Foot/Ankle

Question 1

Foot bone at risk of AVN and why?

Answer 1

Talus, retrograde blood supply

Question 2

Which tendon passes through groove on cuboid bone?

Answer 2

Peroneus longus

Question 3

Which muscle inserts on the tuberosity of naviular

Answer 3

Posterior tibialis

Question 4

Which muscle inserts on base of 5th MT?

Answer 4

Peroneus brevis

Question 5

Contents of tarsal tunnel?

Answer 5

Within medial malleolus
Tibialis posterior
FDH
Posterior tibial A, V, N
FHL

Question 6

2nd MT aligns with which bone?

Answer 6

medial cuneiform

Question 7

Weber/AO classification

Answer 7

Ankle fx (fibula) based on relation to plafond
A: distal to plafond (tibial plane)
B: at plafond
C: proximal to plafond (torn syndesmosis common)

Question 8

Lange-Hansen classification

Answer 8

Ankle fx based on foot position and mechanism
SA: supination/adduction I-II
SER: supination/ER I-IV
PER: pronation/ER I-IV
PA: pronation/abduction I-III

Question 9

Essex-Lopresti fx

Answer 9

Fx of calcaneus

Either tongue-type or joint depression

Question 10

Sanders fx

Answer 10

Calcaneus based on coronal CT findings
I-IV: how many fragments/fracture lines
A-C: lateral to medial

Question 11

Rule out with ankle fx?

Answer 11

Spine injury

Question 12

Bohler’s angle

Answer 12

Lines drawn tangential to anterior and posterior aspects of the calcaneus. May indicate fx if

Question 13

Hawkins classification

Answer 13

Talus neck fx. Predicts AVN risk

I: nondisplaced (

Question 14

Hawkin’s sign

Answer 14

Resorption of subchondral bone in talus (lucency on XR) indicates fracture healing

Question 15

Fleck sign

Answer 15

Avulsion of lisfranc ligament from 2nd MT base

Question 16

Lisfranc (TMT joint) classification

Answer 16

Isolated, homolateral, divergent

Question 17

MT base fx classification

Answer 17

Zone 1: avulsion fx
Zone 2: metadiaphyseal jxn (Jones fx)
Zone 3: proximal diaphysis (stress fx)

Question 18

Jones fx?

Answer 18

Zone 2 fx of MT base (metadiaphysial)

Question 19

1 and # 2 injured ligaments in ankle sprains

Answer 19

ATFL #1, CFL #2

Question 20

Action of ATFL?

Answer 20

Resists anterior motion

Question 21

Action of CFL?

Answer 21

Resists inversion

Question 22

Action of deltoid ligament?

Answer 22

Resists eversion

Question 23

Ankle relocation blocked by which tendons?

Answer 23

EDB (medial) or PT (lateral)

Question 24

Morning foot pain?

Answer 24

Plantar faciitis

Question 25

Thompson test

Answer 25

Squeeze calf, absent foot plantarflexion = achillies tendon rupture

Question 26

Ankle anterior drawer

Answer 26

Stabilize tibia, PF foot, anterior force. Tests lateral ligament (esp. ATFL)

Question 27

Talar tilt

Answer 27

Stabilize tibia, DF foot, invert foot. Tests lateral ligaments (esp. CFL)

Question 28

Ext. rotation stress

Answer 28

Stabilize tibia, ER foot. Tests deep deltoid and syndesmotic ligaments

Question 29

Eversion stress

Answer 29

Stabilize tibiam evert foot. tests superficial deltoid ligament

Question 30

Squeeze test

Answer 30

Compress distal tibia/fibula. Pain may indicate syndesmosis injury

Question 31

Heel rise

Answer 31

Standing, rise onto toes. Heel should go into varus. No varus in PTTD.

Question 32

Coleman block

Answer 32

Lateral foot and heel on block; 1st ray hands free. Flexible hind foot varus: ankle will go into valgus or neutral on block. Fixed hind foot varus: ankle will stay in varus on the block.

Question 33

Tinel's sign (ankle)

Answer 33

Tap nerve posterior to MM. Tingling may indicate tibial nerve entrapment in tarsal tunnel.

Question 34

Compression test ankle

Answer 34

Squeeze foot at MT heads. Pain or numbness/tingling may indicated interdigital (Morton's) neuroma

Question 35

Phases of gait (8) and important muscles

Answer 35

1: heel strike (TA) 2: Foot flat (gastroc) 3: Midstance 4: Heel off (PT+gastroc) 5: Toe off 6: preswing 7: midswing 8: terminal swing

Question 36

1st layer of foot and innervation

Answer 36

Abductor hallucis (MP) Flexor digitorum brevis (MP) Adbuctor digiti minimi (LP 1st branch)

Question 37

2nd layer of foot and innervation

Answer 37

``` Quadratus plantae (LP) Lumbricals (1 - MP, 2-4 - LP) FHL, FDL tendons ```

Question 38

3rd layer of foot and innervation

Answer 38

Flexor hallucis brevis (MP) Adductor hallucis (LP) Flexor digiti minimi brevis (LP)

Question 39

4th layer of foot an innervation

Answer 39

``` Plantar interossei (3) (LP) Dorsal interossei (4) (LP) PL and TP tendons ```

Question 40

Possible entrapment of lateral plantar n?

Answer 40

Abductor DM fascia

Question 41

What artery supplies talar head and neck?

Answer 41

Direct talar branches from dorsalis pedis

Question 42

What decreases achilles tendon rerupture?

Answer 42

Surgical repair

Question 43

#1 musculoskeletal injury?

Answer 43

Ankle sprain

Question 44

Gout findings PE and lab

Answer 44

1st MTPJ, negatively birefringent crystals (yellow when parallel)

Question 45

Hallux rigidus findings on XR?

Answer 45

Dorsal osteophyte or OA

Question 46

Hallux Valgus angle?

Answer 46

>15°

Question 47

Morton neuroma locations?

Answer 47

2nd and 3rd interdigital space

Question 48

Acquired hindfoot cause and stages?

Answer 48

PT tendon failure Stage 1: tenosynovitis, no deformity Stage 2: Pes planus, flexible hindfoot, no single heel raise Stage 3: rigid hindfoot,

Question 49

Haglund's disease

Answer 49

Retrocalcaneal bursitis

Question 50

Baxter's nerve?

Answer 50

1st branch of LP nerve

Question 51

Seronegative spondyloarthropathy, findings?

Answer 51

Psoriasis: Sausage ditit, pencil in cup deformity | Neg RF

Question 52

Deformity of clubfoot?

Answer 52

``` CAVE Cavus midfoot forefoot Adductus subtalar Varus hindfoot Equinus ```

Question 53

Rigid flatfoot types

Answer 53

1) Tarsal coalition: fusion of two tarsal bones Calcaneonavicular #1, Talocalcaneal #2. 2) Congenital vertical talus

Question 54

Anterolateral approach to ankle | IN planes, dangers

Answer 54

IN planes - peroneals (superficial peroneals) EDL (deep peroneal) Dangers: Deep peroneal n, anterior tibial artery

Question 55

Arthroscopy portals ankle (3)

Answer 55

Anteromedial - Saphenous nerve and vein Anterolateral - superficial peroneal nerve Posterolateral - sural nerve, lesser saphenous vein