Lecture 5 Flashcards

1
Q

Key structures to consider following injury of the foot and ankle

A

-talus position
-cuboid position
-navicular position
-base of the 5th
-sesamoid bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What to look for in terms of talus position

A

-is it anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What to look for in terms of cuboid position

A

-is it rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What to look for in terms of navicular position

A

-is it rotated or dropped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What to look for in terms of base of the 5th

A

-tender on palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What to look for in terms of sesamoid bones

A

-pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are the sesamoid bones located

A

-within flexor hallucis brevis tendons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the origin of the plantar fascia

A

-medial process of calcaneal tuberosity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the insertion of the plantar fascia

A

-proximal aspect of digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lateral ligaments of the ankle

A

-anterior talofibular lig (ATFL)
-calcaneofibular lig (CFL)
-posterior talofibular lig (PTFL)
-anterior inferior tibiofibular lig (AITFL)
-posterior inferior tibiofibular lig (PITFL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 most common ligaments sprained in the ankle

A

-ATFL
-CFL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ligaments of the medial ankle

A

-deltoid ligament
-spring ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 4 ligaments make up the deltoid ligament

A

-tibionavicular
-tibiocalcaneal
-tibiospring
-tibiotalar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the spring ligament also known as

A

-plantar calcaneonavicular lig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the different types of tibiotalar ligaments

A

-anterior tibiotalar
-posterior superficial tibiotalar
-posterior deep tibiotalar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What makes up tom dick and harry

A

-tibialis posterior
-flexor digitorum longus
-flexor hallucis longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When to check

A

-when looking at medial aspect of foot ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the movements of tibialis posterior

A

-plantar flexion and inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Deep plantar flexors

A

-tom dick and harry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the movements of the flexor digitorum longus

A

-plantar flexion and toe flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the movements of the flexor hallucis longus

A

-plantar flexion and big toe flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the movements of the tibialis anterior

A

-dorsi flexion and inversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the movement of achilles tendon

A

-plantar flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the peroneal tendons

A

-peroneus longus
-peroneus brevis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the movement of peroneus longus
-eversion
26
What is the movement of peroneus brevis
-plantar flexion and eversion
27
Functional anatomy of the tibialis anterior
-eccentrically lowers the longitudinal arch
27
Functional anatomy of tibialis posterior
-stabilizer of longitudinal arch -absorbs weight of step
28
Functional anatomy of anterior talus
-what happens up the chain
29
What is an eccentric contraction
-lengthening of the muscle as it contracts
30
Ranges of motion of the toes
-flexion -extension -abduction -adduction
31
Joints of the ankle
-tibiotalar joint -subtalar joint
32
Ranges of motion of the tibiotalar joint
-dorsiflexion -plantarflexion
33
Ranges of motion of the subtalar joint
-inversion -eversion
34
What is supination
-combination of plantarflexion, inversion, and adduction -causes the sole of foot to face medially
35
What is pronation
-combination of dorsiflexion, eversion, and abduction -causes the sole of foot to face laterally
36
What is important when looking at someones arches and looking at pronation and supination
-have them walk -not just stand
37
Turf toe MOI
-hyperextension of big toe
38
Signs and symptoms of turf toe
-swelling -brusing -pain -loss of toe dorsiflexion ROM -weak hallux flexion
39
What can turf toe lead to
-can result in instability of 1st metatarsal-phalangeal joint
40
Treatment of turf toe
-limit hyperextension -decrease inflammation (ice, massage)
41
Runners toe MOI
-repeat trauma to end of toe -(hematoma under nail)
42
Signs and symptoms of runners toe
-pain and pressure under nail -discolouration of nail
43
What toe is runners toe most common in
-big toe
44
What usually happens in runners toe
-nail usually falls off
45
How can runners toe be relieved
-drill hole in nail to drain it
46
How is runners toe caused
-foot sliding in shoe -tight or loose toe box -toes rubbing against end of shoe or each other -running downhill
47
Prevention of runners toe
-proper shoe fitting -varied course/terrain
48
What do sesamoid bones act as
-pulleys
49
Sesamoiditis MOI
-repeat trauma to ball of the foot
50
What does sesamoiditis result in
-inflammation of sesamoid bones, FHB tendons and digits
51
Signs and symptoms of sesamoiditis
-pain over sesamoids -swelling -limited big toe extension -weak/painful flexion
52
Treatment for sesamoiditis
-rest -treat inflammation -padded insoles
53
Role of the plantar fascia
-shock absorber -support long arch
54
How can plantar fasciitis start
-as inflammation and degeneration of the plantar fascia
55
Plantar fasciitis MOI
-poor biomechanics -overuse/stress
56
Signs and symptoms of plantar fasciitis
-tender on palpation medial calcaneus or along longitudinal arch -pain with first steps in morning -ankle/toe dorsiflexion pain
57
What often happens up the chain with plantar fasciitis
-tight achilles
58
Treatment for plantar fasciitis
-find the cause -retrain biomechanics -shockwave -soft tissue mobility of tight structures -night splints/orthotics
59
What is the anatomical term for bunions
-hallux vagus
60
Signs and symptoms of bunions
-big toe aligns towards 2nd toe -tender bump medial metatarsal-phalangeal joint
61
What can bunions be a result from
-genetics -poor foot mechanics -tight/narrow footwear
62
How can bunions be used as a red flag
-they may have excessive pronation causing other issues -alter how they'e walking
63
How to progress foot mechanics
-foot balance, eyes open -single leg hip hinge
64
How to properly stand on one foot
-abduct toes (maximize feedback from ground) -stack hip over knee over ankle (athletic position) -tighten through core chest up
65
Tendonitis and shin splints MOI
-poor mechanics -overuse
66
Common structures affected in tendonitis and shin splints
-peroneal tendons -tibialis anterior -tom dick and harry -achilles
67
Signs and symptoms of tendonitis and shin splints
-tenderness on palpation over inflamed tissues -pain with running -pain with resisted muscle testing or stretch of affected structure
68
What does tendonitis and shin splints open up potential for
-stress fractures
69
Treatment of tendonitis and shin splints
-correct foot/lower extremity mechanics -taping -proper footwear -insoles/orthotics
70
Lateral ankle sprains MOI
-ankle inversion -can be in neutral, plantar flexion, or dorsi flexion
71
Possible structures affected in lateral ankle sprains
-ATFL -CFL -PTFL -AITFL -PITFL -peroneals
72
Signs and symptoms of lateral ankle sprains
-pop -giving out -swelling -bruising -limping
73
Treatment for lateral ankle sprains
-sideline management -inflammation -healing -return to play
74
Return to play test for ankle injury
-make them do a big loopy figure 8 hopping -have them do it tighter and tighter to show more ROM more strength
75
Medial ankle sprains MOI
-ankle eversion
76
Possible structures affected in medial ankle sprain
-deltoid lig -spring lig -TDH -navicular position -fibula fracture
77
Signs and symptoms of medial ankle sprains
-pop -giving out -swelling -bruising -limping
78
Fractures of the ankle and foot
-jones fracture -metatarsal fracture -talus -calcaneus -fibula -tib-fib
79
What should be considered for injury management of fractures
-urgent? -distal ciculation? -monitor for shock -splint and send for x-rays
80
Surgical management of unstable fractures
-reduction -fixation
81
Surgical management of stable fractures
-immobilization
82
What is a jones fracture
-peroneus brevis avulsion of base of 5th metatarsal
83
Jones fracture MOI
-inversion sprain
84
Signs and symptoms of jones fracture
-tender on palpation base of 5th metatarsal -pain in weightbearing
85
What to be sure to rule out in jones fracture
-ankle sprain
86
Talus fracture MOI
--severe ankle sprains -land from height -forced dorsiflexion
87
Signs and symptoms of talus fracture
-vary with severity -pain with weight bearing -loss of ROM
88
Calcaneus fracture MOI
-fall/jump from height
89
Signs and symptoms of calcaneus fracture
-extreme pain -unable to weight bear
90
Fibula fracture MOI
-direct blow -ankle sprain mechanism
91
Signs and symptoms of fibula fracture
-vary with severity
92
What shape does the deltoid ligament make
-triangle
93
Special tests for the ankle
-drawer sign -talar tilt -wedge test
94
What is drawer sign used for
-ATFL
95
How to perform drawer sign
-hand over ankle -hand cupping calcaneus -try and pull calcaneus away from foot -no movement should be seen
96
What is talar tilt for
-CFL
97
How to perform talar tilt
-same position as drawer sign -try to tilt foot into plantar flexion and inversion -see if joint gaps
98
What is wedge test used for
-AITFL
99
How to perform wedge test
-stabilize tib fib and push talus from bottom of foot upwards -pain indicates positive test