Practical 1

Question 1

MAPPSSO

Answer 1

Mechanism of injury
Acute or chronic
Previous injury
Pain
Signs and symptoms 
Sounds
Other

Question 2

Dermatomes

L1

Answer 2

Proximal lateral femur to distal medial femur

Question 3

Dermatomes

L2

Answer 3

Proximal lateral femur to distal medial femur

Question 4

Dermatomes:

L3

Answer 4

Lateral femur anterior to Medial knee

Question 5

Dermatomes:

L4

Answer 5

Distal lateral femur anterior to medial shank

Question 6

Dermatomes:

L5

Answer 6

Lateral knee anterior to anterior foot

Question 7

Dermatomes:

S1

Answer 7

Lateral foot posterior to posterior shank and thigh

Question 8

Dermatomes:

S2

Answer 8

Posterior shank and thigh

Question 9

Circulation(2)

Answer 9

Capillary refill

Skin color/temp

Question 10

Pulse(2)

Answer 10

Dorsal pedal

Posterior tibial

Question 11

Functional testing

Ottawa ankle rules explanation

Answer 11

To reduce unneccesory test on foot and ankle injuries

Question 12

Myotomes:

L1

Answer 12

Resist hip flexion

Question 13

Myotomes:

L2

Answer 13

Resist hip flexion

Question 14

Myotomes:

L3

Answer 14

Resist knee extension

Question 15

Myotomes:

L4

Answer 15

resist dorsiflexion

Question 16

Myotomes:

L5

Answer 16

resist great toe extension

Question 17

Myotomes:

S1

Answer 17

resist eversion

Question 18

Myotomes:

S2

Answer 18

resist knee flexion

Question 19

Anterior drawer

Answer 19

Examiner Position: Sitting or standing in front of the patient, one hand grasping the calcaneus with the same forearm holding the foot and the other hand stabilizing the distal tibia and fibula

Forces Applied: Stabilizing hand applies resistance on the tibia/fibula while the other hand anteriorly glides the calcaneus and talus

Question 20

Bump test

Answer 20

Examiner Position: Standing to the side of the affected leg with one hand holding the top of the foot in a maximal dorsiflexed position

Forces Applied: The examiner’s top hand holds the top of the foot in a dorsiflexed position and the examiner firmly taps the bottom of the patient’s heel

Question 21

Dorsal glide

Answer 21

Examiner Position: At patient’s feet. One hand stabilizes rearfoot and ankle mortis, one foot cups base of metatarsal.
One hand stabilizes the metartarsal head/ proximal phalynx, the other cups the phalynx

Forces Applied: A plantarly directed force is applied on the metatarsal or phalynx

Question 22

Dorsiflexion eversion test

Answer 22

Examiner Position: At the patient’s feet. One hand on medial side of heel. one hand on head of metatarsals

Forces Applied: Passively evert the heel and dorsiflex the foot and toes, holding the position for 5 to 10 seconds

Question 23

Eversion stress test

Answer 23

Examiner Position: Stand in front of the patient. One hand should be grasping the calcaneus and the talas, with the thumb on the deltoid ligament. The other hand should stabilize the leg.

Forces Applied: Roll the calcaneus laterally which causes the talas to tilt.

Question 24

Feiss line

Answer 24

Examiner Position: Sitting and observing at the patient’s feet.

Forces Applied: Draw a line from the inferior aspect of the medial malleolus to the plantar aspect of the first MTP.
After the drawing of the dots, the patient steps down and the navicular tuberosity is marked.
Tubercle above the line = Pes Cavus
Tubercle below the line = Pes Planus
Tubercle on the line = Normal

Question 25

Homan’s test

Answer 25

Examiner Position: Examiner is at end of table, stabilization hand is on distal portion of tibia and fibula and examining hand is on plantar portion of foot being tested Forces Applied: Foot is passively dorsiflexed by the examiner on the side being tested with the knee fully extended

Question 26

Inter-metatarsal glide

Answer 26

Examiner Position: Standing in front of the patient’s feet One hand grasping the first MT head The other hand grasping the second MT head Forces Applied: Stabilize one of the MT heads while moving the other in opposite, plantar and dorsal direction Repeat procedure by moving to the lateral MT heads until all four intermetatarsal joints have been evaluated

Question 27

Inversion stress test

Answer 27

Examiner Position: In front of the patient, one hand grasps the calcaneus and talus, the opposite hand stabilizes the leg 10 degree of dorsiflexion. the thumb or forefinger is place along the calcaneofibular ligament so that any gapping of the talus away from the mortise can be felt. Forces Applied: the hand holding the calcaneus provides an inversion stress

Question 28

Kleigers test

Answer 28

Forces Applied: The foot and talus are externally rotated while maintaining a stable leg.To stress the syndesmosis, place the foot in dorsiflexion, and to stress the deltoid ligament, place the foot in neutral or slight plantarflexion. Positive Test: Deltoid ligament: Medial joint pain. Examiner could feel displacement of talus away from med. malleolus.

Question 29

Mortons test

Answer 29

Examiner Position: Standing at the patient’s feet, grasp the forefoot just behind the head of the 1st and 5th MT. Place the index finger and thumb of the opposite hand dorsal and plantar to the web space respectively, as if to pinch. Forces Applied: Compress the transverse arch. Use the thumb and forefinger to apply pressure over the symptomatic interspace between the metatarsals. Forces should be moderately applied.

Question 30

Navicular drop

Answer 30

Examiner Position: Kneeling in front of the patient. Forces Applied: On an index card, mark the height of the navicular tubercle while seated, mark position again while weight bearing. Measure distance between 2 marks.

Question 31

Plantar glide

Answer 31

Examiner Position: At patient’s feet. One hand stabilizes rearfoot and ankle mortis, one foot cups base of metatarsal. One hand stabilizes the metartarsal head/ proximal phalynx, the other cups the phalynx Forces Applied: A plantarly directed force is applied on the metatarsal or phalynx

Question 32

Posterior drawer

Answer 32

Examiner Position: Place stabilizing hand on the distal leg, and have the mobilizing hand grasp the talus and midfoot to maintain the joint in a loose-packed position Forces Applied: Apply an anteroposterior (AP) force to the talus perpendicular to the tibia’s long axis as you examine the amount of quality of movement and end feel

Question 33

Squeeze test

Answer 33

Examiner Position: Standing next to, or in front of the injured leg, with hands cupped behind tibia and fibula away from the site of pain Forces Applied: Gently squeeze (compress) the tibia and fibula, gradually adding more pressure if no pain or other symptoms are elicited. Progress toward the injured site until pain is elicited

Question 34

Thomson

Answer 34

Examiner Position: Standing next to the patient with their hand on their calf. Forces Applied: Squeeze mid-muscle belly on affected side

Question 35

Toe collateral

Answer 35

Examiner Position: One hand is stabilizing the proximal bone close to the joint being tested. The other hand is grasping the bone distal to the joint being tested near the middle of its shaft Forces Applied: Valgus testing is moving the distal bone laterally to open up the joint on the medial side. Varus testing is moving the distal bone medially to open up the joint on the lateral side.