Ankle

Question 1

What is the ankle joint called?

Answer 1

Talocrural joint

Question 2

Where is the articulation of the ankle?

Answer 2

Talus and distal tibia and fibula

Question 3

What tendons form the Achilles tendon?

Answer 3

Gastroc
Plantaris
Soleus

Question 4

What are the biomechanics of the ankle?

Answer 4

The tibia is a concave surface and talus is a convex surface
And the talus moves opposite to the bony lever

Question 5

What muscles are involved in plantar flexion?

Answer 5

Tibialis Anterior
Soleus
Gastroc
Tibialis Anterior

Question 6

What muscles are involved in inversion?

Answer 6

Tibialis anterior and posterior

Question 7

What does the popliteus do?

Answer 7

Flexion
And medial rotation

Question 8

What are the lateral ligaments?

Answer 8

Anterior and Posterior Talofibular
Calcanofibular

Question 9

What are the lateral ligaments known as?

Answer 9

The Lateral Collateral ligaments

Question 10

What ligaments in the ankle are prone to injury?

Answer 10

The LCL

Question 11

What is the syndesmosis?

Answer 11

A movable articulation formed at the distal tibiofibular articulation

Question 12

What is the Mechanism of injury for the syndesmosis?

Answer 12

Eversion or extreme dorsiflexion
(High ankle sprain)

Question 13

What is the Ottawa ankle rules?

Answer 13

It’s a set of guidelines to help decide if a patient with foot or ankle pain should be referred to an X-Ray

Question 14

What are the rules when there’s pain in the malleolar zone?

Answer 14

Bone tenderness along the distal 6cm of the post edge of the tibia or tip of medial malleolus
Bone tenderness along the distal 6cm of the post edge of the fibula or tip of lateral malleolus
Instability with weight bearing both immediately and in the emergency department for 4 steps

Question 15

What are the rules when there’s pain in the midfoot zone?

Answer 15

Bone tenderness at the base of the 5th metatarsal
Bone tenderness at the navicular bone
Instability with weight bearing both immediately and in the emergency department for 4 steps

Question 16

What are the possible causes of pain in the ankle?

Answer 16

Ligamentous sprain
Fracture
Osteochondritis dissecans
Infection
Degenerative or inflammatory conditions

Question 17

Whatbis Osteochondritis Dissecans ?

Answer 17

Poor blood flow to cartilage which results in a fracture from repetitive stress

Question 18

What should the body chart highlight?

Answer 18

Depth,intensity,Quality of pain
Abnormal sensation
Area of current symptoms

Question 19

What special questions can be asked?

Answer 19

Unable to weight bear
Deformity,bruising and swelling
Diabetes

Question 20

What special Tests are done on the ankle?

Answer 20

inversion stress test (ATFL and PTFL,CFL)-LCL
Eversion Stress Test -Deltioid Lig
Anterior Drawer-ATFL
Syndesmosis squeeze test -The Syndesmosis pain or laxity
Thompson-Achilles Tendon Rupture

Question 21

What is a lateral ligament sprain?

Answer 21

When there’s excessive inversion and Plantarflexion.Presents as pain of the lateral aespect

Question 22

What tests can be done to test lateral ligament sprain?

Answer 22

Inversion stress test and anterior drawer

Question 23

What is a deltoid ligament sprain?

Answer 23

Done with excessive eversion and takes longer to heal there’s pain over medial aespect of ankle

Question 24

What test is done to test medial ligament sprain?

Answer 24

The eversion stress test

Question 25

What is the MOI of the high ankle sprain?

Answer 25

DF and ER

Question 26

How does a high ankle sprain present?

Answer 26

There's pain over proximal anterior and lateral ankle and pain with DF

Question 27

What is done to diagnose high ankle sprain?

Answer 27

The squeeze test and passive ER

Question 28

What is Achilles Tendinopathy?

Answer 28

It's an overuse injury and it's common in those who run it occurs when load applied to tendon exceeds tendons ability to withstand load

Question 29

How does Achillies tendinopathy present?

Answer 29

Swelling and thickening of tendon Pain on palpation Pain on single leg hop Pain on calf raise pain on getting up in the morning

Question 30

What should you do in Rehab for Achillies tendinopathy?

Answer 30

Start with isometrics and progress to eccentric exercises and then add hopping Correct footwear

Question 31

What is Achillies tendon rupture?

Answer 31

Sudden onset of pain with gross loss of function

Question 32

How would you test if it was an Achillies tendon rupture?

Answer 32

When doing Thompsons Test there is no PF

Question 33

What is Plantar Fascititis?

Answer 33

It's inflammation that occurs due to repetitive mechanical loading

Question 34

What are the predisposing factors of Plantar Fascitis?

Answer 34

Increased pronation and calf tightness also being overweight and running on hard surfaces

Question 35

What is the clinical picture of Plantar fascitis?

Answer 35

Pain is worse after getting up Pain on ankle DF Tender on palpation

Question 36

What are the treatment options for Plantar Facsitis?

Answer 36

Orthotics Footwear Night splints Shockwave

Question 37

What is Tarsal tunnel syndrome?

Answer 37

An Entrapment of post tibial nerve in fibrosseous tunnel behind the medial melleolus

Question 38

What could cause TTS?

Answer 38

Tight fitting shoes Trauma Excessive pronation

Question 39

What is the clinical picture of TTS?

Answer 39

Sharp pain foot Positive on Tinels test Pain on palpation Parasthesia

Question 40

What is the treatment of TTS?

Answer 40

Changing footwear Calf exercises and stretches Taping

Question 41

What is the treatment for foot and ankle tendinopathies?

Answer 41

Start with isometric and then eccentric training Gradual reloading