Lower leg pathology
Terms
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- movements at talocrural joint
- plantar flexion dorsiflexion
- movements at subtalar joint
- inversion eversion
- inversion ankle sprain
- involve lateral ligaments of ankle
- eversion ankle sprain
- involve medial ligaments of ankle
- high ankle sprain
- dorsiflexion injury; involves tibiofibular ligaments ATF & PTF long healing time
- inversion sprain history
- roll in w/ slight plantar flexion
- lateral ankle ligaments
- anterior talofibular (ATF), calcaneofibular (CF), posterior talofibular (PTF)
- most commonly sprained ankle ligament
- ATF
- medial ankle ligament
- deltoid ligament
- grade 1 ankle sprain
- only ATF involved
- grade 2 ankle sprain
- ATF & CF involved
- grad3 # ankle sprain
- ATF, CF & PTF involved
- ankle sprain treatment
- RICE, protection (horseshoe pad w/ ace wrap), wrap distally tight, work proximally & looser
- chronically weakened tendons
- can rupture
- peroneal tendonitis
- can avulse 5th met
- Achilles’ tendon rupture MOI
- forceful contraction or overstretch
- Achilles’ tendon rupture observation
- visible deformity “window shade effectâ€
- Achilles’ tendon rupture s/s
- can’t plantarflex, audible pop, severe pain
- Achilles’ tendon rupture commonly injured
- weekend warriors
- Achilles’ tendon rupture common location
- 2-6 cm above attachment b/c most avascular area of tendon
- ankle tendinits history
- usually overuse
- difference between tibial and fibular fractures
- tibial fractures create long-term problems if mismanaged, fibular fractures have shorter immobilization
- stress fractures MOI
- repetitive loading, usually to tibia, onset gradual
- medial tibial stress syndrome
- shin splints
- shin splints palpation
- pt tenderness over larger area, tuning fork will keep vibrating
- shin splints treatment
- tape attachment or arch as necessary
- tibialis posterior strengthening
- inversion, toe curling
- compartment syndromes
- acute trauma or repetitive trauma/ overuse
- compartment syndromes most likely location
- anterior compartment or deep posterior compartment, but can occur in any
- name the 4 lower leg compartments
- lateral, anterior, superficial posterior, deep posterior
- actions in superficial posterior compartment
- plantar flexion, toe flexion
- actions in deep posterior compartment
- (medial) inversion, plantar flexion, toe flexion
- actions in lateral compartment
- eversion
- actions in anterior compartment
- dorsiflexion, extend toes
- 2 kinds of compartment syndrome
- exertional compartment syndrome, acute compartmental syndrome
- exertional compartment syndrome
- goes away w/o activity, not a medical emergency
- exertional compartment syndrome treatment
- fasciotomy to increase space; pressure is measured w/ a needle
- acute compartmental syndrome
- medical emergency; swelling can’t get out of compartment & puts pressure on nerves & blood, results in necrosis
- most common acute compartment syndrome
- anterior which leads to a dropped foot
- acute compartmental syndrome palpation
- check pulses, skin temp, capillary refill
- acute compartmental syndrome observation
- skin looks tight & glossy