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</p> Signup and view all the answers

    What is the anatomical characteristic of the first metatarsal head?

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

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

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

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

    <p>Round</p> Signup and view all the answers

    What is the primary reason for ligamentous laxity in females?

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

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

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

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

    <p>Genetics</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</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</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</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</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</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</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</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</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</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</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</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</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</p> Signup and view all the answers

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

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

    What is the staging of hallux abducto valgus based on?

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

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

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

    What is the significance of pinch callus during physical examination?

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

    What is the anatomical characteristic of the first metatarsal head?

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

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

    <p>Square</p> Signup and view all the answers

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

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

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

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

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

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

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

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

    What is the reference value for the PASA?

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

    What is the value of the PASA in this context?

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

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

    <p>8-12</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</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</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</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.</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.</p> Signup and view all the answers

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

    <p>DASA</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.</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.</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.</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</p> Signup and view all the answers

    What is the normal range of the DASA?

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

    What is the DASA used to evaluate?

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

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

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

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

    <p>Parallel</p> Signup and view all the answers

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

    <p>Round</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</p> Signup and view all the answers

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

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

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

    <p>Unstable</p> Signup and view all the answers

    What is the corresponding IMA value for a severe deformity?

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

    What is the correct formula to calculate the True IMA?

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

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

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

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

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

    What is the normal range for the Tibial Sesamoid Position?

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

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

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

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

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

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