chapter 16 foot, ankle & lower leg

pes cavus

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

not permit the individual to participate in activities until being seen by a physician

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

hallus valgus

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

plantar flexion & inversion

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

does the outside of your ankle hurt? If it is swollen it may be grade 1, can you walk a little bit?

You are a high school soccer coach. One of the players sustains an injury during a scrimmage at the end of practice. The player attempts to get up and continue, but he appears to be in pain. Following your assessment, you suspect that the individual has sustained a grade I inversion sprain. How would you explain your suspicion to the player?

rest, ice, compression, elevation

You are a high school soccer coach. One of the players sustains an injury during a scrimmage at the end of practice. The player attempts to get up and continue, but he appears to be in pain. How would you manage this condition?

subtalar joint

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

resisted plantar flexion

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

false

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

talocrural joint

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

false

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

true

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

medial tibial stress syndrome

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

jamming the toe into the end of the shoe

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

30-50

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

true

Although a normal amount of pronation is useful in reducing the peak forces sustained during foot impact, excessive or prolonged pronation can lead to several overuse injuries. A.True B. False

false

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

true

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

Lateral malleolus projects further down than medial malleolus Joint is most open in plantar flexion Weakness in peroneal Decreased ROM in Achilles tendon

Identify 4 factors that predispose individuals to an inversion sprain?

true

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

false

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

1 & 2 because the signs & symptoms are the same

In an eversion ankle sprain, is it more difficult to differentiate between a grade 1 and grade 11 injury or a grade II and grade III injury? Explain your response.

grade 2 and grade 3 because both are very similar with impaired function, "pop" heard, and the swelling

In an inversion ankle sprain, is it more difficult to differentiate between a grade 1 and grade 11 injury or a grade II and grade III injury? Explain your response.

ATFL

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

true

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

calacaneal inversion, foot adduction, plantar flexion

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

hallux

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

application of cold, total rest, immediate referral to an emergency room

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

plantar flexion

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

deltoid ligament

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

Because the 4 compartments of the lower leg are non-yielding, trauma to a compartment can result in increased pressure to the tissues contained within in it, including nerves and blood vessels. The condition is considered a medical emergency because of the potential for comprised neurovascular functions. Signs and symptoms include: ·a recent history of trauma (i.e., direct blow) ·increasing severe pain and swelling appear to be out of proportion to the clinical situation. ·a firm mass, tight skin (because it has been stretched to its limits) ·loss of sensation on the dorsal aspect between the great toe and second toe ·diminished pulse at the dorsalis pedis

The lower leg is divided into compartments. How does this impact injury to the lower leg? What is acute compartment syndrome? What are the signs and symptoms of an anterior acute compartment syndrome?

Foot: second metatarsal Leg: middle 1/3 of tibia Repetitive forces (compression) & repetitive stress in running, jumping, increased training, change in surface/footwear

What are the most common sites for stress fractures in the foot and lower leg? What factors contribute to the development of a stress fracture?

changing running distance, intensity, form, shoes, surface.

What factors contribute to medial tibial stress syndrome? Where will individuals with this injury have point tenderness on palpation?

physical conditioning, strengthening of extrinsic & intrinsic muscles, flexibility, footwear & protective equipment

What strategies would be appropriate in the prevention of foot, ankle, & lower leg injuries?

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

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

inversion sprain

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

hypermobile feet

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

a sign on an achilles tendon rupture is that the individual hears a "pop" in the posterior ankle

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

The severe valgus deformity at the first MTP joint compromises the bony and soft tissue stability at the joint, increasing susceptibility to acute tension stress (such as the hyperextension force associated with a turf toe injury)

Why does hallux valgus make an individual more susceptible to turf toe?

It is excessive in pronation

Why is a hypermobile foot a predisposing factor for an eversion sprain?

Because of the absence of muscular or adipose padding, force is not dissipated and the periosteum receives the impact.

Why is the shin vulnerable to compression-type forces? What is the primary concern with repeated shin contusions?

What's wrong? What happened? What were you doing? Are you able to demonstrate how it happened? Describe the pain on a scale for 1-10. Did you hear anything? Have you injured this before?

You are a high school soccer coach. One of the players sustains an injury during a scrimmage at the end of practice. The player attempts to get up and continue, but he appears to be in pain. What questions would you ask as a part of the history component of an assessment of this condition?

true

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