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Pod Med Final
Heel pain
35
Other
Professional
03/04/2013

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Cards

Term
What are these?

Skin
Adipose tissue
Vascular
Neural structures
Muscle
Tendons/ligaments
Bursas
Capsules
Bones
Definition
The "Systems Approach"
Term
Where is on the foot associate with the following condition?

Tarsal Tunnel Syndrome
Nerve Impingement
Tendonitis
Tibialis Posterior
FDL
FHL
Ligaments:
deltoid ligament
Bone:
Medial malleoli
Medial gutter ankle joint
Calcaneus
Definition
Medial Posterior Heel
Term
What conditions associate with?

Tibial nerve entrapment in the tarsal tunnel at the level of the medial malleoli

Flexor Retinaculum
Definition
Tarsal Tunnel Syndrome
Term
Which condition associate with the following etiology

Diabetes-Nerve Impingemen
secondary to swellin, double crush syndrome

Pattern of branching of the posterior tibial nerve
Accessory muscle belly, hind foot varus with pronation syndrome
Pes planus foot type predispose to tarsal tunnel
Post-traumatic adhesion, bony spurs, chronic inflammation, benign tumors, varicosities
Definition
Term
What are the common symptom of medial posterior heel pain?
Definition
worse at night
no muscle weakness
Usually unilateral
Term
How to make a diagnosis for medial posterior heel pain?
Definition
Positive and tender Tinel sign (tingling upon tapping nerve) behind the medial malleolus
Term
What is the tinel's sign?
Definition
palpation of the tibial nerve cause pain that radiates distally toward the toes
Term
What is the Villeix sign?
Definition
pain radiates proximally toward the calf
Term
What is the Turk's test?
Definition
performed by inflating a systolic blood pressure cuff, can exacerbate symptoms as the venae comitantes become engorged within the tarsal tunnel
Term
What are the branch of posterio tibial nerve that involved in nerve impingement?
Definition
Calcaneal n. branch-cutaneous to medial and posterior aspect of the heel
PorMedial plantar n.-cutaneous branches to the plantar medial aspect of the foot
Lateral plantar n.-1st br. baxter nerve
sensory component: calcaneal periosteum, the long plantar ligamnet and the lateral plantar skin
medially hugging the medial aspect of the calcaneus, adjacent to the heel spur, on its way to supply the quadratus, FDB, and ADM quinti
Term
Porta pedis and branch of posterial nerve:
Definition
Medial plantar nerve
Lateral plantar nerve: give 1st branch to digiti minimi
Calcaneal branch
Term
What condition associated with:

Irritation of the medial calcaneal branch
Entrapment of inferior calcaneal nerve

Pain is aching discomfort along the medial/plantar border of heel
Pain is aggravated by WB but continues with off weight

Make the Diagnosis:
Palpation/+ Tinels to nerve as it travels under abductor hallcis muscle belly on medial side of heel
Definition
Calcaneal Branch Neurodynia
Term
Where does calcaneal nerve lay?
Definition
superficial to abductor hallucis muscle
Term
Where does inferior calcaneal branch lay?
Definition
between deep fascia and abductor hallucis muscle belly
Term
what condition associated with the following?

Swelling in a region of micro damage or partial tear can be detected visually or by touch
Symptoms include ache or pain and stiffness the tendon
Or a burning that surrounds the whole joint around the inflamed tendon
Pain is usually worse during and after activity, and the tendon and joint area is stiffer the following day as swelling impinges on the movement of the tendon
Definition
Tendonitis
Term
All of the following are use to diagnoses for?

Put tendon through ROM against resistance
Or ask patient to hold tendon in place and you try to move it-either will elicit pain
Definition
Tendon on medial aspect:
PT
FDL
FHL
Term
patient is tested by Single raise-bouble raise test* and inablility to stand on their toes on the affected side when off weight bearing on one contralateral limb
Definition
Posterior Tibial Tendonitis
Term
patient presents with painful inflammation of the distal portion of the tendo achilles,

patient may be associated with watershed area
Or may be associated with calcification at the level of the insertion into the calcaneous
Definition
Achilles TendinitisPa
Term
Patients find pain with ankle joint DF, dull, aching
Forms enthesiopathy
Definition
Achilles Tendinitis
Term
What is the point at which a tendon inserts into bone, where the collagen fibers are mineralized and intergrated into bone tissue
Definition
Enthesis
Term
What is called when a patient present with inflammation at the insertion of tendon, muscle into bone
Definition
Enthesitis
Term
What is called as winter heel, pump-bump, knobby heel, calcaneal altus, may be associate with shoegear and activity and a type of enthesopathy
Definition
haglund's deformity
Term
A patient present firm, tendore, rounded knoblike protuberance of the calcaneus lateral to the heel cord, pain with redness and swelling

Abnormal promience located at postero-superior lateral aspect of calcaneus and associated with adventitious bursa
Definition
Haglund's
Term
Subtendinous calcaneal bursa

Subcutaneous calcaneal bursa
Definition
Term
Patient present with pain with direct palpation behind the achilles tendon
Definition
retrocalcaneal bursitis
Term
patient have lateral posterior heel pain
Definition
could be
nerve impingement:
sural nerve
lateral dorsal cutaneous n.
Tendinitis:
peroneus brevis
peroneus longus
Ligaments:
ATF
CF
Term
What is the classic post static Dyskinesia?
Definition
Plantar Fasciitis
Term
how to make a diagnosis for plantar faciitis?
Definition
H&P
Palpaiton
Term
What is bursa?
Definition
Infracalcaneal buritis is common in heels with thinning fat pads
Heel "spur" injections are usually injected into the bursa under the plantar fascia itself
Term
How to diagnoses for calcaneal spur?
Definition
x-ray
Term
what is faciosis?
Definition
plantar faciitis: a degenerative process (fasciosis) without inflammation
Term
What is the symptoms of plantafasciitis?
Definition
pain worsens at night cause heel is plantar flexion during spleep
Term
What structure involved with Lateral platar heel pain?
Definition
Nerve impingement
lateral dorsal cutaneous
Fat Pad Atrophy
Ftracture-stress
Tumor
Osteomyelitis
Term
Patient presents with geographic radiolucents, lytic, expansile lesion with multi-loculated with cortical thinning on the lateral aspect of calcaneus on the x-ray
Definition
osteochondroma
Term
What is the majority of etiology for heel pain?
Definition
Mechanical etiology
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