THE LEG and ANKLE Flashcards
palpate medial malleolus
patient half lying
laterally rotate the leg - identify the medial malleolus using index and middle fingers - palpate the full length
palpate lateral malleolus
patient half lying
medially rotate the leg - palpate full extend of lateral malleolus using index and middle finger
palpate tuberosity of navicular
patient sitting over side of plinth with foot on stool
foot at 90 degrees
identify the tip of medial malleolus
move down and forwards 1 inch until another bony prominence is palpable
palpate the base of 5th metatarsal
patient sitting over side of plinth with foot on stool
index and middle finger proximally along the lateral border of the foot approx half way along length
palpate the head of talus
patient sitting over side of plinth with foot on stool - slight plantar flexion
place middle and index on the lower end of tibia (medial)
slide fingers down and medial distal to the joint line.
inversion will increase prominence.
palpate the full extent
palpate the head of 1st metatarsal
patient in half lying
ask model to flex toes
palpate over dorsal aspect of foot - medial side
then ask model to extend toes
palpate over plantar aspect of foot
palpate the talocrural joint
patient in half lying
from tip of medial malleolus to the tip of the lateral malleolus
passively move the patients foot when palpating over tendon to make easier to see
mark the position of the mortise for completeness
what type of joint is the talocrural joint?
uniaxial, compound, hinge joint
demonstrate full ROM for ankle dorsiflexion
half lying with pillow under knee to reduce tension in gastroc
ask patient to bring toes to nose
demonstrate full ROM for ankle plantarflexion
half lying with pillow under knee to reduce tension in gastroc
ask patient to bring toes to floor
demonstrate full ROM for ankle inversion
half laying
place hand proximal to ankle to keep stable
ask to turn foot inwards fully
demonstrate full ROM for ankle eversion
half laying
place hand proximal to ankle to keep stable
ask to turn foot outwards fully
what is normal ROM for ankle dorsiflexion
0-15
what is normal ROM for ankle plantarflexion
0-55
what is normal ROM for ankle inversion
0-35
what is normal ROM for ankle eversion
0-25
limiting factors for ankle dorsiflexion
tension in gastroc and soleus tension in posterior tibiotalar band of deltoid calcaneofibular ligament posterior capsule articular surfaces
limiting factors for ankle plantarflexion
tension in anterior tibiotalar band and tibionavicular bands of deltoid
tension in calcaneofibular ligament
anterior capsule
limiting factors for ankle inversion
extend of articular surfaces
tension in opposing muscles (NAME)
limiting factors for ankle eversion
extend of articular surfaces
tension in opposing muscles (NAME)
plantar calcanocuboid ligament
how to perform the lateral ligament stress test?
half lying
fully passively invert the foot - feel for opening up at lateral joint line
in neutral for calacneofibular band
in plantar flexion for anterior talofibular band
how to perform the medial ligament stress test?
half lying
fully passively evert the foot - feel for opening up at the medial joint line
how to perform AP fibular @ inferior tibiofibular joint
prone lying with knee flexed to 90 degrees
plinth at mid thigh height
Elbows up!!
Heel of upper hand on anterior border of lateral malleolus.
Heel ofother hand on posterior border of medial malleolus.
Oscillatory movement on lateral malleolus away from patient.
TIBIA should be fixed.
how to perform PA fibula @ inferior tibiofibular joint
prone lying with knee flexed to 90 degrees
plinth at mid thigh height
elbows up!!
Heel of lower hand on posterior border of lateral malleolus.
Heel ofother hand on anterior border of medial malleolus.
Oscillatory movement on lateral malleolus towards the patient.
TIBIA should be fixed.
