Foot / Ankle

Question 1

a patient with remote history of lateral ankle sprain continues to have medial ankle pain long after the initial injury. what etiology are you concerned about?

Answer 1

OCD

Question 2

what is the MOI of a high ankle sprain?

Answer 2

eversion

Question 3

what is the weightbearing portion of the distal tibia?

Answer 3

tibial plafond

Question 4

what is the most anterior portion of the talus?

Answer 4

head

Question 5

what are the two main articulations which comprise the transverse tarsal joint?

Answer 5

calcaneocuboid and talonavicular

Question 6

why does the talus have risk of AVN?

Answer 6

retrograde blood supply from the neck

Question 7

what is os trigonum?

Answer 7

unfused lateral tubercle of the talus

Question 8

the talar head is supported by what ligament?

Answer 8

spring ligament

Question 9

what is Kohler’s disease?

Answer 9

osteonecrosis of the navicular

Question 10

t/f tibialis anterior and posterior insert on the medial cuneiform

Answer 10

true

Question 11

what tendon runs between the medial and lateral tubercles on the posterior talus?

Answer 11

FHL

Question 12

which bone is the sustenaculum talus a part of?

Answer 12

calcaneus

Question 13

what is a normal syndesmosis width ?

Answer 13

< 6mm

Question 14

what is a normal medial clear space width?

Answer 14

< 4mm

Question 15

what are the Weber ankle fracture classifications?

Answer 15

A - distal to plafond
B - at the level of the plafond
C - proximal to plafond

Question 16

what is the bohler angle of the ankle?

Answer 16

angle between the superior aspect of the calcanueus and the overlying talus

Question 17

t/f the bohler angle is usually reduced in a calcaneus fracture

Answer 17

true

Question 18

what is the normal bohler angle?

Answer 18

25-40 degrees

Question 19

most talus fractures occur in what portion of the bone?

Answer 19

neck

Question 20

in a talus fracture, you should look for displacement at what two joints?

Answer 20

subtalar and tibiotalar joints

Question 21

what is the fleck sign in regards to a tarsometatarsal joint injury?

Answer 21

avulsion of the lisfranc ligament from the 2nd MT base

Question 22

on XR, what degree / measurement of widening between the 2nd MT base and cuneiform will be indicative of Lisfranc injury?

Answer 22

> 2mm

Question 23

what is the typical treatment for non displaced Lisfranc injury?

Answer 23

8 weeks, non weightbearing cast

Question 24

if a lisfranc injury has > 2mm widening, what is the treatment?

Answer 24

surgery

Question 25

what is a zone 1 5th MT fracture?

Answer 25

avulsion

Question 26

what is a zone 2 5th MT fracture?

Answer 26

metadiaphyseal junction fracture

Question 27

what is a zone 3 5th MT fracture?

Answer 27

proximal diaphysis fracture

Question 28

what is the general treatment for a non displaced 5th MT fracture zone 1?

Answer 28

hard shoe

Question 29

what is the general treatment for zone 2/3 5th MT fracture?

Answer 29

ortho referral

Question 30

what are the two general principles of conservative treatment for a stable, non displaced phalangeal fracture of the foot?

Answer 30

hard shoe / buddy tape

Question 31

what is the general treatment for intraarticular hallux fracture?

Answer 31

surgery referral

Question 32

the AITFL is injured in what type of Weber ankle injury?

Answer 32

type C

Question 33

What is a Tilaux fracture / fragment?

Answer 33

avulsion injury of the AITFL

Question 34

t/f if the ankle syndesmosis is torn, then the mortise is disrupted

Answer 34

true

Question 35

what are the peroneal retinaculums?

Answer 35

superior and inferior

Question 36

tendon or ligament will generally appear how on MRI

Answer 36

black / dark

Question 37

the Lisfranc ligament connects what two structures?

Answer 37

2nd MT base to the medial cuneiform

Question 38

what is another name for the plantar calcaneonavicular ligament?

Answer 38

spring ligament

Question 39

what portion of the calcaneus does the spring ligament attach to?

Answer 39

sustenaculum tali

Question 40

what joint complex makes up the transverse arch of the foot?

Answer 40

tarsometatarsal joint

Question 41

what is the keystone of the tarsometatarsal joint?

Answer 41

2nd MT base

Question 42

Avulsion of the lisfranc ligament will result in what radiographic sign?

Answer 42

fleck sign

Question 43

t/f fibularis longus attaches to the medial cuneiform

Answer 43

true

Question 44

in a turf toe injury, hyperextension results in avulsion injury of the plantar plate resulting in avulsion of the ligament from which structure?

Answer 44

Metatarsal

Question 45

what are the four anterior ankle tendons?

Answer 45

tibialis anterior, EHL, EDL, fibularis tertius

Question 46

which sensory nerve is posterior to lateral malleolus?

Answer 46

sural nerve

Question 47

which sensory nerve is superior to the medial malleolus?

Answer 47

saphenous nerve

Question 48

what is the normal extension and flexion of the ankle ROM?

Answer 48

25 degrees dorsiflexion and 50 degrees plantarflexion

Question 49

what is the normal amount of flex/extend ROM of the hallux at the MTPJ?

Answer 49

75 degrees in both extension and flexion

Question 50

what peripheral nerve is responsible for foot eversion?

Answer 50

superficial peroneal nerve

Question 51

what nerve supplies sensation to the lateral and medial foot, respectively?

Answer 51

lateral - sural medial - saphenous

Question 52

what are the three bands that make up the plantar fascia?

Answer 52

central, lateral, and medial

Question 53

which muscles adduct the toes?

Answer 53

plantar interossei

Question 54

which muscles abduct the toes?

Answer 54

dorsal interossei

Question 55

the dorsal and plantar interossei are innervated by what nerve?

Answer 55

lateral plantar nerve

Question 56

which nerve runs between the tibialis anterior and EHL tendon?

Answer 56

deep peroneal nerve

Question 57

the lateral dorsal cutaneous nerve of the foot is a continuation of which nerve?

Answer 57

sural nerve

Question 58

what are the functions of the medial and lateral branches of the deep peroneal nerve, respectively?

Answer 58

medial - sensory lateral - motor

Question 59

what nerves give rise to the medial sural cutaneous and lateral sural cutaneous nerve, respectively?

Answer 59

medial - tibial nerve lateral- peroneal nerve

Question 60

which artery gives rise to the dorsalis pedis artery?

Answer 60

anterior tibial artery

Question 61

what is the diagnosis for end stage diabetic foot, consisting of osteopenia, fractures, callus, and joint destruction?

Answer 61

Charcot neuroarthropathy

Question 62

what is the term for hyperkeratosis of skin due to excess pressure on bones?

Answer 62

corn

Question 63

what are the two oral medication treatment options for acute gout?

Answer 63

nsaid/colchicine

Question 64

what is the etiology of hallux rigidus?

Answer 64

DJD of the MTP joint

Question 65

what two findings are you most likely to see on XR of a foot with hallux rigidus?

Answer 65

dorsal osteophyte at the joint space and OA

Question 66

claw toes are associated with what underlying disease?

Answer 66

neurologic disease

Question 67

what is the #1 cause of metatarsalgia?

Answer 67

callus

Question 68

what focal site is the most common area affected by metatarsalgia?

Answer 68

2nd MT

Question 69

what tendon is the major supporting structure of the midfoot arch due to its attachment to the navicular and al midtarsal bones?

Answer 69

tibialis posterior

Question 70

Morton's neuroma most commonly affects which space?

Answer 70

between 2nd/3rd MT

Question 71

the single heel raise and too many toes sign are testing for function of what structure?

Answer 71

posterior tibialis

Question 72

what is Haglund's disease?

Answer 72

retrocalcaneal bursitis

Question 73

generally, what are the two major causes of "runner's foot?"

Answer 73

medial or lateral plantar nerve entrapment or stress injury

Question 74

in the treatment of turf toe, what type of foot orthosis is needed?

Answer 74

blocking dorsiflexion

Question 75

what is the #1 pediatric foot disorder?

Answer 75

metatarsus adductus

Question 76

what are the three types of tarsal coalition?

Answer 76

bony, fibrous, and cartilaginous

Question 77

A patient sustains 5th MT base fracture, non displaced, zone 2. If choosing conservative management at what two time periods should X-ray be repeated to look for healing?

Answer 77

1 week and 4-6 weeks

Question 78

A patient sustains zone 2 fifth MT fracture , non displaced. If choosing conservative management how long should immobilization with boot last?

Answer 78

6-8 weeks

Question 79

A patient sustains zone 2 fifth MT fracture , non displaced. If choosing conservative management how long should immobilization with boot last?

Answer 79

6-8 weeks