Chapter 9: Ankle and Leg Pathologies***

To allow for proper gait, the talocrural joint must provide ___ degrees of dorsiflexion during walking and ___ degrees during running as the opposite limb goes from the stance to the swing phase.

10; 15

Which of the following ligaments is assessed using the anterior drawer test of the ankle?

Anterior fibular

Which ligament is more commonly injured during supination of the ankle?

Anterior talofibular ligament

What portion of the tibia is primarily covered only by skin?

Anteromedial

All of the ligaments in the ankle are actually thickenings of the joint capsule with the exception of one. Which of the following is the extracapsular ankle ligament?

Calcaneofibular

Which ankle ligament is assessed with the talar tilt test for inversion?

Calcaneofibular

Which of the following structures can be palpated just posterior to the fibular head?

Common peroneal nerve

Which mechanism of injury is more likely to result in an injury to the lateral malleolus?

Compressive force from eversion

What test is used to elevate the lateral translation of the talus in the ankle mortise?

Cotton test

The tibial nerve is located in which of the four leg compartments?

Deep posterior compartment

When inspecting the posterior lower leg and ankle, unexplained redness and swelling of the posterior calf could indicate what pathology?

Deep vein thrombosis

What position does the ankle need to be placed in if you want to assess the distal syndesmosis while performing the external rotation test?

Dorsiflexion

The talocrural joint is a modified synovial hinge joint with one degree of freedom that results in which two movements?

Dorsiflexion and plantar flexion

Which of the following is the most common mechanism of injury for the distal tibiofibular syndesmosis?

Dorsiflexion and/or external rotation of the talus

What is the normal end-feel for plantar flexion?

Firm

A fracture of only the fibular shaft is often termed a ___ fracture.

Hugier

Which of the following is not a sign/symptom of anterior compartment syndrome?

Increased dorsiflexion strength

Which of the following is not an anatomical and physiological factor predisposing individuals to lateral ankle sprains?

Increased muscular strength

Which motion is not a result of closed-chain supination of the ankle?

Internal rotation at the hip

Which position is the closed-packed position of the ankle?

Maximal dorsiflexion

According to current research, what is suggested for early management of ankle sprains?

Pain free ROM exercises

Which of the following structures is not located in the deep posterior compartment?

Peroneus Longus

Which of the following is not contained in the anterior compartment?

Peroneus longus

The ankle must be in what position in order to palpate the dome of the talus?

Plantar flexion

The anterior talofibular ligament limits anterior translation of the talus on the tibia and tightens to provide support during what motion?

Plantar flexion

The ankle complex is least stable when it is in the open-packed position, which is a combination of what two motions?

Plantar flexion and inversion

An athlete presents in the athletic training room with pain in the shin area. Which of the following would give you the impression that the injury may be a stress fracture?

Point tenderness in the area of the shin

Which of the following disappears with an ankle sprain?

Sinus tarsi

Correct hand positioning for the anterior drawer test includes one hand stabilizing the leg while the other hand cups the calcaneus with the forearm supporting the foot in what position?

Slight plantar flexion (10-20 degrees)

An os trigonum injury forms when ___ separates from the ___.

Stieda's process; talus

In order for stress tests to achieve a high reliability, they require attention to detail when performing the test. Which of the following is the appropriate way to determine Kleiger test?

The foot and talus are externally rotated while the examiner maintains a stable leg

What portion of the tibialis posterior is most palpable?

The tendon of the muscle posterior to the medial malleolus

Which trauma or pathology is indicative of bony pain located anteriorly?

Tibial stress fracture

Which muscle of the deep posterior compartment is responsible for controlling pronation?

Tibialis posterior

Functional instability of the ankle involves all of the following findings except

abnormal stress test findings.

Which of the following is not a function of the fibula?

it provides medial stability to the ankle mortise

Which of the following is the difference between traumatic compartment syndrome and chronic exertional compartment syndrome?

onset of the injury

Which of the following describes correct patient positioning for the Thompson test?

prone with the foot off the table

What bony structure can be palpated approximately one finger's width inferior from the medial malleolus and serve as an attachment site for the spring ligament?

sustentaculum tali

Which two ligaments of the collective deltoid ligament tighten during dorsiflexion of the ankle?

tibiocalcaneal and posterior tibiotalar

What is the normal AROM for ankle plantar flexion?

0 to 50 degrees

Joint stability tests are most accurate when they are performed how many days following the injury?

4 to 7 days

Rearfoot inversion and eversion ROM allows ___ degrees of inversion from the neutral position and ___ degrees of eversion from neutral.

20; 5

It takes how long after symptom onset before stress fractures are visible on standard radiographs?

3 weeks