Ankle & Foot

Question 1

Diagram: Identify the Lateral Ligaments

Answer 1

1. Anterior tibiofibular

2. Anterior talofibular (Most commonly Injuried)

3. Calcaneofibular

4. Lateral talocalcaneal
5. Interosseous talcalcaneal
6. Cervical talocalcaneal

Question 2

Diagram: Identify the Medial Ligaments

Answer 2

1. Superficial Deltoid
2. Plantar Calcaneonavicular
3. Deep Plantar

Question 3

Content: Main Functions of the Foot (3)

Answer 3

1. Adapt to ground surfaces
2. Shock absorption
3. Rigid lever to propel body (during heel off/end of stance)

Question 4

Q: What 3 bones are involved in the talocrural joint?

Answer 4

1. Distal tibia
2. Distal fibula
3. Talus

Question 5

Content: Normal Range at Talocrural Joint

1. PF
2. DF

Answer 5

1. 0-50
2. 0-20

Question 6

Content: Talocrural Joint Arthrokinematics

1. PF - roll and glide
2. DF - roll and glide

Answer 6

1. Roll posterior, glide anterior
2. Roll anterior glide posterior

Question 7

Q: What motion occurs at the subtalar joint?

Answer 7

Pronation(Eversion)/Supination(Inversion)

Question 8

Content: Normal Range at Subtalar Joint

1. Pronation/Eversion
2. Supination/Inversion

Answer 8

1. 0-10
2. 0-30

Question 9

Content: Surface of the subtalar joint

1. Anteriorly
2. Posteriorly

Answer 9

1. CONVEX talus, CONCAVE calcaneous
2. CONCAVE talus, CONVEX calcaneous

Question 10

Q: At the anterior portion of the subtalar joint roll and glide are in the __________ direction, at the posterior portion of the subtalar joint roll and glide are in the ___________ direction.

Answer 10

same, opposite

Question 11

Q: What portion of the subtalar joint dominants in our view of arthrokinematics?

Answer 11

Anterior (roll and glide the same)

Question 12

Content: Anterior Subtalar Joint Arthrokinematics

1. Pronation/Eversion
2. Supination/Inversion

Answer 12

1. Lateral roll and glide
2. Medial roll and glide

Question 13

Content: Posterior Subtalar Joint Arthrokinematics

1. Pronation/Eversion
2. Supination/Inversion

Answer 13

1. Lateral roll and Medial glide
2. Medial roll and Lateral glide

Question 14

Content: Talonavicular Joint Arthrokinematics

1. Supination
2. Pronation

Answer 14

1. Plantar/medial roll and glide
2. Dorsal/lateral roll and glide

Question 15

Content: MTP/IP Arthrokinematics

1. Flexion
2. Extension

Answer 15

1. Plantar roll and glide
2. Dorsal roll and glide

Question 16

Content: Talocrural Joint

1. Resting Position
2. Close Packed Position

Answer 16

1. 10 PF, midway b/t inversion/eversion
2. Max DF

Question 17

Content: Subtalar Joint

1. Resting Position
2. Close Packed Position

Answer 17

1. Pronation
2. Supination

Question 18

Q: Squatting assesses the functionality of what at the ankle?

Answer 18

DF

Question 19

Q: Heel raises assesses the functionality of what at the ankle?

Answer 19

PF

Question 20

Content: Grade 1 Ankle Sprain (5)

Answer 20

1. < 25% tearing
2. Mild pain/swelling
3. No instability
4. Potential to WB
5. 7-14 days of activity loss

Question 21

Content: Grade 2 Ankle Sprain (5)

Answer 21

1. 26-75% tear
2. Moderate pain/swelling
3. Loss of ROM, slight instability
4. PWB
5. 2-6 wks of activity loss

Question 22

Content: Grade 3 Ankle Sprain

Answer 22

1. Total disruption of ligament
2. Severe pain/swelling
3. Loss of ROM and instability
4. NWB
5. 4-26 wks of activity loss

Question 23

Diagram: Ankle Sprain Grade Table

Answer 23

Question 24

Q: What percent of pts. who suffer ankle sprains develop funtional ankle instability?

Answer 24

30-50%

Question 25

Content: Rearfoot Leg Orientation - Normal (4)

Answer 25

1. Lower leg vertical 2. STJ neutral 3. Calcaneus on surface 4. MT heads on surface

Question 26

T/F: The Calcaneus and MT heads are perpendicular in normal rearfoot alignment.

Answer 26

True

Question 27

Q: How is rearfoot varus compensated for?

Answer 27

STJ Pronates and calcaneus vertical

Question 28

Q: How is an forefoot varus compensated for?

Answer 28

STJ pronated, everted calcaneous, forefoot on surface

Question 29

Content: Gait associated with Rearfoot varus (3)

Answer 29

1. Heel strik and WB with excessive pronation 2. Increased tibial IR 3. Delayed tibial ER

Question 30

Content: Gait associated with Forefoot varus (3)

Answer 30

1. Excessive mobility in midstance and propulsion 2. Decreased supination 3. Makes foot lever arm less effective

Question 31

Content: Possible orthopedic conditions in fore/rearfoot varus (6)

Answer 31

1. Plantar fasciitis 2. Metatarsalgia (nerve issue) 3. Hallus valgus 4. Callus formation (2nd/3rd MT head) 5. Overuse 6. Increase tibial IR

Question 32

Q: How is forefoot valgus compensated for?

Answer 32

STJ supinated, inverted calcaneous, forefoot stabile

Question 33

Content: Deficits of STJ supination

Answer 33

1. Decreased shock absorbing function 2. Increase risk of ankle sprain

Question 34

Q: When does the subtalar joint evert/invert during the gait cycle?

Answer 34

Evert - loading response Invert - Toe off

Question 35

Defn: Forefoot equinus

Answer 35

Lower leg 10 degrees forward of vertical

Question 36

Q: What are the compensations for forefoot equinus

Answer 36

Increase pronation and knee hyperextension

Question 37

Content: Identify the bones in the 1. Hind or rearfoot 2. Midfoot 3. Forefoot

Answer 37

1. Fibula, Tibia, Taluz, Calcaneus 2. Navicular, Cuboid, Cuneiforms 3. MT, Phalanges

Question 38

Q: What test is used to test the anterior talofibular ligament?

Answer 38

Anterior Drawer

Question 39

Q: What test is used to test the calcaneofibular ligament?

Answer 39

Talar tilt

Question 40

Q: What 3 motions is supination a combination of?

Answer 40

Add, IR, PF

Question 41

Q: What 3 motions is pronation a combination of?

Answer 41

Abd, ER, DF

Question 42

Content: Common Symptoms with Ankle/Foot Problems

Answer 42

1. Pain - related to injury of ligament, tendon, pinching of nerve/soft tissue 2. Instability - due to post ligament injury 3. Hypomobility - can be due to fx, scar tissue build up