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KNPE331 > Week 5 > Flashcards

Week 5 Flashcards

1
Q

Key structures of the foot and ankle to consider following injury

A
  • talus position (anterior?)
  • cuboid position (rotated?)
  • navicular position (rotated or dropped?)
  • base of the 5th (tender on palpation)
  • sesamoid bones
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2
Q

Where are the sesamoid bones located in the foot?

A
  • flexor hallucis brevis tendons
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3
Q

Origin of the plantar fascia

A
  • medial process of calcaneal tuberosity
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4
Q

Insertion of plantar fascia

A
  • proximal aspect of digits
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5
Q

Lateral ligaments of the foot

A
  • anterior talofibular (ATFL)
  • calcaneofibular (CFL)
  • posterior talofibular (PTFL)
  • anterior inferior tibiofibular (AITFL)
  • posterior inferior tibiofibular (PITFL)
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6
Q

What are the two most common ligaments impacted in a lateral ankle sprain?

A
  • ATFL
  • CFL
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7
Q

Ligaments of the medial ankle

A
  • deltoid ligament
  • spring ligament
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7
Q

4 Ligaments making up deltoid ligament

A
  1. Tibionavicular
  2. Tibiocalcaneal
  3. Tibiospring
  4. Tibiotalar
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8
Q

Role of the spring ligament

A
  • supports medial arch
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9
Q

Types of tibiotalar ligaments

A
  • anterior tibiotalar
  • posterior superficial tibiotalar
  • posterior deep tibiotalar
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10
Q

Key structures to consider of the medial ankle (tom, dick and harry)

A
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallicus longus
  • tibialis anterior
  • achilles
  • peroneal tendons
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11
Q

What are the deep plantar flexors?

A
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallicus longus
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12
Q

Action of tibialis posterior

A
  • plantarflexion
  • inversion
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13
Q

Action of flexor digitorum longus

A
  • plantarflexion
  • toe flexion
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14
Q

Action of flexor hallucis longus

A
  • plantar flexion
  • big toe flexion
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15
Q

Action of tibialis anterior

A
  • dorsiflexion
  • inversion
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16
Q

Action of achilles

A
  • plantarflexion
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17
Q

What are the two peroneal tendons?

A
  • peroneus longus
  • peroneus brevis
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18
Q

Action of peroneus longus

A
  • eversion
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19
Q

Action of peroneus brevis

A
  • plantarflexion
  • eversion
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20
Q

Functional anatomy of tibialis anterior

A
  • eccentrically lowers longitudinal arch
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21
Q

Functional anatomy of tibialis posterior

A
  • stabilizer of longitudinal arch
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22
Q

Functional anatomy of plantar fascia

A
  • dynamic longitudinal arch support
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23
Q

Functional anatomy of anterior talus (what happens up the chain?)

A
  • limits dorsiflexion
  • leads to pronation at foot to compensate
  • causes internal rotation at tibia
  • valgus at knee
  • femur internally rotates
  • drop in hip
  • back pain
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24
Q

Range of motion of the toes

A
  • flexion
  • extension
  • abduction
  • adduction
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25
Q

Range of motion of the ankle- tibiotalar joint

A
  • dorsiflexion
  • plantarflexion
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26
Q

Range of motion of the ankle- subtalar joint

A
  • inversion
  • eversion
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26
Q

What is supination?

A
  • combination of plantarflexion, inversion, adduction
  • causes sole of foot to face medially
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27
Q

What is pronation?

A
  • combination of dorsiflexion, eversion and abduction
  • causes sole of foot to face laterally
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28
Q

Mechanism of injury of turf toe

A
  • hyperextension of big toe
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29
Q

What is strained in turf toe?

A
  • sprain of 1st MTP plantar ligament
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30
Q

What are the signs and symptoms of turf toe?

A
  • swelling
  • brusing
  • pain
  • loss of toe dorsiflexion ROM
  • weal hallux flexion
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31
Q

What can turf toe result in?

A
  • instability of 1st MTP with gr 3 sprain
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32
Q

Treatment for turf toe?

A
  • limit hyperextension
  • decrease inflammation
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33
Q

What is the mechanism of injury of runner’s toe (subungual hematoma)?

A
  • repeat trauma to end of toes
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34
Q

Signs and symptoms of runner’s toe?

A
  • pain and pressure under nail
  • discoloration of nail
  • nail falls off
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35
Q

What does runner’s toe result from?

A
  • foot sliding in shoe
  • tight or loose toe box
  • toes rubbing against end of shoe or each other
  • running downhill
36
Q

Prevention of runner’s toe

A
  • proper shoe fitting
  • varied course/terrain
37
Q

Where are the sesamoid bones located?

A
  • embedded in flexor hallucis brevis tendons
38
Q

Mechanism of injury of sesamoiditis

A
  • repeat trauma to ball of foot
39
Q

What does sesamoiditis result in?

A
  • inflammation of sesamoid bones and FHB tendons
40
Q

Signs and symptoms of sesamoiditis

A
  • pain over sesamoids
  • swelling
  • limited big toe extension
  • weak/painful flexion
41
Q

Treatment of sesamoiditis

A
  • rest
  • treat inflammation
  • padded insoles
42
Q

Role of plantar fascia

A
  • shock absorber
  • support long arch
43
Q

What can happen after inflammation of plantar fascia?

A
  • degeneration of the plantar fascia
44
Q

Mechanism of injury of plantar fasciitis

A
  • poor biomechanics/overuse stress
45
Q

Signs and symptoms of plantar fasciitis

A
  • tender on palpation of medial calcaneus or along longitudinal arch
  • pain with 1st steps in morning
  • ankle/toe dorsiflexion stretch pain
46
Q

What is the plantar fasciitis associated with?

A
  • tight achilles
47
Q

Treatment of plantar fasciitis

A
  • find cause
  • retrain biomechanics
  • night splints
  • orthotics
  • shockwave
  • soft tissue mobility
48
Q

Signs and symptoms of bunions (hallux valgus)

A
  • big toe aligns towards 2nd toe
  • tender bump on medial metatarsophalangeal joint
49
Q

What can bunions result from?

A
  • genetics
  • poor foot mechanics
  • tight/narrow footwear
50
Q

How can bunions be used as a red flag?

A
  • signal of pronation which could be causing problems up the chain
51
Q

How can we retrain foot mechanics?

A
  • create a stable base
  • ie. balance exercises
52
Q

How can a stable base be created?

A
  • abduct toes
  • stack hip over knee over ankle
  • tighten core, chest up
  • pick other foot up
53
Q

Tendonitis and shin splints mechanism of injury

A
  • poor mechanics
  • overuse
54
Q

Common structures affected in tendonitis and shin splints

A
  • peroneal tendons
  • tibialis anterior
  • tom, dick and harry
  • achilles
55
Q

Signs and symptoms of tendonitis and shin splints

A
  • tender on palpation over inflamed tissues
  • pain with running
  • pain with resisted muscle testing or stretch of affected tissue
56
Q

Treatment for tendonitis and shin splints

A
  • correct mechanics
  • taping
  • proper footwear
  • insoles/orthotics
57
Q

What is there a potential for with tendonitis and shin splints?

A
  • stress fractures at muscle origin
58
Q

Lateral ankle sprain mechanism of injury

A
  • ankle inversion
59
Q

Possible structures affected in a lateral ankle sprain

A
  • ATFL
  • CFL
  • PTFL
  • AITFL
  • PITFL
  • peroneals
  • cuboid position?
  • base of 5th metatarsal?
60
Q

Signs and symptoms of lateral ankle sprain

A
  • “pop”
  • giving out
  • swelling
  • bruising
  • limping
61
Q

Treatment for lateral ankle sprain

A
  • sideline management
  • reduce inflammation
  • healing
  • return to play
62
Q

Return to play test

A
  • figure 8 test
  • start with large loop and get smaller and smaller
63
Q

Mechanism of injury of medial ankle sprain

A
  • ankle eversion
64
Q

Possible structures affected in medial ankle sprain

A
  • deltoid ligament
  • spring ligament
  • tom, dick, harry
  • navicular position
65
Q

Signs and symptoms of medial ankle sprain

A
  • “pop”
  • giving out
  • swelling
  • bruising
  • limping
66
Q

Treatment of medial ankle sprain

A
  • similar as lateral
  • retrain medial contractile tissues
67
Q

Common fractures of foot and ankle

A
  • jones fracture
  • metatarsal fractures
  • talus
  • calcaneus
  • fibula
  • tib-fib (often with dislocation)
68
Q

Things to consider for injury management of fractures

A
  • urgent vs non-urgent?
  • distal circulation?
  • monitor for shock
  • splint and send for x-rays
68
Q

Surgical management of unstable fractures

A
  • reduction
  • fixation
69
Q

Surgical management of stable fractures

A
  • immobilization
70
Q

What is impacted in a Jones fracture?

A
  • peroneus brevis avulsion of base of 5th metatarsal
    **always rule this out in a lateral ankle sprain
71
Q

Mechanism of injury of Jones fracture?

A
  • inversion sprain
72
Q

Signs and symptoms of Jones fracture

A
  • tender on palpation of base of 5th metatarsal
  • pain in weightbearing
73
Q

Why should you always rule out lateral ankle sprain?

A
  • ankle sprain symptoms may distract from jones fracture
74
Q

Mechanism of injury of talus fracture

A
  • severe ankle sprains
  • land from height
  • forced dorsiflexion
75
Q

Signs and symptoms of talus fracture

A
  • vary with severity
  • pain with weight bearing
  • loss of ROM
76
Q

Mechanism of injury of calcaneus fracture

A
  • fall/jump from height
77
Q

Signs and symptoms of calcaneus fracture

A
  • extreme pain
  • unable to WB
78
Q

Mechanism of injury of fibula fracture

A
  • direct blow
  • ankle sprain mechanism
79
Q

Signs and symptoms of fibula fracture

A
  • vary with severity
80
Q

What to do as part of pre-tape assessment

A
  • explain chosen tape job and why
  • ask permission
  • clear contraindications
  • check ROM that you want to limit (pre and post test)
  • check cap refill
81
Q

Contraindications of taping (when not to tape)

A
  • allergies to adhesives
  • immediately after injury
  • injury hasnt been fully assessed
  • return to play criteria not met
  • to areas of altered skin sensation
  • overnight
  • check that sport governing body allows tape
82
Q

Indication of ankle taping (when to tape)

A
  • chronic ankle instability from previous sprains
  • RTP following treatment of recent ankle sprain
  • when ankle bracing doesnt fit in athletic shoe properly or a sport does not permit bracing
83
Q

Ankle testing

A
  • drawer sign
  • talar tilt and eversion talar tilt
  • wedge test
84
Q

Which ligament does the drawer sign test test?

A
  • anterior talofibular ligament
85
Q

Which ligament does the talar tilt test test?

A
  • calcaneofibular ligament
86
Q

Which ligament does the eversion talar tilt test test?

A
  • deltoid ligament
87
Q

Which ligament does the wedge test test?

A
  • anterior inferior tibiofibular ligament
88
Q

Indications of prowrap

A
  • sensitivity to adhesives
  • hair
89
Q

Indications of arch taping

A
  • arch pain
  • medial tendonitis/osis
  • shin splints
  • bunions

KNPE331 (5 decks)

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