National Physical Therapy Examination (NPTE) Practice Exam

Which areas should be monitored for tissue breakdown in a patient with a new plastic solid ankle-foot orthosis?

1. Popliteal space, posterior calf musculature, malleoli, Achille tendon, and base of metatarsals

2. Pelvic band, quadriceps tendon, popliteal space, tibial tuberosity, and navicular

3. Calf band, fibular head, popliteal fossa, malleoli, and styloid process of the 5th metatarsal

4. Tibial condyles, tibial tuberosity, anterodistal tibia, and metatarsal heads

The correct answer is: Calf band, fibular head, popliteal fossa, malleoli, and styloid process of the 5th metatarsal

The correct response focuses on specific anatomical areas where pressure and friction are more likely to occur due to the positioning and mechanics of a new plastic solid ankle-foot orthosis (AFO), especially in the context of a new fit. Monitoring the calf band, fibular head, popliteal fossa, malleoli, and the styloid process of the 5th metatarsal is crucial because these regions are prone to tissue breakdown due to their proximity to the orthosis. The calf band can create pressure on the posterior aspect of the leg, leading to skin irritation or breakdown, while the fibular head can be subjected to pressure from the orthosis, particularly during mobility. The popliteal fossa is another critical area to monitor because it can be compressed when the knee is flexed during ambulation, potentially leading to vascular and nerve irritation. The malleoli are prominent bony landmarks at the ankle that can be easily irritated against the rigid structure of the AFO. Lastly, the styloid process of the 5th metatarsal is relevant as it is the most lateral aspect of the foot and can be subjected to lateral pressures from the orthosis. These areas are chosen due to their anatomical relevance in relation to the