Physiotherapy Exam: 1st MTPJ Assessment
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Questions and Answers

What is the result of articular damage on physical examination?

  • Crepitus (correct)
  • Poor quality of motion
  • Tracking
  • Pain location

In which position are dorsiflexion and plantarflexion evaluated during physical examination of the 1st MTPJ?

  • Neutral position
  • Weight-bearing position
  • Abnormal position
  • Corrected position (correct)

What is the primary cause of tracking in the 1st MTPJ?

  • Lateral soft tissue contracture (correct)
  • Distal cartilage damage
  • Proximal cartilage damage
  • Medial soft tissue contracture

What is the significance of hyperkeratotic lesions during physical examination of the foot?

<p>They tell the story of how the foot is functioning (A)</p> Signup and view all the answers

What is the anatomical characteristic of the first metatarsal head?

<p>It has no tendinous attachments (A)</p> Signup and view all the answers

What is the significance of the sub 1st metatarsal callus during physical examination?

<p>It indicates plantarflexed first ray/hypertrophic sesamoid (A)</p> Signup and view all the answers

What is the correlation between ballet dancing and forefoot pathology?

<p>There is a strong correlation between ballet dancing and forefoot pathology (A)</p> Signup and view all the answers

What is the ratio of male to female for elective surgical bunion correction?

<p>1:15 (D)</p> Signup and view all the answers

What is the shape of the first metatarsal head that is most unstable?

<p>Round (A)</p> Signup and view all the answers

What is the primary reason for ligamentous laxity in females?

<p>Hormonal changes (A)</p> Signup and view all the answers

What is the typical age range for peak onset of bunion formation?

<p>30-60 years (D)</p> Signup and view all the answers

What is the relationship between excessive weightbearing and bunion formation?

<p>There is no proven link between excessive weightbearing and bunion formation (D)</p> Signup and view all the answers

What is the primary factor that contributes to first ray stability?

<p>A congruent and stable 1st MTPJ during push off (A)</p> Signup and view all the answers

Which of the following is an intrinsic factor that contributes to hallux abducto valgus?

<p>Genetics (D)</p> Signup and view all the answers

What is the relationship between shoe gear and hallux abducto valgus?

<p>Shoe gear may speed up the progression of hallux abducto valgus (C)</p> Signup and view all the answers

Which of the following is NOT a factor that contributes to first ray stability?

<p>Footwear with a wide toe box (A)</p> Signup and view all the answers

What is the significance of the metatarsal parabola in relation to hallux abducto valgus?

<p>It is a risk factor for hallux abducto valgus (A)</p> Signup and view all the answers

What is the role of excessive weightbearing in the development of hallux abducto valgus?

<p>It is a contributing factor to the development of hallux abducto valgus (D)</p> Signup and view all the answers

What is the term used to describe a modification of a biological structure where an ancestral genetic trait reappears after being lost through evolutionary change?

<p>Atavism (A)</p> Signup and view all the answers

Which of the following genetic factors contributes to the destabilization of the medial column and produces an elevation of the first metatarsal?

<p>Pes planus (C)</p> Signup and view all the answers

What is the term used to describe a short first metatarsal, which is often associated with hallux abducto valgus (HAV) deformity?

<p>Morton foot (B)</p> Signup and view all the answers

Which of the following genetic factors contributes to the loss of mechanical pull and locking mechanism in the foot?

<p>Pes planus (B)</p> Signup and view all the answers

What is the term used to describe the condition where the gastrocnemius muscle is tight, contributing to early and increased forefoot overload?

<p>Equinus (B)</p> Signup and view all the answers

Which of the following genetic factors is associated with a higher correlation of HAV deformity?

<p>Morton foot (D)</p> Signup and view all the answers

What is the initial stage of bunion formation?

<p>Failure of the medial supporting structures of the metatarsophalangeal joint (A)</p> Signup and view all the answers

What is the consequence of the metatarsal head sitting on the tibial sesamoid?

<p>Erosion of cartilage and the median crista (D)</p> Signup and view all the answers

What is the result of the balance between the abductor hallucis and the adductor hallucis being lost?

<p>The plantomedial insertion of the abductor hallucis rotates inferiorly (B)</p> Signup and view all the answers

What is the consequence of the weaker, dorsal capsule rotating medially?

<p>Further joint instability (A)</p> Signup and view all the answers

What is the final stage of bunion formation?

<p>The metatarsal head elevates and transfers plantar pressures laterally (D)</p> Signup and view all the answers

What is the staging of hallux abducto valgus based on?

<p>First MTPJ alignment (C)</p> Signup and view all the answers

What is the significance of crepitus during physical examination of the 1st MTPJ?

<p>Articular damage (A)</p> Signup and view all the answers

What is the primary cause of the inability to adduct the hallux during physical examination?

<p>Lateral soft tissue contracture (C)</p> Signup and view all the answers

In which plane of motion should the hallux interphalangeal joint be evaluated during physical examination?

<p>Sagittal and transverse plane (C)</p> Signup and view all the answers

What is the significance of pinch callus during physical examination?

<p>Abnormal pronatory roll off (A)</p> Signup and view all the answers

What is the anatomical characteristic of the first metatarsal head?

<p>It has no tendinous attachments (D)</p> Signup and view all the answers

In which position are dorsiflexion and plantarflexion evaluated during physical examination of the 1st MTPJ?

<p>In the corrected position (D)</p> Signup and view all the answers

What is the correlation between joint morphology and foot pathology?

<p>They have a major role in the development of hallux abducto valgus (B)</p> Signup and view all the answers

What is the primary reason for the correlation between age and bunion formation?

<p>Biomechanical changes occur with age (A)</p> Signup and view all the answers

What is the effect of ligamentous laxity on foot morphology?

<p>It decreases the stability of the medial column (B)</p> Signup and view all the answers

What is the shape of the first metatarsal head that is associated with stability?

<p>Square (C)</p> Signup and view all the answers

What is the correlation between pes planus and hallux abducto valgus?

<p>They are directly correlated (A)</p> Signup and view all the answers

What is the effect of relaxin and progesterone on ligamentous laxity?

<p>They increase ligamentous laxity (D)</p> Signup and view all the answers

Which of the following factors is NOT a primary contributor to first ray stability?

<p>Excessive load (D)</p> Signup and view all the answers

What is the role of footwear in the development of hallux abducto valgus?

<p>It speeds up the progression of hallux abducto valgus (D)</p> Signup and view all the answers

Which of the following is an example of an intrinsic factor that contributes to hallux abducto valgus?

<p>Joint morphology (A)</p> Signup and view all the answers

What is the relationship between sexual dimorphism and hallux abducto valgus?

<p>Females are more likely to develop hallux abducto valgus due to their joint morphology (A)</p> Signup and view all the answers

What is the significance of the first tarsometatarsal joint in relation to hallux abducto valgus?

<p>It is a contributing factor to first ray stability (D)</p> Signup and view all the answers

Which of the following is NOT a common extrinsic factor that contributes to hallux abducto valgus?

<p>Sexual dimorphism (C)</p> Signup and view all the answers

In a stage 1 hallux abducto valgus, what is the characteristic of the radiographic angles?

<p>They are all normal (B)</p> Signup and view all the answers

What is the characteristic of the 1st MTPJ in a stage 4 hallux abducto valgus?

<p>It is subluxed (D)</p> Signup and view all the answers

In a stage 2 hallux abducto valgus, what is the characteristic of the first metatarsal alignment?

<p>It is normal (D)</p> Signup and view all the answers

What is the characteristic of the hallux in all stages of hallux abducto valgus?

<p>It is abducted (C)</p> Signup and view all the answers

In a stage 3 hallux abducto valgus, what is the characteristic of the radiographic angles?

<p>The intermetatarsal angle and the hallux abductus angle are abnormal (D)</p> Signup and view all the answers

What is the primary factor used to stage hallux abducto valgus?

<p>Radiographic angles (B)</p> Signup and view all the answers

What is the consequence of the peroneus longus losing its function in the foot?

<p>Loss of mechanical pull and locking mechanism (C)</p> Signup and view all the answers

What is the relationship between equinus and hallux abducto valgus?

<p>Equinus contributes to the development of hallux abducto valgus (B)</p> Signup and view all the answers

What is the effect of a 'Morton Foot' on the foot's function?

<p>It increases the correlation of hallux abducto valgus (D)</p> Signup and view all the answers

How does ligamentous laxity contribute to bunion formation?

<p>It plays a large role in bunion formation of both adults and juveniles (C)</p> Signup and view all the answers

What is the result of the first ray becoming hypermobile?

<p>It produces an elevation of the first metatarsal (C)</p> Signup and view all the answers

What is the effect of pes planus on the foot's function?

<p>It causes the foot to pronate and destabilizes the medial column (B)</p> Signup and view all the answers

What is the Proximal Articular Set Angle (PASA) defined as?

<p>The angle formed by a line perpendicular to the longitudinal bisection of the 1st metatarsal and the line formed by marking the medial and lateral aspects of the 1st metatarsal head cartilage (B)</p> Signup and view all the answers

What is the reference value for the PASA?

<p>0 – 8° (B)</p> Signup and view all the answers

What is the purpose of drawing the longitudinal bisection of the 1st metatarsal?

<p>To determine the PASA (B)</p> Signup and view all the answers

What is the next step after drawing the line perpendicular to the longitudinal bisection of the 1st metatarsal?

<p>Measure the PASA (A)</p> Signup and view all the answers

What is the importance of the PASA?

<p>It is used to assess the alignment of the 1st metatarsal head (A)</p> Signup and view all the answers

What is the value of the PASA in this context?

<p>24° (C)</p> Signup and view all the answers

What is the consequence of not considering metatarsus adductus during bunion correction?

<p>Under-correction of the bunion deformity (C)</p> Signup and view all the answers

What is the formula to calculate the true intermetatarsal angle (IMA) if the MAA is greater than 15°?

<p>IMA = (MAA - 15) + IMA (D)</p> Signup and view all the answers

What is the normal range for the intermetatarsal angle (IMA)?

<p>8-12 (C)</p> Signup and view all the answers

What is the significance of the metatarsus adductus angle (MAA)?

<p>It can hide the severity of the bunion deformity (A)</p> Signup and view all the answers

What is the definition of the intermetatarsal angle (IMA)?

<p>The angle formed by the longitudinal bisection of the 1st and 2nd metatarsal (C)</p> Signup and view all the answers

Why is it important to consider the metatarsus adductus angle (MAA) during bunion correction?

<p>Because it can hide the severity of the bunion deformity (B)</p> Signup and view all the answers

What is the significance of an increased PASA in procedure selection and efficacy?

<p>It indicates the degree of articular cartilage deviation, which affects the suitability of certain procedures. (A)</p> Signup and view all the answers

What is the definition of the DASA?

<p>The angle formed by the longitudinal bisection of the proximal phalanx of the hallux and the line perpendicular to the medial and lateral aspects of the cartilage. (A)</p> Signup and view all the answers

Which of the following angles is evaluated from the proximal phalanx of the hallux?

<p>DASA (D)</p> Signup and view all the answers

What is the significance of the DASA in evaluating the 1st MTPJ?

<p>It evaluates the distal articular cartilage of the 1st MTPJ. (C)</p> Signup and view all the answers

What is the relationship between the PASA and procedure selection?

<p>A high PASA indicates that some procedures will work, while others will not, or may need to be modified. (D)</p> Signup and view all the answers

What is the role of the DASA in evaluating the 1st MTPJ?

<p>It evaluates the articular cartilage of the 1st MTPJ. (D)</p> Signup and view all the answers

What is the anatomical structure that the longitudinal bisection of the proximal phalanx of the hallux intersects with in order to form the DASA?

<p>Medial and lateral aspects of the cartilage of the proximal phalangeal base (D)</p> Signup and view all the answers

What is the normal range of the DASA?

<p>7-12° (D)</p> Signup and view all the answers

How is the DASA measured?

<p>By drawing the longitudinal bisection of the proximal phalanx and the line perpendicular to the distal cartilage line (A)</p> Signup and view all the answers

What is the significance of the DASA in evaluating the alignment of the hallux?

<p>It helps to diagnose hallux abducto valgus (A)</p> Signup and view all the answers

What is the DASA used to evaluate?

<p>The alignment of the hallux (D)</p> Signup and view all the answers

What is the correlation between the length of the 1st metatarsal and function?

<p>Direct correlation (B)</p> Signup and view all the answers

What is the characteristic of the joint lines in a congruous joint?

<p>Parallel (A)</p> Signup and view all the answers

What is the shape of the metatarsal head that is considered most unstable?

<p>Round (D)</p> Signup and view all the answers

What is the term used to describe a modification of a biological structure where an ancestral genetic trait reappears?

<p>Atavism (D)</p> Signup and view all the answers

What is the effect of shortening the 1st metatarsal length on plantar pressures?

<p>Abnormal pressure (A)</p> Signup and view all the answers

What is the significance of medial cuneiform obliquity in relation to stability?

<p>Unstable (A)</p> Signup and view all the answers

What is the corresponding IMA value for a severe deformity?

<p>&gt; 16° (A)</p> Signup and view all the answers

What is the correct formula to calculate the True IMA?

<p>(MAA - 15) + IMA (B)</p> Signup and view all the answers

What is the significance of the Hallux Abductus Angle (HAA) in surgical procedure selection?

<p>It determines the degree of deformity (B)</p> Signup and view all the answers

What is the reference value for a normal Hallux Abductus Angle (HAA)?

<p>&lt; 15° (A)</p> Signup and view all the answers

What is the order of angles measured on the AP view, from proximal to distal?

<p>MAA, PASA, IMA, HAA, DASA (C)</p> Signup and view all the answers

What is the significance of the True IMA in surgical procedure selection?

<p>It determines the degree of deformity and guides surgical procedure selection (A)</p> Signup and view all the answers

What is the significance of metatarsus adductus in relation to bunion deformity?

<p>It hides the true severity of the bunion deformity (D)</p> Signup and view all the answers

How is the true intermetatarsal angle (IMA) calculated when the metatarsus adductus angle (MAA) is greater than 15°?

<p>IMA = (MAA - 15) + IMA (B)</p> Signup and view all the answers

What is the significance of the intermetatarsal angle (IMA) in evaluating the bunion deformity?

<p>It is used to evaluate the severity of the bunion deformity (A)</p> Signup and view all the answers

What is the reference value for a moderate deformity of the intermetatarsal angle (IMA)?

<p>14-16° (D)</p> Signup and view all the answers

What is the purpose of evaluating the metatarsus adductus angle (MAA) in relation to the bunion deformity?

<p>To consider the correction of the bunion deformity (A)</p> Signup and view all the answers

What is the impact of metatarsus adductus on the correction of the bunion deformity?

<p>It limits the correction of the bunion deformity (A)</p> Signup and view all the answers

What is the significance of the hallux abductus angle in relation to the first MTPJ?

<p>Measures the degree of hallux deviation from the midline (A)</p> Signup and view all the answers

Which angle is used to evaluate the proximal cartilage of the 1st MTPJ?

<p>Proximal articular set angle (A)</p> Signup and view all the answers

What is the anatomical structure that the longitudinal bisection of the proximal phalanx of the hallux intersects with to form the DASA?

<p>First metatarsal head (C)</p> Signup and view all the answers

What is the primary factor that contributes to the significance of the PASA in procedure selection?

<p>It confirms the presence of a deformity independent of the 1st MTPJ (B)</p> Signup and view all the answers

What is the significance of the intermetatarsal angle in relation to the 1st MTPJ?

<p>Measures the degree of deviation between the 1st and 2nd metatarsals (D)</p> Signup and view all the answers

What is the significance of the tibial sesamoid position in relation to the 1st MTPJ?

<p>Measures the degree of medial deviation of the sesamoid (A)</p> Signup and view all the answers

What is the purpose of measuring the Tibial Sesamoid Position?

<p>To understand the relationship of the sesamoid bones to the 1st metatarsal (B)</p> Signup and view all the answers

What is the significance of the Distal Articular Set Angle (DASA)?

<p>It indicates the deformity within the proximal phalanx (C)</p> Signup and view all the answers

What is the normal range for the Tibial Sesamoid Position?

<p>1-3 (A)</p> Signup and view all the answers

What is the purpose of measuring the Intermetatarsal Angle (IMA)?

<p>To measure the alignment of the metatarsals (A)</p> Signup and view all the answers

What is the significance of the Proximal Articular Set Angle (PASA)?

<p>It influences procedure selection (C)</p> Signup and view all the answers

What is the purpose of measuring the Metatarsal Protrusion Distance (MPD)?

<p>To measure the length of the 1st metatarsal (A)</p> Signup and view all the answers

What is the Metatarsal Protrusion Distance (MPD) defined as?

<p>The distance between the length of the 1st and second metatarsals (C)</p> Signup and view all the answers

What is the reference value for the Metatarsal Protrusion Distance (MPD)?

<p>5 mm +/- 2mm (C)</p> Signup and view all the answers

What is the purpose of using a compass to draw a parabola in measuring the Metatarsal Protrusion Distance (MPD)?

<p>To use the angle vertex as the point to draw the parabola (B)</p> Signup and view all the answers

What is the significance of the Metatarsal Protrusion Distance (MPD) in evaluating the foot?

<p>It evaluates the alignment of the metatarsals (A)</p> Signup and view all the answers

How is the Metatarsal Protrusion Distance (MPD) measured?

<p>By measuring the distance between the length of the 1st and second metatarsals (C)</p> Signup and view all the answers

What is the importance of the Metatarsal Protrusion Distance (MPD) in relation to hallux abducto valgus?

<p>It evaluates the alignment of the metatarsals and its significance in hallux abducto valgus (A)</p> Signup and view all the answers

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