lower leg

Question 1

Anterior shin splints AKA

Answer 1

Lateral tibial stress syndrome

Question 2

Posterior shin splints AKA

Answer 2

Medial tibial stress syndrome

Question 3

Shin splint presentation

Answer 3

Achy pain on weight bearing, following running on hard surface or after break

Question 4

Anterior muscles act as ___, posterior as ___

Answer 4

Shock absorbers, stabilizers

Question 5

Pathognomonic for shin splints

Answer 5

Pain in middle or lower third of tibia. Non-responsiveness to Tx also clue

Question 6

Shin splint management

Answer 6

Rest, ice, strapping, new shoes

Question 7

Proximal, middle, and distal stress fractures are seen in ___, ___, ___

Answer 7

Military, dancers, runners (middle and distal)

Question 8

Dreaded black line =

Answer 8

Middle shaft tibia fracture in dancers

Question 9

Tibia stress fx management

Answer 9

Rest 5-7 weeks

Gradual return to impact

Question 10

Achilles tendon can function with __% continuity

Answer 10

25%

Question 11

Achilles tendinits cause

Answer 11

Jumping, running

Question 12

Pump Bump AKA ___ results from ______

Answer 12

Hagland deformity, retrocalcaneal bursitis

Question 13

Achilles tendinitis ddx

Answer 13

Reiters/ AS enthesopathy, Sever’s apophysitis

Question 14

____ test for Achilles rupture AKA ___

Answer 14

Thompson, Simmond’s

Question 15

Proximal tibia pain ddx (3)

Answer 15

Pes anserine bursitis, stress fx, tumor

Question 16

MIddle and distal tibia pain ddx (3)

Answer 16

Stress fx, periostitis, shin splints

Question 17

Calf muscle pain ddx (2)

Answer 17

Muscle tear, DVT

Question 18

Achilles insertion pain ddx (4)

Answer 18

Retrocalcaneal bursitis, exostosis, tendinitis, swelling or hypertrophy

Question 19

___ can initiate a DVT

Answer 19

Minor trauma in older patient

Question 20

Neurogenic vs vascular claudication

Answer 20

Neuro- spinal stenosis, can walk/ ride farther before pain, typically in flexed position

Vascular- Blood vessel stenosis, common with atherosclerosis

Question 21

Homan’s SIGN

Answer 21

Local swelling over biceps surae- indicates DVT

Question 22

Tib/ fib local swelling

Answer 22

Stress fx

Question 23

Close packed foot position

Answer 23

SUpination (phalanges- extension)

Question 24

Supination involves

Answer 24

Adduction, plantarflexion, inversion

Question 25

Pronation involves

Answer 25

Abduction, dorsiflexion, eversion

Question 26

FPS aggravated by ___, plantar fasciitis by ___

Answer 26

Compression/ squeezing, stretching

Question 27

Fat pad syndrome (foot) pain locates where

Answer 27

Middle of heel

Question 28

__% of compartment syndrome is caused by tibial fx

Answer 28

45%

Question 29

CS signs (3)

Answer 29

absence of distal pulse, paresis, hypoesthesia

Question 30

Normal and CS pressures

Answer 30

10-12, 30

Question 31

CS most commonly affects

Answer 31

Anterior compartment

Question 32

6 P's of acute extremity ischemia

Answer 32

Pain, paresthesia, pallor, pulselessness, paresis, poikilothermia (temp changes)

Question 33

Acute CS management

Answer 33

Elevate limb TO LEVEL OF heart, no above | Release one side of cast if applicable

Question 34

Commonly injured in lateral tibial plateau fx

Answer 34

Anterior tibial artery

Question 35

Provides sensation to first dorsal web space

Answer 35

Deep peroneal nerve

Question 36

Sensation to sole of foot

Answer 36

Posterior tibial nerve

Question 37

Sensation to lateral foot and distal calf

Answer 37

Sural nerve

Question 38

At risk for DVT

Answer 38

Females taking oral contraceptives

Question 39

__% of DVTs are asymptomatic

Answer 39

50%

Question 40

____ for diagnosis of DVT

Answer 40

Doppler ultrasound

Question 41

Cellulitis causes (2)

Answer 41

Gram positive organisms, chronic venous thrombosis

Question 42

Venous insufficiency presentation

Answer 42

Chronic lower leg swelling, itching, dull ache with standing, multiple varicosities

Question 43

Venous insufficiency management

Answer 43

Supportive stockings, weight loss, reduce salt intake, avoid standing too long

Question 44

Varicosities usually affect

Answer 44

Long saphenous vein

Question 45

Bilateral leg edema, orthopnea

Answer 45

Congestive heart failure

Question 46

Tarsal tunnel affects which nerve

Answer 46

Posterior tibial n

Question 47

Predisposing factor in tarsal tunnel

Answer 47

Dropped longitudinal arch (foot everts, stresses area)

Question 48

Nerve root test for tarsal tunnel

Answer 48

L4 (plantarflexion and inversion)

Question 49

Passes through heads of gastroc, supplies dorsiflexors

Answer 49

Tibial n

Question 50

Sensory branch of tibial n, supplies lateral foot and leg

Answer 50

Sural n

Question 51

Sensory to plantar surface of medial 3.5 toes, motor for plantarflexion and and inversion

Answer 51

Medial plantar n (branch of post tibial)

Question 52

Sensory to plantar surface of lateral 1.5 toes, motor to small muscles, culprit in Morton's neuroma

Answer 52

Lateral plantar n (branch of post tibial)

Question 53

Branch of tibial n, results in heel pain

Answer 53

Medial calcaneal n

Question 54

Vulnerable to entrapment at fibular neck- lateral knee pain

Answer 54

Common peroneal n

Question 55

Sensory to ant leg, dorsum of foot, part of 2-5th digits. Pain over lateral leg, ankle

Answer 55

Superficial pernoeal

Question 56

Entrapped above ankle by extensor retinaculum, spurs, ganglia. Big toe pain and weakness on dorsiflexion and inversion

Answer 56

Deep peroneal n

Question 57

Loss of sensation, burning pain over distal medial leg.

Answer 57

Saphenous n