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SCS Study Guide- Ankle and Foot Flashcards

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1
Q

what muscles are innervated by the deep peroneal nerve

A

the anterior compartment
tib ant, EHL, EDL, fibularis tertius

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2
Q

what muscles does the tibial nerve innervate

A

superficial layer of posterior compartment : gastroc, soleus, plantaris

deep posterior compartment: popliteus, FHL, FDL, tibialis posterior

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3
Q

what muscles does the superficial peroneal innervate

A

lateral compartment: peroneal (fib) longus, Peroneal (fib) brevis

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4
Q

what are the ligaments of the lateral ankle

A

anterior talofibular, calcaneofibular and posterior talofibular

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5
Q

what are the ligaments of the medial ankle

A

anterior and posterior tibiotalar, tibiocalcaneal, tibionavicaular

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6
Q

some additional support ligaments of the ankle

A

inferior and posterior tibiofibular ligament and interosseous membrane

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7
Q

which two ligaments are the most commonly injured in a syndesmotic injury

A

inferior anterior and posterior tibiofibular ligaments

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8
Q

most medial edge of foot, starting with metatarsals and working posteriorly, what are the bones on the medial aspect of the foot

A

metatarsals
medial cuneiform
navicular
talus
calcaneus

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9
Q

what are the ankle rules

A

pain in malleolar zone, and bony tenderness at the posterior half distal tib/fib
tip of medial/lateral malleolus
inabiltiy to walk 4 steps

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10
Q

what are common views for ankle pathology

A

internal oblique, mortise and lat view, AP view

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11
Q

what are the foot rules

A

pain in mid foot, and tender over navicular, 5th met, inability to walk 4 steps

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12
Q

common foot views

A

AP/LAT/oblique

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13
Q

morton’s test

A

metatarsalgia or neuroma

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14
Q

achilles tendon reflex

A

S1 nerve root

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15
Q

tinel sign

A

tarsal tunnel

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16
Q

anterior drawer test

A

anterior talofibular ligament

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17
Q

calf squeeze,

A

achilles rupture

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18
Q

ER test

A

syndesmotic, high ankle sprain

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19
Q

impingment test

A

impingment to the talocrural joint

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20
Q

navicular drop test

A

medial longitudinal arch by looking at navicular height

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21
Q

squeeze test lower let

A

tibiofibular syndesmotic injury

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22
Q

squeeze test calcaneous

A

stress fracture

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23
Q

windlass test

A

fascial and ligamentous impairments

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24
Q

Maisonnuerve fracture cause, exam

A

cause: tearing of interosseous and fx of prox fibula: ER force
palpate prox fibula!

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25
tillaux fracture (SH type) cause and imaging
type: SH 3 of anterior lateral tibial epiphysis (avulsion) cause: avulsion of ATFL from ER injury x-ray then CT if needed
26
jones fracture cause, exam and treatment and imaging
cause: forefoot adduction with PF, fx at base 5th metatarsal exam: swelling and pain over the 5th met imaging: ant/post/lat and mortise view, or oblique view treatment: non op 6-8 weeks cast, crutches and immob, WB as pain subsides
27
jones fractures are at risk of what
mal/non union
28
lisfranc fracture cause, exam, imaging
TMT fx/dislocation with dorsal displacement of the proximal end of metatarsals cause: crush to midfoot, sudden rotation force with PF foot exam: alignment, medial plantar bruising, swelling/tenderness at dorsum of foot imaging: MRI (missed on x-ray)
29
fracture of the talar dome cause, exam and treatment
cause: severe INV/DF or INV with PF force exam: pain with WB, catching, swelling after activity treatment: NWB, immob, conservative fails, surgery
30
severs disease cause, exam and treatment
calcaneal apophysitis cause: 8-14y/o, traction injury exam: pain at posterior heel below Achilles, swelling at calcaneus treatment: RTS 2-8 weeks
31
what is the most common MT to stress fracture
2nd (AKA MARCH FX)
32
cause, exam, imaging and treatment of metatarsal stress fracture
cause: change in training, milage, surface, forefoot varus, hallux valgus, flat foot exam: dull pain with gradual onset progressing to pain at rest. Diffuse at first then localizes imaging: bone scan treatment: rest, boot, restricted WB, orthotics
33
what are the 6 critical areas for stress fractrues
anterior tibialis, medial metatarsal, talus, 5th MET, navicular, seasmoids
34
what is the difference in treatment between non-critical stress fx and critical stress fx
non-critical can have rest and immob, critical may need surgery
35
calcaneal fracture cause exam and treatment
cause: landing after jump or fall exam: swelling, inability to WB treatment: non-displaced, immob and early ROM
36
cuboid sublux cause, exam and treatment
cause: pronation with trauma, often with INV exam: pain along 4th MT and over cuboid, inc pain with standing after prolonged sitting treatment: manip of cuboid and orthotics
37
hallux rigidus cause, exam and treatment
cause: loss of DF due to degenerative process and changes in articular cartilage exam: restricted, causes foot to roll laterally, great toe cannot DF and forced DF causes pain treatment: stiffer shoe with larger toe box, orthotics, osteotomy
38
1st MTP joint sprain: AKA cause, exam and treatment
turf toe cause: forced DF of MTP player hit from behind during plant exam: pain with DF< pain at met head of one, antalgic gait treatment: stiffer shoe, steel/graphite insert, taping to prevent DF
39
metatarsalgia cause, exam and treatment
general term for ball of foot pain cause: restricted DF, shortened midstance phase of gait exam: possible callous formation in forefoot treatment: rule out stress fx, metatarsal pad and alleviate restricted DF.
40
MOI of lateral ankle sprain
PF and IVN
41
how do you asses for a lateral ankle sprain
lateral swelling and bruising, antalgic gait, tenderness at ATFL, PTFL and CFL and talar tilt, and anterior drawer
42
medial ankle sprain MOI
eversion
43
signs and symptoms of medial ankle sprain
medial swelling and bruising, tenderness at deltoid ligament, pain lateral due to compression, and talar tilt and Kleiger's
44
a deltoid ligament injury may cause... and why
increased pronation or decreased arch due to deltoid ligament contribution to supporting the arch
45
MOI of syndesmotic injury
ER/Forced DF
46
signs and symptoms of syndesmotic tear
decreased PF, TTP at ant and post tibiofib ligament, pain between bones, posteromedial pain at ankle joint Squeeze test, ER test, crossed leg test and cotton test
47
what might an x-ray show that is indicative of a syndesmotic tear
increased tibiofib space, decreased tibiofib overlap and inc medial clear space
48
achilles rupture cause, exam and treatment
cause: pushing off WB foot with knee ext, unexpected DF exan: pop "felt like shot" (+) Thompson test and MRI
49
retrocalcaneal bursitis cause, exam and treatment
cause: inflammation of the bursa between achilles and calcaneus from rubbing against a shoe, Haglund's deformity exam: RRP, bump, swelling treatment: RICE, NSAIDs, stretching and heel lift
50
sublungal hematoma cause, exam and treatment
blood under toenail from getting stepped on, repeated shear like kicking and running treatment: drilling a small hole IF NO FX PRESENT
51
hammer toe is a contraction of what joing in what position
flexion contracture to PIP
52
mallet toe is a ____ contracture of what joint
flexion of DIP
53
claw toe is a ___ contracture of what joint
flex contracture at DIP, and hyperextended MP
54
joggers foot: what is it, cause and exam
local nerve entrapment of medial plantar nerve at tunnel of abd hallicus and navicular tuberosity cause: running induced nerve pain exam: pain medial arch into medial toes
55
joggers foot is associated with _____ hindfoot deformity, and what activity
valgus, long distance running
56
Haglund's Deformity
bony enlargement of back of heel "pump bump"
57
Morton's neuroma between what met heads
3rd and 4th
58
morton neuroma is associated with excessive...
pronation
59
medial tibial stress syndrome AKA
shin splints cause: repetitive micro trauma (running and jumping)
60
imaging for MTSS
3 phase x-ray, may look cloudy and an MRI
61
classification of acute, acute exertional and chronic compartment syndrome
acute is trauma and emergency acute exertional is when you have min to mod activity chronic, consistently with activity
62
exam to dx MTSS
deep aching, swelling and tightness in compartment and pain with stretching
63
what are the mmHG of pressures for pre, 1 min and 5 min post exercise
pre <15 1 min post: >30 5 min post> 20
64
RTP after fasciectomy
2-4 months
65
what kind of orthotic for turf toe
total contact orthotic, with carbon fiber plate and a rocker sole extended heel shank
66
what kind of orthotic for mortons neuroma
total contact orthotic with MT pad prox to 2nd met head
67
what kind of orthotic for bunion
larger toe box, stretch shoe and total contact orthotic with medial posting
68
what kind of orthotic for sesamoiditis
custom total contact with met pad, viscoelastic polymer under sesamoids, full length steel sheath and ant rocker bottom
69
what kind of orthotic pes cavus
OTC with shock abosorption and total contact with lateral forefoot posting
70
what kind of orthotic pes planus
OTC full insoles with medial posting
71
what kind of orthotic achilles tendinopathy
firm heel cushion, heel elevation and TCO with medial posting and heel cup
72
what kind of orthotic for sever's
OTC insole with good arch support and absorption
73
modified brostrom WB status
initially WBAT in boot (D/C at 4-6 weeks)
74
RTS for brostrum
8-12 weeks
75
avoid what two movements for 6 weeks post op Brostrum
adduction and inversion
76
non-op achilles casting/bracing and ROM and strengthening
2 week cast with DF block and NWB then boot with 20 degrees PF WBAT week 6, remove 1 wedge and gentle NWB strengthening
77
how long do you need a 1cm heel wedge for non op achilles care
at 10 week mark wtih boot is d/c, the 1cm wedge is kept for 3 months
78
Achilles tendon debridement WB, strengthening, running RTP
WB when pain and swelling decrease strengthening at 2-3 weeks running 6-10 weeks RTS: 3-6 months
79
initially post op Achilles tendon repair, how is the leg placed
in a post splint with stirrup
80
post op achilles repair, when can you do unilateral heel raises
3 months
81
RTP when ___% and at what time
6-12 months, when 80%

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