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Physical Exam Ankle
From WikiSM
(Redirected from Physical Exam Foot)
Contents
Other Names
- Physical exam ankle
- Physical exam foot
Introduction
- Physical exam should be performed with shoes and socks removed
- Ideally, there is a weight bearing component and a seated component
Introduction
- Follows the IP-PASS examination methodology
- Inspection
- Palpation
- Passive Range of Motion
- Active Range of Motion
- Strength & Neurovascular
- Special Tests
Inspection
- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Pressure sores, calluses, blisters
- Bunions, hammer toes, claw toes, calluses
- Toenails
- Swelling or Joint effusion
- Muscle tone: atrophy, hypertrophy
- Deformity: asymmetry, rotation, amputation
- Areas of emphasis for foot and ankle exam exam
- Look at patients shoes (wear pattern, arch support, etc)
- Gait examination and evaluation (consider normal, walking on insides and outsides of feet, heel and toe-walk, tandem, running)
- Arch (Pes Cavus or Pes Planus)
- Ankle alignment (posteriorly)
- Knee alignment
Palpation
- Palpate for
- Effusion
- Clicking
- Snapping
- Crepitus
- Tenderness
- Temperature
- Masses
- Ankle Areas of Emphasis
- Posterior aspect of medial and lateral malleolus
- Lateral Ankle Ligaments: ATFL, CFL, PTFL
- Medial Ankle Ligaments: Deltoid Ligament
- Achilles Tendon and insertion
- Foot Areas of Emphasis
- Navicular
- Lisfranc Joint
- Base of 5th metatarsal
Range of Motion
- Ankle
- Dorsiflexion: 20-30°
- Plantarflexion: 40-50°
- Pronation: 30°
- Supination: 60°
- Foot
- Inversion: 35°
- Eversion: 25°
- Metatarsophalangeal joints
- Flexion: 30°
- Extension: 80°
- Interphalangeal joints of toes
- Flexion: 50°
- Extension: 50°
Strength
- Ankle
- Plantarflexion: Gastrocnemius, Soleus, Plantaris, Tibialis Posterior, Fibularis Longus
- Dorsiflexion: Tibialis Anterior, Extensor Hallucis Longus, Extensor Digitorum Longus
- Eversion: Fibularis Longus, Fibularis Brevis
- Inversion: Tibialis Posterior
- Great Toe
- Extension: Extensor Hallucis Brevis, Extensor Hallucis Longus
- Flexion: Flexor Hallucis Longus, Abductor Hallucis, Flexor Hallucis Brevis
- Abduction: Abductor Hallucis
- Adduction: Adductor Hallucis
- Toes 2-4
- Extension: Extensor Digitorum Brevis, Extensor Digitorum Longus, Lumbricals
- Flexion: Flexor Digitorum Longus, Flexor Digitorum Brevis, Abductor Digiti Minimi, Quadratus Plantae, Lumbricals, Flexor Digiti Minimi Brevis
- Abduction: Abductor Digiti Minimi, Dorsal Interossei
- Adduction: Plantar Interossei
Neurovascular
- Sensory Nerves
- L4: Lateral thigh, anterior knee, medial leg
- L5: Lateral leg, dorsal foot
- S1: Posterior Leg
- S2: Plantar foot
- Dermatome
- Needs to be updated
- Reflexes
- Patellar (L3, L4)
- Achilles (S1, S2)
- Myotomes:
- L4: Knee Extension, Dorsiflexion
- L5: Hip Abduction, Hip Extension, Toe Dorsiflexion, Foot Inversion, Dorsiflexion
- S1 Foot Version, Plantarflexion
- S2: Toe Plantar Flexion
- Vascular:
- Popliteal Artery
- Dorsalis Pedis Artery
- Posterior Tibial Artery
- Capillary refill on toes
Special Tests
- General
- Peroneal Tendon Injuries
- Achilles Tendon Rupture
- Posterior Tibial Tendon Dysfunction
- Lateral Ankle Sprain
- Medial Ankle Sprain
- Syndesmotic Injury
- Peroneal Nerve Injury
- Tarsal Tunnel Syndrome
- Hindfoot Deformity
- Calf Strain
- Upper Motor Neuron Disease
- Plantar Fasciitis
- Anterior Ankle Impingement Syndrome
- Foot Pronation
- Posterior Ankle Impingement Syndrome
See Also
- Internal
- External
- Sports Medicine Review Ankle Pain: https://www.sportsmedreview.com/by-joint/ankle/
- Sports Medicine Review Foot Pain: https://www.sportsmedreview.com/by-joint/foot/
References
Created by:
John Kiel on 22 August 2021 06:40:14
Authors:
Last edited:
4 October 2022 12:33:48
Categories: