WorksheetsChapter 15 — Ankle and Lower Leg Worksheet Questions
Total questions: 65
Worksheet time: 33mins
The ankle joint or talocrural joint is formed by which bones? Select all that apply. (3)
Tibia
Fibula
Talus
Calcaneus
The joint between the talus and calcaneus is called the ______ joint and allows ______ and ______.
subtalar; inversion and eversion
talocrural; dorsiflexion and plantarflexion
tarsometatarsal; pronation and supination
calcaneocuboid; flexion and extension
What structure holds the tibia and fibula together?
Interosseous membrane (syndesmosis)
Deltoid ligament
Plantar fascia
Achilles tendon
The stability of the medial aspect of the ankle comes from the ______ ligament.
Deltoid ligament
Anterior talofibular ligament
Calcaneofibular ligament
Spring (plantar calcaneonavicular) ligament
What is present that makes it more difficult to evert the ankle joint?
The lateral malleolus acts as a bony block
The Achilles tendon is shorter laterally
The anterior talofibular ligament is stronger than the deltoid
The talus is wider posteriorly
Which lateral ligaments of the ankle are more susceptible to injury? Select all that apply. (3)
Anterior talofibular ligament (ATFL)
Calcaneofibular ligament (CFL)
Posterior talofibular ligament (PTFL)
Deltoid ligament
Spring (plantar calcaneonavicular) ligament
Which muscles primarily produce dorsiflexion at the ankle? Select all that apply.
Tibialis anterior
Extensor hallucis longus
Gastrocnemius
Extensor digitorum longus
Which muscles primarily produce plantarflexion at the ankle? Select all that apply.
Gastrocnemius
Soleus
Tibialis anterior
Peroneus (fibularis) longus
Which muscles primarily produce inversion of the foot? Select all that apply.
Tibialis posterior
Tibialis anterior
Peroneus (fibularis) brevis
Flexor hallucis longus
Which muscles primarily produce eversion of the foot? Select all that apply.
Peroneus (fibularis) longus
Peroneus (fibularis) brevis
Tibialis posterior
Peroneus (fibularis) tertius
Select the keys to preventing ankle injuries. Choose all that apply.
Proper footwear and playing surface maintenance
Strengthening and neuromuscular/proprioceptive training
Appropriate warm-up and flexibility work
Prophylactic taping or bracing when indicated
Avoid any conditioning to prevent fatigue
List all the things you would ask in the history section of an ankle assessment. Select all that apply.
Mechanism of injury
History of previous ankle injuries
Presence of any sounds (snap/pop) at the time of injury
what type of pain are you having
List 3 things you are looking for in an ankle assessment. Select all that apply.
Swelling and discoloration
Deformity or asymmetry
Range of motion limitations
skin color changes
What is the primary purpose of palpation during an injury evaluation?
To locate areas of point tenderness and identify involved structures
To increase blood flow to speed healing
To measure joint angles precisely
To distract the patient from pain
There is a progression of palpating an ankle injury. Which sequence best represents correct progression?
Begin away from the painful area, compare bilaterally, then move systematically to bony landmarks and soft tissues
Start directly on the point of maximal pain, then stop if tenderness is present
Palpate only the tendons, then the muscles, avoid bones
Move randomly between structures to prevent guarding
If a fracture is suspected, which test may be used to help in the determination?
Bump (percussion) test
Anterior drawer test
Thompson test
Talocrural compression only
The anterior drawer test is used to check the integrity of which ligament?
Anterior talofibular ligament
Deltoid ligament
Calcaneofibular ligament
Posterior talofibular ligament
What structure is primarily assessed by the talar tilt test?
Calcaneofibular ligament
Anterior cruciate ligament
Spring ligament
Peroneus longus tendon
Excessive inversion while the ankle is plantar flexed indicates a sprain of which ligament?
Anterior talofibular ligament
Deltoid ligament
Calcaneofibular ligament
Posterior talofibular ligament
List 3 things that could be included in the functional tests of the ankle.
Hopping on the affected ankle
Jogging in a straight line
Running a figure-eight pattern
Lateral shuffle cuts
Passive range-of-motion only
An _____ sprain is the most common and affects the lateral ligaments. (1)
Inversion
Eversion
High ankle (syndesmotic)
Chronic
The _____ ligament is the weakest of the lateral ligaments.
Anterior talofibular ligament
Calcaneofibular ligament
Posterior talofibular ligament
Deltoid ligament
Inversion and plantar flexion is the most common MOI for an ankle sprain. T or F (1)
True
False
_____ sprains are less common.
Inversion
Eversion
High ankle (syndesmotic)
metatarsal
An _____ fracture may occur to the _____ ligament just before it tears.
Avulsion/ deltoid
Stress/ calcaneofibular
Comminuted/ anterior tibiofibular
Spiral /posterior talofibular
What three ligaments are involved in a high ankle sprain?
Anterior inferior tibiofibular ligament
Posterior inferior tibiofibular ligament
Interosseous membrane
Deltoid ligament
Anterior talofibular ligament
Ankle sprains are graded in 3 levels, what describes a Grade 1
Mild stretching of ligaments with minimal swelling and no instability
Partial ligament tear with moderate swelling and some instability
Complete ligament rupture with severe swelling and marked instability
Fracture without ligament involvement
Ankle sprains are graded in 3 levels, Grade 2 is described as........
Mild stretching of ligaments with minimal swelling and no instability
Partial ligament tear with moderate pain, swelling, and some instability
Complete ligament rupture with severe swelling and marked instability
No soft-tissue damage; pain only with activity
Ankle sprains are graded in 3 levels, explain Grade 3.
Mild stretching of ligaments with minimal swelling and no instability
Partial ligament tear with moderate pain, swelling, and some instability
Complete ligament rupture with severe swelling, marked instability, and inability to bear weight
Muscle strain without ligament damage
Controlling _____ is the MOST important treatment in ankle sprains.
Swelling
Pain
Loss of strength
Muscle spasm
The acronym PRICE stands for?
Protection, Rest, Ice, Compression, Elevation
Prevent, Rotate, Immobilize, Cool, Exercise
Protective taping, Range, Ice, Calf stretch, Elevate
Pressure, Reduce, Immobilize, Cold, Elevation
Returning to full activity should consist of what functional activities?
Progressive running (walk–jog–sprint)
Cutting and agility drills
Sport-specific practice at full speed
Immediate competition without progression
Passive stretching only
An inversion sprain may cause a fracture to the _____ _____.
Lateral malleolus
Medial malleolus
Navicular bone
Talar dome
Fractures may occur to the _____ _____ when the foot is everted and the _____ ligament is also affected.
Medial malleolus and deltoid ligament
Lateral malleolus and anterior talofibular ligament
Navicular and spring ligament
Calcaneus and plantar fascia
With avulsion injuries, it is usually the fracture that prolongs the healing time rather than the ligaments. T or F
True
False
Explain the care of an ankle fracture. (3)
Immobilize, non–weight bearing, and immediate medical referral
Rest only and return to play when pain subsides
Apply heat and deep massage the first day
Continue activity with a supportive tape job
_____ of the surrounding tendons of the ankle are common in athletes.
Tendinitis/tendonosis
Ruptures
Ossifications
Neoplasms
Name the 3 common tendinitis sites of the ankle.
Achilles tendon
Peroneal tendons
Posterior tibial tendon
Deltoid ligament
Anterior cruciate ligament
What is the appropriate care for tendinitis/tendinosis?
Activity modification and relative rest
Ice, compression, and anti-inflammatory measures
Stretching and progressive strengthening of involved tendon
Immediate maximal plyometrics
Ignore pain and continue full sport
Name 3 things from the History portion of the lower body assessment.
Mechanism of injury and onset
Previous injuries and treatments
Location and nature of pain
Palpation findings
Special test results
Name 3 things from the observation phase of a lower body evaluation.
Gait pattern and weight bearing
Swelling, bruising, and deformity
Range-of-motion quality during movement
Past medical history
X‑ray interpretation
Name 3 things you are palpating for in a lower leg evaluation.
Point tenderness over bony landmarks
Warmth and crepitus along tendons
Swelling and tissue texture changes
Mechanism of injury description
Balance testing
Name 3 special test you would perform in a lower leg evaluation.
Anterior drawer and talar tilt
Squeeze test for syndesmosis
Thompson test for Achilles
Color vision screening
Blood pressure measurement
The _____ is the most commonly fractured long bone in the human body.
Tibia
Fibula
Femur
Humerus
What are the possible mechanisms of injury for lower leg fractures?
Direct blow
Torsional or rotational force
Repetitive microtrauma only
Thermal injury
What are the signs of injury to a tibial fracture? (1)
Focal bony tenderness with obvious deformity
Painless swelling only
Improved function with activity
Minimal discomfort without tenderness
What are the signs of injury to a fibular fracture? (1)
Lateral lower-leg pain with point tenderness
inability to walk
increased temperature
Generalized thigh swelling
What is the mechanism of injury for a lower leg stress fracture? (1)
Repetitive loading and overuse
Single high-energy impact
change of surface
improper shoes
List the signs of injury for a lower leg stress fracture.
Localized pain that increases with activity and decreases with rest
Point tenderness along the bone
Pain with hopping or percussion
Immediate deformity visible at rest
Complete loss of proprioception
What is the general care for a lower leg stress fracture?
Relative rest and activity modification
Protected weight bearing as needed and medical evaluation
Alternate heat and Ice
tape and participate
Define shin splints. (1)
Pain along the tibia caused by overuse of the lower leg muscles and stress to the bone/periosteum
pain caused from the pulling away of muscle
Inflammation the shin muscles
Bruising of the anterior tibialis due to a blunt blow
List 2 signs/symptoms of shin splints.
Diffuse pain along the medial tibia during or after activity
Localized tenderness at the lateral malleolus only
Tightness in the lower leg muscles
Increased pain with running or jumping
Visible deformity of the ankle joint
What is the recommended care for shin splints?
Relative rest and modification of training
Ice and anti‑inflammatory measures after activity
Immediate surgical fixation of the tibia
Stretching and strengthening of lower leg and calf muscles
Continue intense running without changes
Explain why the shin is vulnerable to shin contusions. (1)
The anterior tibia has minimal soft‑tissue protection, making it susceptible to direct blows
The shin is surrounded by thick muscle padding that absorbs impact
The tibia is a flexible bone that bends on contact
The shin receives increased blood flow that prevents bruising
List the signs/symptoms of shin contusions and the care for it.
Localized pain and swelling over the tibia after a direct blow
Discoloration/bruising at the impact site
Care includes ice, compression, elevation, and padding for protection
Immediate fasciotomy for all contusions
Complete immobilization for six months
What is compartment syndrome? (1)
A dangerous increase in pressure within a closed muscle compartment that compromises circulation and nerve function
A minor bruise to the calf muscles that heals on its own
A dislocation of the ankle joint from twisting
An infection of the lower leg bones
List the 3 types of compartment syndrome. (3)
Acute compartment syndrome
Acute exertional compartment syndrome
Chronic (exertional) compartment syndrome
Congenital compartment syndrome
Postural compartment syndrome
List 3 signs/symptoms of compartment syndrome. (3)
Severe, progressive pain out of proportion to the injury
Tight, firm compartment with increased pressure
Paresthesia or numbness/tingling in the affected limb
Brisk capillary refill and bounding pulses throughout
Immediate relief with continued exercise
Explain the care for compartment syndrome. (2)
For acute cases, immediate medical referral and possible fasciotomy; for chronic cases, activity modification and monitoring
Apply heat and deep massage to increase compartment pressure
Ignore symptoms and continue training to strengthen the area
Treat all cases only with ankle bracing
The (a) tendon is the largest tendon in the body. (1)
Inflammation of the achilles is called (a) . (1)
Where is the pain noticed most in achilles tendinitis? (1)
At the back of the heel along the Achilles tendon, especially just above its insertion
On the front of the shin over the tibia
On the lateral side of the knee joint
Under the arch of the foot
What is the treatment for achilles tendonitis? (3)
Relative rest and activity modification
Ice and anti‑inflammatory measures
Gentle stretching and eccentric strengthening of the calf/Achilles
Immediate surgical repair for all cases
High‑impact running daily to increase tolerance
What causes an achilles tendon rupture? (1)
A sudden, forceful plantar flexion or push‑off often with degenerative tendon changes
Gradual stretching during yoga practice
Low‑impact walking on soft surfaces
Cold weather alone without activity
List the signs/symptoms of an achilles tendon rupture and what is the care given?
Sudden sharp pain and a popping sensation in the back of the ankle
Loss of plantar flexion strength and difficulty walking
Palpable gap in the tendon
Care involves urgent medical referral; immobilization and surgical repair are commonly indicated
Self‑massage only with no follow‑up
