ankle

Question 1

subtalar rom

Answer 1

inversion 0-5

eversion 0-5

Question 2

talocrural ankle rom

Answer 2

PF 50

DF 20

Question 3

talocrural open pack

Answer 3

10 PF

Question 4

talocrural closed pack

Answer 4

full DF

Question 5

midtarsal, transverse tarsal, chopart rom

Answer 5

inversion 35

eversion 15

Question 6

pathology?

• Partial tear of the lateral ligament complex with mild joint instability,
• moderate intra- capsular swelling and tenderness,
• some loss of ROM and joint function

Answer 6

moderate Grade II right lateral ankle sprain

Question 7

pathology?

• Complete rupture of the anterior talofibular ligament, calcaneofibular ligament, and capsule with mechanical joint instability;
• severe intra/extra-capsular swelling, ecchymosis,
• tenderness
• inability to weight-bear.

Answer 7

severe or Grade III lateral ankle sprain

Question 8

pathology?

• Stretch of the lateral ligament complex with no macroscopic tear or joint instability,
• little swelling or tenderness

Answer 8

mild or Grade I lateral ankle sprain

Question 9

pathology?

• Partial tear of the syndesmosis,
• creating generalized swelling and tenderness throughout the ankle joint complex;
• inability to bear weight,
• severe ecchymosis,
• mortise widening.

Answer 9

high ankle sprain, Syndesmosis sprain

Question 10

purpose?
Talar tilt test
ankle inversion stress test

Answer 10

torn calcaneofibular ligament, inversion sprain

resists inversion of the talus within the midrange of talocrural motion

Question 11

purpose?

Anterior drawer test

Answer 11

sprain of the anterior talofibular ligament, inversion sprain
- resists inversion of the talus and calcaneus and is taut during plantar flexion.

Question 12

purpose?

Ottowa rules

Answer 12

rule out fracture and is used as a common screening

Question 13

what test? purpose?
Patient prone and asked to relax as the therapist squeezes the muscle bellies of the gastrocnemius and soleus.
Positive: absence of plantar flexion.

Answer 13

Thompson Test

Achilles tendon rupture.

Question 14

DF needed for gait, what phase?

Answer 14

10deg DF for midstance

Question 15

PF needed for gait, what phase?

Answer 15

20deg PF

preswing (pushoff)

Question 16

purpose?

ankle eversion stress test

Answer 16

deltoid ligament integrity

Question 17

purpose?

posterior drawer test on ankle

Answer 17

posterior talofibular ligament

- resists posterior translation of the talus and is the strongest of the lateral ligaments

Question 18

pathology?

• due to excessive eversion forces with the ankle in plantar flexion, dorsiflexion or neutral.
• frequently accompanied by an avulsion fracture of the distal tibia.

Answer 18

medial ankle sprains - deltoid ligament

Question 19

risk factors achilles tendon rupture?

Answer 19

• males
• between the ages of 30 and 50
• who exercise inconsistently (e.g., “weekend warriors”).
• Racquet sports, basketball, agility sports - requires frequent and sudden changes in direction as well as rapid acceleration.

Question 20

what test? purpose?
Patient supine, actively extend his knee.
Once the knee is extended the examiner raises the patient’s straight leg to 10 degrees, then passively and abruptly dorsiflexes the foot and squeezes the calf with the other hand.
Positive: Deep calf pain and tenderness may indicate

Answer 20

Homans’ sign - detection of a deep vein thrombosis in the lower leg.
The test lacks specificity and therefore a positive finding cannot be considered conclusive without the use of more formal diagnostic tests.

Question 21

what pathology?

• serious medical condition that causes compression of nerves and blood vessels in an anatomical space (eg. anterior leg).
• dangerous disruption of nerve conduction and blood flow that can threaten the viability of the limb.
• Symptoms include severe, unyielding pain in the affected area as well as a tight, shiny skin appearance, and weakness.
• associated with a trauma that has occurred in the area of the complaint.

Answer 21

Compartment syndrome

Question 22

talocrural joint motions?

movement with supination and pronation?

Answer 22

DF, PF
talocrural joint
- laterally (externally) rotates with supination
- IR with pronation

Question 23

Ottawa Ankle Rules

need radiograph if

Answer 23

pain present in the malleolar zone AND ANY ONE of the following are present:
Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus
OR
Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus
OR
An inability to bear weight both immediately and in the emergency department for four steps