KNPE331 > Week 5 > Flashcards

Week 5 Flashcards

(92 cards)

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1
Q

Key structures of the foot and ankle to consider following injury

A
  • talus position (anterior?)
  • cuboid position (rotated?)
  • navicular position (rotated or dropped?)
  • base of the 5th (tender on palpation)
  • sesamoid bones
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2
Q

Where are the sesamoid bones located in the foot?

A
  • flexor hallucis brevis tendons
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3
Q

Origin of the plantar fascia

A
  • medial process of calcaneal tuberosity
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4
Q

Insertion of plantar fascia

A
  • proximal aspect of digits
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5
Q

Lateral ligaments of the foot

A
  • anterior talofibular (ATFL)
  • calcaneofibular (CFL)
  • posterior talofibular (PTFL)
  • anterior inferior tibiofibular (AITFL)
  • posterior inferior tibiofibular (PITFL)
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6
Q

What are the two most common ligaments impacted in a lateral ankle sprain?

A
  • ATFL
  • CFL
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7
Q

Ligaments of the medial ankle

A
  • deltoid ligament
  • spring ligament
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7
Q

4 Ligaments making up deltoid ligament

A
  1. Tibionavicular
  2. Tibiocalcaneal
  3. Tibiospring
  4. Tibiotalar
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8
Q

Role of the spring ligament

A
  • supports medial arch
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9
Q

Types of tibiotalar ligaments

A
  • anterior tibiotalar
  • posterior superficial tibiotalar
  • posterior deep tibiotalar
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10
Q

Key structures to consider of the medial ankle (tom, dick and harry)

A
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallicus longus
  • tibialis anterior
  • achilles
  • peroneal tendons
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11
Q

What are the deep plantar flexors?

A
  • tibialis posterior
  • flexor digitorum longus
  • flexor hallicus longus
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12
Q

Action of tibialis posterior

A
  • plantarflexion
  • inversion
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13
Q

Action of flexor digitorum longus

A
  • plantarflexion
  • toe flexion
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14
Q

Action of flexor hallucis longus

A
  • plantar flexion
  • big toe flexion
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15
Q

Action of tibialis anterior

A
  • dorsiflexion
  • inversion
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16
Q

Action of achilles

A
  • plantarflexion
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17
Q

What are the two peroneal tendons?

A
  • peroneus longus
  • peroneus brevis
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18
Q

Action of peroneus longus

A
  • eversion
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19
Q

Action of peroneus brevis

A
  • plantarflexion
  • eversion
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20
Q

Functional anatomy of tibialis anterior

A
  • eccentrically lowers longitudinal arch
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21
Q

Functional anatomy of tibialis posterior

A
  • stabilizer of longitudinal arch
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22
Q

Functional anatomy of plantar fascia

A
  • dynamic longitudinal arch support
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23
Q

Functional anatomy of anterior talus (what happens up the chain?)

A
  • limits dorsiflexion
  • leads to pronation at foot to compensate
  • causes internal rotation at tibia
  • valgus at knee
  • femur internally rotates
  • drop in hip
  • back pain
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24
Range of motion of the toes
- flexion - extension - abduction - adduction
25
Range of motion of the ankle- tibiotalar joint
- dorsiflexion - plantarflexion
26
Range of motion of the ankle- subtalar joint
- inversion - eversion
26
What is supination?
- combination of plantarflexion, inversion, adduction - causes sole of foot to face medially
27
What is pronation?
- combination of dorsiflexion, eversion and abduction - causes sole of foot to face laterally
28
Mechanism of injury of turf toe
- hyperextension of big toe
29
What is sprained in turf toe?
- sprain of 1st MTP plantar ligament
30
What are the signs and symptoms of turf toe?
- swelling - brusing - pain - loss of toe dorsiflexion ROM - weal hallux flexion
31
What can turf toe result in?
- instability of 1st MTP with gr 3 sprain
32
Treatment for turf toe?
- limit hyperextension - decrease inflammation
33
What is the mechanism of injury of runner's toe (subungual hematoma)?
- repeat trauma to end of toes
34
Signs and symptoms of runner's toe?
- pain and pressure under nail - discoloration of nail - nail falls off
35
What does runner's toe result from?
- foot sliding in shoe - tight or loose toe box - toes rubbing against end of shoe or each other - running downhill
36
Prevention of runner's toe
- proper shoe fitting - varied course/terrain
37
Where are the sesamoid bones located?
- embedded in flexor hallucis brevis tendons
38
Mechanism of injury of sesamoiditis
- repeat trauma to ball of foot
39
What does sesamoiditis result in?
- inflammation of sesamoid bones and FHB tendons
40
Signs and symptoms of sesamoiditis
- pain over sesamoids - swelling - limited big toe extension - weak/painful flexion
41
Treatment of sesamoiditis
- rest - treat inflammation - padded insoles
42
Role of plantar fascia
- shock absorber - support long arch
43
What can happen after inflammation of plantar fascia?
- degeneration of the plantar fascia
44
Mechanism of injury of plantar fasciitis
- poor biomechanics/overuse stress
45
Signs and symptoms of plantar fasciitis
- tender on palpation of medial calcaneus or along longitudinal arch - pain with 1st steps in morning - ankle/toe dorsiflexion stretch pain
46
What is the plantar fasciitis associated with?
- tight achilles
47
Treatment of plantar fasciitis
- find cause - retrain biomechanics - night splints - orthotics - shockwave - soft tissue mobility
48
Signs and symptoms of bunions (hallux valgus)
- big toe aligns towards 2nd toe - tender bump on medial metatarsophalangeal joint
49
What can bunions result from?
- genetics - poor foot mechanics - tight/narrow footwear
50
How can bunions be used as a red flag?
- signal of pronation which could be causing problems up the chain
51
How can we retrain foot mechanics?
- create a stable base - ie. balance exercises
52
How can a stable base be created?
- abduct toes - stack hip over knee over ankle - tighten core, chest up - pick other foot up
53
Tendonitis and shin splints mechanism of injury
- poor mechanics - overuse
54
Common structures affected in tendonitis and shin splints
- peroneal tendons - tibialis anterior - tom, dick and harry - achilles
55
Signs and symptoms of tendonitis and shin splints
- tender on palpation over inflamed tissues - pain with running - pain with resisted muscle testing or stretch of affected tissue
56
Treatment for tendonitis and shin splints
- correct mechanics - taping - proper footwear - insoles/orthotics
57
What is there a potential for with tendonitis and shin splints?
- stress fractures at muscle origin
58
Lateral ankle sprain mechanism of injury
- ankle inversion
59
Possible structures affected in a lateral ankle sprain
- ATFL - CFL - PTFL - AITFL - PITFL - peroneals - cuboid position? - base of 5th metatarsal?
60
Signs and symptoms of lateral ankle sprain
- "pop" - giving out - swelling - bruising - limping
61
Treatment for lateral ankle sprain
- sideline management - reduce inflammation - healing - return to play
62
Return to play test
- figure 8 test - start with large loop and get smaller and smaller
63
Mechanism of injury of medial ankle sprain
- ankle eversion
64
Possible structures affected in medial ankle sprain
- deltoid ligament - spring ligament - tom, dick, harry - navicular position
65
Signs and symptoms of medial ankle sprain
- "pop" - giving out - swelling - bruising - limping
66
Treatment of medial ankle sprain
- similar as lateral - retrain medial contractile tissues
67
Common fractures of foot and ankle
- jones fracture - metatarsal fractures - talus - calcaneus - fibula - tib-fib (often with dislocation)
68
Things to consider for injury management of fractures
- urgent vs non-urgent? - distal circulation? - monitor for shock - splint and send for x-rays
68
Surgical management of unstable fractures
- reduction - fixation
69
Surgical management of stable fractures
- immobilization
70
What is impacted in a Jones fracture?
- peroneus brevis avulsion of base of 5th metatarsal **always rule this out in a lateral ankle sprain
71
Mechanism of injury of Jones fracture?
- inversion sprain
72
Signs and symptoms of Jones fracture
- tender on palpation of base of 5th metatarsal - pain in weightbearing
73
Why should you always rule out lateral ankle sprain?
- ankle sprain symptoms may distract from jones fracture
74
Mechanism of injury of talus fracture
- severe ankle sprains - land from height - forced dorsiflexion
75
Signs and symptoms of talus fracture
- vary with severity - pain with weight bearing - loss of ROM
76
Mechanism of injury of calcaneus fracture
- fall/jump from height
77
Signs and symptoms of calcaneus fracture
- extreme pain - unable to WB
78
Mechanism of injury of fibula fracture
- direct blow - ankle sprain mechanism
79
Signs and symptoms of fibula fracture
- vary with severity
80
What to do as part of pre-tape assessment
- explain chosen tape job and why - ask permission - clear contraindications - check ROM that you want to limit (pre and post test) - check cap refill
81
Contraindications of taping (when not to tape)
- allergies to adhesives - immediately after injury - injury hasnt been fully assessed - return to play criteria not met - to areas of altered skin sensation - overnight - check that sport governing body allows tape
82
Indication of ankle taping (when to tape)
- chronic ankle instability from previous sprains - RTP following treatment of recent ankle sprain - when ankle bracing doesnt fit in athletic shoe properly or a sport does not permit bracing
83
Ankle testing
- drawer sign - talar tilt and eversion talar tilt - wedge test
84
Which ligament does the drawer sign test test?
- anterior talofibular ligament
85
Which ligament does the talar tilt test test?
- calcaneofibular ligament
86
Which ligament does the eversion talar tilt test test?
- deltoid ligament
87
Which ligament does the wedge test test?
- anterior inferior tibiofibular ligament
88
Indications of prowrap
- sensitivity to adhesives - hair
89
Indications of arch taping
- arch pain - medial tendonitis/osis - shin splints - bunions
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