Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OCS Exam > The Foot and Ankle > Flashcards

The Foot and Ankle Flashcards

1
Q

What are the major anatomic divisions of the bones of the foot?

A

The rear foot (tarsus) consists of the talus and calcaneus.
The midfoot (lesser tarsus) consists of the navicular, cuboid, and cuneiforms (lat, med, intermed)
The metatarsals
The phalanges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the four muscular layers of the plantar surface of the foot, from superficial to deep?

A

3-2-3-2
First layer: abd hallucis, FDB, Abd. digiti minimi

Second layer: quadratus plantae, lumbricals (tendons of the FDL and FHL pass through)

Third Layer: Flex hallucis brevis, add hallucis, flexor digiti minimi

Fourth Layer: Plantar interossei (3), dorsal interossei (4) (tendons of peroneus longus and tibialis posterior pass through this layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe normal ankle ROM?

A

PF: 50*
DF: 20*
Inv: 35*
Ev: 15*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define pronation and supination in relation to the rear foot.

A

During gait, pronation occurs at heel strike through loading response. Supination occurs from midstance until toe off.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the common arches of the normal foot?

A

4 primary arches:
medial longitudinal arch
lateral longitudinal arch
proximal transverse arch (navicular, 3 cuneiforms and cuboid)
distal transverse arch (heads of the 5 MT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is pes planus?

A

congenital flatfoot with no longitudinal arch and an everted ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What percentage of weight does the fibular bear?

A

12% to 17%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Fick’s angle?

A

the angle of toe-out, typically 12-18 degrees in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the function of the deltoid ligament?

A

medial collateral ligament consisting of 4 portions: tibio navicular, tibiocalcaneal, tibiotalar (anterior and posterior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the lateral collateral ligaments of the ankle and rear foot?

A

The LCL complex consists of the anterior and posterior talofibular ligaments and the calcaneofibular ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define Lisfranc;s ligament?

A

the plantar tarsometatarsal ligament spanning the medial cuneiformto the base of the second metatarsal. Commonly avulsed after dislocations to Lisfracn’s joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the spring ligament?

A

The calcaneonavicular ligament which spans from the posterior sustentaculum tali to the navicular.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the bifurcate ligament?

A

A Y-shaped ligament that originates from the anterior floor of the sinus tarsi and anterior process of the calcaneus. It extends and divides into two bands that attach to the cuboid laterally and the navicular medially.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define Chopart’s joint.

A

A midtarsal joint consisting of the talonavicular and calcaneocuboid joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Define Lisfranc’s joint?

A

The tarsometatarsal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the sinus tarsi?

A

a funnel shaped opening in the rearfoot between the talus and calcaneus. It is widest anterolaterally and narrows posteromedially. It separates the anterior and middle facet from theposterior facet. The narrow posteromedial portion is often called the tarsal canal. Through this area pass the interosseous talocalcaneal ligaent and the major blood supply to the body of the talus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the contents of the tarsal tunnel?

A 
Tom, Dick, ANd Harry
Tibilais posterior
Flexor Digitorum longus
Posterior tibial artery
Tibial nerve
Flexor Hallucis longus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List the five nerves that cross into and supply the motor and sensory fibers to the foot?

A
  1. Sural nerve (posterolaterally)
  2. Superficial peroneal nerve (anterolaterally)
  3. Deep peroneal nerve (anteriorly, traveling with the dorsalis pedis artery)
  4. Saphenous nerve (anteromedially, as a continuation of the femoral nerve)
  5. Posterior tibial nerve (postermedially, supplying the foot distally as the medial and lateral plantar nerve)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What structure is referred to as the freshmen nerve?

A

The plantaris tendon. It is flat, firm, revealing it is a tendon. Deep to the gastroc, superficial to the soleus and lies medial to the achilles tendon to attach at the medial aspect of the posterior calcaneal tuberosity.

20
Q

Describe the function of the sesamoids.

A

Located beneath the head of the first metatarsal to increase the lever arm of the FHL in the second layer

21
Q

How many muscles attach to the Talus?

A

none.

22
Q

What is metatarsus adductus?

A

one of the most common pediatric foot disorders, describes the position of the forefoot varus and adduction (kidney bean)

23
Q

What areas of the achilles complex need to be palpated?

A

Important to discriminate between pain at the attachment site (may be inflamed retrocalcaneal bursa) and the myotendinous junction which is often associated with muscular strain

24
Q

What is the treatment for achilles tendonitis?

A

It is necessary to unload the tendon with heel lifts and activity modification. With Tendonosis, use a heel lift of 1/2 inch plus eccentric exercise

25
Q

Describe Achilles tendon rupture.

A

The most common site is the midsubstance rupture, approximately 1-2.5 inches above insertion. Typically occurs in patients older than 40 who may be “weekend athletes”. A rupture is diagnosed with the Thompson test. The optimal Tx is surgery (avoid DF for 4 months), but non operative management can be beneficial.

26
Q

What is posterior tibialis tendon dysfunction?

A

a progressive degeneration and the most common cause of painful acquired flatfoot deformity in adults. The best treatment is immobilization, calf stretching, and pain-free range of the posterior tibialis and foot intrinsics. Eccentric training should be the method of choice. The best exercise to selectively train this muscle is resisted foot adduction with the foot in contact with the floor (windshield wiper motion)

27
Q

What is Haglund’s deformity?

A

Pump bump

28
Q

What is plantar fasciitis?

A

pain on the plantar surface of the foot, arising from the insertion of the plantar fascia. Characterized by progressive pain with WB and pain with the first few steps upon rising from sitting.

29
Q

What is the best treatment for plantar heel pain?

A

Patient education to reduce stress through taping, heel cushions, etc. Mobilizing the joint. Strengthening muscles that support the arch: posterior tibial, peroneal, and intrinsic muscles

30
Q

What is Sever’s disease?

A

Calcaneal apophysitis usually caused by running or jumping. Usually a heel lift can help dec pain and stretching may hel with the cause.

31
Q

What are the guidelines for return to sport after ankle sprain?

A

Full ROM at the ankle, no limp, single leg-hop test/HJ test, 30 yard zig zag test at least 90% of uninolved side

32
Q

What is a syndesmotic ankle sprain?

A

Injury to the anterior and posterior inferior tibfib ligaments, AKA high ankle sprain. Most common mecanism is ER of tibia on planted foot.

33
Q

What are shin splints?

A

Not a specific diagnosis. Pain may be caused by tibial stress fracture, and compartment syndrome. AKA tibial overusue syndrome. May be characterized based on the location.
Anterior tibial stress syndrome: tibialis anterior fatigue in runners
Posterior medial tibial stress syndrome: may be caused by soleus and FDL tightness
The best treatmentis considered to be rest, with other treatment being footwear and location specific.

34
Q

Define sinus tarsi syndrome.

A

Tenderness in the tarsal sinus indicates disruption or dysfunction of the subtalar complex. May be caused by chronic ankle sprains

35
Q

Describe hammertoes.

A

A MTP extension with PIP flexion. Pain often results from a callus on the dorsum of the PIP or under the MT head. Tx includes stretching of dorsal extrinsics in a position of ankle PF MT ext, strengthening the intrinsics, and wearing a deeper shoe

36
Q

What is the most common site of a neuroma?

A

Most commonly in the 3rd web space between the 3rd and 4th MT. The neuroma is secondary to irritation of the intermetatarsal plantar digital nerve as it travels under the MT ligament. Pain is often elicited with MTP extension which causes tightness of the ligament and compresses the nerve.

37
Q

How is the level of protective sensation tested?

A

Using the Semmes-Weinstein microfilament test. (10 gram bending force is the standard delineation).

38
Q

How are ankle fractures classified?

A

Single malleolar fracture
Bimalleolar fracture
Trimalleolar fracture: fracture of the medial and lateral malleolus and posterior aspect of the distal tibial articular surface
Any injury that causes two breaks in the ankle joint “ring” requires surgery.

39
Q

How is a bipartite sesamoid distinguished from a sesamoid fracture?

A

A bipartite sesamoid occurs in 10-30% of the population and is usually bilateral, has smooth sclerotic borders, and exhibits no callus after weeks of immobilization.

40
Q

What is a pilon ankle fracture and how is it treated?

A

An intra-articular fracture of the distal tibia produced by DF and/or axial loading forces due to the talus driving into the ankle mortise.

41
Q

What is the pathophysiology of stress fractures of the foot?

A

A break that develops after cyclical, submaximal loading. In states of increased activity, bone is resorbed faster than it is replaced, which results in physical weakening of the bone.

42
Q

What fractures of the foot are at risk for AVN?

A

The talus and navicular. Most of the talar body blood supply enters the undersurface and flows posteriorly. Both of these bones have large articular surfaces and therefore dec blood flow

43
Q

What is a Jones fracture?

A

a fracture of the 5th MT base. Occurs at the watershed area of blood supply, leading to delayed or nonunions.

44
Q

What is Charcot neuroarthropathy?

A

A process of chronic, non-infective painless joint disruption. Spontaneous onset of a warm swollen foot with no pain or vague pain.

45
Q

How is subtalar neutral position determined?

A

palpate the medial and lateral head of the talus and find the mid position. This inter-rater reliability is poor but the intra-rater is higher and may allow each clinician to develop a repeatable method for his or her own use

46
Q

How do orthotics relieve Morton’s neuroma?

A

A biomechanical orthosis addresses the mechanisms. A MT pad placed proximal to the involved MT heads elevate the shafts and take pressure off of the interdigital nerves. The apex should be placed between the affected MTs.

47
Q

Does the use of prophylactic foot orthoses have any effect on the incidence of LBP in active individuals?

A

Not in the absence of history of LBP. A preventative measure does not appear to be of any benefit

OCS Exam (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions