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DPT MSK Fall 22' - Spring 23' > ankle & foot sprains - final exam > Flashcards

ankle & foot sprains - final exam Flashcards

(46 cards)

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1
Q

-What is one of the MOST frequent injuries in the sporting population?
–up to _____ of people unable to attend work for > 1wks.

A

Sprains
1/4

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2
Q

The risk of re-injury is common following a _____ sprain

A

inversion

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3
Q

General RF of ankle sprains: (4)

A

Previous ankle sprain(s)
Lack of external support
Lack of warm-up
Lack of coordination training

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4
Q

RF of ankle sprains: IMPAIRED DF possibly due to:

A
  1. Shortened Triceps Surae (Calf)
  2. Talar hypomobility
    —decreased post. glide
    —decreased ER
  3. Fribrosed capsule
    –universal hypo
    –no distraction and limited glide in all directions
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5
Q

Limited DF may excessively load lateral foot because ___________jt. not reaching ______ and staying in a _______ longer before pronating.

A

talocrural; CPP; supination

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6
Q

Etiology of Lateral Ankle Sprains:

A

excessive PF and IV

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7
Q

Structures involved with Lateral Ankle Sprains:

A

Talocural Ligaments
—-ATF MOST COMMONLY
—CF
—PTF

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8
Q

The CF ligament is primarily torn with ______ ______
—will be on slack with ______

A

pure inversion
PF

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9
Q

The Talocalcaneal and ________ ligaments can also be involved with lateral ankle sprains.
—intraarticular -
—extraarticular -

A

subtalar
ant. interosseous
lateral attaches and runs parallel top CF lig so they will be damaged together

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10
Q

Lateral Sprains: BONE INVOLVEMENT
1. avulsion fx of lateral malleolus due to:
2. avulsion fx of 5th MT from:
3. medial malleolus fx form:
4. cuboid displacement due to:
5. fibula ant. subluxed on tibia by:

A
  1. ligamentous attachment
  2. excessive action of Peroneus Brevis
  3. excessive IV
  4. excessive action of pernoeus longus
  5. reversal of mm. action of peroneals
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11
Q

Symptoms of Lateral Sprains:
onset:
observation:
ROM:

A

sudden onset with trauma by “rolling ankle” and the foot turning inward
lat. ankle P!/swelling
limited and P!ful ROM, especially point foot (PF) and turning inward (IV)
difficult and P!ful WB

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12
Q

Signs: Lateral Sprains (cont. symptoms)
observation:

CDR to determine the need of:
Resisted/MMT:

A

swelling and possible ecchymosis
antalgic and asymmetrical gait

radiographs; determine ankle or foot
possible weak and P!ful EV

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13
Q

Signs of Lateral Sprains
Accessory motions findings: (2)

A

likely hypermobile ant, Talar glides due to ATF lig. laxity
possible hypomobile cuboid from subluxation

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14
Q

Lateral Lig. Special Tests:
What are these tests listed below: general or specific; talus or subtalar?
1. Stabilize leg, apply PA force to talus through calcaneus in 15º PF
2. In HL, with ankle in 15º PF apply AP force to leg

A

General; Talus
1. ant. drawer test
2. reverse ant. drawer (RADT)

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15
Q

Lateral Lig. Sprains: Special Tests
What are the specific test for ATF:

A

reverse antlat drawer (RALDR) -add ankle IR to RADT
antlat. talar palpation- palpate antlat talus with RALDT

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16
Q

Lateral Lig. Sprains: Special Tests
What is the specific test for CF:
What is the specific test for PTF:

A

medial talar tilt for CF - near 20º DF, IV and pull calcaneus obliquely to chest
-in neutral, twist calcaneus/talus in ER

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17
Q

Lateral Lig. Special Tests:
What is this test for below: general or specific; talus or subtalar?
1. pt. in side lying calcaneal medial glide stabilize talus in supine

A

general; subtalar

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18
Q

Specific Subtalar Lateral Lig. Special Tests: IV (2)

A

ant. interosseou hold IV then PF calcaneus: (-) no give
lateral- hold IV then DF calcaneus

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19
Q

Medial Sprains: Etiology

20
Q

Structures involved w/ medial sprains

Study These Flashcards
A

Deltoid Ligaments:
3 that connect Tibia w/talus. calcanues and navicular
reinforces medial arch

21
Q

Structures involved w/ medial sprains: _______ or __________ lig.
intraarticular:
extraarticular:

Study These Flashcards
A

subtalar; talocalcaneal
post. interosseous
medial

22
Q

Medial Sprain: Bone Involvement
Bone- avulsion fx of
epiphyseal plate
muscle/tendons- possible __________strain and or subluxation if _________ torn

Study These Flashcards
A

medial malleolus
medial malleolus
tibialis posterior; flexor retinaculum

23
Q

Medial Sprain Symptoms:
Onset:
Observation:
ROM:
WB?

Study These Flashcards
A

sudden onset w/trauma with ankle turning outward
medial ankle P!ful/swelling
limited and P!ful ROM, especially turning outward (EV)
difficult and P!ful weight bearing

24
Q

Medial Sprain Symptoms: cont
Observation:
CDR to determine:
ROM:
Resisted/MMT:

Study These Flashcards
A

swelling and possible ecchymosis & anatalgic and asymmetrical gait
If radiograph needed
limited and P!ful EV
possible weak and P!ful IV

25
Signs: Medial Sprains --Accessory Motion Testing: --Special Tests: ___________ & ____________ jt. --_________ over-involved structures
potentially hypermobile calcaneal EV glides talocrural & subtalar TTP
26
What are Medial Sprain Special Tests: --General Talar/Subtalar: (2) --Delt. 3 fibers: (3)
Ant. and Reverse Ant. Drawer / medial calcaneal glide --tibionavicular fibers --tibiocalacaneal fibers --tibiotalar fibers
27
Syndesmotic Sprains aka __________
high ankle sprain
28
Etiology of High Ankle Sprains:
primarily DF (talus wider anteriorly than posteriorly) so excessive Talar posterior glide with ER aka peeling mechanism, possibly EV
29
Structures involved with w/high ankle sprain: ---in order: 1st-4th ---bone:
1. AITFL 2. Interosseous membrane or syndesmosis 3. PITFL 4. Deltoid lig. talar or distal tib/fib Fx
30
What are the symptoms of a high ankle sprain: (4) onset? location? limited?
sudden onset w/trauma with ankle bent up often anterior ankle P!/swelling limited and P!ful ROM, especially bending ankle up difficult and painful WB
31
High ankle sprain ROM: primarily limited and P!ful PF and possibly IV -T or F?
False: DF and possibly EV
32
High Ankle Sprain: Signs --AM --Special Tests: likely (+) ligamentous test: -gen/specific test?
likely hypermobile post-Talar glides Inf. TibFib --gen: reverse post. drawer --specific: w/fibular ant/post-translation (possibly same as med. sprain)
33
High Ankle Sprain: --__________test if able - inability is MOST sens syndesmotic test --__________over-involved structures
single leg hop test TTP
34
Chronic Ankle Instability aka CAI: --presence of _________ or _________ instability --RF (3)
functional and mechanical increased Talar curvature lack of external support lack of coordination training following a prior sprain
35
Etiology: CAI
past severe and/or recent sprain(s) 80% reinjury rate following an IV sprain -------*P! gone does not mean pt. functionally ready
36
S&S: CAI ------possible ________ S&S if aggravated otherwise may be asymptomatic
acute: **DO NOT fall for mm strain
37
CAI: S&S of hypermobility/instability plus:
decreased postural stability/proprioception and plantar sensation altered mm. activation patterns aberrant joint motion the fibula is significantly more lateral from the tibia
38
All Sprains: PT Rx ______% successful possibility brief period of ___________ and/or assistive device ____________ prn for protection/function Modalities: ---best benefits _____ should NOT be used w/acute sprains
90% Immobilization bracing/taping cryotherapy US
39
All Sprains: PT Rx Taping standard - mechanical support significantly _________after 30 mins of exercise Talar technique to limit __________glide
decreased anterior
40
Distal TibFib Taping Technique: Indication: limits:
high ankle sprain limits separation and anterior distal fibular glide
41
MT with MET _______ including/for lymphatic drainage for swelling
STM
42
JM with MET: 4 goals
ROM, proprioception, tissue tolerances, and AP talar mobes
43
--sprains MET ultimate purpose? --positional/directional biases?
tissue proliferation and stabilization lateral (EV DF), medial (IV PF), high ankle sprain (PF)
44
Balance and Neuromuscular Training: prevent ________ improved _________ and ___________ joint position sense and greater motor neuron excitability (reaction time)
reoccurrences balance and inversion
45
What is the prognosis for return to activity following a sprain:
Grade I: 1-2 wks. Grade II: 2-6 wks. Grade: II >6 wks. ** track athletes shorter due to mostly in one plane
46
MD Rx - CAI Sx Early functional rehabilitation appears ___________ to 6 weeks immobilization in restoring early function.
no procedure is better than another superior

DPT MSK Fall 22' - Spring 23' (29 decks)

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