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PHTH 565 - MSK > ANKLE AND FOOT > Flashcards

ANKLE AND FOOT Flashcards

1
Q

What information can you get from a squat test

A
  • Location of pain
  • talocrural wrinkles (indication of range compared side to side
  • Splay of mortice
  • DF/Compression test
  • Strength
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2
Q

During the sway test, what do you expect to occur?

A

Ipsilateral calcaneous to side rotated to should invert and contralateral should evert

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3
Q

What should happen in heel raise

A

Calcaneous should invert at the top of the heel raise

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4
Q

What is the MOI of a high ankle sprain

A

Talus getting driven between med and late malleoli by hyperdorsiflexion combined with ER of the foot

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5
Q

What are the 3 pain provocation tests for the ITF joint

A
  • Dorsiflexion/compression test (deep squat + compression)
  • Squeeze test (squeezing proximally)
  • Palpation or Point test
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6
Q

What are you looking for on the dorsiflexion/compression pain provocation test

A
  • Pain without compression

- Decreased pain or increased range with compression

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7
Q

What are you looking for with the squeeze test

A

Pain reproduction at inferior tib-fib joint

- And distraction at ITF joint?

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8
Q

Where do you palpate in the palpation or point test for the ITF joint

A

Proximal to t/c line and 2/3 lateral

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9
Q

What are the 3 stability tests for the ITF joint

A
  • anterior and/or posterior glide of fibula
  • Splay on squat
  • External rotation test
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10
Q

How do you conduct the anterior and/or posterior glide of the fibular

A

Stabilize tib in crook lying apply sustained hold for 10 seconds and compare to other side
SUSTAIN SUSTAIN SUSTAIN

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11
Q

What is a positive finding on the Splay on squat test

A
  • > 2mm with calipers

measure at most splayed point

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12
Q

What are you looking for and What is a positive test for the external rotation test of the ITF joint?

A

Looking for available ROM, end feel, and symptom reproduction

Pain reproduced over ITF joint when foot is passively taken into DF and ER

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13
Q

What are two tests for general talocrural stability

A
  • Talocrural distraction

- Talocrural compression

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14
Q

For talocrural compression where do you apply the force

A

through the plantar aspect of the calcaneus

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15
Q

What are the tests of inversion stability

A
  • ATFL
  • Calcaneofibular ligament
  • PTFL
  • Dorsal calcaneocuboid ligament
  • Lateral talocalcaneal ligament (subtalar)
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16
Q

Where are you hands positioned when testing the ATFL? What motion do you create?

A

Distal fibula and anterior talus

Inversion in a position of PF

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17
Q

Where are you hands positioned when testing the Calcaneofibular ligament? What motion do you create?

A

Distal fibula and calcaneus

Inversion in neutral foot position

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18
Q

Where are you hands positioned when testing the PTFL? What motion do you create?

A

Distal fibula and Posterior talus

External rotation in full DF

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19
Q

Where are you hands positioned when testing the Dorsal calcaneocuboid ligament? What motion do you create?

A

Calcaneus and cuboid (have thumbs side by side). your body is turned away for Pt

Invert and abduct cuboid (gaping it)

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20
Q

Where are you hands positioned when testing the lateral talocalcaneal (subtalar)? What motion do you create?

A

Stabilize annterior talus and move calcaneus

Invert and gap lateral side of calcaneus

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21
Q

What are the 3 eversion ligament stability tests

A
  • Deltoid
  • Medial talocalcaneal (subtalar)
  • Spring (plantar calcaneonavicular) ligament
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22
Q

What are the 4 fibres of the deltoid

A
  • Anterior talus
  • Navicular
  • Calcaneus
  • Posterior talus
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23
Q

What motion to you create for all fibres of the deltoid ligament

A

Eversion

24
Q

In what position do you test the anterior talus fibres of the deltoid ligament

A

PF

25
Q

In what position do you test the navicular fibres of the deltoid ligament

A

Slight PF

26
Q

In what position do you test the calcaneal fibres of the deltoid ligament

A

In neutral

27
Q

In what position do you test the posterior talar fibres of the deltoid ligament

A

Full DF

28
Q

Where are you hands positioned when testing the Medial talocalcaneal ligament? What motion do you create?

A

Stabilize talus and evert and gap medial side of calcaneus

29
Q

How do you stress test the spring (plantar calcaneonavicular) ligament

A

Roll up two towels - one under navicular one under calcaneus (sustentacular tali)
Using web of hand apply pressure directly down through neck of the talus

May be a visual deformity even prior to testing

30
Q

What are the accessory movements at the ankle

A

anterior and posterior glides

31
Q

What are the accessory movements at the talocrural joint

A

anterior (PF) glide

Posterior (DF) glide

32
Q

How do you conduct an anterior glide at the TC joint

A
  • stabilize distal tib-fib
  • Pull talus anteriorly (avoid pulling through calcaneous)
  • Pull along curve of the joint
33
Q

How do you conduct an posterior glide at the TC joint

A
  • Stabilize distal TibFIb on posterior part of calf

- Push talus posteriorly along the curve of the joint

34
Q

Posterior calcaneus in ______ and the anterior is _____ (at the joints with the talus)

A

Convex

Concave

35
Q

Where does the spring ligament run and what is its role

A

from the navicular to the sustentacular tali, keeps the medial head of the talus off the floor

36
Q

Why is sustained pressure important when testing the spring ligament

A

because injury to this ligament is often due to overload

37
Q

medial glide of the anterior calcaneus on the talus helps with what motions

A

Inversion and supination

38
Q

What is the hand position for a medial glide of the anterior subtalar joint

A
  • Stabilize anterior talus
  • Moving hand anterior to peroneal tubercle , posterior to calcaneocuboid joint line
  • elbows out
39
Q

In what position do you assess movement of the anterior subtalar joint ? treat?

A

supine

side lying

40
Q

Lateral glide of the anterior calcaneus on the talus helps with what motions

A

Eversion and pronatino

41
Q

What is the hand position for a lateral glide at the anterior subtalar joint

A
  • stabilize across anterior talus
  • moving hand is over the sustentaculum tali
  • Elbows out
42
Q

What glides will you perform at the talonavicular joint

A

plantar and dorsal

43
Q

For the talonavicular, navicular-medial cuneiform, and 1st TMT joints what are the two motions and the terms used to describe them

A
  1. Fold: plantar glide with medial rotation

2. Fan: dorsal glide with lateral rotation

44
Q

For the calcanealcuboid joint what are the two motions and the terms used to describe them

A
  1. Fold: plantar glide and lateral rotation

2. Fan: Dorsal glide with medial rotation

45
Q

What is mobilization with movement

A

Get them to do a motion where they feel pain or restriction, then apply glide while doing that same motion. GLIDE FIRST MOVE SECOND

46
Q

What are the indications for a talocrural traction manipulation

A
  1. To restore the end of range of ankle OF or DF when mobs are no longer effective
  2. To gain the final few degrees of PF or DF when a non-capsular limitation of motion is present
47
Q

Why should joint stability be retested after a manip

A

there may be an underlying hypermobility or instability causing the loss of end range ROM

48
Q

What are the effects of a talocrural traction manipulation

A
  • Possible tearing of post-traumatic adhesions

- Quick strethc to joint capsule and stimulation of mechanoreceptors - neurophysiological effect

49
Q

What are the risks of a talocrural traction manipulation

A
  • Tearing of soft tissues (unintentionally)
  • Post treatment soreness
  • Fracture (unlikelY)
50
Q

What are the contraindications of a talocrural traction manipulation

A
  • Fracture in area
  • Joint instability in direction of manip
  • Inflammatory joint disease
  • Malignancy
  • Bone disease
  • Open wounds
  • Poor circulation or sensory deficit in area
  • Spasm or increased pain on test pull
  • Unsure of general health or diagnosis
  • Anticoagulant use
  • Haemophiliacs
  • Inability of patient to relax
  • Physio factors
51
Q

What are some additional cautions and contras for novice manipulators

A
  • Pain or instability proximally in the lower kinetic chain
  • uncertainty about indication for technique
  • Children
  • Diabetics
  • The elderly
  • positive SLR on affected side
52
Q

Is the pre-manipulative hold part of consent

A

yes

53
Q

what are you looking for in the pre-manipulative hold

A

pain or spasm

54
Q

What do you retest following a manip

A

Mobility and stability

55
Q

What is the follow-up treatment after a manip?

A
  • ROM exercises, assuming joint is stable
  • Post-treatment soreness can occur; warn patient, suggest the use of ice
  • Balance, proprioception, strength, protected function (in new ROM)
  • Taping, bracing if joint is unstable

PHTH 565 - MSK (8 decks)

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