Week 5- ankle Flashcards
Name the three joints of the ankle
inferior tibiofibula
talocrural
the subtalar joint
What is the talocrural joint
The articulation between the talus, medial malleolus (distal tibia) and lateral malleolus (distal fibula)
talocrural type of joint
uniaxial modified hinge joint
Movements allowed at talocrural joint
flexion (plantarflexion)/ extension (dorsiflexion)
combined mvements of inversion/eversion possible with subtalar joint
What is the inferior tibiofibular joint?
The articulation between the distal tibia and the distal fibula
What type of joint is the tibiofibular (distal)
syndesmosis (designed for stability)
what injury occurs at the inferior tibiofibular joint
high ankle sprains
What is the subtalar joint
articulation between the talus and the calcaneus
What type of joint is the subtalar joint
Plane synovial joint
Movements allowed at the subtalar joint
Pronation (calcaneovalgus)
Supination
(calcaneovarus)
Which muscles dorsiflex the foot
Tibialis anterior
Extensor digitorum longus
Extensor hallicis longus
Which muscles plantarflex the foot
gastrocnemius
soleus
plantaris
Which muscles invert the foot
Tibialis posterior
tibialis anterior
Extensor hallicus longus
Which muscles evert the foot
Peroneus longus
peroneus brevis
peroneus tertius
Which muscls toe flex
Flexor hallicus longus
Flexor hallicus brevis
flexor digitorum longus
flexor digitorum brevis
Which muscles toe extend
Extensor hallicus longus
extensor hallicus brevis
Extensor digitorum longus
extensor digitorum brevis
What is the most common ankle injury
lateral ankle sprain
MOI lateral ankle sprain
Excessive supination / inversion (+/-plantarflexion)
Signs and symptoms of lateral ankle sprain
pain
swelling / +/- ecchymosis
instability
Management of lateral ankle sprain (Acute phase)
acute phase (24-72 hours)
POLICE (OL dependant on grade of injury
- ankle pumos 10-20 per hours
Crutches (gat retraining) _WBAT
Ottawa akles rules
taping / bracing
Management of LAS (repair stage)
Joint mobilizations passive stretch (gastroc/soleus) Isometric exercise (as soon as patient can tolerate) Strengthening proprioception shoe assessment taping/bracing
Management of LAS (remodelling phase) (15-28 days - 3 weeks 60% strength, 3 months 100% strength
Begin running / jumping forward and backwards
Incorporation of multidirectional agility drills
progress to jumping sideways
progress to box drills
simulated sport specific exercises
Achilles Tendinopathy signs and symptoms
pain activity related pain tendon thickening pain on palpation reduced strength stiffness of the tendon
AT management
Alfredson Exercise Protocol (Eccentric exercises ) 3 sets x 15 reps twice daily both with knee bnt and straight
What does tendinitis refer to
inflammation of the tendon
What does tendinosis refer to?
degeneration of the tendon
what does tendinopathy refer to?
makes no assumption about the underlying tendon pathology
Ligaments of the ankle
Saladin
Nerves of the ankle
Saladin
Ottawa ankle rules part 1
A series of x-ray films is required only If there is any pain in malleolar zone and any of these findings :
- Bone tenderness at Posterior edge or tip of lateral malleolus -6cm
- inability to bear weight both immediately and in emergency department
Ottawa ankle rules part 2
A series of x-ray films is required only If there is any pain in malleolar zone and any of these findings :
Bone tenderness at base of fifth metatarsal
Bone tenderness at navicular
-inability to bear weight both immediately and in emergency department
What is sensitivity
Ruling out
What is specificity
Ruling in
