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Ankle, Lower Leg Lab

Ankle, Lower Leg Lab. BONY PALPATION:. Anterior Aspect . fibular head. fibular shaft. tibial plateau . tibial shaft. Posterior Aspect. medial malleolus. lateral malleolus. calcaneus. SOFT TISSUE PALPATION:. Lateral Aspect. lateral compartment (peroneals).

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Ankle, Lower Leg Lab

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  1. Ankle, Lower Leg Lab

  2. BONY PALPATION:

  3. Anterior Aspect

  4. fibular head

  5. fibular shaft

  6. tibial plateau

  7. tibial shaft

  8. Posterior Aspect

  9. medial malleolus

  10. lateral malleolus

  11. calcaneus

  12. SOFT TISSUE PALPATION:

  13. Lateral Aspect

  14. lateral compartment (peroneals)

  15. Note: B is peroneus brevis and C is peroneus tertius

  16. anterior talofibular ligament

  17. calcaneofibular ligament

  18. posterior talofibular ligament

  19. Medial Aspect

  20. deep posterior muscles • posterior tibialis muscle; flexor digitorum longus muscle; flexor hallucis muscle

  21. deltoid ligament:anterior tibiotalar

  22. deltoid ligament:tibionavicular

  23. deltoid ligament:tibiocalcaneal

  24. deltoid ligamentposterior tibiotalar

  25. Anterior Aspect

  26. anterior tibialis muscle extensor hallucis longus muscle extensor digitorum longus muscle anterior compartment

  27. anterior tibiofibular ligament

  28. Posterior Aspect

  29. gastrocnemius muscle superficial posterior compartment

  30. superficial posterior compartment • soleus muscle

  31. Achilles tendon

  32. posterior tibiofibular ligament

  33. calcaneal bursa

  34. retrocalcaneal bursa

  35. SPECIAL TESTS

  36. Anterior Drawer Test Positioning the Athlete: The athlete is seated on a table with the knee flexed to 90 degrees and the involved foot relaxed in slight plantar flexion. The examiner stabilizes the tibia and fibula with one hand and grasps the calcaneus with the other. Action: While assuring stabilization of the distal tibia and fibula, the examiner applies an anterior force to the calcaneus and talus. Positive Finding: Anterior translation of the talus away from the ankle mortise that is greater on the involved side, as opposed to the noninvolved side, indicates a positive sign for a possible anterior talofibular ligament sprain.

  37. Anterior drawer test

  38. Talar Tilt Test- Inversion Positioning the Athlete: The athlete lies on the uninvolved side on a table with the involved foot relaxed and the knee flexed to approximately 90 degrees. Make sure to stabilize the distal tibia with one hand with grasping the talus with the other. Action: The examiner first places the foot in the neutral plantar flexion and dorsiflexion position (anatomical position). Then tilt the talus into an adducted position. Positive Finding: Range of motion in the adducted position on the involved foot greater than that of the noninvolved foot reveals a positive test. This may be indicative of a tear of the calcaneofibular ligament of the ankle.

  39. Talar tilt test-inversion

  40. Talar Tilt Test- Eversion Positioning the Athlete: The athlete lies on the involved side on a table with the involved foot relaxed and the knee flexed to approximately 90 degrees. Make sure to stabilize the distal tibia with one hand with grasping the talus with the other. Action: The examiner first places the foot in the neutral plantar flexion and dorsiflexion position (anatomical position). Then tilt the talus into an abducted position. Positive Finding: Range of motion in the abducted position on the involved foot greater than that of the noninvolved foot reveals a positive test. This may be indicative of a tear of the deltoid ligament of the ankle.

  41. Talar tilt test-eversion

  42. Kleiger Test-Deltoid Positioning the Athlete: The athlete sits with the leg off of the table and the knee at approximately 90 degrees of flexion. The examiner stabilizes the distal tibia and fibula with one hand and the medial and inferior aspects of the calcaneus with the other. The ankle should be in a neutrally aligned position. Action: The examiner applies an externally rotated force upon the calcaneus. Positive Finding: Complaints of pain along the medial aspect of the ankle when an externally rotated force is applied in neutral dorsiflexion may indicate a deltoid ligament injury.

  43. Kleiger test-deltoid

  44. Kleiger Test- Syndesmosis Positioning the Athlete: The athlete sits with the leg off of the table and the knee at approximately 90 degrees of flexion. The examiner stabilizes the distal tibia and fibula with one hand and the medial and inferior aspects of the calcaneus with the other. The ankle should be in a dorsiflexed position. Action: The examiner applies an externally rotated force upon the calcaneus. Positive Finding: Pain may be present medially and slightly more proximally, indicating distal tibiofibular syndesmotic involvement.

  45. Kleiger test-syndesmosis

  46. Compression Test Positioning the Athlete: The athlete lies supine with the affected leg extended and the ankle/foot just off the examining table. The examiner stands next to the athlete’s leg and notes where the pain originates. Action: The examiner squeezes the tibia and fibula together at some point away from the painful area. Positive Finding: Pain at the site of injury my be indicative of a fracture. Compression of the two bones may exaggerate pain at the fracture site.

  47. Compression test

  48. Bump test

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