Ankle Flashcards

Question

Lisfranc injury, where is the lisfranc ligament, how to test for this

Answer 1

Fx location between tarsals and metatarals ligament over the medial cuneiform and 2nd MT Most common injured is 2nd and 1st MT. MOI is supination and axial loading. Tests: Gao sign, increased space btwn 1/2nd toes. Fleck sign for avulsion of ligament. CHECK PULSES, sensation of 1st webspace due to deep fibular N,.

Answer 2

good specificty

Answer 3

Increased strain from PF and EV therefore painful with MMT. Need imaging to see if torn. Tears are from acute MOI such as LAI. Chronic injuries and from CAI adn tendon subluxign and may affect retinacul and lead to clicking.

Answer 4

increased thickening of tissue, (+) Arc sign, Royal London hospital test (decrease pain dorsiflexion). Treted with load and pain monitoring, Ionto, stretching

Answer 5

Obese, middle aged woman, posterior tib tenderness, too many toes sign

Answer 6

Active or overweight children 8- 15 years old. Will present with limited dorsiflexion pain with palpation distal to Achilles insertion and pain with passive dorsiflexion. Tests: calcaneus quiz test, pain with one he'll stand. Treated with stretching orthoses heel cup wedge plantar flexion strengthening. Concern of growth plate issue also known as calcaneal apophysitis

Answer 7

Similar to Seivers disease but does not improve. Bone stress injury does not = a stress fracture line, changes must be seen on imaging. Recommendation to have bone scan for diagnosis.

Answer 8

No tendon thickening seen. Will present like insertional Achilles tendinopathy with palpable painful bursitis

Answer 9

Ossicle usually fuses with Talus at early development. If not fused, overuse or trauma can lead to impingement. Will have posterior talus pain and pain at end range plantar flexion due to pinching. Rule out Achilles tendinitis or Sever's disease with PROM dorsiflexion. Should not have posterior calcaneus tenderness or Achilles tenderness. Also known as posterior impingement syndrome. Fragment will be seen on imaging over posterior talus.

Answer 10

Will have pain at distal 2/3 of medial tibia and have worsened pain with activity improved with rest. Pain should be 5 consecutive cm along medial tibia. Caused by bony overload, traction forces over fascia and perhaps strong plantar flexors or posterior tibialis. Treatment should include load management with pain monitoring <2/10

Answer 11

Entrapment of tibial nerve. Symptoms are poorly localized and will reflect site of entrapment. Location of Tom Dick and Harry over medial malleolus. Worse at night with weight-bearing and walking/standing.

Answer 12

Distal entrapment = Jogger's foot. Baxters neuropathy

Answer 13

medial arch and toes 1,2,3 are painful or have dysesthesia. Positive Tinel's sign symptoms with dorsiflexion eversion and MTP extension

Answer 14

Chronic medial heel pain. Will have burning and chronic history. Think tibial nerve and rule out plantar fasciitis- Will get better with activity instead of a neuropathy that will not to get better with activity.

Answer 15

Usually between 3/4 digits. Second most common 2nd/3rd toes. 10 times more common in female dancers. Will present as sharp shooting burning cramping doll ache sensation and walking on lump

Answer 16

Plantar fasciitis/optehy or heel pain Will get better and then worse with activity and have pain with the first step. Positive windlass test. Will respond well to treatment such as improving ROM due to decreased dorsiflexion, taping, orthoses night splints ionto/phonophoresis and laser. Fat pad atrophy will be most likely due to corticosteroid injections. Rule out with negative wind last test no plantar flexion tenderness and rule in with a heel cushion

Answer 17

2 -10 day recovery due to micro tearing of ATFL

Answer 18

Ankle: Pain in malleolar zone PLUS poster edge or tip of medial/malleolus tenderness within distal 6 cm and ability to weight bear immediately and in emergency department Foot: Tenderness at mid foot PLUS pain at navicular, base of fifth, and ability to weight bear immediately and in emergency department fracture tests have goos sensitivity

Answer 19

30-90 days . Unstable, ligamentous tear involvement of anterior capsule. Difficulty weight-bearing, may be unable to wheat beer after injury. Accompanied with fracture so make sure the screen. Moderate to severe joint instability.

Answer 20

10–30 days. Moderate functional loss due to partial tearing. Initial pain may be well controlled, diffuse swelling that limits activity. Partial weight-bearing trouble to walking mild moderate joint instability. ATFL and CFL disturbance

Answer 21

Grade 3 ankle sprain or high ankle sprain will require > 6 months recovery. Too conservative of weight-bearing restrictions prolong recovery for grade 1/2 . Protected weight-bearing for grade 3 is ideal, immobilize high ankle sprains. No indications for ultrasound or laser use, neuro-re-ed instead. Return to sport with brace indicated – lace up. Dorsiflexion expectations 30° at tibial shaft or 9 to 10 cm LWBT test

Answer 22

Mechanical instability versus functional instability. Mechanical instability: Implies mechanical changes to biomechanics degenerative changes and laxity. Functional instability: Result of neural control and strength posture deficits. Persistent weakness giving away pain instability and self-reported disability= CAI. Greeted with a discharge of injury prevention program to avoid the second and third episodes, increased self management with multimodal approach is recommended

Answer 23

Increased plantar fascia thickness, increased compression of properties at heel pad, neovascularity, fat disposition, overproduction of nitric acid with a tissue apoptosis. pad and tenocyte proliferation. Pain related to fear avoidance activity is greatest contributor to disability

Answer 24

Not required however can be performed to differentiate from Achilles tendinitis can be differentiated from fat pad abnormalities. Plantar fascia thickness and heel pain ARE related and thickening be seen on ultrasound. Bone spurs not related to PF

Answer 25

1. Plantar medial heel pain with first steps, worse with prolonged weight-bearing to. 2.Heal pain onset with new weight-bearing demands. 3. Pain at proximal plantar flexor insertion 4. Windlass test performed in weight-bearing 5. Negative tarsal tunnel test 6. Decrease active and passive range of motion TC mobility 7. abnormal FPI score, both extremes ares seen 8.. Increased BMI and non-athletic patient

Answer 26

FAAM, HSAQ, FFI, But, FAAM and LEFS are simple to use. Increase score is increased function for patient. MCID for LEFS 9

Answer 27

C phonophoresis, low-level razor, rocker shoe. No ultrasound D Iontophoresis E Weight loss management F: expert opinion neuromotor control balance eccentric pronation training, intrinsic foot control, dry needling, extracorporeal shockwave, steroid injections due to adverse effects

Answer 28

inserts on plantar surface of metatarsal plantar surface of 1 and 2 , 1st dorsal interosseous and lateral side of cuneiform. Allows for first raised ability. Works with tibialis posterior or metatarsal stabilizing sling. Innervated by superficial peroneal nerve. Eversion and plantar flexion of first MT

Answer 29

decreased dorsiflexion, increased BMI, running, work related standing wiyh poor shock absorption.

Answer 30

No. Instead, genetic factors such as neuronal phenotype cause abnormal collagen production or nerve infiltration and tendon causing hyper sensitivity

Answer 31

Overload due to tensile loading and shearing. Tenocytes and neovascularity lead to thickening of tendon. Tendon becomes weaker due to collegen thinning and disorganization. Increase in non-collageniac and fibrocartilage matrix with fat disposition leads to less efficient loading

Answer 32

Older age, hypertension, increased cholesterol, abnormal subtalar ROM, abnormal foot mechanics, abnormal dorsiflexion, decreased PF strength deficits, antibiotic use, rigid orthotics, DM, lipidemia, obesity, systemic disease

Answer 33

1. Gradual onset of pain 2–6 cm proximal to insertion 2. tenderness over tendon. 3. + Arc Sign: identify most swollen area with active movement with swelling at tendon. 4. + Royal London hospital test: Palpate most tender area, if decreased active DF and decreased pain with active Achilles stretch then positive

Answer 34

Ankylosing spondylitis, rheumatoid arthritis, psoriatic arthritis

Answer 35

Most common location for stress fracture. Risks include: women, military, running 25 miles a week. Will present with anterior tibia tenderness, edema pain with tuning fork. MRI equals gold standard. Managed with activity modification and weight-bearing. Prognosis is worse if treatment is delayed

Answer 36

Active cancer Immobilization or cast disability. Bedridden at least three days. Tenderness over venous system. Entire lower extremity swelling. Greater than 3 cm calf swelling. Pitting edema. Non-varicose *superficial* veins. Alternative diagnosis -2 points. Over three equals 75%

Answer 37

Claudication, cramp tight feeling of tiredness, achiness. Relieved with rest. Objectivly check skin and pulses ABI 1-1.4 is normal .8-.9 is moderate .4 is severe

Answer 38

Improved symptoms with a flexion, worsened with extension. Bilateral symptoms, leg pain will be worse than back pain. Pain with walking and standing and relief with sitting. Will be over 48 years old. Test with two stage treadmill test or bike test. PAD symptoms will get worse with these tests due to exertion and stenosis will respond well to flexion

Answer 39

A post is a wedge. Post reduces motion and frontal plane and therefore addresses subtalar motion.

Answer 40

Adjust rear foot

Answer 41

Osseous or fibrous connection between two tarsal bones usually navicular calcaneus or talus calcaneus. Will have ridgid flat arches with x-rays to diagnose. Interventions include orthotics to address hindfoot due to compromise of sub talar motion. Low dye taping to support medial arch. Immobilized for 3 to 6 weeks in ortho boot

Answer 42

SCFE at hip is example Fracture through physis

Answer 43

Plantar flexion and Main Everter The peroneus brevis originates from the lower two-thirds of the lateral fibula and inserts on the proximal fifth metatarsal

Answer 44

Insensate feet, fixed deformities with bony prominences. Will provide cushion and protection with shock absorption. Unable to feel at least 10 mm of pressure with seams Weinstein filament = insensate

Answer 45

Chains with control flexible deformities. Decreased motion. Not for fat pad atrophy. Mid or forefoot arthritis flexible deformities

Answer 46

Most common and offer shock absorption/protection. Weight redistribution and support control for flexible deformities. Hope offload high pressure areas of plantar surface. Patient with diabetes with heel and forefoot plantar pressure points

Answer 47

Medial post

Answer 48

Lateral post

Answer 49

Will correct hindfoot Dalgas scene with posterior tib dysfunction

Answer 50

Will need to limit inversion and Iverson with hinged AFO or SMO supramalleolar orthoses

Answer 51

Will need to stabilize transversed her soul and tarsometatarsal joint. UCBLRAFO device. Will benefit from rocker or double rocker soled shoes

Answer 52

Decreased femoral pulse and thigh muscle wasting indicates iliac artery occlusive disease. Location of pain may indicate level of obstruction thigh or butt

Answer 53

Hyperextension injury of first MTP resulting in plantar plate injury. Will disrupt sesamoids tracking.

Answer 54

Grade 1: stretching of plantar plate with some swelling. Return to play as tolerated Grade 2: partial tear with moderate swelling. Restricted motion due to pain. Treat with crutches as needed and returned to play in two weeks taping in plantarflexed position Grade 3: complete disruption. Significant swelling in flexion weakness with instability will occur. Immobilization or surgery is required. Anticipated RTP 10–16 weeks. Will require 50 to 60° pain-free MTP passive dorsiflexion before running or plyometrics

Ankle Flashcards

(82 cards)