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ECOS I Exam 1 > Ankle And Foot Complaint > Flashcards

Ankle And Foot Complaint Flashcards

(59 cards)

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1
Q

What should be palpated on the foot?

A

Anterior ankle joint, medial and lateral malleolus, Achilles’ tendon, MP joint and heads, heel

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2
Q

What is normal muscle strength?

A

5/5

Active motion against gravity and full resistance without evidence of fatigue

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3
Q

What is the talar tilt test?

A

Lateral ankle sprain

Calcaneofibular ligament or anterior talofibular ligament injury

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4
Q

What is the eversion test?

A

Medial ankle sprain

Deltoid ligament injury

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5
Q

Anterior drawer test can also test for what injury?

A

Lateral ankle sprain

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6
Q

What is the squeeze test?

A

High ankle sprain

Distal tibiofibular syndesmosis injury

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7
Q

What does Homan’s sign test for?

A

DVT

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8
Q

What are the three main types of ankle sprains?

A

Lateral ankle sprain, medial ankle sprain and syndesmosis ankle sprain (aka high ankle sprain)

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9
Q

What is the most common ankle sprain?

A

Lateral ankle sprain

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10
Q

Describe lateral ankle sprains

A

Mechanism of injury is foot inversion and/or plantar flexion
Most likely ligaments injured include anterior talofibular ligament* and calcaneofibular ligament

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11
Q

What positive special tests are associated with lateral ankle sprains?

A

Talar tilt test (inversion test) and anterior drawer

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12
Q

Describe medial ankle sprains

A

Mechanism of injury is forced eversion
Most likely ligament involved is the deltoid ligament
Associated positive special test is eversion test

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13
Q

What is a grade 1 ankle sprain?

A

No laxity in the joint = minimal ligament damage

Manage conservatively with NSAIDs, RICE, PT

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14
Q

What is a grade 2 ankle sprain?

A

Mild to moderate laxity in the joint

Manage conservatively

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15
Q

What is a grade 3 ankle sprain?

A

Complete disruption of the ligament

Conservative management with immobilization x3 weeks (if unstable surgery is likely needed)

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16
Q

What is a syndesmodic/high ankle sprain?

A

Mechanism of injury is forced external rotation of a dorsiflexed ankle
Most likely ligament involved tibiofibular syndesmosis
Associated positive test: squeeze test

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17
Q

What are the most common Achilles diagnoses?

A

Tendinitis, Achilles rupture and Sever’s disease (calcaneal apophysitis)

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18
Q

What is Achilles tendonitis?

A

Inflammation of the Achilles tendon
Repetitive motions create micro tears in the tendon resulting in inflammation
Most commonly associated with competitive/recreational activites

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19
Q

What are signs and sx for Achilles tendonitis?

A

Pain/stiffness at tendon insertion
Recent increase in exercise/activity level
Pain is worse with activity and goes away with rest
NEGATIVE Thompson test

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20
Q

What is Achilles’ tendon rupture?

A

A tear of the Achilles’ tendon

Most commonly associated with competitive/recreational athletes

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21
Q

What are the signs and sx for Achilles’ tendon rupture?

A

80% occur during high impact recreational sports
Pts report a popping sensation at their heel
+/- pain
Associated special test: positive Thompson test

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22
Q

What is Sever’s disease (calcaneal apophysitis)?

A

An inflammation or stress injury to the areas on and around an apophysis (growth plate)
Active children going through growth spurts are affected

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23
Q

What are sings and sx for Sever’s disease?

A

Chronic heel pain in growing children
Pain is related to increased activity
Pain is reproduced with direct palpation over the apophysis

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24
Q

What is tibiotalar effusion?

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A

An abnormal accumulation of fluid in or around a joint

Can be caused by a number of things including injury, arthritis, infection or hemearthrosis

25
What is pes planus?
A loss of the longitudinal arch of the foot | Flat feet
26
What is pes cavus?
An exaggeration of the longitudinal arch of the foot
27
What is hallux valgus (aka a bunion)?
Very common foot malformation Defined by the lateral deviation of the big toe Progressively leads to the development of a prominence on the medial aspect of the MP joint (a bunion) Presence of hallux valgus can lead to inflammation and irritation at the first MTP joint
28
What is plantar fasciitis?
Inflammation of plantar fascia | The result of repetitive biomechanical use resulting in micro tears of the fascia
29
What are the signs and sx of plantar fasciitis?
Sharp stabbing plantar/heel pain Pain is worse with first few steps in the morning and improves as the day goes on Pain is made worse by prolonged standing Pain reproduced with forced dorsiflexion
30
What is Morton’s neuroma?
Inflammation and thickening of tissue that surrounds the nerve between the toes Pt will report feeling like they are walking on a marble* Palpable in web space which will replicate burning pain Can have radiation of pain and numbness of toes
31
What is the relevant special test of Morton’s neuroma?
Mulder’s sign - a palpable clicking sensation between the third web space as the transverse arch is compressed
32
What is fibular nerve compression?
When the fibular nerve gets compressed leading to dysfunction of the distal nerve Most commonly compressed at the point it wraps around the lateral aspect of the fibular head (prolonged lying, crossing legs, ankle sprains, prolonged immobilization in a cast)
33
What is Charcot foot?
A consequence of chronic foot inflammation that ultimately results in mid foot deformities and a collapse of the longitudinal arch Always associated with neuropathy of the foot (diabetic neuropathy)
34
What are the signs and symptoms of Charcot foot?
Visible collapse of the longitudinal arch Warmth, redness and edema over the joint History of minor trauma Long term history of peripheral neuropathy
35
What is diabetic neuropathy?
A common complication of uncontrolled diabetes When the pts blood sugar remains elevated peripheral nerves are damaged which no longer function well and pts will lose sensation As a result pts frequently develop injures in their feet
36
What is gout?
An inflammatory arthropathy caused by the deposition of monosodium urate crystals in the joints
37
What are the signs and sx of gout?
Most commonly occurs in the first MTP joint Diet high in purines Pts frequently have past exacerbation Joint aspiration reveals negatively birefringement needle shaped crystals
38
Because the distal fibula is attached to the talus and calcaneus, motion of the ankle will cause what?
Motion of the fibula
39
Injures at the ankle will frequently cause dysfunction in what?
The knee due to the linked motion at the fibular head
40
What is supination of the foot?
Plantar flexion + inversion + adduction | Pronation is opposite
41
Motion at the foot/ankle can both be what?
A modality to create and treat SD at the fibular head
42
What is dorsiflexion of the tibiotalar joint?
Posterior glide of the talus is the minor motion with dorsiflexion Makes the ankle stable
43
What occurs with plantar flexion of the tibiotalar joint?
Anterior glide of the talus is the minor motion | Makes ankle less stable
44
What is the minor motion with eversion of the tibiotalar joint?
Anteromedial glide of the talus
45
What is the minor motion with inversion?
Posterolateral glide of the talus
46
As the calcaneus moves into eversion the talus will do what?
Glide anteriorly and medially 5-10 degrees
47
As the calcaneus moves into inversion, the talus will do what?
Glide posteriorly and laterally 5-10 degrees
48
What is plantar glide?
A sliding motion (along an axis) of a tarsal bone toward the plantar surface in relation to surrounding bones
49
What is dorsal glide?
A sliding motion along an axis of tarsal bones toward the dorsum of the foot in relation to surrounding bones
50
The plantar glide of the cuboid and navicular bones are coupled with what?
Rotation about an AP axis which creates an eversion of the cuboid and an inversion of the navicular during plantar glide
51
What motion does the cuboid prefer?
Eversion glide with plantar glide
52
What motion does the navicular prefer?
Inversion glide with plantar glide
53
What motion do the cuneiforms prefer?
Plantar glide only
54
Describe metatarsal motions
The metatarsals will glide toward the plantar and dorsal surface as they articulate with their respective tarsal bones Motion is named for the direction of the metatarsal head Thus the motions that we evaluate at the metatarsals are dorsal and plantar glide
55
What are the three motions of the MTP, PIPs and DIPs?
Dorsal/plantar glide (flexion/extension) Rotatory glide (internal/external rotation) Abduction/adduction (medial/lateral glide)
56
What are the Ottawa ankle rules?
The guidelines for when to order X rays on a pt with an ankle injury
57
What do the Ottawa ankle rules when a pt has pain in the malleolar zone?
Must have at least one of the following: Bone tenderness at the posterior tip of the medial and lateral malleolus Unable to bear weight immediately after injury and unable to walk 4 steps in the office
58
What do Ottawa ankle rules state when a pt has pain in the mid foot region?
Must have at least one of the following: Bone tear depress at 5th metatarsal or the navicular Unable to bear weight immediately after injury and unable to walk 4 steps in the office
59
What are the two types of pain that should make you consider an X-ray?
Pain in the malleolar zone or pain in mid foot region

ECOS I Exam 1 (26 decks)

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