MSK_Ankle-Foot_ALL

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  1. ROM
    • DF - 20
    • PF - 50
    • Inversion - 35
    • Eversion - 15
    • Subtalar inversio/eversion - 5
  2. Talocrural jt - formed by what? what motions?
    • Tibia + Fibula + Talus
    • DF + PF ONLY
  3. Subtalar jt - formed by what? what motions?
    • Talus + Calcaneus
    • Inversion + eversion ONLY
  4. Talocrural jt - Loose-packed & closed-packed position
    • Loose - 10 PF + Mid bet inversion/eversion
    • Closed - Full DF
  5. Subtalar jt - Loose-packed & closed-packed position
    • Loose - Mid ROM
    • Closed - Supination
  6. Mid foot movements - 2
    • Inversion + ADD
    • Eversion + ABD
    • Image Upload
  7. Ankle - Articular innervation comes from - 2
    • Deep fibular nn
    • Tibial nn
  8. Dorsalis pedis artery - Location; palpate where; important why
    • Passes over navicular& cuneiform bones just lateral to extensor hallucis longus tendon
    • Palpation - On dorsum of foot
    • Rule out - intermittent claudication
  9. Ligaments - check DF, PF, Inversion, Eversion
    • DF - posterior talofibular
    • PF - anterior talofibular
    • Inversion - calcaneofibular + anterior & posterior talofibular 
    • Eversion - deltoid
    • Image Upload
  10. Longitudinal arch - supported by what ligament?
    • Long plantar ligament
    • Image Upload
  11. What bone is key to lateral arch?
    Cuboid
  12. Ankle inversion - prime movers - 1
    Posterior tibialis
  13. Fibula rotates how w/DF to accommodate wider portion of talus?
    Laterally
  14. Early stance - position at subtalar jt; midfoot jt; tibial rotation; calcaneus; Transmetatarsals
    • Pronation (subtalar jt)
    • Tibial IR
    • Midfoot ADD
    • Calcaneal eversion
    • TT unlocked
    • Image Upload
  15. Late stance - position at subtalar jt; midfoot jt; tibial rotation; calcaneus; Transmetatarsals
    • Supination (subtalar jt) - foot goes into rigidity to push off
    • Tibial ER
    • Midfoot ABD
    • Calcaneal inversion
    • TT locked - for push off
    • Image Upload
  16. Pronation - Open-chain - position at talocrural, subtalar & midfoot jts
    • DF (talocrural jt)
    • Eversion (subtalar jt)
    • ABD (midfoot)
  17. Supination - Open-chain - position at talocrural, subtalar & midfoot jts 
    1 thing different in closed-chain

    • PF (talocrural jt)
    • Inversion (subtalar jt)
    • ADD (midfoot)
  18. Closed chain - ABD (midfoot) - to push off toe
  19. Tibial rotation - pronation vs supination; at what jt?
    • Pronation - IR
    • Supination - ER
    • Subtalar joint
    • Image Upload  Image Upload
  20. Subtalar pronation - what other compensations in leg? - 3
    • Tibial, Femoral, & pelvic IR
    • Opposite for subtalar supination
  21. TO INC mobility of mortise when it is restricting ankle DF do what glide?
    Distal tibiofibular anterior or posterior
  22. Talocrural posterior glide INC what?
    DF
  23. Talocrural anterior glide INC what?
    PF
  24. Medial Subtalar glide INC what?
    Eversion
  25. Lateral subtalar glide INC what?
    Inversion
  26. Achilles' Tendon Rupture - mechanism of injury - 2
    • Sudden DF stress while gastroc contracted
    • Direct blow
  27. Achilles' Tendon Rupture - S/S - 5
    • Swelling/discoloration within 24 hours
    • Severe distal calf pain
    • Sense of snapping
    • Weak PF
    • No push-off during gait
  28. Ankle sprain - inversion - mechanism of injury; what ligament; special test; PT CONTRA
    • Foot is PF/inverted
    • ATFL + Calcaneofibular
    • Talar tilt - Subtalar inversion + Talar ADD
    • NO STRETCHING
  29. Ankle sprain - eversion - mechanism of injury; what ligament; special test; PT CONTRA
    • Deltoid ligament
    • Talar tilt - Subtalar eversion + Talar ABD
    • NO STRETCHING
  30. Plantar fasciitis - S/S (4); d/t what?
    • Pain where?
    • PT initial & later
    • Heel pain w/WB
    • Pain worse upon initial WB after rest - in am
    • Point tenderness over medial calcaneal plantar tuberosity
    • Tight triceps surae (soleus)
    • D/t Excessive pronation
    • PT - initial = casting at night
    • PT - later = Flexibility of plantar fascia for pes cavus foot; Careful flexibility exercises for triceps surae; Strengthening of invertors of foot
  31. Plantar fasciitis - diff from tarsal tunnel syndrome
    (-) Tinel's sign
  32. Pes planus - another name; 2 types + differentiate bet them
    • Flatfoot or "Fallen arches"
    • Flexible - Medial arch/foot pronates w/WB but reforms w/NWB
    • Rigid - deformity persists in WB/NWB & during active supination
    • Talus ADD/PF on everted calcaneus
    • Foot fatigue
  33. Pes cavus - another name; what arches are involved & how
    • “Hollow foot”
    • Longitudinal arch - INC height
    • Transvere (anterior) arch - dropped = splayed forefoot
    • Ankle PF
    • Claw toes
    • Image Upload
  34. Hallux Valgus - S/S (3); Normal angle?; D/t what? (3)
    • Pain/bunion @ 1st MP joint
    • Medial deviation of 1st metatarsal
    • Lateral deviation/rotation of hallux
    • Image Upload
    • Normal angle - 8-20 deg
    • D/t - Abnormal foot mechanics; Pointed toe shoe wearers; Excessive pronation
  35. Morton's Neuroma - pain where; pain INC w/what? what arch involved; subtalar jt in what position
    • U/L - Tenderness at 3rd/4th metatarsal heads & web spaces
    • Numbness/pain INC w/WB
    • Antalgic gait
    • Flat transverse arch
    • Pronated foot
    • 3rd/4th metatarsal calluses
  36. Metatarsalgia - S/S - 4
    • Plantar foot pain & fatigue w/WB
    • Antalgic gait
    • Callus over middle metatarsals
    • Hypermobile or pronated foot
  37. Metatarsalgia - mechanical etiologies - 5
    • Tight triceps surae group and/or Achilles' tendon
    • Collapse of transverse arch
    • Short first ray
    • Pronation of forefoot
    • Changes in footwear
  38. Metatarsus Adductus - Rigid vs Flexible foot position
    Image Upload   Image Upload
    • Rigid
    • Medial subluxation of TMT jts
    • Hindfoot - in slight valgus
    • Navicular - lateral to head of talus

    • Flexible
    • ADD of all 5 metatarsals at TMT jt
  39. Charcot-Marie-Tooth disease - definition + S/S (4); d/t what
    • Slowly progressing degenerative nn disease of peroneals
    • MM - weakness + DEC mm size
    • High arches
    • Hammertoes
    • D/t DEC sensation
  40. Talipes equinovarus vs Talipes Equinus 
    • 1Image Upload vs  2Image Upload
    • 1 - Talipes equinovarus (clubfoot) - PF, ADD, and inverted foot
    • 2 - Talipes Equinus - PF; Subtalar pronation
  41. Tibial fx - spiral - mechanism of injury
    • Severe torsion during a skiing accident
    • Slow healing - tibia has a relatively poor blood supply
  42. Trimaleolar fx - mechanism of injury?
    • Fracture of both malleoli & posterior tubercle of distal tibia
    • Falling off of something & landing on feet
  43. Trimaleolar fx - what is best radiograph view?
    AP & lateral
  44. Bimalleolar fx - mechanism of injury
    Coming down on ankle – really bad inversion sprain
  45. Name & describe - S/S - 5; pain where?
    • Image Upload
    • Tarsal Tunnel syndrome - entrapment of posterior tibial nn in tarsal tunnel - tibial neuritis
    • Pain/numbness along medial ankle to plantar surface of foot
    • PROM - pain w/PF & eversion
    • (+) Tinel's over tarsal tunnel
    • MIMICKS PLANTAR FASCITIS
  46. Pain location difference for:
    • plantar fasciitis vs tarsal tunnel syndrome vs. posterior tibial tendonitis
    • Plantar fasciitis - medial calcaneal plantar tuberosity
    • Tarsal tunnel syndrome - medial ankle to plantar surface of foot
    • Posterior tibial tendonitis - medial ankle & up into calf
  47. This pain referral suggests what pathology?
    • Image Upload
    • Tarsal Tunnel Syndrome
  48. This pain referral suggests what pathology?
    • Image Upload
    • Plantar fascitis
  49. This pain referral suggests what pathology?
    • Image Upload
    • Posterior tibial tendonitis
  50. Lisfranc injury/fx (midfoot injury; tarsometatarsal injury) - define; mechanism of injury (3); S/S (2)
    • 1 or all metatarsal bones displaced from tarsus
    • Mechanism of injury - crush injury (heavy object on foot) or landing on foot from significant height
    • Athletes - PF + another player lands on their heel (football/soccer)
    • Bruising on BOTTOM of foot 
    • Pain INC w/standing or walking
  51. Name test; tests what; describe; (+)
    • Image Upload
    • Anterior drawer test
    • ATFL - Anterior talofibular ligament
    • Pt supine, w/heel just off edge of table in 20° PF
    • PT stabilizes lower leg/Pulls talus anterior
    • (+) Excessive anterior glide; Pain
  52. Name test; tests what; describe; (+)
    • Image Upload
    • Talar tilt
    • CFL ligament w/ADD
    • Deltoid ligament w/ABD
    • Pt sidelying, knee slightly flexed, ankle in neutral
    • (+) Excessive ADD/ABD + Pain
  53. Name test; tests what; describe; (+)
    • Image Upload
    • Thompson's
    • Achilles' tendon
    • Pt prone, w/foot off edge of table
    • PT squeezes calf muscles
    • (+) No movement of foot while squeezing calf
  54. Name test; tests what; describe; (+)
    • Image Upload
    • Morton's test
    • Identifies stress fx or neuroma in forefoot
    • Pt supine, w/foot supported on table
    • PT grasps around metatarsal heads & squeezes
    • (+) Pain in forefoot
  55. Tinel's sign @ ankle - tests what? - 2
    • Posterior tibial nn - posterior to medial malleolus
    • Deep fibular nn - anterior to talocrural joint
  56. Name test; tests what; describe; (+)
    • Image Upload
    • Squeeze Test
    • Injury of syndesmosis ligament
    • Pt sitting, PT grasps anterior leg proximally & squeezes fibula & tibia together (squeezing interrosseous ligement)
    • (+) Pain at ankle
  57. Name test; tests what; describe; (+)
    • Image Upload
    • Homan's Sign
    • Tests for DVT
    • Pt supine
    • Pt DF ankle as PT squeezes calf
    • (+) Pain in back of leg
  58. Name test; tests what; describe; (+)
    • Image Upload
    • Navicular drop test
    • Medial longitudinal arch
    • Pt standing, Subtalar jt in neutral
    • Measure navicular height in full WB & relaxed
  59. Grade II inversion ankle sprain - subacute phase - PT - 2
    • Subacute - 2 weeks
    • Closed-chain strengthening
    • Proprioceptive exercises
  60. Anterior drawer test - done in what position of foot?
    20 PF
  61. Fixed forefoot varus malalignment - compensatory motions/postures - 4
    • Excessive mid tarsal or subtalar pronation
    • PF 1st ray
    • Hallux valgus
    • Excessive tibial; tibial & femoral; or tibial, femoral & pelvic IR
  62. Rearfoot varus vs. rearfoot valgus - deformity observed
    • Forefoot varus vs. forefoot valgus - deformity observed
    • ALL OBSERVED W/SUBTALAR JT IN NEUTRAL

    • Rearfoot varus - Rigid inversion of calcaneus
    • Rearfoot valgus - Eversion of calcaneus
    • Image Upload
    • Forefoot varus - Inversion of forefoot
    • Forefoot valgus - Eversion of forefoot
    • Image Upload
    • Image Upload

Card Set Information

Author:
Tanuisha
ID:
324113
Filename:
MSK_Ankle-Foot_ALL
Updated:
2016-12-28 18:13:58
Tags:
MSK Ankle Foot ALL
Folders:
MSK
Description:
MSK_Ankle-Foot_ALL
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