Week 2 Masterclass

Question 1

What are the 3 joints of the midfoot

Answer 1

tibiofibular, talocrural, subtalar

Question 2

What movements can the talocrural joint perform

Answer 2

DF and PF

Question 3

What is the nerve supply for toe ext

Answer 3

Deep peroneal nerve

Question 4

How much dorsiflexion ROM do you typically need to descend stairs?

Answer 4

20 degrees

Question 5

How can muscle tightness or contractures be identified during an assessment of range of motion in the calf?

Answer 5

If gastroc is tight, the ankle ROM is limited with the knee extended.

If soleus is tight, ankle ROM is limited with knee flexed

Question 6

What movement injures ATFL

Answer 6

flexed, inverted and adducted position

Question 7

What movement injures deltoid ligament

Answer 7

flexed, everted and abducted

Question 8

What bony landmark does the flexor hallicus run underneath

Answer 8

Sustentaculum Tali

Question 9

Describe what happens to the talus during DF

Answer 9

Talus slides posteriorly on the tibia causing the anterior surface to become compressed

Question 10

Describe what happens to the talus during PF

Answer 10

Talus glides anteriorly on the tibia, causing the anterior surface to become stretched

Question 11

What movements make up pronation

Answer 11

Dorsiflexion, Eversion and abduction

Question 12

What movements make up supination

Answer 12

Plantarflexion, Inversion and adduction

Question 13

What are the joints of the foot

Answer 13

Subtalar (rearfoot)
Transverse Intertarsal (mid foot)
Tarsometatarsal
Metatarsophalangeal (MTP)
Interphalangeal

Question 14

What are causes of pain in the achilles which is often missed

Answer 14

Achilles rupture
Referred pain from peripheral nerves or lumbar spine
Sever’s disease
Soondyloarthropathy

Question 15

What is the Ottawa ankle rule

Answer 15

X-ray if:
There is pain/tenderness over malleoli 6cm proximally
There is pain/tenderness over navicular
Tenderness over base of 5th metatarsal
Inability to weightbear for at least 4 steps after the time of injury and at time of evaluation

Question 16

How to rule out ligament rupture of the ankle

Answer 16

No haematoma
No pain on palpation
Negative anterior drawer test approximately 5 days after the trauma

Question 17

What is the Ottawa ankle rule used for

Answer 17

To rule out fracture, subtler dislocation or lisfranic injury (high sensitivity. Rule out. SnOUT)

Question 18

What is your diagnosis if the pt hears a popping sound in their ankle?

Answer 18

Does not mean fracture, acute ankle sprain is still a possibility

Question 19

What movement would cause pain in a lateral ankle sprain

Answer 19

Supination

Question 20

Special tests for ATFL

Answer 20

Anterior Draw Test

Question 21

Special tests for Calcaneofibular ligament injury

Answer 21

Talar tilt test

Question 22

When is pain most common in plantar fasciopathy pt

Answer 22

Start and end of day

Question 23

Do heel spurs contribute to plantar fasciopathy

Answer 23

No. Heel spurs are normal

Question 24

What can be observed in plantar fasciopathy pt

Answer 24

Flat feet or high arches. Overpronation during gait

Question 25

Where would a plantar fasciopathy pt be tender

Answer 25

Calcanea tubercle

Question 26

Special test of plantar fasciopathy

Answer 26

windlass test

Question 27

What joint action may provoke symptoms of plantar fasciopathy pt

Answer 27

Toe ext, heel raise, single leg standing (sometimes)

Question 28

Achilles rupture special test

Answer 28

Thompson test

Question 29

Where would an Achilles tendinopathy pt feel pain

Answer 29

2-6cm above the calcaneal insertion

Question 30

How is pain described to be in plantar fasciopathy

Answer 30

poking hot pain in foot

Question 31

How is pain described to be in plantar fasciopathy

Answer 31

Stiff in the morning but 'warms up'. Pt can also pinpoint exactly where the pain is

Question 32

What is a PROM for achilles tendinopathy

Answer 32

VISA-A

Question 33

Achilles Tendinopathy Special tests

Answer 33

Royal London Hospital Test, Arc Sign Test

Question 34

Description of pain for Tarsal tunnel syndrome

Answer 34

Burning, tingling, or a sensation of 'pins and needles' in the foot and toes. Pain can also radiate up leg

Question 35

Tarsal Tunnel Special Test

Answer 35

Tinel's sign

Question 36

What does SCEBS stand for

Answer 36

Somatic Cognitive Emotional Behavioural Social

Question 37

What are somatic q's (SCEBS)

Answer 37

When did it begin? How often do symptoms occur? What is the pain like? T1, T2, T3

Question 38

What are cognitive q's (SCEBS)

Answer 38

What do you expect from the treatment? Is there anything you do to improve the symptoms? Do you think you have any influence on the pain?

Question 39

What are Emotional q's (SCEBS)

Answer 39

How do you feel when you have symptoms? Do you think about _______ all the time?

Question 40

What are Behavioural q's (SCEBS)

Answer 40

What do you do when you have symptoms? What activities are hindered by your complaint? Do you think that exercise is harmful for someone with your condition?

Question 41

What are social q's (SCEBS)

Answer 41

What does your partner think about your complaint? Does the complaint affect your social life?

Question 42

What are the 9 physical examinations that you have to go through when assessing a pt

Answer 42

1. Observation 2. Palpation 3. Passive ROM 4. Active ROM 5. Passive Accessory Movements 6. MMT 7. Neurological Screening 8. Special Tests 9. Functional Tests

Question 43

What does it mean if PROM is greater than AROM

Answer 43

Muscular weakness

Question 44

What does it mean if PROM and AROM is limited

Answer 44

Structural deformity

Question 45

What are you looking for when assessing passive ROM

Answer 45

What ROM is available Is there any resistance through ROM Can you apply over pressure What is the end feel (e.g soft, spasm, bony etc.)

Question 46

Ankle P+AROM Dorsiflexion ROM

Answer 46

0-20 degrees

Question 47

Ankle P+AROM PF

Answer 47

45 degrees

Question 48

Ankle P+AROM Inv

Answer 48

0-30 degrees

Question 49

Ankle P+AROM Ev

Answer 49

0-15 degrees

Question 50

Can PAM's be performed by the pt?

Answer 50

No

Question 51

Nerve supply of PF muscles

Answer 51

Tibial nerve

Question 52

Nerve supply of DF muscles

Answer 52

Deep peroneal nerve

Question 53

Nerve supply of Inv muscles of the ankle

Answer 53

Tibial

Question 54

Nerve supply of Ev muscles of the ankle

Answer 54

Fibularis longus + brevis - Superficial fibularis Fibula's terminus, Extensor digitorum longus - Deep Fibularis

Question 55

Explain what MTSS is

Answer 55

Inflammation of the surface on the bone caused by overuse of the muscles