Foot/Ankle

Question 1

Pronation = what motions?

Answer 1

DF
Eversion
ABduction
*Mnemonic = PEDAB

Question 2

Supination = what motions?

Answer 2

PF
Inversion
ADduction
*Mnemonic: IPADS

Question 3

High Ankle Sprain: MOI

Answer 3

DF + ER

Question 4

High Ankle Sprain: structures commonly involved

Answer 4

AITFL
PITFL
Transverse TFL
Deltoid Ligament

Question 5

High Ankle Sprain: key sxs & special tests

Answer 5

-Swelling (less than lateral sprain).
-Limited PF ROM.
-Inability to WB/walk.
-P! with passive end-range DF & ER.
(+) Squeeze Test
(+) Point Test
(+) Cotton Test

Question 6

High Ankle Sprain: indicator of deltoid ligament damage

Answer 6

Talus displaces away from medial malleolus during passive DF & passive ER.

Question 7

Squeeze Test: procedure, purpose, (+)

Answer 7

High ankle sprain.
Squeeze distal tib & fib together, work up the leg.
(+) = P! at syndesmosis w/ squeezing proximally.

Question 8

Point Test: procedure, purpose, (+)

Answer 8

High ankle sprain (AITFL).
Apply pressure w/ finger over AITFL.
(+) = P!

Question 9

Cotton Test: procedure, purpose, (+)

Answer 9

High ankle sprain (instability).
Passively move heel side to side.
(+) = lateral translation.

Question 10

High Ankle Sprain: treatment

Answer 10

Surgical repair if very displaced and/or fracture also present.
Control pronation (bc DF + ER restricted).

Question 11

Lateral Ankle Sprain: structures commonly involved

Answer 11

ATFL
CFL
PTFL (rare)

Question 12

Lateral Ankle Sprain: MOI

Answer 12

Inversion + PF

Question 13

Lateral Ankle Sprain: special tests

Answer 13

Anterior Drawer: ATFL.
Talar Tilt: CFL

Question 14

Talar Tilt Test: procedure, purpose, (+)

Answer 14

CFL sprain.
Passive inversion (neutral PF/DF).
(+) = excessive motion.

Question 15

Tarsal Tunnel Syndrome: definition & pathophysiology

Answer 15

Compression of posterior tibial N

Question 16

Structures within the tarsal tunnel

Answer 16

Tibialis Posterior tendon.
FDL tendon.
FHL tendon.
Tibial N.
Posterior tibial artery & vein.

Question 17

Posterior Tibial N supplies what muscles?

Answer 17

Tibialis Posterior.
FDL.
FHL.
Soleus.

Question 18

Tarsal Tunnel Syndrome: key sxs & special tests

Answer 18

-P! and paresthesia over medial malleolus, medial arch, & plantar surface.
-Agg by excessive pronation.
-P! with passive DF & eversion.
-P! with active PF & inversion.
(+) Tinel’s

Question 19

Medial Tibial Stress Syndrome: definition & pathophysiology

Answer 19

Posterior shin splints.
Overuse (running, jumping).
Excessive traction of soleus & post tib mm.
Can lead to stress fx.

Question 20

Medial Tibial Stress Syndrome: key sxs

Answer 20

-P! in posterior/medial calf.
-Agg by active combined PF + inversion.

Question 21

Medial Tibial Stress Syndrome: treatment & prevention

Answer 21

-Eccentric calf strengthening.
-Core & hip strengthening.
-Proprioception, balance.
-Shoes w/ good shock absorption.

Question 22

Achilles Tendinitis: risks & MOI

Answer 22

-Overuse (jumping, running).
-Muscle imbalance of gastroc & soleus = overworks Achilles.
-Over pronation.

Question 23

Achilles Tendinitis: key sxs

Answer 23

-P! with active PF & heel raises.
-P! with passive DF.
-Limited DF ROM.

Question 24

Plantar Fasciitis: key sxs & special tests

Answer 24

-P! under heel.
-Agg by WB, esp in the morning.
-P! with passive great toe ext.
(+) Windlass Test

Question 25

Windlass Test: procedure, purpose, (+)

Answer 25

Plantar Fasciitis. Passive MTP ext (allow IP to relax/flex, avoids false positive from tight EHL). (+) = heel P!

Question 26

Navicular Drop Test: procedure, purpose, (+)

Answer 26

Subtalar pronation. Palpate navicular while pt shifts weight from non-test leg onto test leg. (+) = significant inferior displacement.

Question 27

Talar Bulge: what does it look like & indicates what?

Answer 27

Talar head protrudes medially. Subtalar pronation.

Question 28

Rearfoot angles: neutral, pronation, supination

Answer 28

Neutral = 4deg valgus to 4deg varus. Pronation = 5deg valgus. Supination = 5deg varus.

Question 29

Talocrural arthrokinematics (open chain)

Answer 29

Talus (convex) rolls & slides on tibia. -DF = anterior roll, posterior slide. -PF = posterior roll, anterior slide.

Question 30

Talocrural arthrokinematics (closed chain)

Answer 30

Tibia (concave) rolls & slides on talus. -DF = anterior roll & slide. -PF = posterior roll & slide.

Question 31

Subtalar Joint: bones & movements

Answer 31

Talus & Calcaneus. Inversion & Eversion.

Question 32

Talocrural Joint: bones & movements

Answer 32

Tib + Fib & Talus. Primarily PF & DF. PF = slight inversion + add. DF = slight eversion + abd.

Question 33

Distal Tib-Fib Posterior Glide: procedure & promotes what motion?

Answer 33

PF. Slightly IR tibia, stabilize medial malleolus. Push down on lateral malleolus.

Question 34

Distal Tib-Fib Anterior Glide: procedure & promotes what motion?

Answer 34

DF. Slightly IR tibia, stabilize medial malleolus. Hook hand & push upward on lateral malleolus.

Question 35

Talocrural Anterior Glide: procedure & promotes what motion?

Answer 35

PF Stabilize distal tib/fib. Pull upward on calcaneus.

Question 36

Talocrural Posterior Glide: procedure & promotes what motion?

Answer 36

DF Stabilize distal tib/fib. Push downward just above malleoli.

Question 37

Subtalar Medial Glide: procedure & promotes what motion?

Answer 37

Eversion (some DF + pronation). Stabilize talus, push medially on calcaneus.

Question 38

Subtalar Lateral Glide: procedure & promotes what motion?

Answer 38

Inversion (some PF + supination). Stabilize talus, push laterally on calcaneus.

Question 39

Intertarsal & Tarsometatarsal Plantar Glides: procedure & promotes what motion?

Answer 39

Supination. Stabilize proximal bone. Push plantarly on distal bone.

Question 40

Intertarsal & Tarsometatarsal Dorsal Glides: procedure & promotes what motion?

Answer 40

Pronation. Stabilize proximal bone. Push dorsally on distal bone.