The Ankle Part 2: Exam 3 Flashcards Preview

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Flashcards in The Ankle Part 2: Exam 3 Deck (62):
1

MOI lateral ankle sprain

Inversion and plantar flexion

2

Lateral ankle sprain ligaments

-ATFL
-CFL

3

How ATFL is injured

Plantar flexion and inversion

4

How CFL is injured

Inversion

5

Etiology of grade one ligament sprain

-inversion and plantar flexion
-causes stretching of ATFL

6

Symptoms of grade 1 ligament sprain

-mild pain and disability
-minimally impaired weight bearing
-point tenderness over ligament and no laxity

7

Management of grade 1 sprain

-RICE 1-2 days
-limited weight bearing initially and then agressive strengthening rehab
-tape can provide additional support
-return to activity in 7-10 days

8

Etiology of grade 2 sprain

-moderate inversion force causing great deal of disability with many days of lost time

9

Symptoms of grade 2 sprain

-feel/ hear a pop or snap
-moderate pain with difficulty bearing weight
-tenderness and edema
-special tests will be positive for laxity

10

Management of grade 2 sprain

-RICE for 72 hours
-x-ray to rule out fracture
-crutches for 5-10 days
-progress to weight bearing

11

Etiology of grade 3 sprain

-relativity uncommon but extremely disabling
-caused by significant force resulting in spontaneous subluxation and reduction
-damages the anterior/ posterior talofibular and calcaneofibular ligaments as well as the capsule

12

Symptoms of grade 3 sprain

-severe pain
-swelling
-hemarthosis
-discoloration
-unable to bear weight
-grossly positive instability test

13

Management of grade 3 sprain

-RICE
-x-ray
-possible dorsiflexion splint
-progressive weight bearing
-isometrics in cast
-ROM exercises and balance exercises one out of cast
-possibly surgery

14

Eversion ankle sprain etiology

-5-10%

15

What is injured with an eversion sprain?

-deltoid ligament and possible fib fracture

16

Who is more susceptible to eversion sprains?

-pronated and hypermobile

17

Symptoms of eversion sprain

-severe pain
-unable to bear weight

18

Management of eversion sprain

-RICE
-xray
-no weight bearing initially
-posterior splint
-NSAIDs
-same course of treatment of grade 2 sprain

19

What can happen with grade 2 or higher sprain?

Considerable instability and may cause weakness in medial longitudinal arch resulting in excessive pronation or fallen arch

20

Etiology of high ankle sprain

-external rotation and or forced dorsiflexion

21

What is injured in high ankle sprain

-anterior/posterior tibiofibular ligaments
-sydesmosis

22

Symptoms of high ankle sprain

-Pain anterolaterally
-loss of function
-pain

23

Management of high ankle sprain

-difficult and longer to treat
-modified weight bearing

24

Another name for high ankle sprain

Syndesmotic

25

Ankle fracture etiology

-blunt trauma and strong multidirectional forces

26

Symptoms of ankle fracture

-swelling
-pain
-crepitis
-deformity

27

Management of ankle fracture

-RICE
-walking cast or brace with immobilization lasting 6-8 weeks

28

Etiology of achilles tendon strain

Common and occurs with sprains or increased dorsiflexion

29

Symptoms of Achilles strain

-pain
-partial or complete rupture of achilles

30

Management of achilles strain

-RICE
-conservative treatment should be used to avoid chronic tendinitis
-elastic wrap
-heel lift
-stretching and strengthening

31

Achilles tendinitis etiology

-inflammatory condition
-overload due to extensive stress

32

Symptoms of tendinitis

-pain and stiffness
-warm/ pain to touch
-tendon thickening

33

Management of tendinitis

-RICE
-NSAIDs
-long term healing time

34

Achilles rupture etiology

-sudden stop and go
-more common in 30+ years

35

Symptoms of achilles rupture

-pain and rapidly subsides
-decreased range of motion
-swelling
-discoloration
-loss of function
-point tenderness

36

Management of achilles rupture

-RICE
-NSAID
-NWB

37

Peroneal tendon injuries

-dislocation and subluxation
-tendinitis
-similar symptoms

38

Peroneal tendon etiology

Direct blow to posterior lateral malleolus

39

Symptoms of peroneal tendon injuries

-pain
-snapping and instability
-discoloration
-swelling
-tenderness
-crepitus

40

Management of peroneal tendon injury

-RICE
-NSAID
-analgesic
-possible surgery

41

Tendinopathy/ tendinitis

Can occur in any of the tendons that cross the joint and is usually due to overuse and poor biomechanics

42

Muscle or shin contusions etiology

Direct blow

43

M/s contusion symptoms

-pain
-weakness
-swelling
-discoloration
-hard
-rigid
-inflexible

44

M/S contusion management

-RICE
-Modalities
-MAINTAIN ROM
-wrap or tape

45

Acute leg fractures etiology

-most common in fibula (mid third)
-tibial (lower third)
-direct blow or indirect trauma

46

Symptoms of acute leg fracture

-pain
-swelling
-leg hard and swollen due to increased pressure

47

Management of acute leg fractures

-splint
-xray
-reduction
-cast up to 6 weeks

48

Another name for shin splint

Medial tibial stress syndrome

49

Etiology of shin splint

-stress fracture
-repetitive micro-trauma
-10-15% running

50

Four grades of shin splint pain

-pain after activity
-pain before and after activity
-pain before, during, after activity
-pain severe and cannot perform activity

51

Management of shin splints

-referral for xray and bone scan
-decreased activity
-biomechanics correction
-RICE

52

Stress fracture of tibia or fibula etiology

Overuse or unconditioned or non-experienced individuals

53

Symptoms of stress fx

-pain more intense after exercise
-point tenderness and percussion
-bone scan

54

Management of stress fx

-2 weeks decreased activity
-NWB
-activity progression

55

Etiology of acute compartment syndrome

-traumatic and occurs after direct blow
-medical emergency due to risk of neurovascular compromise

56

Acute exertional compartment syndrome

Evolves with minimal to moderate activity and non traumatic

57

Chronic compartment syndrome

Symptoms arise during activity and in lower body sports

58

Symptoms of compartment syndrome

-deep aching pain and tightness due to pressure and swelling
-reduced circulation and sensation in foot
-intracompartamental pressure measures

59

Management of compartment syndrome

-conservative: RICE and NSAIDS
-acute and severe exertional: pressure monitored
-fasciotomy for chronic condition
-surgical release patient return to activity 2-4 months

60

Rehab for injuries

-weight bearing progression
-joint mobilizations
-flexibility (achilles)
-strengthening of surrounding muscles
-proprioception
-tape/brace
-functional progression

61

What decreases likely hood of eversion sprain?

-bony protection and ligament strength decrease likelihood of injury

62

Other than eversion sprains how can the deltoid ligament be injured?

-deltoid can also be impinged and contused with inversion sprains