04 Foot/Ankle Palpations: Medial Flashcards Preview

7232 Ortho > 04 Foot/Ankle Palpations: Medial > Flashcards

Flashcards in 04 Foot/Ankle Palpations: Medial Deck (39):
1

first MTP joint: clinical significance

- MTP sprain
- OA
- hallux valgus
- gout
- turf toe

2

During the propulsive phase of the gait cycle, the MTP needs this much extension

50˚

3

Why is the first metatarsal so big compared to the others?

- final propulsive push off is off the biggest bone during the gait cycle
- causes a lot of stress and pressure

4

joint between the first metatarsal and medial cuneiform: clinical significance

occasionally get OA changes

5

navicular: clinical significance

- Cohler's syndrome
- os navicularis
- landmark for navicular drop test

6

Cohler's syndrome

osteonecrosis of navicular

7

os navicularis

- accessory bone
- get stress fractures here and may be recalcitrant to healing

8

Which bone is the keystone of the medial longitudinal arch?

navicular

9

medial side of calcaneus: clinical significance

site of compression fracture

10

What landmark is located one body inch down from the medial malleolus?

sustentaculum tali

11

sustentaculum tali: clinical significance

- acts as a fulcrum for Tom, Dick, and Harry
- rarely injured

12

How do you palpate the sustentaculum tali?

from medial malleolus, move down one body inch and push superiorly

13

Where is the talar tubercle?

from posterior tip of the medial malleolus, move to the posterior part of the talus

14

talar tubercle: clinical significance

- avulsion of the deltoid ligament
- occasionally gets injured with an eversion injury

15

Where is the head of the talus located?

- draw an imaginary line between medial malleolus and navicular
- press in between these two and that's the head

16

How do you make the head of the talus more prominent?

plantarflex
evert

17

head of talus: clinical significance

possible (but not likely) distal tibial fractures

18

deltoid ligament: clinical significance

not common, but worth palpating if there was an eversion ankle sprain

19

deltoid ligament location

- runs from anterior to posterior medial malleolus
- head of talus along sustentaculum tali
- bac to the medial tubercle of talus

20

spring ligament: clinical significance

primary stabilizer for longitudinal arch

21

Where does the spring ligament run?

sustentaculum tali to navicular

22

What runs from the medial malleolus to the medial side of the calcaneus?

lancinate ligament (flexor retinaculum)

23

flexor retinaculum: clinical significance

- stabilizes Tom, Dick, and Harry
- tarsal tunnel syndrome
- landmark for Tinel's sign
- site of myositis, tendonitis/osis, etc.

24

Tom

tibialis posterior

25

tibialis posterior: palpation

- closest to posterior edge of medial malleolus
- follow down to navicular

26

tibialis posterior: actions

- plantarflexion
- inversion

27

What happens when Tom actively contracts?

goes behind the malleolus

28

Dick

flexor digitorum longus

29

flexor digitorum longus: palpation

- inferior to medial malleolus
- won't jump out at you

30

how to isolate Dick

- hold big toe
- have pt PF and invert ankle and wiggle other toes
- should feel tendon rising up just inferior to posterior tip of the medial malleolus

31

Harry

flexor hallucis longus

32

FHL: how to isolate

- hold lateral 4 toes and have them flex the big toe while PF and inverting the ankle
- deepest of the tendons inferior to the medial malleolus

33

Where does the abductor hallucis run?

medial side of calcaneus to medial side of first metatarsal

34

abductor hallucis: actions

- medial dynamic stabilizer of the foot
- abducts the great toe

35

abductor hallucis: clinical significance

hypertrophies with overpronation to keep up with the arch

36

What is the nerve/artery that runs through the tarsal tunnel?

- posterior tibial n.
- posterior tibial artery.

37

Where do the posterior tibial n. and artery run?

posterior aspect of medial malleolus

38

palpating the posterior tibial artery

- fingers between where you visualize Dick and Harry
- may need to PF and evert the foot

39

posterior tibial artery: clinical significance

primary blood supply to the foot