Examination of Orthopedic Athletic

Injuries 4th Edition Starkey Test Bank

Visit to download the full and correct content document: https://testbankdeal.com/dow
nload/examination-of-orthopedic-athletic-injuries-4th-edition-starkey-test-bank/
Chapter 8: Foot and Toe Pathologies

MULTIPLE CHOICE

1. Which of the following bony landmarks are located on the calcaneus?

a. Peroneal tubercle, dome, sustentaculum tali
b. Medial malleolus, peroneal tubercle, tarsal tunnel
c. Sustentaculum tali, peroneal tubercle, lateral cuboid articulation
d. Calcaneal tubercle, tarsal tunnel, dome
ANS: C
Rationale: The dome is part of the talus, the medial malleolus is on the tibia, and the tarsal
tunnel is not a bony landmark.

PTS: 1

2. Which tarsal bone (often referred to as the “keystone”) comprises the main structure of the
medial longitudinal arch?
a. Navicular
b. Calcaneus
c. Cuboid
d. First cuneiform
ANS: A
Rationale: The navicular is referred to as the “keystone” because it is the stabilizing element
between the proximal and distal sides of the medial longitudinal arch.

PTS: 1

3. Which bone is the primary insertion for the tibialis posterior?

a. Navicular
b. Calcaneus
c. Cuboid
d. Base of the fifth metatarsal
ANS: A
Rationale: The primary insertion of the tibialis posterior is the navicular tuberosity.

PTS: 1

4. Which bone is the most lateral bone of the midfoot?

a. Navicular
b. Calcaneus
c. Cuboid
d. Third cuneiform
ANS: C
Rationale: The cuboid is the lateral bone of the midfoot that articulates with the lateral
cuneiform, navicular, calcaneus, and the fourth and fifth metatarsals.

PTS: 1
5. Which movements occur at the subtalar joint?
a. Pronation and supination
b. Inversion and eversion
c. Plantar flexion and dorsiflexion
d. Internal and external rotation
ANS: A
Rationale: The subtalar joint is a complex joint with one degree of freedom of movement,
which occurs around an oblique axis.

PTS: 1

6. Which ligament is also referred to as the “spring” ligament?

a. Calcaneocuboid
b. Long plantar
c. Medial talocalcaneal
d. Plantar calcaneonavicular
ANS: D
Rationale: The “spring” ligament provides support to the medial longitudinal arch.

PTS: 1

7. Which of the following produces the windlass effect?

a. Flexion of the toes causes the calcaneus to come forward.
b. Extension of the toes causes the calcaneus to come forward.
c. Flexion of the toes causes the navicular to drop down.
d. Extension of the toes causes the navicular to drop down.
ANS: B
Rationale: Much like pulling the string of a bow, when the toes extend and pull the calcaneus
forward, the arch is accentuated.

PTS: 1

8. Which vascular structure is found behind the medial malleolus?

a. Medial tibial artery
b. Posterior tibial artery
c. Arcuate artery
d. First dorsal metatarsal artery
ANS: B
Rationale: The posterior tibial pulse is taken from the posterior tibial artery just behind the
medial malleolus.

PTS: 1

9. A male athlete presents in the athletic training room with redness, swelling, and pain in the
great toe with no mechanism of injury. Evaluation reveals pain on palpation, but pain does not
increase with toe extension. Which of the following injuries is indicated by these signs and
symptoms?
 a. Gout
b. First-degree sprain of the great toe
c. Bunion
d. Ingrown toenail
ANS: A
Rationale: Other risk factors to look for when evaluating for gout include obesity, weight
gain, alcohol intake, and impaired renal function.

PTS: 1

10. For which problem would one recommend proper bathing, regularly changing socks, and
keeping the area dry to help prevent the buildup of fungi?
a. Molluscum contagiosum
b. Tinea pedis
c. Verruca plantaris
d. Hard corns
ANS: B
Rationale: Tinea pedis is more commonly known as “athlete’s foot” and is the only answer
listed that relates to the buildup of fungi.

PTS: 1

11. What injury results in an abducted first ray at the metatarsophalangeal (MTP) joint?
a. Hallux rigidus
b. Hallux maximus
c. Hallux valgus
d. Hallux internus
ANS: C
Rationale: Hallux valgus results from a progressive degeneration and subluxation of the first
MTP joint that leads to an increased joint angle in the frontal plane.

PTS: 1

12. An athlete presents in the athletic training room with a bump on the back of the heel. It is
red, swollen, and painful to the touch. The athlete states that it has been there for a while, but
the new shoes he is wearing have irritated it. What does this athlete have?
a. Retrocalcaneal exostosis
b. Os trigonum
c. Achilles tendonitis
d. Plantarcalcaneal exostosis
ANS: A
Rationale: Retrocalcaneal exostosis is also known as Haglund deformity or “pump bumps”
and is often associated with rearfoot varus, retrocalcaneal bursitis, and/or Achilles
tendinopathy.

PTS: 1
13. What structure serves to provide inferior support to the talus and is generally found one
thumb’s width below the medial malleolus?
a. Navicular
b. First cuneiform
c. Sustentaculum tali
d. Plantar fascia
ANS: C
Rationale: The sustentaculum tali is a palpable structure on the calcaneus and serves as an
attachment site for the calcaneonavicular ligament.

PTS: 1

14. Which of the following is the best position for the ankle when assessing passive range of
motion for extension of the great toe?
a. 90° (anatomical neutral)
b. 5° of plantar flexion
c. 15° of plantar flexion
d. 25° of plantar flexion
ANS: C
Rationale: This measure should be taken with the ankle in a relaxed position, which is about
15° plantar flexed from anatomical position.

PTS: 1

15. Which muscular layer of the foot contains the abductor hallucis, flexor digitorum brevis, and
abductor digiti minimi?
a. Superficial
b. Middle
c. Deep
d. Interosseous
ANS: A
Rationale: The superficial layer is the first layer of the foot’s intrinsic muscles.

PTS: 1

16. How many structural bones form the three regions of the foot?
a. 25
b. 26
c. 27
d. 28
ANS: B
Rationale: These 26 bones include 7 tarsals, 5 metatarsals, and 14 phalanges.

PTS: 1

17. Which section of the foot is composed of the navicular, three cuneiforms, and the cuboid
bones?
a. Forefoot
 b. Midfoot
c. Rearfoot
d. Toes
ANS: B
Rationale: The midfoot is comprised of the five tarsals that are not located in the rearfoot.

PTS: 1

18. What bone(s) of the foot is (are) responsible for assisting in absorbing and redirecting
weight-bearing forces, reducing friction, and protecting the tendon?
a. Talus
b. Calcaneus
c. Sesamoids
d. Navicular
ANS: C
Rationale: There are at least three sesamoid bones located on the plantar aspect of the great
toe.

PTS: 1

19. Which of the following joints is not involved with pronation and supination?
a. Talocrural
b. Subtalar
c. Proximal tibiofibular syndesmosis
d. Midtarsal
ANS: C
Rationale: It is the distal, not proximal, tibiofibular syndesmosis that is involved in pronation
and supination.

PTS: 1

20. How many muscles attach to the talus?

a. Zero
b. One
c. Two
d. Three
ANS: A
Rationale: The talus is the only axial bone that has no muscle attachments.

PTS: 1

21. What joint is better known as the Lisfranc joint?

a. Intermetatarsal
b. Tarsometatarsal
c. Metatarsophalangeal
d. Interphalangeal
ANS: B
 Rationale: The Lisfranc joint lies at the junction of the midfoot and forefoot where the five
metatarsal heads form gliding articulations with the bones of the midfoot.

PTS: 1

22. The foot’s intrinsic muscles originate and insert from the foot and are grouped into how many
layers?
a. Two
b. Three
c. Four
d. Five
ANS: C
Rationale: These four layers are the superficial layer, middle layer, deep layer, and
interosseous layer.

PTS: 1

23. Which of the following is not one of the five bones that form the medial longitudinal arch?
a. Cuboid
b. Calcaneus
c. Talus
d. First cuneiform
ANS: A
Rationale: The cuboid is a lateral bone of the midfoot, and thus it helps form the lateral
longitudinal arch as opposed to the medial longitudinal arch.

PTS: 1

24. The lateral arch is composed of all of the following bones except the
a. calcaneus.
b. cuboid.
c. fifth metatarsal.
d. talus.
ANS: D
Rationale: The talus is a bone that supports the medial longitudinal arch.

PTS: 1

25. Which of the following conditions does not result in retrocalcaneal pain?
a. Inflammation of the retrocalcaneal bursa
b. Degeneration of the Achilles tendon
c. Os trigonum pathology
d. Weakness of the gastrocnemius
ANS: D
Rationale: Weakness of the gastrocnemius muscle is not known to cause retrocalcaneal pain.

PTS: 1
26. Walking on the heel to avoid push-off may indicate all of the following except
a. metatarsal fracture.
b. calcaneal injury.
c. plantar fasciitis.
d. great toe pathology.
ANS: B
Rationale: Someone with a calcaneal injury will typically walk on his or her toes.

PTS: 1

27. Which of the following deformities involves the progressive contracture of the interosseous or
lumbrical muscles?
a. Claw toe
b. Hammer toe
c. Morton’s toe
d. Hallux valgus
ANS: A
Rationale: Along with degeneration, claw toe is often associated with pes cavus and can
present with a callus over the dorsal proximal interphalangeal joint.

PTS: 1

28. Which of the following deformities is formed by the first metatarsal being shorter than the
second?
a. Claw toe
b. Hammer toe
c. Morton’s toe
d. Hallux valgus
ANS: C
Rationale: Although it will appear that the second toe is longer than the first, Morton’s toe is
actually the result of the first metatarsal being shorter than the second.

PTS: 1

29. Which of the following is described as contractures of the associated toe extensors and flexors
accompanied by an inability of the interosseous muscles to hold the proximal phalanx in the
neutral position?
a. Claw toe
b. Hammer toe
c. Morton’s toe
d. Hallux valgus
ANS: B
Rationale: Hammer toe often develops due to the increase in the activity of the toe extensors
or flexors to account for weakness in the primary plantar flexors or dorsiflexors.

PTS: 1

30. A quantitative measure of what motion can be calculated using the navicular drop test?
 a. Pronation
b. Supination
c. Plantar flexion
d. Dorsiflexion
ANS: A
Rationale: Navicular drop is the distance that the navicular moves when going from
non–weight-bearing subtalar neutral to weight-bearing in a relaxed stance.

PTS: 1

31. Which of the following muscles is (are) found within the second layer of intrinsic foot
muscles?
a. Abductor hallucis
b. Flexor digitorum brevis
c. Abductor digiti minimi
d. Lumbricals
ANS: D
Rationale: The abductor hallucis, flexor digitorum brevis, and abductor digiti minimi are
located in the first layer.

PTS: 1

32. In which of the following foot postures does the rearfoot become hypermobile, resulting in
increased pronation?
a. Rearfoot varus
b. Rearfoot valgus
c. Forefoot varus
d. Forefoot valgus
ANS: B
Rationale: Rearfoot valgus is rarely seen but is identified by the calcaneus being everted
relative to the long axis of the tibia.

PTS: 1

33. During static weight bearing, in which of the following foot postures does the forefoot
compensate by abducting and everting, resulting in a more planus foot?
a. Rearfoot varus
b. Forefoot valgus
c. Forefoot varus
d. Rearfoot valgus
ANS: C
Rationale: With forefoot varus, the metatarsal heads are inverted relative to the rearfoot.

PTS: 1

34. Which is not a factor that can predispose someone to hallux valgus?
a. Pes cavus
b. Improperly fitted shoes
 c. Rheumatoid arthritis
d. Wearing of high heels
ANS: A
Rationale: A person with pes planus is more likely to experience hallux valgus.

PTS: 1

35. Which nerve is inflamed when someone is suffering from intermetatarsal neuroma?
a. Plantar
b. Tibial
c. Superficial peroneal
d. Deep peroneal
ANS: A
Rationale: The plantar surface of the foot is innervated via the lateral medial plantar nerve.

PTS: 1

36. Typically, where is pain centralized when someone has plantar fasciitis?
a. Medial calcaneal tubercle
b. Sustentaculum tali
c. Navicular tuberosity
d. Base of the fifth metatarsal
ANS: A
Rationale: The plantar fascia attaches to the medial calcaneal tubercle.

PTS: 1

37. The Mulder Sign involves compression of what structure?

a. Medial longitudinal arch
b. Lateral longitudinal arch
c. Transverse arch
d. Distal tibiofibular joint
ANS: C
Rationale: Compression of the transverse arch will place pressure on the interdigital nerve in
an attempt to reproduce symptoms associated with intermetatarsal neuroma.

PTS: 1

38. Which drop is considered normal when performing the navicular drop test?
a. 0.6 to 1.8 cm
b. 1.8 to 2.3 cm
c. 0 to 0.6 cm
d. 0 cm
ANS: A
Rationale: When going from seated to standing, it is normal to see the navicular drop between
0.6 and 1.8 cm.

PTS: 1
39. When measuring the angle of the medial longitudinal arch, which static position is considered
normal?
a. 121° to 130°
b. 131° to 152°
c. 153° to 162°
d. 110° to 120°
ANS: B
Rationale: A low arch is identified by an angle less than 131°, and a high arch is identified by
an angle greater than 152°.

PTS: 1

40. Which description best describes rearfoot varus?

a. Metatarsal heads are inverted relative to the rearfoot
b. Metatarsal heads are everted relative to the rearfoot
c. Calcaneus is inverted relative to the long axis of the bisected lower leg
d. Calcaneus is everted relative to the long axis of the tibia
ANS: C
Rationale: When identifying rearfoot position one needs to note the relative position of the
calcaneus to the long axis of the lower leg.

PTS: 1

41. Which muscle inserts onto the styloid process of the base of the fifth metatarsal?
a. Peroneus brevis
b. Peroneus longus
c. Peroneus tertius
d. Tibialis posterior
ANS: A
Rationale: The peroneus tertius inserts onto the dorsal surface of the base of the fifth
metatarsal, whereas the peroneus longus inserts onto the lateral aspect of the base of the first
metatarsal.

PTS: 1