CCEP Lower Extremity Treatment 4

Question 1

A dancer presents with pain at the posterior ankle reproduced by passive plantarflexion compression. The most likely diagnosis is:

Accepted Answer

Os trigonum syndrome

Answer

Passive plantarflexion compressing a posterior ankle bony or soft tissue prominence is the hallmark provocative test for os trigonum syndrome.

Question 2

Which nerve is most at risk during a proximal fibular manipulation for peroneal nerve entrapment?

Accepted Answer

Common peroneal nerve

Answer

The common peroneal nerve wraps around the fibular head and is directly at risk during proximal fibula joint procedures.

Question 3

What is the recommended chiropractic approach for a Grade II lateral ankle sprain in the subacute phase (days 4-14)?

Accepted Answer

HVLA thrust to restore subtalar motion, with proprioceptive rehabilitation

Answer

Subacute ankle sprains benefit from gentle HVLA to restore restricted talocrural and subtalar motion paired with early proprioceptive training.

Question 4

A patient with hallux limitus has restricted first MTP dorsiflexion. The preferred joint mobilization glide direction is:

Accepted Answer

Dorsal glide of the proximal phalanx on the metatarsal head

Answer

To restore dorsiflexion (extension) at the first MTP, a dorsal glide of the proximal phalanx is applied per the concave-convex rule.

Question 5

Which muscle, if weak, most commonly contributes to 'too many toes' sign during posterior observation of gait?

Accepted Answer

Tibialis posterior

Answer

Tibialis posterior weakness allows hindfoot valgus and forefoot abduction, causing more toes to be visible lateral to the heel from behind.

(CCEP) Certified Chiropractic Extremity Practitioner Practice Test