Ankle Diseases, Injuries and Treatments (Msq Drill 179)

1. Does the deltoid complex have a superficial and a deep layer?

Yes, it has two layers

No, it has one layer only

2. What grade is: laxity and abnormal motion on exam is present, weight bearing very difficult

Grade 1

Grade 2

Grade 3

3. What grade : gross instability, unable to weight bear

Grade 1

Grade 2

Grade 3

4. Grade 1 – no laxity, can weight bear, mild injury

True or false?

True

False

5. The most commonly injured ligament in ankle injuries is the:

Calcaneofibular ligament

Deltoid ligament

Anterior talofibular ligament

6. Can you order physical therapy for LCL sprains. True or false?

True

False

7. One should remember that in syndesmosis injuries there is usually an accompanying high ankle injury true or false?

True

False

8. Why would you perform an external rotation test or squeeze test on a patient. What are you suspecting?

Low ankle injury

High ankle injury

9. Is a medial ankle sprain common?

Yes

No

10. Peroneal tendonitis is frequently misdiagnosed as:

Medial ankle sprain

Lateral ankle sprain

11. Can peroneal tendonitis becone cnronic?

Yes

No

12. Where would you feel tenderness in a patient with peroneal tendonitis?

Posterior to the lateral malleolus

Anterior to the lateral malleolus

Posterior to the medial malleolus

Anterior to the medial malleolus

13. You might order an x-ray in a patient with peroneal tendonitis to look for shelf like fractures around the lateral or medial malleolus. True or false?

Lateral malleolus

Medial malleolus

14. What is the largest tendon in the human body?

Tibialis anterior tendon

Tibialis posterior tendon

Achilles tendon

15. Overuse from athletic activities can cause achilles tendonitis. True or false?

True

False

16. The mechanism of injury usually determines the type of ankle fracture. True or false?

True

False

17. An achilles tendon should always be injected with a steroid. True or false?

True

False

You should NEVER inject the achilles tendon with steroids.

Explanation

You should NEVER inject the achilles tendon with steroids.

18. When you treat fractures you should use a c-arm. True or false?

True

False

19. Does a maisonneuve fracture usually involve syndesmotic injury?

Yes

No

20. Both posterior and anterior ankle impingements can occur. True or false?

True

False

21. In an x-ray of a talus in which treatment for avascular was carried out you observe a subchondral radioluscent band. Is this a negative or positive Hawkins sign?

Positive

Negative

22. Can the calcaneal prominence that sticks out in Haglunds deformity cause problems with the bursa or achille's tendon?

Yes

No

23. Surgery is often the only treatment for Haglund's deformity. True or false?

True, surgery is the only treatment for resection of the prominence

False, RICE, heel lifts, PT, immobilization and modifying shoewear. surgery is seldom necessary.

24. If you inject lidocaine in the peroneal tendon and the pain goes away, does this confirm the diagnosis?

Yes

No

25. If conservative treatment fails is surgery an option for peroneal tnedonitis?

Yes

No

26. In a bimalleolar fracture is the syndesmotic ligament is almost always torn. True or false?

True

False

they have to be treated with surgery.

Explanation

they have to be treated with surgery.

27. The syndesmosis of the ankle is between which two bones?

Tibio-talar

Tibio-fibular

Subtala jjoint

28. Lateral collateral ligament sprains are graded by severity by what grading system?

Grade 1-5

Grade 0-4

Grade1-3

29. Which of the following make up the syndesmosis?

Interosseous ligament

Interosseuos membrane

Anterior inferior tibio-fibular ligament

Posterior inferior tibio-fibular ligament

Submit

30. Would you use RICE and braces for grade 1 & 2 ankle sprains?

Yes

No

31. There is a difference of opinions on whether to RICE or surgically treat grade 3 sprains. True or false?

True

False

32. Ankle syndesmosis injury is usually caused by:

Internal rotation injury

External rotation injury

33. Which is more serious, a high ankle sprain or a lateral ankle sprain?

High ankle sprain

Lateral ankle sprain

A high ankle sprain takes longer to heal.

Explanation

A high ankle sprain takes longer to heal.

34. Medial ankle sprains are usually caused by ankle inversion or eversion?

Ankle eversion

Ankle inversion

35. What bone is affected in Haglund's deformity?

Talus

Tibia

Fibula

Calcaneus

Navicular

36. What population most commonly sufferes from Haglund's deformity?

Football athletes

Marathon runners

Tennis players

Women who wear high heels

37. Deltoid ligament injury requires surgery 100% of the time. True or false?

True

False

It almost never required surgery even if associated with severe fracture dislocations.

Explanation

It almost never required surgery even if associated with severe fracture dislocations.

38. What test would you use to check for peroneal tendonitis?

Xray

CT scan

MRI

39. The most common fracture around the ankle is the

Bimalleolar fracture

Distal fibula fracture

Avulsion fracture of the distal fracture

Distal tibial fracture

40. There are two ways to treat an arthritic ankle.

Ankle replacement

Fusion

OMT

Submit

41. What is the best test to diagnose avascular necrosis?

CT

MRI

Bone density scan

PET

42. The deltoid complex is on the lateral or medial side of the ankle?

Lateral

Medial

43. What two tendons pass under the fibular retinaculum?

Peroneus longus tendon

Achilles tendon

Extensor digitorum brevis tendon

Peroneus brevis

Submit

44. Which of the following make up the lateral collateral ligament?

Posterior talofibular ligament

Anterior talofibular ligament

Middle calcaneal fibular ligament

Anterior tibiofibular ligament

Submit

45. What two tests can you do to test for LCL sprains?

Anterior draw sign

Talar tilt sign

Thompson test

Thomas test

Submit

46. You can treat a high ankle injury with RICE. When would you have to do an internal fixation?

If the tibia is fractured

If there is widening between the the distal tibia and fibula

If the fibula is fractured

47. Does absence of the Hawkin's signs suggest a high or low risk of avascular necrosis?

High risk

Low risk

48. Basically in Haglund's deformity there is a prominence of the calcaneus that sticks out in the anterior or posterior ankle?

49. Is the achilles tendon the most frequently ruptured tendon?

Yes

No

50. What types of fractures usually occur after a fall from a high level and are very difficult to fix?

Bimalleolar fracture

Distal tibial fracture

Pilon fracture

fx to the distal tibia

Explanation

fx to the distal tibia

51. A maisonneuve fracture is a fracture of the _________ right below the knee.

Tibia

Fibula

52. Which malleolus is affected in a maisonneuve fracture?

Medial

Lateral

53. Osteochondritis dessicans occurs mostlhy in the lateral or medial side of the ankle.

Lateral

Medial

54. What nerve is compressed in tarsal tunnel syndrome?

Deep peroneal

Plantaris nerve

Tibial nerve

55. According to the Ottawa rules, everybody who walks into the emergency room complaining of lateral ankle pain should have an x-ray. True or false?

True

False

The Ottawa Rules essentially state that x-rays are necessary only for individuals with suspected ankle sprains who cannot bear weight on the injured leg and for individuals with tenderness over the bones (as opposed to the ligaments)

Explanation

The Ottawa Rules essentially state that x-rays are necessary only for individuals with suspected ankle sprains who cannot bear weight on the injured leg and for individuals with tenderness over the bones (as opposed to the ligaments)

56. Which of the following actions might lead to peroneal tendonitis?

Inversion ankle injury (ATF)

Eversion ankle injury

Forceful contraction of the peroneal tendons on a dorsiflexed ankle

Forceful contraction of the posterior tibial tenson on a plantarflexed ankle

Submit

57. How do you reduce the peroneal tendons before you immobilize the extremity?

Place in dorsiflexion with slight eversion below the knee

Plave in plantar flexin with slight evertsion below the knee

Placein plantar flexion in slight inversion below the knee

Place in dorsiflexion in slight inversion below the knee

58. What part of the ankle is affected in a posterior impingement?

Distal fibula

Os trigonum

Distal tibia

Subtalar joint

59. Why is the talus the bone that is affected the most by avascular necrosis?

Because of its relationship with the tibia

Because of its relationship with the calcaneus

Because it is the most central bone in the ankle

Because of limited collateral circulation

60. Is decompression usually necessary in tarsal tunnel syndrome?

Yes

No

61. The ankle is a hinge joint that is made up of the following three joints:

Fibula

Calcaneus

Fibula

Talus

Submit

62. Which of the following ligaments are located on the lateral side of the ankle?

Anterior talo-fibular

Calcaneal-fibular

Posterior talo-fibular

Posterior tibial-fibular

Anterior tibial-fibular

Submit

63. Do both the anterior and posterior tibial tendons extend to the foot via the medial side or the lateral side?

Medial

Lateral

64. It will take about how many months for revasscularization of the talus?

5

12

24

36

48

65. Which of the following are symptoms of achilles tendonitis?

Mild pain after excersicing that graduallu worsens

Episodes of diffuse or localized pain, sometimes severe along the tendon during or a few hours after running

Morning tenderness or stiffness that gradually diminishes as the tendon warms up with use

Swelling

Tenderness at the end of the day from use during the day

Submit

66. Which of the following is the most common bone affected with avascular necrosis in the ankle?

Tibia

Talus

Calcaneus

Fibula

67. The ankle mortise is made up the articulation of which of the following?

Distal tibia

Medial malleolus

Tibia

Distal fibula

Submit

68. What is the most common mechanism of injury seen in LCL sprains?

Ankle eversion

Ankle dorsiflexion

Ankle

Supination

Ankle inversion

69. What test is useful in diagnosing achilles related ankle pain?

Thomas

Thompson

Ober

Ankle Diseases, Injuries and Treatments (Msq Drill 179)

1. Does the deltoid complex have a superficial and a deep layer?

2.

What first name or nickname would you like us to use?

2. What grade is: laxity and abnormal motion on exam is present, weight bearing very difficult

3. What grade : gross instability, unable to weight bear

4. Grade 1 – no laxity, can weight bear, mild injuryTrue or false?

5. The most commonly injured ligament in ankle injuries is the:

6. Can you order physical therapy for LCL sprains. True or false?

7. One should remember that in syndesmosis injuries there is usually an accompanying high ankle injury true or false?

8. Why would you perform an external rotation test or squeeze test on a patient. What are you suspecting?

9. Is a medial ankle sprain common?

10. Peroneal tendonitis is frequently misdiagnosed as:

11. Can peroneal tendonitis becone cnronic?

12. Where would you feel tenderness in a patient with peroneal tendonitis?

13. You might order an x-ray in a patient with peroneal tendonitis to look for shelf like fractures around the lateral or medial malleolus. True or false?

14. What is the largest tendon in the human body?

15. Overuse from athletic activities can cause achilles tendonitis. True or false?

16. The mechanism of injury usually determines the type of ankle fracture. True or false?

17. An achilles tendon should always be injected with a steroid. True or false?

18. When you treat fractures you should use a c-arm. True or false?

19. Does a maisonneuve fracture usually involve syndesmotic injury?

20. Both posterior and anterior ankle impingements can occur. True or false?

21. In an x-ray of a talus in which treatment for avascular was carried out you observe a subchondral radioluscent band. Is this a negative or positive Hawkins sign?

22. Can the calcaneal prominence that sticks out in Haglunds deformity cause problems with the bursa or achille's tendon?

23. Surgery is often the only treatment for Haglund's deformity. True or false?

24. If you inject lidocaine in the peroneal tendon and the pain goes away, does this confirm the diagnosis?

25. If conservative treatment fails is surgery an option for peroneal tnedonitis?

26. In a bimalleolar fracture is the syndesmotic ligament is almost always torn. True or false?

27. The syndesmosis of the ankle is between which two bones?

28. Lateral collateral ligament sprains are graded by severity by what grading system?

29. Which of the following make up the syndesmosis?

30. Would you use RICE and braces for grade 1 & 2 ankle sprains?

31. There is a difference of opinions on whether to RICE or surgically treat grade 3 sprains. True or false?

32. Ankle syndesmosis injury is usually caused by:

33. Which is more serious, a high ankle sprain or a lateral ankle sprain?

34. Medial ankle sprains are usually caused by ankle inversion or eversion?

35. What bone is affected in Haglund's deformity?

36. What population most commonly sufferes from Haglund's deformity?

37. Deltoid ligament injury requires surgery 100% of the time. True or false?

38. What test would you use to check for peroneal tendonitis?

39. The most common fracture around the ankle is the

40. There are two ways to treat an arthritic ankle.

41. What is the best test to diagnose avascular necrosis?

42. The deltoid complex is on the lateral or medial side of the ankle?

43. What two tendons pass under the fibular retinaculum?

44. Which of the following make up the lateral collateral ligament?

45. What two tests can you do to test for LCL sprains?

46. You can treat a high ankle injury with RICE. When would you have to do an internal fixation?

47. Does absence of the Hawkin's signs suggest a high or low risk of avascular necrosis?

48. Basically in Haglund's deformity there is a prominence of the calcaneus that sticks out in the anterior or posterior ankle?

49. Is the achilles tendon the most frequently ruptured tendon?

50. What types of fractures usually occur after a fall from a high level and are very difficult to fix?

51. A maisonneuve fracture is a fracture of the _________ right below the knee.

52. Which malleolus is affected in a maisonneuve fracture?

53. Osteochondritis dessicans occurs mostlhy in the lateral or medial side of the ankle.

54. What nerve is compressed in tarsal tunnel syndrome?

55. According to the Ottawa rules, everybody who walks into the emergency room complaining of lateral ankle pain should have an x-ray. True or false?

56. Which of the following actions might lead to peroneal tendonitis?

57. How do you reduce the peroneal tendons before you immobilize the extremity?

58. What part of the ankle is affected in a posterior impingement?

59. Why is the talus the bone that is affected the most by avascular necrosis?

60. Is decompression usually necessary in tarsal tunnel syndrome?

61. The ankle is a hinge joint that is made up of the following three joints:

62. Which of the following ligaments are located on the lateral side of the ankle?

63. Do both the anterior and posterior tibial tendons extend to the foot via the medial side or the lateral side?

64. It will take about how many months for revasscularization of the talus?

65. Which of the following are symptoms of achilles tendonitis?

66. Which of the following is the most common bone affected with avascular necrosis in the ankle?

67. The ankle mortise is made up the articulation of which of the following?

68. What is the most common mechanism of injury seen in LCL sprains?

69. What test is useful in diagnosing achilles related ankle pain?

4. Grade 1 – no laxity, can weight bear, mild injury

True or false?