Exam (elaborations)
AN 3203 – BUNIONS AND SESAMOIDS EXAM QUESTIONS AND ANSWERS
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AN 3203 – BUNIONS AND SESAMOIDS EXAMQUESTIONS AND ANSWERS
Bunions (Hallux Abducto-Valgus) - ANSWER Greater than 15 degrees
of angulation of the great toe toward the fewer toes concerning the first
metatarsal bone and appears as a medial bony enlargement of the first
metatarsal head.
T or F:
Bunions are considered less than 10 degrees - ANSWER FALSE
Greater than 15 degrees
How many steps are there in the pathological process of Bunions (Hallux
Abducto-Valgus)? - ANSWER 8
Pathological process of Bunions (Hallux Abducto-Valgus): Step 1 -
ANSWER Medial Sesamoid and medial collateral ligaments fail.
Pathological process of Bunions (Hallux Abducto-Valgus): Step 2 -
ANSWER Metatarsal head now drifts medially slipping off the sesamoid
tracks
Pathological process of Bunions (Hallux Abducto-Valgus): Step 3 -
ANSWER Since the proximal phalanx is tethered to the sesamoids,
plantar plate and adductor hallucis, it moves into a valgus position.
Pathological process of Bunions (Hallux Abducto-Valgus): Step 4 -
ANSWER The metatarsal head sits on the medial sesamoid wearing out
the crista.
Pathological process of Bunions (Hallux Abducto-Valgus): Step 5 -
ANSWER Bursa thickens because of prominence rubbing on shoe.
Pathological process of Bunions (Hallux Abducto-Valgus): Step 6 -
ANSWER EHL bowstrings increasing the phalanx valgus.
,Pathological process of Bunions (Hallux Abducto-Valgus): Step 7 -
ANSWER Metatarsal head pronates due to malaligned muscle forces.
Pathological process of Bunions (Hallux Abducto-Valgus): Step 8 -
ANSWER Abductor hallucis unable to resist valgus movement of hallux
and adductor hallucis dominates
Risk Factors of Bunions (Hallux Abducto-Valgus):
Affects _____% of those 18-65 but _____% of those over 65.
Predominantly _____
Causes foot _____, reduced _____ _____ _____, impaired _____,
_____ alterations and increased risk of _____ - ANSWER Affects 23%
of those 18-65 but 36% of those over 65.
Predominantly female
Causes foot pain, reduced quality of life, impaired balance, gait
alterations and increased risk of falls
T or F:
Bunions (Hallux Abducto-Valgus) suggested causes are footwear,
genetics and over-pronation. - ANSWER TRUE
What is the term bunion derived from? - ANSWER from latin word
"turnip"
Progressive subluxation of the 1st MTP joint with a lateral deviation of
the hallux. Eventually crowds the 2nd toe causing lesser toe deformity
and accompanied by a painful prominence called a Bunion
Risk Factors Continued...:
Correlated in _____ but not thought to be as genetic as originally
believed as there was no difference between _____ and _____ twins.
Footwear with a _____ toe-box was a risk factor
, Repetitive forces on the _____ aspect of the hallux causes attenuation
of the medial ligaments and capsule and contracture of the _____. -
ANSWER Correlated in twins but not thought to be as genetic as
originally believed as there was no difference between monozygotic and
dizygotic twins.
Footwear with a constrictive toe-box was a risk factor
Repetitive forces on the medial aspect of the hallux causes attenuation
of the medial ligaments and capsule and contracture of the lateral.
Risk Factors Continued...:
Restrictive footwear and _____ of the _____ ray would do this.
Once the _____ occurs the muscle pull continues to produce greater
_____ subluxation of the hallux - ANSWER Restrictive footwear and
hypermobility of the first ray would do this.
Once the malalignment occurs the muscle pull continues to produce
greater lateral subluxation of the hallux
_____ of the first ray could lead to _____ leading to pressure on the
medial hallux (because of forefoot abduction) during heel lift. -
ANSWER Hypermobility of the first ray could lead to hyperpronation
leading to pressure on the medial hallux (because of forefoot abduction)
during heel lift.
Which metatarsal and sesamoid buns are affected with bunions? -
ANSWER 1. increase 1st met length, round first metatarsal head
2. LATERAL sesamoid displacement
NOTE:
Footwear and overpronation were less conclusive
What increases the risk of the bunions overlapping on other toes? -
ANSWER Odds of having hallux valgus and overlapping toes were
significantly increased in those with pronated foot function, while odds of
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