Deck 9: Ankle and Leg Pathologies

Question 1

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

A) Flexor hallucis longus
B) Peroneus longus
C) Tibialis posterior
D) Flexor digitorum longus

Answer 1

B

Question 2

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

A) Plantar flexion
B) Anatomical joint neutral
C) Slight plantar flexion
D) Maximal dorsiflexion

Answer 2

D

Question 3

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

A) It serves as a site of muscular origin and attachment.
B) It serves as a site of ligamentous attachment.
C) It provides medial stability to the ankle mortise.
D) It serves as a pulley to increase the efficiency of the muscles that run posteriorly to it.

Answer 3

C

Question 4

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

A) Signs of the injury
B) Onset of the injury
C) Symptoms of the injury
D) Treatment of the injury

Question 5

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

A) 1 week
B) 2 weeks
C) 3 weeks
D) 6 weeks

Question 6

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

A) Paresthesia in the web space between the first and second toes
B) Decreased ability to extend the toes
C) Absence of the dorsalis pedis pulse
D) Increased dorsiflexion strength

Question 7

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

A) Dorsiflexion and/or external rotation of the talus
B) Dorsiflexion and/or internal rotation of the talus
C) Plantar flexion and/or external rotation of the talus
D) Plantar flexion and/or internal rotation of the talus

Question 8

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?

A) Diffuse pain in the area of the shin
B) Point tenderness in the area of the shin
C) Pain with rest
D) Night pain

Question 9

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 a Kleiger test?

A) The knee is bent and the foot and tibia are externally rotated while the examiner maintains a stable femur.
B) The foot and talus are internally rotated while the examiner maintains a stable leg.
C) The foot and talus are externally rotated while the examiner maintains a stable leg.
D) The foot is plantar flexed and dorsiflexed while the examiner maintains a stable leg.

Question 10

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

A) Inversion and eversion
B) Dorsiflexion and plantar flexion
C) Flexion and extension
D) Pronation and supination

Question 11

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

A) Anterior talofibular
B) Calcaneofibular
C) Posterior talofibular
D) Deltoid

Question 12

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

A) Calcaneofibular
B) Anterior talofibular
C) Posterior talofibular
D) Deltoid

Question 13

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

A) Internal rotation at the hip
B) External tibial rotation
C) Knee extension
D) External rotation at the hip

Question 14

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

A) Tibialis posterior
B) Flexor hallucis longus
C) Flexor digitorum longus
D) Soleus

Question 15

What is the normal active range of motion (ROM)for ankle plantar flexion?

A) 0° to 75°
B) 0° to 20°
C) 0° to 60°
D) 0° to 50°

Question 16

What is the normal end-feel for plantar flexion?

A) Hard
B) Soft
C) Bony
D) Firm

Question 17

Which of the following disappears with an ankle sprain?

A) Sinus tarsi
B) Lateral malleolus
C) Base of the fifth metatarsal
D) Dorsalis pedis pulse

Question 18

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

A) Tibialis anterior
B) Peroneus tertius
C) Extensor hallucis longus
D) Peroneus longus

Question 19

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

A) Anterior talofibular
B) Anterior tibiofibular
C) Calcaneofibular
D) Deltoid

Question 20

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

A) Peroneus longus
B) Lateral meniscus
C) Common peroneal nerve
D) Peroneal artery

Question 21

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

A) Triceps surae strain
B) Achilles tendinopathy
C) Deep vein thrombosis
D) Tibial stress fracture

Question 22

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

A) Decreased proprioceptive ability
B) Tightness of the triceps surae muscle group
C) Increased muscular strength
D) Lack of muscular coordination

Question 23

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

A) Tibiocalcaneal and posterior tibiotalar
B) Tibiocalcaneal and tibionavicular
C) Tibionavicular and posterior tibiotalar
D) Anterior tibiotalar and tibionavicular

Question 24

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

A) 20; 5
B) 15; 10
C) 10; 15
D) 5; 20

Question 25

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

A) abnormal stress test findings.
B) proprioceptive and neuromuscular deficits.
C) decreased strength.
D) decreased postural control.

Question 26

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.

A) 2; 7
B) 5; 10
C) 10; 15
D) 15; 20

Question 27

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

A) Tibial stress fracture
B) Fibular stress fracture
C) Calcaneal fracture
D) Anterior compartment syndrome

Question 28

The ankle complex (talocrural and subtalar joints)is least stable when it is in the open-packed position,which is a combination of what two motions?

A) Plantar flexion and eversion
B) Plantar flexion and inversion
C) Dorsiflexion and eversion
D) Dorsiflexion and inversion

Question 29

What portion of the tibialis posterior is most palpable?

A) The muscle belly
B) The muscle at its origin
C) The muscle at its insertion
D) The tendon of the muscle posterior to the medial malleolus

Question 30

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

A) Eversion
B) Inversion
C) Plantar flexion
D) Dorsiflexion

Question 31

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

A) Anterolateral
B) Anteromedial
C) Posterolateral
D) Posteromedial

Question 32

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

A) Anterior compartment
B) Lateral compartment
C) Superficial posterior compartment
D) Deep posterior compartment

Question 33

Joint stability tests (stress testing and special tests)are most accurate when they are performed how many days following injury?

A) 1 to 2 days
B) 2 to 4 days
C) 4 to 7 days
D) 7 to 10 days

Question 34

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

A) Neutral
B) Dorsiflexion
C) Plantar flexion
D) Inversion

Question 35

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

A) Sustentaculum tali
B) Cuboid
C) Navicular bone
D) Peroneal tubercle

Question 36

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

A) Supine with the foot on the table
B) Supine with the foot off the table
C) Prone with the foot on the table
D) Prone with the foot off the table

Question 37

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

A) Talar tilt test
B) Anterior drawer test
C) Kleiger's test
D) Cotton test

Question 38

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?

A) Neutral
B) Slight plantar flexion (10° to 20°)
C) Slight dorsiflexion (10° to 20°)
D) Slight inversion (5° to 10°)

Question 39

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

A) Anterior talofibular ligament
B) Posterior talofibular ligament
C) Calcaneofibular ligament
D) Anterior tibiofibular ligament

Question 40

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

A) Dorsiflexion
B) Plantar flexion
C) Inversion
D) Eversion

Question 41

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

A) Immobilization
B) Weight-bearing ambulation
C) Pain-free range-of-motion (ROM) exercises
D) Taping and bracing

Question 42

An os trigonum injury forms when _____________ separates from the __________.

A) Stieda's process; talus
B) the sustentaculum tali; calcaneus
C) the navicular tuberosity; navicular
D) the lateral facet; talus

Question 43

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

A) trimalleolar
B) Hugier
C) Maisonneuve
D) stress fracture

Question 44

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

A) Tensile force from eversion
B) Compressive force from eversion
C) Tensile force from plantar flexion
D) Compressive force from plantar flexion