foot/ankle Flashcards Preview

Ortho > foot/ankle > Flashcards

Flashcards in foot/ankle Deck (54):
1

what major muscle is responsible for foot eversion?

peroneus longus

2

what major muscle is responsible for plantarflexion?

gastroc/soleus

3

what major muscle is responsible for dorsiflexion?

anterior tibialis

4

what major muscle is responsible for foot inversion?

posterior tibialis

5

this is what distal connection of the tibia to the fibula

syndesmosis joint (made up of AITFL, PITFL, and transverse ligament)

6

nerve responsible for hip flexion

L2

7

nerve responsible for medial hamstring reflex

L5

8

Nerve responsible for cremasteric and Babinski reflexes

S2-S4

9

positive anterior drawer sign of the ankle means what?

ATF sprain (anterior talofibular ligament)

10

positive findings on the talar tilt test indicate what?

calcaneofibular ligament tear (lateral....pain with inversion)

11

In the _______ test, the patient is prone with feet dangling over the edge of the bed. Provider squeezes the gastroc and looks for the foot to ________. If this does not happen, it may indicate rupture of the ___________

Thompson test, plantarflex (normal), absence = Achilles tendon rupture

12

during this test, the patient will experience reproduction of pain at a point away from the site of pain and suggests a fracture of syndesmotic injury

compression test

13

This view of the ankle in plain film is taken at 15 degrees internal rotation

Mortise view

14

This view allows us to see tib/fib/talar joint

mortise

15

What tendon is exclusively lateral ankle?

peroneal

16

whenever you suspect an ankle sprain/inversion injury and there's ttp of the peroneal nerve, what must you ALWAYS do?

palpate the insertion at the 5th metatarsal for avulsion/fx

17

How do you tx ankle sprain? (medial or lateral)

1) walking boot
2) PT

18

which ankle ligament is strongly a/w the medial malleolus?

deltoid ligament

19

If you suspect a medial ankle sprain/eversion injury and there's ttp to the deltoid ligament, what must you ALWAYS do?

palpate the proximal fibula for avulsion/fx

20

Your patient has pain with dorsiflexion and resisted plantar flexion. There is ttp over the Achilles tendon. How will you treat?

Achilles tendonitis, tx with
1) walking boot with heel lift,
2) PT
3) NTG patch

21

How do you know if it's Achilles tendonitis vs Achilles rupture?

1) acute onset
2) defect/gap
3) THOMPSON TEST

22

What is the tx for an Achilles rupture?

short leg cast x 4 weeks, then walking boot.

sx for young athletes

23

What tests should you do if you suspect a low leg stress fx?

compression test, xrays usually negative, do MRI

24

What is common in the history of pts with stress fx?

shin splints

25

what is the tx for stress fx?

No wt bearing x 6 weeks

26

Your young patient felt a "pop" when he twisted his ankle playing soccer. You detect ttp on the lateral retinaculum (tendon sheath). When you evert the foot you can feel subluxation.

subluxating peroneal tendon

27

what kind of imaging will you order for the subluxating peroneal tendon?

xray to r/u avulsion

28

how will you tx a subluxating peroneal tendon?

SLC x 6 weeks for older, Surgical fixation of sheath in young

29

What are the 3 types of distal fibula tx?

1) Weber A, below syndesmosis
2) Weber B, at level of syndesmosis
3) Above syndesmosis

30

How will you tx the Weber levels?

A--SLWBC x 6 wks
B--non-displaced: SLC x 4 wks, WB x 4 wks
B--displaced: sx
C--sx

31

This is a common foot fx, typically resulting from avulsion s/p inversion sprain (peroneus tendon)

proximal 5th metatarsal fx

32

Where is the 5th metatarsal most likely to fx?

the styloid

33

What do most pt's say when they have a 5th metatarsal fx?

that they have sprained their ankles

34

How do you treat a 5th metatarsal fx?

firm soled shoe or WB

35

What is the term for a fx of the metaphyseal/diaphyseal junction of the 5th metatarsal, which makes wt bearing nearly impossible?

Jones fx

36

How do you tx a Jone's fx?

SLC x 6-10 wks or screw fixation

37

This injury usually occurs in young athletes due to repetitive stress on lateral foot (bball, running). Characterized by gradual increase of pain. Poor healing w/out tx.

stress fx of 5th metaphyseal diaphysis.

38

how would you tx the pseudo Jones fx (stress fx)?

SLC x 20 weeks or screw fixation

39

Your patient is c/o terrible heel pain, especially bad in the morning. PE reveals ttp of the medial calcaneal tuberosity. How will you tx this patient?

Dx: plantar fasciitis, tx will heel cord stretching, inserts, overnight splints

40

What is a history question you should be asking for any patient with plantar fasciitis?

Are they getting steroid injections, which cause atrophy of the fat pads

41

What joint connects metatarsals to tarsals?

Lisfranc

42

A Lisfranc injury typically occurs as a result of trauma/MVA/fall and will have a physical exam with significant ttp over the _______ joint causing pain/swelling on ___________ and ______ of the foot. Typically they have an inability to bear wt.

Lisfranc, plantar and dorsal

43

How do you treat a Lisfranc Injury?

start with a non-walking boot, escalate to sx PRN

44

Toe abnormality, commonly 2nd toe, that presents with flexion of PIP and exention of DIP

hammer toe

45

How will you tx hammer toe and other "lesser toe" abnormalities?

footwear with wide toe, dorsal foot pad

or RFL to sx

46

This toe abnormality presents with flexion of the DIP

mallet toe

47

This problem is genetic, commonly affects females, and involves the lateral deviation of the big toe

hallux valgus aka bunion

48

How will you tx hallux valgus?

wide low shoes, orthotics, night splint, sx

49

This condition results from the loss of the medial longitudinal arch of the foot. It is common in kids and typically resolves

pes planus (aka flat feet)

50

When would pes planus necessitate sx?

If the foot looses flexibility

51

Pes planus places you at higher risk for developing __________

tibialis tendonitis/rupture

52

This condition causes burning and tingling between interspaces of involved toes (2nd-4th most common)

Morton's Neuroma compresses interdigital nerve

53

The _______ sign is positive for patients with Morton's neuroma, and is characterized by palpable clicks and ttp in the intermetatarsal web space

Mulder's sign

54

How do you tx a Morton's neuroma

change footwear, injections, sx RFL