Ankle, Foot, Toes (Exam 2) Flashcards

1
Q

25% of all sports related injuries are ____ ankle sprain.

A

Inversion

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2
Q

95% of all ankle sprains are of the ____ ligament complex, due to inversion sprains.

A

Lateral

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3
Q

Single ligament injured. (Usually anterior talofibular ligament)

A

1st Degree Sprain

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4
Q

Two ligament injured. (anterior talofibular and fibulocalcaneal)

A

2nd Degree Sprain

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5
Q

All three lateral ligaments injured. (anterior talofibular, posterior talofibular, fibulocalcaneal)

A

3rd Degree Sprain

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6
Q

Generally 1st and 2nd degree sprains can be effectively managed _______.

A

Non-operatively.

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7
Q
RICE
WBAT
Joint Protection (Braces, Orthoses, Tape, Cast)
AROM DF and Eversion
Isometric Exercises
A

Phase I - Maximum Protection

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8
Q
Weight Bearing without crutches
ROM and Isometrics without pain
Controlled Swelling
FWB
Concentric/Eccentric Exercises (Theraband/Ankle Weights)
Joint Protection
Proprioception Exercises
Avoidance of unwanted stresses
A

Phase II - Moderate Protection Phase

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9
Q
All resistive exercises
Ambulate without pain/limping
Approximately 4 weeks after injury
Joint protection during activities
Running (Straight-line Jogging 1st)
Jumping
Plyometrics
Proprioception Exercises
A

Phase III - Minimum Protection Phase

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10
Q

Complete deltoid ligament ruptures occur in combination with _____.

A

Ankle fractures

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11
Q

Two types of instabilities with chronic ankle sprains.

A

Mechanical Instabilities and Functional Instabilities

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12
Q

Laxity of the ankle ligaments. (Mechanical Instability)

A

Peroneus brevis is rerouted through a surgically constructed tunnel in distal fibula. Stabilizes the lateral ankle.

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13
Q

Rehab following surgical repair for mechanical instability.

A

Strict, rigid cast immobilization for 2 weeks. Followed by hinged rigid orthosis that allows limited ROM for 5-6 weeks. PROM DF and PF later immobilization phase.

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14
Q

Feeling of giving away. (Functional Instability)

A

Problems with strength, proprioception, and/or ligament stability.

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15
Q

Rehab for functional instability.

A

Close Chain Resistance Exercises (Cone Tapping)
Proprioception
Concentric/Eccentric Loading
Bracing for support

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16
Q

Sprain of the syndesmotic ligaments of the distal tib-fib joint. Example: Leg/Foot twist into ER (Football, Hockey, Soccer).

A

High Ankle Sprain

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17
Q

Instability of the peroneal tendons with resulting pain and disability. Example: DF with slight everted.

A

Subluxing Peroneal Tendons

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18
Q

Some patients have a loose ___ that supports tendons in the peroneal groove.

A

Retinaculum

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19
Q

Acute Injury Subluxing Peroneal Tendons

A

Rigid-cast immobilization and NWB for 6 weeks.

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20
Q

Chronic or Recurring Subluxing Peroneal Tendons

A

Surgical repair. (Bone block, rerouting, periosteal flaps, groove deepening, tendon slings).

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21
Q

Overuse injury resulting from repetitive micro trauma and accumulative overloading of the tendon.

A

Achilles Tendonitis

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22
Q

Localized pain at mid portion or distal third of the tendon, or where it inserts into the calcaneus.

A

Primary Feature (Achilles Tendonitis)

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23
Q

Decreased vascularity, aging, degeneration, increased pronation, poor gastroc/soleus flexibility, changing in training, poor footwear.

A

Causes of Achilles Tendonitis

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24
Q

One of the most common injuries in many sports, but is very prevalent in runners.

A

Achilles Tendonitis

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25
Q

Greater injury in Men > Women. Ages 35-45 usually.

A

Achilles Tendonitis

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26
Q

Chronic degeneration of tissue without inflammation.

A

Tendinosis

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27
Q

In most cases, _______ is the result of tendinosis not tendinitis.

A

Achilles Tendon Pain

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28
Q

Helps to control pronation.

A

Achilles Tendon

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29
Q

Excessive pronation, decreased DF ROM, decreased subtalar eversion.

A

Risk Factors of Achilles Tendonitis

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30
Q

Two Types of Achilles Tendinitis

A

Mid-portion, Insertional

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31
Q

Medial portion of tendon. Usually 2-6 cm above insertion.

A

Mid-portion Tendinopathy

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32
Q

Less common, deep surface of tendon. More resistant to treatment.

A

Insertional Tendinopathy

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33
Q

Bony enlargement at the back of the heel.

A

Haglund’s Deformity

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34
Q

Between achilles and calcaneus.

A

Bursitis

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35
Q

Calcified portions of achilles tendon.

A

Posterior Heel Spurs

36
Q

72 hours after injury (phase)

A

Inflammation

37
Q

1-4 weeks (phase)

A

Repair

38
Q

A long time! (phase)

A

Remodeling

39
Q

Rehab for Achilles Tendinopathy

A
Initially:
RICE
Ultrasound, Iontophoresis
Heel-lift in shoe
After acute pain subsides:
Gastroc/Soleus stretching
Progressive tendon loading
Eccentric training for gastro/soleus
40
Q

Educational Intervention, Unloading of Tendon, Gradual Reloading of Tendon, Prevention of Tendon Pain

A

EdUReP Model

41
Q

Time course of Intervention

A

Unload: Weeks, Reload: Months, Prevent: Years

42
Q

Braces applied in circumfrential manner to impose a compressive force.

A

Unload

43
Q

Tendon loading stimulates an acute increase of collagen synthesis, and increases degradation of collagen.

A

Tendon Reloading

44
Q

Excessive sudden PF. Usually occurs 3-4 cm proximal to achilles insertion. Mostly males 20-50.

A

Achilles Tendon Rupture

45
Q

Rehab for Achilles Rupture (Non-operative)

A

Immobilization 8 weeks. Regain strength, ROM, progressive strengthening.

46
Q

Rehab for Achilles Rupture (Surgical)

A

Immobilization 6 weeks. Progression of ROM, strength, and proprioception. Good results usually 6-9 months.

47
Q

Acute or chronic elevated tissue pressure with in a closed fascial space.

A

Compartment Syndromes

48
Q

Tibial fractures, direct trauma, muscle rupture, burns.

A

Causes of Compartment Syndrome

49
Q

Muscular contraction and exertion result in muscle hypertrophy, leading to increased intracompartmental pressure.

A

Exertional Compartment Syndrome

50
Q

Tibialis anterior, anterior tibial vein and artery, foot extensor muscles.

A

Anterior Compartment

51
Q

Superficial peroneal nerve, short and long peroneal muscles.

A

Lateral Compartment

52
Q

Soleus, plantaris, gastrocnemius tendons.

A

Superficial Posterior Compartment

53
Q

Posterior tibial muscle, peroneal artery and vein, tibial nerve, and posterior tibial nerve and vein.

A

Deep Posterior Compartment

54
Q

Acute Compartment Syndrome longer than 12 hours.

A

Severe and irreversible damage occurs.

55
Q

Bimalleolar fracture plus posterior margin of tibia.

A

Trimalleolar Fracture

56
Q

For ankle fractures avoid ___ and ___ motions.

A

Inversion and Eversion

57
Q

Vertical or axial load that drives or compresses tibia onto talus.

A

Pillon Fracture

58
Q

Caused by falls from height.

A

Calcaneus Fracture

59
Q

Falling from height and landing on foot in couched position.

A

Talus Fracture

60
Q

Apophysitis of the calcaneus. Boys ages 7-15. Posterior heel pain occurs during awakening and during/after activity.

A

Sever’s Disease

61
Q

Tibia bends slightly due to ground reaction forces.

A

Tibia Loading

62
Q

Pain which extends for at least 2 inches along the middle to bottom 1/3 of the shin. Aggravated by weight bearing activity, subsides with rest.

A

MTSS (Medial Tibial Stress Syndrome)

63
Q

Throbbing, aching, or burning pain along the medial aspect of the tibia. Increases as a run continues. Tenderness along the medial edge of the tibia and medial anterior tibia.

A

MTSS (Medial Tibial Stress Syndrome)

64
Q

Females twice as likely to develop _______.

A

MTSS

65
Q

Long distance runners are more likely to develop _________ compared to other athletes. Very common first few weeks of an athletic season.

A

Stress Fracture

66
Q

Training errors, amenorrhea, anorexia, osteoporosis, leg length discrepancies, forefoot varus, poor eating habits, and high arches.

A

Risk Factors for Stress Fractures

67
Q

Treadmill runners may be decrease risk for _____ due to less tibial strain.

A

Stress Fractures

68
Q

Most ____ occurs at the junction of the middle and distal one third, along the posterior medial surface.

A

Tibial Stress Fractures

69
Q

Navicular, 2nd or 3rd Metatarsals, Narrowest point of bone.

A

Common areas for Stress Fractures

70
Q

Localized dull ache that worsens with activity. Initially feels better during middle of runs. Tenderness at the fracture site. If activity continues will have pain at rest.

A

Stress Fractures

71
Q

Single Leg Hop Test

A

Stress Fracture

72
Q

Chronic inflammation of the plantar aponeurosis. Repetitive micro trauma.

A

Plantar Fasciitis (Heel Spur Syndrome)

73
Q

Another Chronic Plantar Fasciitis Name

A

Plantar Fasciosis

74
Q

Pain along medial border calcaneus on plantar surface. Worse in the morning, tender at medial tuberosity of balances and plantar aponeurosis.

A

Plantar Fasciitis

75
Q

Medial longitudinal arch, is reduced and medial border of foot contracts ground in standing (Foot Flat).

A

Pes Planus

76
Q

Abnormally high arch. Painful calluses beneath metatarsal heads due to friction and pressure.

A

Pes Cavus

77
Q

Neuroma usually located between 3rd and 4th metatarsals. Diffuse pain, occasionally radiating distally to toes and proximally to dorsal or plantar surface of foot (Burning, Cramping, Catching). Painful mass.

A

Morton’s Neuroma

78
Q

Lateral (valgus) deviation of the great toe with soft tissue and bony deformity. (Bunions)

A

Hallux Valgus

79
Q

MTP Neutral or Extended
PIP Flexion
DIP Flexion or Extended

A

Hammer Toes

80
Q

MTP Hyperextension
PIP Flexion
DIP Flexion

A

Claw Toe

81
Q

MTP Neutral
PIP Neutral
DIP Flexed

A

Mallet Toe

82
Q

Allows greater joint movement. Needed for accommodating shock and irregular terrain.

A

Pronation

83
Q

Joints become less mobile. Necessary for effective push off.

A

Supination

84
Q

To correct forefoot varus.

A

Medial Post

85
Q

To correct forefoot valgus.

A

Lateral Wedge

86
Q

To correct rearfoot varus.

A

Medial Posting