Ankle

Question 1

What does Simmonds test

Answer 1

Achilles tear/rupture

Question 2

Simmonds technique

Answer 2

Pt prone
Feet off couch
Squeeze calves

Question 3

+ve Simmonds

Answer 3

No plantar flexion

Question 4

What does talar tilt test

Answer 4

Inversion- lateral sprain (ant/post talofibular ligament, calcaneofibular lig, post talofibular lig)

Eversion- medial sprain (deltoid lig)

Question 5

Talar tilt technique

Answer 5

Pt seated or supine
Place pillow under knee
Hand placement on lat + med malleoli
Invert foot & plantar flex is ant talofibular
Evert foot
Neutral calcanofibular
Full Doris flex post talofibular

Question 6

+ve Talar tilt

Answer 6

Inversion- lateral sprain/rupture= P + increased motion

Eversion- med sprain= P + increased motion

Question 7

Specificity of Talar tilt

Answer 7

75

Question 8

Sensitivity of Talar tilt

Answer 8

67

Question 9

What does ant/post drawer test

Answer 9

Ant talofibular ligament instability

Post ankle ligament instability

Question 10

Ant/post drawer technique

Answer 10

Pt supine
Bend leg, foot on couch
Fix top of foot
Support round back of Achilles, pull forward post
Ant- push shin

Question 11

+ve Ant/post drawer

Answer 11

Increased ant movement (ATFL)

Increased post movement (PTFL)

Question 12

Ant/post drawer clinical notes

Answer 12

Compare bilaterally
In normal individuals test should produce little to no motion

Question 13

What does Tinel’s sign test

Answer 13

Tarsal tunnel syndrome (post tibial nerve)

Question 14

Tinels sign technique

Answer 14

Pt supine with hip of affected side ER + foot slightly everted
Tap behind medial malleolus- post tibial nerve/medial plantar nerve
Over the dorsum of the ankle near the neck of talus- deep peroneal

Question 15

+ve Tinels foot

Answer 15

Radiating P in foot + toes due to aggravation of tibial N (heel)

Question 16

What does Homans sign test

Answer 16

Thrombosis
Strain
Achilles rupture

Question 17

Homans technqiue

Answer 17

Pt supine with leg straight
Raise leg to 10 deg
Forcefully dorsiflex foot + squeeze calf with other hand

Question 18

+ve Homans

Answer 18

Deep P in calf- thrombosis
Local- gastrocs/soleus strain
No PF with squeeze- complete achilles rupture

Question 19

Specificity of Homans

Answer 19

41

Question 20

Sensitivity of Homans

Answer 20

35-48

Question 21

Achilles tap test procedure

Answer 21

Pt supine, seated or prone
Tap over achilles with fingers or reflex hammer
Observe for PF

Question 22

Achilles tap test interpretation

Answer 22

P or lack of PF= achilles tendonitis, achilles tendon rupture

Question 23

Buergers test

Answer 23

Pt supine
Leg straight at 45
Hold for 3 mins
Lower leg, below table, instruct Pt to sit up
Observe refilling of dorsal veins of foot

Question 24

Buergers interpretation

Answer 24

> 1-2 mins required for cyanosis (red) + refilling of dorsal veins of foot to occur = lower ex vascular compromise (PVD, atherosclerosis)

Question 25

Calcaenus squeeze test

Answer 25

Pt prone Flex knee to 90 Squeeze in three locations 1. side 2. calcaneal tuberosity (post calcaneus) 3. medial calcaneal tubercle Observe for P or discomfort

Question 26

Calcaneal squeeze test interpretation

Answer 26

P with 1. side- # 2. calcaneal tuberosity- retrocalcaneal bursitis, # 3. medial- plantar fasciitis

Question 27

Fibular translation test

Answer 27

Pt side lying Examiner stabilises medial malleolus (cupping) + applies anterior + posterior force over lateral malleolus

Question 28

Fibular translation interpretation

Answer 28

P or discomfort of fibula- tear of syndesmosis ligaments

Question 29

Fib translation sens

Answer 29

82

Question 30

Fib translation spec

Answer 30

88

Question 31

Mortons procedure

Answer 31

Pt supine or seated Examiner squeezes foot around metatarsal heads Observe for P/discomfort

Question 32

Mortons interpretation

Answer 32

P- mortons neuroma, metatarsal Jt arthritis, # of metatarsal heads

Question 33

Mortons clinical notes

Answer 33

Usually between distal metatarsals Between 3-4 55%, 2-3 45%

Question 34

Mortons DDx

Answer 34

Metatarsalgia P less localised with P under metatarsal heads (parasthesia not present) Stress # P localised to metatarsal shaft- not between metatarsals (palpate directly) Deep peroneal neuropathy- S+S between 1+2 toes

Question 35

Subtalar glide

Answer 35

Pt supine Stabilise talus and apply a medial then lateral force to the calcaneus

Question 36

Subtalar glide interpretation

Answer 36

P or displacement calcaneus= subtalar sprain or instability

Question 37

Subtalar spec

Answer 37

75

Question 38

Subtalar sens

Answer 38

78

Question 39

Subtalar glide clinical notes

Answer 39

Should be minimal movement

Question 40

Windlass procedure

Answer 40

Pt seated Examiner stabilises ankle in neutral + extends big toe while allowing the IP Jt to flex Repeat with Pt standing

Question 41

Windlass interpretation

Answer 41

P or symptom reproduction- plantar fasciitis

Question 42

Windlass clinical notes

Answer 42

May extend all toes Windlass effect is primary mechanism that lifts the medial longitudinal arch during toe off