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MSK > ankle and foot > Flashcards

ankle and foot Flashcards

1
Q

The ______________ is formed by the intersection of a line drawn along the midshaft of the first metatarsal and a line bisecting the talus on the lateral view of the foot

A

talometatarsal angle

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2
Q

a painful overuse tendon injury with
the presence of inflammatory cells

A

tendinitis

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3
Q

The degeneration of the tendon in the absence of inflammatory cells

A

tendinosis

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4
Q

Typically results from some form of excessive overuse, trauma, muscle fatigue just proximal (2-6cm) to the tendon’s insertion near the calcaneus

A

Achilles tendinopathy

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5
Q

achilles tendinopathy is most common in ____ and occurs in people that participate in running or jumping

A

males

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6
Q

what injury is bc of excessive eccentric loading from training errors, changes in training, increased distance, or changes in terrain of the back of the leg

A

achilles tendon

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7
Q

contributing factors of achilles tendon pathology

A

 Increased pronation
 Pes planus
 Increased rearfoot mobility
 Calf weakness
 Poor footwear
 Changes in training program
 Diabetes
 Obesity
 Steroid exposure
 Hypertension
 Quinolone antibiotics

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8
Q

for achilles tendinopathy results suggest that of the patients who undergo surgical repair, 75% have favorable outcomes and return to premorbid function. Poorer outcomes are reported to be associated with _________________________________________

A

advanced age, intertendon lesions, and partial tendon ruptures

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9
Q

acute achilles tendinitis rehab

A

 Compression
 Cryotherapy
 Rest
 Heel wedge
 Walking boot
 Soft tissue mobilization (STM)
 Activity modification

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10
Q

chronic achilles tendinopathies

A

 Stretching
 Night splints
 Strengthening
 Orthotic therapy
 Biomechanical correction
 Sclerotic therapy
 Extracorporeal shockwave therapy
(ESWT

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11
Q

what age group commonly sprains their ankles

A

younger than 35; most commonly 15-19 years

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12
Q

which occurs when the ligaments on the lateral portion of the ankle are injured. The most common ligaments injured are the anterior tibiofibular ligament and the calcaneal fibular ligament.

A

lateral ankle sprains (65%)

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13
Q

which are synonymous with high ankle sprains and anterior tibiofibular ligaments sprains.
These sprains occur when there is an injury to the ligaments between the two major bones of the lower leg (tibia and fibula) at the level of the ankle

A

syndesmotic sprains (10%)

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14
Q

which are the rarest and occur when there is an injury to the deltoid ligament

A

medial ankle sprains (5-10%)

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15
Q

Grade I sprain?

A

The most common sprain requires the least amount of treatment and
recovery. The ligaments connecting the ankle bones are often over stretched and
damaged microscopically but not actually torn. The ligament damage has occurred
without any significant instability developing

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16
Q

grade 2 sprain?

A

(second-degree) sprain: A more severe sprain indicates that the ligament
has been more significantly damaged, but there is no significant instability. The
ligaments are often partially torn

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17
Q

grade 3 sprain?

A

(third-degree) sprain: A grade III sprain is the most severe. This indicates
that the ligament has been significantly damaged and that instability has resulted.
A grade III injury means that the ligament has been torn.

18
Q

what are most commonly injuried in an ankle sprain?

A

lateral ligs and anterior-lateral capsule from trauma

ATFL is the number 1 guy and CFL is guy number 2

19
Q

Syndesmotic sprains are believed to occur when the ankle is planted in
dorsiflexion with external rotation of the lower leg. Most syndesmotic ankle sprains are
believed to occur because of direct contact.

A

high ankle sprain

20
Q

medial ankle sprains occur with

A

plantar flexion with eversion

21
Q

What are the 3 phases for ankle sprain healing/rehab

A
  1. acute inflam and edema control and protection
  2. subacute; decreasing pain, increasing pain free ROM, limit loss of strength and proprioception
  3. restoration of full ROM, strength, and proprioception with return to function

note: focus on gentle joint mobilization and early mobilization for collagen and edema control

22
Q

is a general term for pain along the distal two thirds of the posterior
medial tibia and can be a debilitating injury in runners

A

shin splints

23
Q

is a more specific label that excludes diagnoses of stress fracture or posterior compartment syndrome.

A

medial tibial stress syndrome

24
Q

what are the three categories of an overuse injury

A

1) Anatomical and biomechanical factors.
2) Training errors.
3) Interaction between shoes and the running surface

25
Q

what are 3 causes of shin splints

A
  • periostitis at the posterior medial border of the distal tibia
  • the soleus
  • the FDL and deep crural fascia
26
Q

T of F: a shin splint is an overuse or unaccustomed use injury

A

true

27
Q

what are contributing factors to shin splints

A
  • excessive navicular drop
  • higher BMI in runners
  • Increased pronation
28
Q

common signs and symptoms of shin splints pain

A
  • palpation pain
  • dull ache but can be intense
  • lasts hours to days
  • increased with WB
29
Q

aggravating factors for shin splints

A
  • walking
  • ballistic exercise
  • downhill walking

note: easing activities are non-weightbearing activities and rest

30
Q

what are the goals of rehab for shin splints

A
  • activity modification
  • non-painful activities
  • NWB exercise
  • Education regarding risk factor mod
  • strength, ROM, endurance
  • taping or orthotics
  • decrease inflam and move in a pain free range
31
Q

what is a surgical option for shin splints

A

fasciotomy

32
Q

what should you focus on with shin splint rehab after inflam has decreased

A
  • addressing impairments
  • stretch and improve dorsiflexion and decrease pronation
  • strengthen the muscles that control pronation
  • mobilization of talocrural joint
    note: custom orthotics and shoes may improve selective activation
33
Q

Inflammation of the _____________, most common at its proximal insertion at the medial tubercle of the calcaneus. However, active inflammation is not necessary

A

plantar fascia

note: bone spurs at attachment site are common.

This is a chronic overuse injury

34
Q

The plantar aponeurosis is most often injured at the _________________of the plantar fascia into the ______________ calcaneal tubercle

A

proximal attachment
medial

35
Q

general belief: Excessive tension through the _________ causing chronic inflammation and microtears, especially at its proximal insertion

A

plantar fascia

36
Q

T or F: histological findings do not necessarily support presence of inflammatory cells

A

T: the presence of inflammation controversial

37
Q

presence of a ______________________ is thought to increase the tensile force within the plantar fascia, thus causing micro tearing

A

low medial longitudinal arch

38
Q

when does plantar fascia often occur and what category of people

A

40-60 years
obese indv, male runners, and athletes

higher prev in females

39
Q

what effect allows passive stability of the osseous structures of the foot when
tensioned via rearfoot supination and toe dorsiflexion. This allows progression of body weight over a rigid and stable foot.

A

spanish windlass

40
Q

MOI for plantar fascia

A
  • increased tensile load
  • excessive pronation
  • micro tears and degeneration
  • inadequate talocrural dorsiflexion ROM
  • BMI
41
Q

signs and symptoms of plantar fascia

A
  • insidious onset of progressively worsening medial heel pain
  • worse in AM when you stand up and put weight on foot
  • pes planus
  • limited gastrocnemius and soleus flexibility
  • up/down stairs
42
Q

when working with plantar fascia what are rehab goals

A
  • mobility at the talocrural joint
  • improving talocrural dorsiflexion
  • strengthen the dynamic medial longitudinal arch stabilizers

MSK (19 decks)

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