Ankle and Lower Leg

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Ankle and Lower Leg

• Chapter 19

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BONES OF THE ANKLE AND LOWER LEG

• TIBIA
• MEDIAL MALLEOLUS
• FIBULA
• LATERAL MALLEOLUS
• TALUS
• CALCANEUS

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JOINTS OF THE ANKLE

• TIBIAL - TALAR
• SUBTALAR

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MAJOR LIGAMENTS OF THE ANKLE

• Lateral Aspect
• anterior tibiofibular
• anterior talofibular
• lateral talocalcaneal
• calcaneofibular

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LIGAMENTS (cont.)

• Medial Aspect
• deltoid
• Posterior
• posterior talofibular
• posterior talocalcaneal

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Lateral View of Ankle
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Medial View of Ankle
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MUSCLES OF ANKLE AND LOWER LEG

• Gastrocnemius
• Soleus
• Peroneus longus
• Peroneus brevis
• Anterior tibialis
• Posterior tibialis
• Extensor digitorum longus
• Extensor hallucis longus
• Flexor digitorum longus
• Flexor hallucis longus

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• Anterior Musculature

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• Deep Posterior musculature

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• Superficial posterior musculature

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LOWER LEG COMPARTMENTS

• ANTERIOR
• EDL, EHL, Tibialis anterior, ant. tib. artery
• LATERAL
• Peroneus longus muscle, peroneal brevis, fibula
• DEEP POSTERIOR
• Tib. Post., FDL, FHL, post. tib. artery
• SUPERFICIAL POSTERIOR
• Soleus, gasroc

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ADDITIONAL STRUCTURES

• INTEROSSEOUS MEMBRANE
• DISTAL TIBIOFIBULAR
• SYNDESMOSIS
• BURSAE

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PREVENTING INJURY TO LOWER LEG ANKLE

• Achilles Tendon Stretching
• Strength Training
• Neuromuscular Control Training
• Footwear
• Preventive Ankle and Braces

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PHYSICAL EXAM

• Weight bearing status
• Bilateral comparisons
• Inspection and Palpation
• Inspection of lateral structures
• Inspection of medial structures
• Inspection of anterior structures
• Inspection of posterior structures
• Special tests

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SPECIFIC INJURIES OF THE ANKLE AND LOWER LEG -
ASSESSMENT

• Ankle Sprain
• Ankle Fractures
• Peroneal Tendon Problems
• Anterior/Posterior Tibialis Tendonitis
• Shin Conditions
• Leg Cramps Spasm
• Gastroc / Achilles Strain
• Stress Fracture Syndrome of Lower Leg

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REHABILITATION

• General
• Weight Bearing
• Joint Mobilization
• Flexibility
• Strengthening
• Proprioception
• Taping and Bracing