Ankle & Foot Examination Flashcards

(63 cards)

1
Q

where is the L1 dermatome?

A

upper thigh

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2
Q

where is the L2 dermatome?

A

middle thigh

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3
Q

where is the L3 dermatome?

A

Lower Thigh
Knee Joint Region

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4
Q

where is the L4 dermatome?

A

Medial (and post med) Shin
Medial Malleolus

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5
Q

where is the L5 dermatome?

A

Lateral (and post lat) shin
Top of foot
Great toe

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6
Q

where is the S1 dermatome?

A

Lateral border of foot
Heel
Middle of posterior calf

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7
Q

where is the S2 dermatome?

A

Popliteal fossa
Posterior thigh

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8
Q

what is the L1-L2 myotome action?

A

Hip flexion

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9
Q

what is the L3 myotome action?

A

Knee extension

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10
Q

what is the L4 myotome action?

A

Ankle DF

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11
Q

what is the L5 myotome action?

A

Great toe extension

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12
Q

what is the S1 myotome action?

A

Ankle PF

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13
Q

what is the S2 myotome action?

A

knee flexion

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14
Q

what is the S3-4 myotome action?

A

Toe Flexion

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15
Q

what is the L3/4 reflex?

A

Patellar tendon

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16
Q

what is the S1 reflex?

A

Achilles tendon

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17
Q

what is Fawn’s beard?

A

Patch of hair on low back
Indicative of spina bifida

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18
Q

what is Cafe Au Last spot?

A

Neurofibromatosis
Birthmarks w/ focal region to lumbar spine
May be present w/ scoliosis

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19
Q

what are some red flags of CNS impairments?

A

Gait Deficits
Romberg Test
Babinski Sign
Clonus Test
Cauda Equina sequelae

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20
Q

what are some red flag musculoskeletal impairments?

A

Fracture: advanced age + corticosteroid use + trauma = consider serious risk

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21
Q

what are some red flags cardiovascular & pulmonary impairments?

A

Constitutional S/S
Intermittent Claudation
Anginal symtoms
SOB

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22
Q

what are some red flag integumentary impairment?

A

Skin changes, rashes, itching
Wounds

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23
Q

what nerve roots do heel walking/ toe walking?

A

L4/S1 involvement

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24
Q

what can the heel drop test, test for?

A

Appendicitis
Spinal
Peritonitis

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25
what are Stoddard's warning signs?
Previous Malignancy Late onset in life Serious LOF Intense pain Area other than cervical & lumbar Constitutional Signs Gross weakness Loss of bowel/bladder Continuous pain Blood work
26
what are some reasons for a medical referral?
No apparent movement dysfunction exists No causative factors can be identified Finding are not consistent w/ neuromuscular or musculoskeletal dysfunction Presentation of suspicious red-flag signs or symptoms
27
pain at rest is usually indicative of?
Not usually mechanical
28
pain with activity is normally?
structural
29
pain after activity is normally?
inflammatory
30
what is a finding of painless & strong after resisted isometric test indicative of?
contractile tissue not source
31
what is a finding of painless & weak after resisted isometric movements indicative of?
contractile tissue denervated, ruptured or deconditioned
32
what is a finding of painful & strong after resisted isometric movements indicative of?
inflammation
33
when discussing symptoms what does the "when" establish?
timeframe
34
when discussing symptoms the patterns of what makes it better/ worse establish?
Nature & Behavior
35
what are the Figure 8 Steps?
1. Begin Mid-Way b/w tibialis anterior tendon & lateral malleolus 2. Draw tape medially across instep & placed distal to navicular tubercle 3. Draw tape across plantar foot placing it proximal to styloid of 5th metatarsal 4. Draw tape across talus towards distal medial malleolus 5. Move tape posteriorly behind & aim for other distal lateral malleolus 6. Return to start of tape to take measurement
36
what is the order of an examination?
1. History 2. Observation & Inspection 3. LQS prn 4. Foot & Ankle ROM 5. Muscle Performance 6. Functional testing 7. Special tests 8. Joint Play 9. Neurodynamic Testing 10. Palpation
37
What is pitting edema?
Apply pressure w/ thumb for at least 5 seconds & if pit develops
38
Describe Claw Toe
Extend, Flex, Flex
39
Describe Hammer Toe
Extend, Flex, Extend
40
how much DF/PF at talocrural joint during gait?
DF:10 PF: 20
41
how much DF/PF at talocrural joint going upstairs?
DF: 20-30 PF: 10-15
42
how much DF/PF at talocrural joint during running?
DF: 25 PF: 25
43
what are some common sites for fracture in foot & ankle?
Calcaneous 5th Metatarsal (Jones fx) Stress Fx of metatarsals (March Fx) Distal fibular avulsion fx (traumatic) Fibular stress fx
44
what are the special test for fractures of foot & ankle?
Ottawa Foot & ankle rules Metatarsal Compression Test Tuning fork
45
what is a positive test for Metatarsal Compression Test
(+) pain w/ metatarsal fx or neuroma
46
what is a positive test for tuning fork?
different sound in bilateral comparison
47
what is a positive test for Thompson test?
if non responsive ankle PF during the test
48
what special test for DVT?
Homan's Sign Calf Swelling Well's Critera
49
what is a positive Homan's Sign?
popliteal and/or calf pain when squeezed
50
what is a positive test for calf swelling?
If bilateral comparison reveals difference of 15 mm for men or 12 mm for women
51
describe Biomechanical examination in non-weight bearing & short-sitting?
Inspection of foot health view transverse arch: most evident in this position measure tibial torsion
52
describe Biomechanical examination in non-weight bearing & prone?
Passive hip rotation Subtalar Joint Neutral
53
describe the Biomechanical examination in weight bearing, anterior?
Proximal <--> distal observation Inspection of how arches change from NWB to WB - medial longitudinal arch change most evident
54
describe the Biomechanical examination in weight bearing, posterior?
Calf Symmetry Achilles Shape Haglunds Deformity Tibial Varum Rearfoot varus/valgus
55
what are the special tests for achilles tendonitis?
SLS Heel raises for PF strength & FTPO Confirm Achilles Tendon Integrity Foot/Ankle Biomechanical exam
56
what is Grade A evidence for Achilles Tendonitis?
Eccentric exercise
57
what is Grade B evidence for achilles tendonitis?
modalities
58
what are some observations that may bee seen with posterior tibialis tendon dysfunction?
-No calcaneal inversion with heel raise - Too many toe signs - Medial talar buldge
59
what are the signs/symptoms of musculotendionous injury?
pain w. active contraction of muscle & passive lengthening of muscle (STT testing) (+) Biomechanical examination
60
what is grade a evidence for heel pain/plantar fasciitis?
- Plantar Fascia Stretching & Gastric/soleus stretching - Joint Mobilization to improve talocrurcal DF - STM to plantar fascial, gastric/soleus trigger points - Application of antipronation taping - Foot orthoses & night splints
61
what is grade F evidence for heel pain/ plantar fasciitis?
Strengthening exercises & movement training for muscles that control pronation & attenuate forces during weight bearing
62
what are the special test for lateral ankle sprain?
Anterior Draw Reverse Anteriolateral Drawer Test Posterior Draw
63
what are types of insertional achilles tendonitis?
Haglund's Deformity Pretendon Bursitis Retrocalcaneal Bursitis