Tom, Dick, and Nervous Harry

Tom, Dick, and Nervous Harry: 

a mnemonic device to help remember the tendons and vessels that pass through the medial malleolus.

Goniometry

Goniometry definition: the measurement of range of motion in a joint.  It is used in diagnosis and rehabilitation of joint injuries.  Both active range of motion AROM and passive range of motion PROM can be measured.

A goniometer is a tool used for measuring the joint.

There are several different types of goniometers including shape and size; some are designed for easier use at the different joints of the body.

Parts of a goniometer:

• protractor: the round aspect of the tool with the numbers used for measurement of degrees in joint.
• fulcrum: axis of rotation in the center of the protractor.
• stationary arm: is the arm that is a part of the protractor and is used for stabilization on proximal body part; it usually has a line drawn in the middle of it.
• movement arm: is the arm that is free moving around the fulcrum and is place on the distal body part that moves during joint movement; the arm usually has measurements on it.

When measuring a joint:

1. Position the joint being measured in the neutral position.
2. Locate the axis of the joint; this is where the fulcrum with be aligned
3. Find the distal and proximal bony landmarks; this is where the stationary and movement arms will be aligned respectively. 
4. Measure the neutral position; that measurement will be equal to zero. Although some joints require a specific position to be recorded as neutral.
5. Keeping the arms in the same spots you can record the measurements of flexion and extension; record these measurements and compare them to the neutral position measurement.
6. You can continue this process bilaterally to compare the results of the injured to the uninjured structure.

Sinus Tarsi

The sinus tarsi is the indention on the lateral aspect of the foot, anterior to the lateral malleoli, that is the collecting place for the edema after an injury to the ankle. 


To help rid swelling from this area or even prevent swelling from this area after an injury a horse shaped pad can be cut out and place under the lateral malleoli with a compression wrap over it.  This will help push all swelling up and out of the leg to help relieve pain and retain original range of motion.  

If the swelling is not controlled there could be issues with normal healing time, range of motion, and if there is a fracture it will make it harder to read an x-ray.

Talus - Fun Fact

The Talus is a bone in the foot at the ankle joint.  It is the only axial bone in the body to not be attached to muscle.  It only has ligament attachments which means it only articulates with other bones.

Connected to these five bones by different ligaments:
Tibia
medial malleolus
lateral malleolus
calcaneus
navicular