Bio 106 October 26,28,30
Bio 106 October 26,28,30 Biology 106- Organismal Biology
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This 6 page Class Notes was uploaded by JustAnotherStudent on Monday November 2, 2015. The Class Notes belongs to Biology 106- Organismal Biology at Washington State University taught by Dr. Cousins & Dr. Carloye in Fall 2015. Since its upload, it has received 12 views. For similar materials see Biology 106 in Biology at Washington State University.
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Date Created: 11/02/15
October 26, 28, 30 Kines 266 Chapter 14: The Foot… continued Metatarsal Fractures o It is difficult to isolate midfoot pain from metatarsal sprains o May be more point tender o Occasional visible or palpable deformity o X-ray needed to rule in rule out o Treatment: PRICE, short leg walking cast for 3-6 weeks, surgery, show with large toe box Jones Fracture o Fracture near the proximal end of the 5 metatarsal o Sharp pain o Poor blood supply and delayed healing o Treatment: non-weight baring short leg cast for 6-8 weeks, surgery for highly active patient Toe Fractures o Occur by kicking or stubbing toe or dropping object on toes o Generally have swelling and discoloration o Great toe fractures should be referred to physician o Treatment: buddy tape, ice, decrease activity for 3-4 weeks, modified limiting weight bearing Bunions (hallux valgus deformity) o Affects 1 MTP o Chronic o Red, callus o Treatment: widen toe box of shoe, bunion tape, toe spacers, or surgery Longitudinal Arch Strain o Pain occurs running o Pain below medial malleolus & posterior tibial tendon o Swelling tenderness medial aspect of foot o Pes planus (flat feet) o Treatment: PRICE, arch taping, supportive insoles, rest Morton’s Neuroma o Entrapment of nerves between metatarsal heads rd o Burning and numbness in forefoot often localized to space between 3 th and 4 metatarsal heads o Hyperextension and pressure can increase symptoms o Treatment: tear-drop shaped padding to encourage toe splay in weight bearing, wear shoe with wider toe box Turf Toe- 1 MTP Sprain o Hyperextension of 1 MTP o Pain with pushing off toe o Sometimes effusion o Treatment: tape, steel sole inserts, ultrasound, ice Subungual Hematoma o Blood accumulation under nail Chapter 15: The Ankle and Lower Leg Overview o Bony anatomy o o o o o o The ankle and lower leg o The ankle joint is made of 3 bones Tibia, fibula, talus o 2 joints Talocrural Subtalar Calcaneus and talus Common Has 4 range of motion o Plantarflexion Talorcrural o Dorsiflexion T o Inversion S o Eversion S Lower Leg Anatomy o Tibia and Fibula- Joints o Talocrural Ankle mortise Tibia and fibula on talus o Subtalar Talus on calcaneus Muscle Compartments o 4 compartments or groups of muscles o By location and action Anterior Dorsiflexors (shorten pulls toes towards you nose) o Includes Tibialis anterior Extensor hallucis longus Extensor digitorium longus Lateral Everters (shorten lateral muscles) o Peroneus longus o Peroneus brevis Deep posterior (closer to vascular tissues) Inverters o Includes Tibialis posterior Flexor digitorium longus Flexor hallucis longus Superficial posterior (superficial closer to surface, point toes down) Plantarflexors o Includes (Triceps surae) Gastrocnemius o Two heads Soleus Ligaments of the Ankle o Ligaments in conjunction with interosseous membranes provide support for the ankle joint o 3 lateral ligaments Anterior talofibular Posterior talofibular Calcaneofibular o 1 medial ligament- with multiple bands Deltoid Neurovascular Anatomy o Popliteal artery (back of knee) Tibial artery Anterior Posterior o Fibular artery o Common fibular nerve o Superficial fibular nerve Cutaneous branch o Deep fibular nerve Dermatomes (sensory) o L4- medial aspect o L5- anterior and dorsum o S1- lateral aspect o S2- posterior calf Myotomes o L4- ankle dorsiflexion o S1- ankle plantarflexion o Deep tendon Reflex S1- Achilles tendon Injury Assessment o History o Observation o Palpations o Special Tests ROM Manual muscle test Special test Neurovascular scan Palpation (KNOW THESE, MAY BE PICTURE WITH DOT) o Bony Length of tibia Medial malleolus Length of fibula Lateral malleolus o Soft Tibialis anterior and tendon Achilles tendon Gastrocnemius Knee straight Most posterior Soleus Pressing gas pedal Anterior talofibular ligament finger roll always from talus Posterior talofibular ligament Calcaneofibular ligament Deltoid ligament Only anterior, medial side 3 different bands o Posterior tib, goes through to the arch and a little further Rom o Plantarflexion Gastrocnemius & soleus o Dorsiflexion Tibialis anterior o Inversion w/ dorsiflexion Tibialis anterior & toe extensions o Inversion w/ plantarflexion Posterior tibialis o Eversion w/ dorsiflexion Peroneus tertius o Eversion w/ plantarflexion Peroneus longus and brevis Special Tests o Anterior Drawer- stresses anterior talofibular ligament Moving talus up o Posterior Drawer- stresses posterior talofibular Push down o Eversion Stress Test- stresses deltoid ligament Rock out, use multiple planes o Inversion Stress Test- stresses lateral ligament W/foot plantarflexed = anterior talofibular lig. W/ foot neutral= Calcaneofibular lig. W/foot dorsiflexion= posterior talofibular lig. o Squeeze & Bump Fracture Tests Bump heel firmly or squeeze on medial & lateral aspect of calf o Thompson’s Test Squeeze calf to assess integrity of Achilles tendon Inversion (lateral) ankle sprain o Most common ankle sprain o Classified by mechanism- inversion o Degree of sprain based on pain and laxity and can change depending on provider o In general, the anterior talofibular ligament is most commonly damaged o More extensive injury can involve calcaneofibular and posterior talofibular ligaments Eversion Ankle Sprain o Less common type of ankle sprain o Classified by mechanism- eversion o Deltoid ligament is damaged o Foot positioning can effect different fibers of the ligament Fibular Fracture o Avulsion Acute Forceful contraction with inversion mechanism Splint and refer to physician Depending on severity, 4-6 of gradual weight bearing o Distal fibular fracture Can be acute or chronic (stress) Blow to lateral side of lower leg Splint and refer to physician Non-displaced fractures may take 4-6 weeks boot or cast Achilles Injury o Tendinosis Thickening of tendon in response to increase stress Can be caused by poor foot mechanics RICE, insoles, strengthen of lower leg, ankle, foot o Rupture Acute Sudden, forceful plantarflexion Palpable defect May not be able to plantarflex foot Surgical repair with 6-8 weeks immobilization Medial tibial stress syndrome o AKA “shin splints”- all-encompassing term for “my lower leg hurts” o MTSS involves the distal 2/3 of the medial aspect of the tibia o Whereas, pain on the anterior portion of sin may be due to stress reaction or stress fracture o Can be result of faulty foot mechanics, overtraining o Care: must rule out fracture, rest, modify activity, address mechanics Prevention o Lengthening tissues that are tight Achilles tendon complex o Strengthen tissues that are weak Lateral compartment of the lower leg Deep posterior compartment of lower leg Intrinsic muscles of foot o Improving neuromuscular control Balance, skill work on uneven surface o Bracing, taping, insoles, foot wear