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Musculoskeletal Physiotherapy 1 > Week 6 > Flashcards

Week 6 Flashcards

1
Q

What are the three regions of the foot

A

rear, midfoot and forefoot

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2
Q

What does the midfoot comprise of

A

navicular, cuneiforms and cuboid bones and joints

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3
Q

What does the forefoot comprise of

A

metatarsals and phalanges

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4
Q

list ligaments of the foot (3)

A
  • Plantar calcaneocuboid ligament (short plantar ligament)
  • Long Plantar Ligament
  • Plantarcalcaneonavicular ligament (spring ligament)
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5
Q

4 functions of the ligaments of the foot

A

-Plantar reinforcement
-Structural stability to lateral column
PCNL-Structural floor & Wall medially
- Provides support

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6
Q

What does altered sensation of the foot impact on? (4)

A

Foot health
lower extremity injuries
LBP
Balance

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7
Q

Layer 1 intrinsic muscles of the foot includes and what function they do(3)

A

Flexor digitorum brevis
Abductor hallucis
Abductor digiti minimi
*abducts & flexes their respective digits

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8
Q

Layer 2 intrinsic muscles of the foot includes and what function they do(2)

A

Quadratus Plantae
- stabilises FDL tendon
Lumbricals
- Action similar to hand

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9
Q

Layer 3 intrinsic muscles of the foot includes and what function they do(3)

A 
Adductor hallucis
- adduct & flex great toe
Flexor hallucis brevis
Flexor digiti minimi
-Both fex MTPs of respective toes
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10
Q

Layer 4 intrinsic muscles of the foot includes and what function they do(2)

A 
Plantar interossei (3)
Dorsal interossei (4)
-Strutural stability to fot vs dexterity in hand
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11
Q

Name nerves of the foot (6)

A

Dorsal surface

  • Deep peroneal nerve
  • sural nerve
  • intermediate dorsal cutaneous nerve
  • Medial dorsa cutaneous nerve

Sole/Plantar surface

  • Lateral plantar nerve
  • Medial plantar nerve
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12
Q

Name 3 arches of the foot

A

Medial longitudinal arch
Lateral longitudinal arch
Transverse arch

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13
Q

Origin and insertion of the Plantar fascia

A

O- medial calcaneal tubercle

I- metatarsal heads

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14
Q

Function of the plantar fascia

A

provide stability to the arch of foot and aid in resupination of the foot during propulsion

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15
Q

common causes of rearfoot pain

A

plantar fasciitis

foot pad contusion

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16
Q

Less common causes of rearfoot pain (6)

A 
Calcaneal fractures (traumatic, stress fractures)
Medial calcaneal nerve entrapment
lateral plantar nerve entrapment
Tarsal tunnel syndrome
Talar stress fractures
retrocalcaneal bursitis
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17
Q

What causes of pain shouldn’t be missed (3)

A

Spondyloarthropathies
Osteoid osteoma
CRPS Type 1
-post knee or ankle injury

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18
Q

Common causes of midfoot pain (5)

A 
Navicular stress #
Midtarsal joint sprain
Extensor tendinopathy 
Tib post tendinopathy
plantar fascia strain
19
Q

Less common causes of midfoot pain (9)

A 
Cuneiform stress #
cuboid stress fracture#
Base 2nd MT stress #
Peroneal tendinopathy
ABD hallucis strain
Cuboid syndrome
Tarsal syndrome
Tarsal coalition
-Young adolescent 
Kohler's 
 - young children
Accessory navicular bone
20
Q

Don’t miss causes of midfoot pain (3)

A 
Lisfranc joint injury
- TMT joints
-dislocation or #
Osteoid osteoma
CRPS type 1
- post knee or ankle injury
21
Q

Common causes of forefoot pain (12)

A 
1st MTP joint sprain
Hallux Limitus
Moreton's neuroma
Synovitis of MTP joints
MT stress # 
Jone's # (5th MT diaphysis)
Hallux valgus
Sesamoid pathology
subungual haematoma 
Corns, calluses
Onychocryptosis
22
Q

Less common forefoot pain causes (8)

A 
Freiberg's osteochondritis
Joplin's neuritis
Sesamoid stress #
Base MT 2 stress #
Synovitis of MT-Cuneiform joint
Toe Clawing
sublungual extosis
plantar warts
23
Q

Don’t miss causes forefoot pain(1)

A

CRPS type 1

post knee ankle injury

24
Q

Most common disorders of the foot (6)

A 
Plantar fasciitis
Navicular stress fracture 
Hallux rigidus/ limitus
Moreton's neuroma (metatarsalgia)
Hallux valgus
Tibialis posterior tendon dysfunction
- PTTD
25
Q

Causes of plantar fasciitis(4)

A

Pes planus increases risk
Excessive pronation or lack of resupination in late stance
Pes cavus - lack of mobility in foot &reduce absorption
Tight proximal myofascial structures
-esp calf ham and glutes

26
Q

Pages to review

A

34, 37

27
Q

Clinical features of plantar fasciitis (7)

A

Gradual onset
characterised by medial plantar heel pain
Worse with walking and running
Worse upon rising in the morning / first step
TOP medial tuberosity calcaneus
Gait biomechanics play role
Muscular tightness and weakness impact

28
Q

Treatment for plantar fasciitis (12)

A

Avoidance of activity, cryotherapy, stretching (plantar fascia and calf), taping, STM, NSAIDS, corticosteroid, heal pad, strengthening, footwear, orthoses, surgery

29
Q

causes of navicular stress # (3)

A

overuse and training error play role
possible impingement between proximal & distal tarsal bones
Decrease DF range - increase risk

30
Q

Signs and symptoms of Navicular stress #

A

Insidious onset
Midfoot pain
Localised tenderness at N spot

31
Q

What to use to find Navicular stress factures

A

MRI/ CT scans

X-ray has low sensitivity

32
Q

Treatment of Navicular stress fracture treatment (2)

A

Rest from WB + Aircast
- 6-8/52
Post immobilisation

33
Q

What is Hallux limitus (inc 1st MTP Sprain)

A

Pimarily posttraumatic injury to the plantar ligament, capsule, tendon and sesamoid #

34
Q

MOI of Hallux limitus

A

Hyperextension

  • turf toe
  • limits extension to 5 degrees
35
Q

Treatment for Hallux limitus

A 
Reduced activity
NSAIDs/ corticosteroid 
PT - increase ROM, biomechanical corrections
Orthoses 
Surgery
36
Q

What is Morton’s neuroma

A

swelling of nerve + scar tissue from compression of interdigital nerve ( commonly 3-4 MTs)

37
Q

Contributing factor to Morton’s neuroma

A

Excessive pronation - MT hypermobility + impingement

38
Q

Presenting factors of Morton’s neuroma

A

Pain radiating into toes
P&N
Pain increase with WB and tight shoes

39
Q

Treatment of Morton’s Neuroma

A 
Ice
MT padding
corticosteroid
strengthening of foot intrinsic and extrinsics 
-transverse arch and pronation control
Orthoses
chronic- nerve ablation
40
Q

What is Hallux valgus

A

valgus deformity between 20-30 degrees of the big toe - increases up to 60%

41
Q

causative factors of hallux valgus (6)

A

secondary to intrinsic and extrinsic factors
Footwear
Excessive pronation
increase length 1st MT and Hallux
Trauma - medial + plantar ligament, med sesamoid bone
degenerative or neuromuscular disorders

42
Q

Presentation of hallux valgus (4)

A

Deformity
Tenderness over medial eminence
Possible blistering
Inflamed bursa medially

43
Q

Treatment of hallux valgus

A

Padding, footwear, foot function correction, orthoses, surgery

Musculoskeletal Physiotherapy 1 (12 decks)

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