KNES CH 16 Foot, Ankle, and Lower Leg Conditions

10. A common mechanism of injury for a turf toe is A. Wearing shoes that don't fit properly B. Jamming the toe into the end of the shoe C. Increase in training D. Severe

B. Jamming the toe into the end of the shoe

3. The ligaments that stabilize the lateral aspect of the ankle include each of the following except the: A. anterior talofibular ligament B. deltoid ligament C. posterior talofibular ligament D. calcaneofibular ligament

B. deltoid ligament

9. The immediate management of a suspected acute compartment syndrome includes I) Application of cold II) Application of a compression wrap III) Elevation of the lower leg IV) Total rest V) Immediate referral to an emergency room VI) Referral to a physician prior to return to activity A. I, II, III, IV, and V B. I, II, III, IV, and VI C. I, IV, and V D. I, IV, and VI

C. I, IV, and V

24. Because the lateral malleolus extends further down than the medial malleolus, inversion sprains are more common than eversion sprains. A. True B. False

true

28. Turf toe is a sprain of the plantar capsular ligament of the first MTP joint. A. True B. True

true

30. Stress fractures of the tibia and fibula result from repetitive stress to the leg leading to muscle fatigue. A. True B. False

true

S&S of medial tibial stress syndrome

-dual ache- pain -early vs later stages; performance -pain with resisted plantar flexion or standing on toes

S&S of acute compartment syndrome

-hx of trauma -increasingly severe pain- out of proportion to situation (pain is more severe when muscles stop moving and contracting; pressure builds) -Firm and tight skin over anterior shin -loss of sensation between 1st and 2nd toes (dorsum) -diminished pulse- dorsalis pedis functional abnormalities within 30 mins

contributing factors of medial tibial stress syndrome

-intensity- speed work -frequnecy -form -shoes -surface

S&S of eversion ankle sprain

-mild to moderate injuries (both grade 1 and 2) *initial pain, but often subsides, individual continues to play *swelling may or may not be evident *often able to not recall MOI -severe *they will know what happened and there will b loss of function (stability compromised)

S&S of achilles tendon rupture

-pop -feeling of being shot/kicked in heel -visible defect -unable to stand on toes/ balance on affected leg -excessive passive dorsiflexion

Etiology of stress fractures

-running -jumping -increase in training -change in surface -footwear

management of ankle sprains

-standard acute care: crutches if necessary -physician referral (especially if impaired function

Grade 2 Ankle Sprain

-tear fibers ATF ligament and stretch/ tear fibers of CF ligament -hear a pop -feel tearing sensation -impaired function

Grade 3 ankle sprain

-tearing ATF ligament and post talofibular ligament -loss of function

8. Which of the following is a common injury associated with pes planus? A. peroneal tendonitis B. plantar fasciitis C. metatarsalgia D. medial tibial stress syndrome

D. medial tibial stress syndrome

Explain ankle stability of bony

mild

Describe the three areas that should be addressed with regard to prevention of injury to the foot, ankle, and lower leg: protective equitment

shin guards, ankle braces, and orthotics

management of gastrocnemius contusion

-cold w/ gentle stretch -if symptoms persist > 2-3 days physican referral -no compression wrap; non-yielding compartment- would make tighter

most common type of stress fracture

2nd metacarsal (neck) (in foot) middle 1/3rd in tibia (leg)

The _______ is the main body stabilizer during walking or running. A. hallux B. metatarsal arch C. talocrural joint D. subtalar joint

A. Hallux

23. True or False? Management of a contusion to the gastrocnemius includes the application of cold and placing the muscle in a stretched position. A. True B. False

A. True

2. The true ankle joint is the A. talocalcaneonavicular joint B. calcaneocuboid joint C. subtalar joint D. talocrural joint

A. talocalcaneonavicur joint

6. Prolonged pressure against the medial aspect of the first MTP joint that leads to thickening of the medial capsule and bursa and results in a severe valgus deformity of the great toe is referred to as A. Hallus rigidus B. Hallus valgus C. MTP sprain D. Claw toe

B. Hallus valgus

14. Which of the following predisposes an individual to eversion ankle sprains? A. pes cavus B. hypermobile feet C. hypomobile feet D. pes planus

B. hypermobile feet

18. Acute rupture of the Achilles tendon is more commonly seen in individuals between the ages of A. 15 to 20 B. 20 to 30 C. 30 to 50 D. Over 50

C. 30 to 50

16. Which of the following is correct? A. An individual who has sustained a grade I inversion ankle sprain will report hearing a "pop" and will be able to bear weight immediately after the injury B. Swelling and ecchymosis are accurate indicators of the severity of an inversion sprain C. An individual who has sustained a grade II inversion ankle sprain will be able to bear some weight, but definitely walks with a limp. D. An individual who has sustained a grade III inversion ankle sprain will report hearing a "pop" and be able to bear some weight, but definitely walks with a limp.

C. An individual who has sustained a grade II inversion ankle sprain will be able to bear some weight, but definitely walks with a limp.

12. The common mechanism for a lateral ankle sprain is A. Dorsiflexion and inversion B. Dorsiflexion and eversion C. Plantar flexion and inversion D. Plantar flexion and eversion

C. Plantar flexion and inversion

4. Supination is the combination of the movements of: A. calacaneal eversion, foot abduction, dorsiflexion B. calacaneal eversion, foot adduction, plantar flexion C. calacaneal inversion, foot adduction, plantar flexion D. calacaneal inversion, foot abduction, plantar flexion

C. calacaneal inversion, foot adduction, plantar flexion

5. Inversion and eversion movements occur primarily at the: A. talocrural joint B. intertarsal joints C. tarsometatarsal joints D. subtalar joint

D. subtalar joint

What is an individual often able to continue to play even with a moderate eversion ankle sprain?

as the ankle goes back to normal anatomical position after the injury the pain subsides

What etiological factors are associated with stress fracture to the foot and lower leg?

changes in surface, intensity, or shoe type.

management of acute compartment syndrome

cold, no compression/elevation, immediate physician referral

MOI of Acute Compartment Syndrome

direct blow; anterolateral

MOI of eversion ankle Sprain

excessive dorsiflexion and eversion

contributing factors of inversion ankle sprain

excessive supination,

What is pes canvus?

excessively high arch, rigid foot

25. In an acute compartment syndrome, signs of neurovascular compression will develop after the individual stops exercising. A. True B False

false

27. The mechanism of injury for an acute compartment syndrome is typically related to training errors (e.g., too much activity too soon.) A. True B. False

false

29. As stress is applied to the ankle during plantar flexion and inversion, the first ligament to tear is the calcaeofibular ligament. A. True B. False

false

How do the signs and symptoms of a 1st and 2nd degree inversion sprain differ?

in grade 1- theres minimal loss of function and in grade 2- hear a pop noise, tearing sensation, and impaired function

S&S of stress fractures

incidious onset; pain increase activity -decrease rest

The most common type of ankle sprain is an inversion sprain. Why?

inversion sprains happen due to there being no protection on the outter side of the leg. Eversion sprains dont happen as often due to there being another leg medially to protect it

contributing factors of turf toe

jamming toe into shoe, repetative overload

management of stress fractures

physician referral

What are the motions of the ankle joint?

plantarflexion and dorsiflexion

MOI inversion of ankle sprain

plantarflexion and inversion

MOI medial tibial stress syndrome

prolonged pronation -- eccentric contraction (tension) (muscle weakens could not absorb shock anymore; stress put into bone)

How can footwear aid in treating turf toe?

wearing a stiff shoe that wont let your toe move can help the healing process and can help the injury from worsening

21. The type of footwear worn for an activity has minimal impact on the prevention of injuries to the foot and ankle. A. True B. False

B. False

MOI For Stress Fractures

foot- repetative forces (compression)

MOI Achilles Tendon Rupture

push of forefoot while knee is extending

S&S of gastrocemius contusion

-immediate pain/weakness -rapid hemorrhage --> palpable mass

how long does it take for irrevrsibile damage to occur with acute compartment syndrome?

12-24 hours

13. In an inversion ankle sprain, the first ligament to tear is the A. Anterior talofibular ligament (ATFL) B. Calcaneofibular ligament (CFL) C. Posterior talofibular ligament (PTFL) D. Deltoid ligament

A. Anterior talofibular ligament (ATFL)

7. An excessively high arch that does not flatten during weight bearing is referred to as A. pes cavus B. pes planus C. plantar fasciitis D. hallus rigidus

A. pes cavus

11. The least stable position of the ankle is A. Dorsiflexion B. Plantar flexion C. Inversion D. Eversion

B. Plantar flexion

17. An individual reports to the coach with a complaint of localized tenderness over the Achilles tendon that began approximately two weeks earlier, morning stiffness to the area, and pain with active and passive motions involving the Achilles tendon. The coach should A. Assess the condition B. Permit the individual to participate in activities as normal, but encourage the individual to see a physician as soon as possible C. Not permit the individual to participate in activities until being seen by a physician D. Apply ice and compression to the area as well as fit the individual for crutches

C. Not permit the individual to participate in activities until being seen by a physician

20. Medial tibial stress syndrome is aggravated by: A. passive plantar flexion B. active plantar flexion C. resisted plantar flexion D. active dorsiflexion

C. resisted plantar flexion

S&S of inversion ankle injury

Grades 1-3

What is pes planus?

flat foot; typically acquired deformity resulting from injury/trauma

Describe the three areas that should be addressed with regard to prevention of injury to the foot, ankle, and lower leg: physical conditioning

flexibility, strengthening exercises for intrinisic and extrinsic muscles

How can footwear contribute to the onset of turf toe?

footwear that grips playing surfaces (cleats), high heels, all can put extensive pressure on the big toe

Grade 1 Inversion Ankle Sprain

minimal loss of function stretching of ATF ligament pointender at ligament

Explain ankle stability of ligamentos

moderate

Explain ankle stability of muscular

moderate\

MOI of turf toe

moi: hyperextention of the great toe

What age group is more susceptible to an Achilles tendon rupture?

over the age of 30

What are some potential contributing factors for medial tibial stress syndrome?

repetative activity on hard surfaces

If an acute compartment syndrome is not managed properly, irreversible damage can occur within 12 - 24 hours. A. True B. False

true

MOI Gastrocnemius contusion

compression

19. Which of the following statements is true? A. A sign of an Achilles tendon rupture is that the individual hears a "pop" in the posterior ankle. B. An individual with an Achilles tendon rupture will be able to balance on the affected leg. C. A suspected Achilles tendon rupture requires summoning of EMS D. Achilles tendon ruptures typically occur at the musculotendinous junction.

A. A sign of an Achilles tendon rupture is that the individual hears a "pop" in the posterior ankle.

15. Which of the following is the most common ankle sprain? A. Inversion sprain B. Eversion sprain C. Syndesmosis sprain D. No one ankle sprain is more common than another

A. Inversion sprain

Describe the three areas that should be addressed with regard to prevention of injury to the foot, ankle, and lower leg: footwear

foot, heel, and arch support depending on the activity

S&S of turf toe

pain: pt, swelling - plantar aspect of MP joint extreme pain with extention

management of achilles tendon rupture

standard acute care physician referral

management of turf toe

standard acute care: RICE key: rest-protection from excessive motion

What is the true ankle joint?

talocalcaneonavicur joint

Why does valgus deformity at the 1st MP joint increase susceptibility to turf toe?

the distal end joint goes outward