain before and after activity
  • pain before, during, after activity
  • pain severe and cannot perform activity
51
Q

Management of shin splints

A
  • referral for xray and bone scan
  • decreased activity
  • biomechanics correction
  • RICE
52
Q

Stress fracture of tibia or fibula etiology

A

Overuse or unconditioned or non-experienced individuals

53
Q

Symptoms of stress fx

A
  • pain more intense after exercise
  • point tenderness and percussion
  • bone scan
54
Q

Management of stress fx

A
  • 2 weeks decreased activity
  • NWB
  • activity progression
55
Q

Etiology of acute compartment syndrome

A
  • traumatic and occurs after direct blow

- medical emergency due to risk of neurovascular compromise

56
Q

Acute exertional compartment syndrome

A

Evolves with minimal to moderate activity and non traumatic

57
Q

Chronic compartment syndrome

A

Symptoms arise during activity and in lower body sports

58
Q

Symptoms of compartment syndrome

A
  • deep aching pain and tightness due to pressure and swelling
  • reduced circulation and sensation in foot
  • intracompartamental pressure measures
59
Q

Management of compartment syndrome

A
  • conservative: RICE and NSAIDS
  • acute and severe exertional: pressure monitored
  • fasciotomy for chronic condition
  • surgical release patient return to activity 2-4 months
60
Q

Rehab for injuries

A
  • weight bearing progression
  • joint mobilizations
  • flexibility (achilles)
  • strengthening of surrounding muscles
  • proprioception
  • tape/brace
  • functional progression
61
Q

What decreases likely hood of eversion sprain?

A

-bony protection and ligament strength decrease likelihood of injury

62
Q

Other than eversion sprains how can the deltoid ligament be injured?

A

-deltoid can also be impinged and contused with inversion sprains