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43 Cards in this Set

  • Front
  • Back
What is a sprain?
Injury to a ligament (bone-to-bone)
What is a strain?
injury to a tendon (muscle-to-bone)
What is the ankle joint made of?
Talus, distal tibia, distal fibula
How many ankle injuries per year?
1 million
What percentage of injuries are ankle sprains?
85%
An ankle sprain often follows a _________________________
Sudden stretch (secondary to inversion)
What is the most commonly sprained ankle ligament?
Anterior talofibular ligament
What happens in an inversion of the ankle?
the ankle turns in; pull lateral ligaments
What is the second most frequently torn ligament
the calcaneofibular ligament
What are some clinical manifestations of a sprain?
pain, swelling, bruising, loss of motion, loss of function; if severe the patient might say they hear a "pop" (resulting from the ligament tear
What are some clinical manifestations of a strain?
(injury to tendon/muscle); complete loss of use of muscle, cramping, weak, swelling, muscle spasm, heals on its own
What are some clinical manifestations of a ruptured achilles tendon?
hear "pop"; patient loses reflex
What is the achilles tendon attached to?
gastronemeous muscle
What are the 7 steps of examination for the ankle?
Inspect, Palpate, Range of Motion (ROM), Strength, joint above and joint below, neuro, and vascular.
Describe what you are looking for in the following steps of examination. Inspect?
Looking for swelling, bruising (acomyosis), bone deformity
Palpate?
see for infusion (fluid), pain, tenderness in objective
ROM?
active v. passive; move ankle joint.
What is the difference between active and passive ROM?
Active - patient moves joint; passive - doctor moves joint
Strength?
measure on a 0-5 scale; +5/5 is normal strength
Joint above and joint below?
Do 4 things... (?)
Neuro?
Sensation & Reflexes; do they have sensation in the area? deep tendon intact?
Vascular?
good blood supply? (check dorsalis pedis & posterior tibialis)
What does it mean if the ankle is "frozen"?
The ankle joint is considered "frozen" if the doc/PA can't move it past what the patients says (?)
How can you assess sensation?
with the "Light touch" method (using cotton balls) or with the sharp/dull test (use a swab and a stick and see if patient can tell the difference)
What is plantar flexion?
pointing toes down
Dorsiflexion?
lifting ankle up
What is a Grade 1 sprain?
Mild sprain; overstretching or slight tearing of ligaments with no joint instability; patient can still bear weight
What do you do for a Grade 1 sprain?
wrap it
What is a Grade 2 sprain?
moderate sprain; partial tearing of a ligament; swelling is present and patient has a difficult time bearing weight (resulting in a "limp")
Waht is a grade 3 sprain?
severe sprain; complete tear or rupture of a ligament; patient can't bear weight
What are some more symptoms of a grade 3 sprain?
patient experiences significant pain, bruising, and swelling
What should you do for grade 2 and 3 sprains to r/o a fracture?
order an x-ray (not good for soft tissue)
Why should you choose an x-ray over an MRI?
Costs less money
What does the acronym PRICE stand for (in relation to mide-moderate sprains)?
Protect, Rest, Ice, Compression, Elevate
What is something else used for mild-moderate sprains?
OTC NSAID
When do you need to cast the patient?
If they have a moderate-severe ankle sprain
What is the recovery time for the following: Mild?
1-2 weeks
Moderate?
3-6 weeks
Severe?
8-12 months
When is physical therapy recommended?
In treatment for moderate - severe sprains
What are the Ottawa ankle rules in relation to specificity and sensitivity?
sensitivity: 97.8% and specificity of 31.5
(Ottawa Ankle Rules) When is an ankle x-ray required?
Only if there is pain in the malleolar zone and any of the following are found:
- bone tenderness at A or B (posterior edge/tip of
lateral/medial malleolus)
- inability to bear weight both immediately and in the emergency department
(Ottawa Ankle Rules) When is a foot x-ray required?
Only if there is pain in the midfoot zone and any of the following are found:
- bone tenderness at C or D (Base of limb metatarsal/ Navicular)