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THER EX 2: LQ > lecture 7: therapeutic exercise for the ankle and foot > Flashcards

lecture 7: therapeutic exercise for the ankle and foot Flashcards

1
Q

what are the primary motions of the talocrural joint

A

DF and PF

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2
Q

during OKC supination and pronation what is the motions of the foot

A

sup: calcaneus PF , add and inversion

pro: calcaneus DF , ADB and eversion

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3
Q

during CKC supination and pronation what is the motions of the foot

A

SUP: calcaneal inversion , talus abd and DF

pro: calcaneal eversion , talus add and PF

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4
Q

what is included int he bifurcate ligament and when is it injured

A

calcaneonavicular ligament
calcaneocubdoid ligament

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5
Q

what 4 ligaments are included in the deltoid ligament

A

posterior tibiotalar
tibiocalcaneal
tibionavicular
anterior tibiotalar

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6
Q

what are the primary plantar flexors

A

 Gastrocnemius
 Soleus
 Plantaris

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7
Q

what are the secondary plantar flexors

A

 Posterior Tibialis, FDL, FHL
 Peroneal longus and brevis

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8
Q

what is the primary and secondary DF

A

 Anterior Tibialis (primary)
 EHL
 EDL
 Peroneal tertius

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9
Q

what does the tibial nerve break off into

A

medial calcaneal nerves
inferior calcaneal nerves
lateral plantar nerve
medial plantar never

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10
Q

what mms are responsible for eversion of the foot

A

 Peroneal longus
 Peroneal brevis
 Peroneal tertius

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11
Q

what mms are responsible for inversion of the foot

A

tib ant and post

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12
Q

what are included int he foot intrinsic dorsaly

A

EDB
EHB

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13
Q

what is the function fo the foot intriniscis

A

toe motion and arch stability

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14
Q

what are the 4 layers of the foot intrinsics plantarlly

A

Layer 1 (superficial): Abductor Hallucis, FDB,
Abductor DM

Layer 2: Quadratus Plantae, Lumbricals

ayer 3: FHB, Adductor Hallucis, FDMB

Layer 4: Plantar Interossei, Dorsal Interossei

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15
Q

in CKC tibial IR and ER is associated w what at the foot

A

IR= pro
ER= sup

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16
Q

as the heel strikes the ground there is slight ___ and as at the foot lowers to the ground there is __- to absorb some of the impact of the ground)

A

sup
pro

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17
Q

as the foot is fixed on the ground and the tibia comes up over the foot what happens at the ankle

A

DF

tibia IR , reinforces pronation of the foot

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18
Q

what happens at the tibia and hind foot during instance thru terminal stance

A

tibia ER
initiating supination of hind foot , locking transverse tarsal joint (foot is in closed packed position)

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19
Q

what is claw toe

A

MTP hyperextension and IR flexed

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20
Q

what is hammer toe

A

MTP hyperextension
PIP flex
DIP hyperextension

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21
Q

what is the MOI for a lateral ankle sprain

A

inversion and PF

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22
Q

if you are examining an ankle after an inversion and PF MOIn and there is a slight stretching and microscopic tearing of the ligament fibers , they have some mild tenderness and swelling around the ankle what grade would u suspect and what lig is prob injured

A

grade 1 sprain (mild)

anterior talofibular ligament

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23
Q

what is a grade 2 sprain (moderate) of a lateral ankle

A

partial tearing of anterior talofibular lig and some tearing of the calcaneofibualr lig

mod tenderness and swelling

recover in 2-3 weeks

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24
Q

what is a grade 3 lateral ankle sprain (severe)

A

complete tear for the ATFL , CF and PTFL

sig tenderness and swelling around the ankle

takes 3-12 weeks to recover

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25
if a pateint comes in and their MOI is forced eversion and DF of the ankle wha kind of sprain are u thinking
syndesmotic ankle sprain (high ankle sprain)
26
what is the most common ligament that is invovled in the syndesmotic ankle sprain
anterior interior tibiofibular ligament
27
what are teh S/S for a syndesmotic ankle sprain
less swelling , inability to bear weight , inability to fully PF and ecchymosis
28
what is the MOI of a medial ankle sprain
eversion
29
what are the validated outcome measures used for a ankle sprain
PROMIS FAAM LEFS
30
what do u assess and document for a ankle sprain
ankle swelling ROM (DF using weight bearing lunge test( talar translation talar inversion single leg balance
31
is it recommended to use a prophylactic bracing for a ankle sprain ?
yes level A evidence
32
what is recommended as level A evidence for patients w acute LAS
use external supports (bracing or taping ) progressively bear weight on affected limb
33
what kind of therapeutic exercises should be used for a ankle sprain
- focus on proprioception and balance drills - focus ther ex on impairments - protected AROM , stretching , NM training
34
is it good to do manual therapt and joint mobilization for ankle sprains
yes level A evidence
35
for ankle sprains use .. therapeutic exercises to reduce ____ , improve pain free ankle and foot ___ and normazlize ___ parameters
swelling , mobility , gait
36
can u use ultrasound for LAS
noooooonnonononnononno
37
what do u prescribe for chronic ankle instability
proprioceptive and NM therapeutic exercises to improve dynamic postural stability and patient perceived stability during function
38
what special test can u use for ankle sprain
reverse anterolateral drawer test anterolaterla talar palpation anterior drawer test
39
should u use a external support as a stand alone intervention to improve balance and postural stability in people w CAI
NOOOO
40
what outcome measures can u used for achilles tendinopathy
VISA-A FAAM LEFS
41
for achilles tendinopathy what should u used to decrease pain and improve function for patients with midportion Achilles tendinopathy without presumed frailty of the tendon structure.
use mechanical loading - isometrics early for pain control - progress to eccentric drills
42
For patients with nonacute midportion Achilles tendinopathy, clinicians should advise that complete rest is ___ indicated and that they should continue with their recreational activity within their pain tolerance while participating in rehabilitation
not
43
Use ____ with ____ to decrease pain and improve function in patients with acute midportion Achilles tendinopathy
iontophoresis with dexamethasone
44
what outcome measures shoudl u use for plantar fasciitis
FAAM FHSQ FFL LEFS
45
for plantar fasciitis you should Use ___ ___ to treat relevant LE joint mobility and calf flexibility deficits
manual therapy
46
what kind of stretching should u use to provide short-term (1 week to 4 months) pain relief for individuals with heel pain/plantar fasciitis. Heel pads may be used to increase the benefits of stretching.
plantar fascia specific and gastroc and soleus stretching
47
for plantar fasciitis Use _____ taping for immediate (up to ___ weeks) pain reduction and improved function for individuals with heel pain/plantar fasciitis. Additionally, clinicians may use ___ therapeutic tape applied to the gastrocnemius and plantar fascia for short-term (1 week) pain reduction.
anti pronation 3 elastic
48
for plantar fasciitis Use foot ___, either prefabricated or custom fabricated/fitted, to support the medial longitudinal arch and cushion the heel in individuals with heel pain/plantar fasciitis to reduce pain and improve function for short- (2 weeks) to longterm (1 year) periods, especially in those individuals who respond positively to antipronation taping techniques
oorthoses
49
should people w heel pain/plantar fasciitis wear a night splint
yes
50
what is the diagnosis for plantar fasciitis
- positive windlass test (bolded) - abnormal foot posture index score (bolded) -tight hammy - limited active and passive talocrual joint DF ROM pain w palpation of the proximal insertion of the plantar fascia
51
what is the tarsal tunnel syndrome
Pain over the tarsal tunnel radiating to the arch and plantar foot.  Pain may radiate up to the calf.
52
what will a pt report if they have tarsal tunnel syndrome
sharp shooting foot pain plantar numbness paraesthesias alone posterior tibia never pain at end range DF and eversion
53
when is tarsal tunnel syndrome worse and better
worse at night , walking standing or activity better w rest
54
how is the tarsal tunnel syndrome severity rating rated
10 is normal 0 indicates that the conditions symptoms are severe
55
what are teh 5 symptoms for the Tarsal Tunnel Syndrome Severity Rating
• Spontaneous pain or pain with movement • Burning pain • Tinel sign • Sensory disturbance • Muscle atrophy or weakness
56
where is the lisfranc joint
medial cuneiform to 2nd MT to 3rd MT to 4th MT
57
in the lisfranc joint where are the ligaments located
between the medial cunifomr and the 2nd MT
58
what are the symptoms of a lisfranc injury
- dorsum of foot is swollen/painful - bruising on the bottom or top of foot (most commonly on plantar) - pain that is worse w standing or walking - abnormal widening of foot
59
for a post op ankle what is usually NWB and what is WBAT
plate is NWB intramedullary nail is WBAT
60
what motion is likely to be limited w screws connecting tibia and fibula
DF
61
what has the purpose to stimulate bone growth using distraction osteogenesis (pulling apart bone to stimulate new bone growth)
Ilizarov Frames
62
what MUST u do for a Ilizarov Frames
WBBBBBBBB
63
what are some DF stretching/ROM exercises
sitting - heel slide under chair standing - knee flexed or extended near a wall
64
what are ROM/strtching exercseis for PF
mobs and AROM quadruped stertch
65
when it MTP extension critical for and how can u increase ROM or stretch
terminal stance heel raises in sitting
66
what can u use soft issue massage for
calf’s peroneals anterior tibialis plantar fasciitis
67
what STM for dr P like for planar fascia
self massage
68
what are some examples of NM control for the foot/ankle
marble pick up for toe flex , PF and inv and Ev toerl scrunches for toe flexors rocker board/BAPD board
69
what is Dr. P go to for NM control and strength for post tib and foot intrinsics
arch raises (short foot)
70
what are some toe isolation exercises for NM control , strength
- toe yoga - splay toes - toe resistance activation
71
how can u progress CKC exercseis for the foot and ankle
start in bilateral stance and progress to SLS add perturbations
72
what are dynamic strengthening for PF and DF
 PF – heel raises; squats  DF – walk on heels

THER EX 2: LQ (9 decks)

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