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Clinical Management of Patient w/Musculoskeletal Dysfunction USC > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

What are the components of the ICF Model?

A 
Health Condition
Body Structure and Function
Activity
Participation
Contextual Factors
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2
Q

For self-reported outcomes, what 3 questionnaires are patients given for Region Specific information?

A

LEFS: Lower Extremity Functional Scale
DASH: Disabilities of the Arm, Shoulder, and Hand
NDI: Neck Disability Index

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3
Q

For Self-reported Outcomes, what 2 questionnaires are patients given for Joint Specific information?

A

HOS: Hip Outcome Sores
FAAM: Foot and Ankle Measurements

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4
Q

For Self-reported outcomes, what 2 questionnaires are patients given for Tissue Specific information?

A

VISA-A: Index of severity of Achilles Tendinopathy

VISA-P Index of severity of Patellar Tendinopathy

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5
Q

What are the common Red Flags therapists should ask patients in their subjective examination?

A

Have you been experiencing any of the following

  1. Fever
  2. Chills
  3. Night Sweats
  4. Malaise/Fatigue
  5. Unexplained Nausea/Vomiting
  6. Paresthesia: Tingling associated with nerve pathology
  7. Shortness of Breath
  8. Dizziness
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6
Q

During a subjective examination, clinicians should categorize a patients sources of pain and movement dysfunction in regards to what 3 factors?

A
  1. Local Neuro and/or Musculoskeletal
    - Intra Articular
    - Extra Articular
  2. Remote and/or Referred Neuro/Musculoskeletal
  3. Systemic Sources
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7
Q

When analyzing a patients movements, a therapist should analyze why it is they move the way they do. What are the 6 common symptoms for such movements?

A
  1. Pain: Trauma, overuse, abnormalities
  2. Neuromuscular: Strength or control issue
  3. Range of Motion: Bony Deformity, Joint Pathology, Shortened, Musculature
  4. Habit (work, Sport, Leisure)
  5. Structural Deformity (mild to Extreme)
  6. The life history of the patient
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8
Q

What is the specific questionnaire designed to rule in/out if a patient has a fracture?

A

Ottawa Ankle Rules

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9
Q

For someone who suffered a Grade 3 ankle sprain, underwent surgery, and is now referred to physical therapy, what will your differential diagnosis include? (8 things)

A
  1. Fracture: (Ottawa Ankle Rules)
  2. Subtalar Sprain: Other Ligament Sprains
  3. Peroneal Tendon Injury: Tendon vs. Retinaculum
  4. Achilles Rupture: Palpation, Thompson
  5. Osteochondral Lesion: shows up later
    6: Fifth Meta-Tarsal Fracture: Avulsion vs. Jones Fracture
  6. Midfoot Sprain: Cuboid Positional Fault
  7. Fracture Anterior Calcaneal Process
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10
Q

List the Ligaments of the Ankle and their relative position. (Lateral, Medial)

A

Posterior Tibiofibular Ligament (Lateral)
Calcaneofibular Ligament: (Lateral)
Anterior Tibiofibular Ligament (Lateral)
Anterior Talofibular Ligament (Lateral)

Deltoid Ligament (Medial)
Posterior Talocalcaneal Ligament (Medial)
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11
Q

What are the different levels to the stress/strain curve and their definitions?

A

Grade 1: Fibers are tightened to the point of microscopic failure (Minor Tear)
Grade 2: Macroscopic failure (Incomplete Tear)
Grade 3: Rupture of the structure (Disruption of the Ligament with Instability)

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12
Q

What are the 4 common effects of immobilization to a structure?

A
  1. Cartilage Degeneration
  2. Decreased Mechanical and Structural Properties of Ligaments
  3. Decreased Bone Density
  4. Weakness/Atrophy of Muscles
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13
Q

Upon Assessing a patient, what are the general techniques from start to finish? (beginning of assessment to the end of the process)

A
  1. Gait Analysis
  2. Observation (could be postural)
  3. Edema Assessment
  4. Neurological Screen (determine if needed)
  5. ROM Measurements
  6. Manual Muscle Testing
  7. Special Tests
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14
Q

If a patient suffers from Inadequate ROM, what 4 things can therapists provide?

A
  1. Joint Accessory Motion
  2. Soft Tissue Mobilization of the Muscle
  3. Weakness: unable to move through AROM
  4. Motor Re-Education/Education
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15
Q

What are the 6 Categories for the FOOT POSTURE INDEX?

A
  1. Talar Head Palpation
  2. Supra and Infra Lateral Malleolar Curve
  3. Calcaneal Frontal Plane Position
  4. Bulge in Region of TNJ
  5. Height of Congruence of MLA
  6. Abduction/Adduction of the FF on RF
    (Optional) 7. Forefoot Assessments for Forefoot
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16
Q

Describe how to perform a Forefoot Position Assessment?

A
  1. Bisect the Calcaneus and Draw a vertical line
  2. Place the ankle into STN
  3. Use index finger along metatarsal heads 2-5 to formulate line.
  4. Assess weather the foot is Neutral, Varus, or Valgus
    - Neutral: Forefoot line and Calcaneal line = Perpendicular
    - Varus: Supinated midfoot
    - Valgus: Pronated Midfoot
17
Q

A patient presents to you with limited dorsiflexion. When you place them into Subtalar Neutral, they are able to actively attain 0-5° of Dorsiflexion. However, when the patients knee is flexed, they are able to attain 0-10° of active ankle Dorsiflexion. Explain why you think this is and what treatment you will perform.

A

Gastroc-Soleus complex is tight, restricting ankle dorsiflexion.
Assessment:
-Soft-Tissue Mobilization of the Gastroc-Soleus Complex
-Self-Stretch Gastroc-Soleus Complex Seated/Standing
-Soft-Tissue Mobilization of the Plantar Fascia
-Self-Stretch of Plantar Fascia

18
Q

Soft-Tissue Mobilization: Gastroc-Soleus Complex

Explain how to perform this test

A

Patient: Prone or side-lying w/pillow under foot
Therapist: Stride Stance at foot of table
Mobilizing hand: Distal to proximal calf
Variations: Ulnar Border, Flat Fist, Thumbs

19
Q

Self-Stretch: Gastroc-Soleus Complex

Explain how to perform this test and its variations

A

Patient: Long sitting, with towel/rope wrapped around forefoot and ends held in both hands
Action: Keeping knee extended, pull o ntowel with both hands, until stretch is felt in calf
Compensations: Kne

Clinical Management of Patient w/Musculoskeletal Dysfunction USC (1 decks)

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