13. Ankle Foot (unfinished) COPY Flashcards
What is proximal to the Chopart joint?
Talus and calcaneus
What bones make up the midfoot?
Cuboid
Navicular
Cuneiforms (3)
What bones make up the forefoot?
metatarsals
phalanges
What makes up the rearfoot?
talus
calcaneus
if someone is pronated they will have calcaneo_____
valgus
if someone is supinated, they will have calcaneo______
varus
DF/PF is a motion of _____ joint
talocrural
INV/EV is a motion of _____ joint
subtalar
Abd/Add is a motion of _____ joint
subtalar (forefoot)
flexion and extension happens ______ in the foot
in the toes
Pronation is made up of what 3 motions
DF
Eversion
Abduction
Supination is made up of what 3 motions
PF
Inversion
Adduction
@ proximal tibiofibular joint, _____ tibial facet and ____ fibular facet
convex tib
concave fib
Proximal tibiofibular joint ________ belongs to knee and _______ belongs to ankle/foot
Anatomically
Functionally
Distal tib-fib joint is a _____ union
Syndesmosis
@ distal tib-fib joint, what ligaments are there
- anterior & posterior tib-fib ligaments
- interosseous ligaments
function of talocrural joint is dependent on stability of ______ joint
tibiofibular
hypermobility of proximal tibfib jt could lead to _____ nerve injury
common fibular
distal tibfib joint injury to syndesmosis can lead to _______ of ________
widening of “mortise”
= instability @ talocrural joint
Talocrural is a ____ ____ joint
synovial hinge
What 3 bones make up the Talocrural joint
Tibia/fibula on talus
the proximal articulating surface of Talocrural joint is _______ + _______ = _______
concave tibial plafond + malleoli = mortise
____ and ____ describe the Talocrural joint capsule
Weak and thin
another name for MCL of talocrural joint is
Deltoid ligament
What shape is deltoid ligament
fan shape
Where does the deltoid/MCL insert (3 bones)
navicular
talus
calcaneus
What ankle motion will sprain deltoid/MCL?
Eversion
The LCL of talocrural is made up of ____ and ____ and _______
anterior and posterior talofibular ligament & calcaneofibular ligament
What does LCL of talocrural help limit? ____ and ____
inversion
supination
between LCL and MCL of talocrural, which is stronger
MCL
LCL is weaker
what passive structure supports the talocrural ligaments?
extensor retinaculum
Talocrural axis is inclined down laterally ____ degrees
posteriorly ____ degrees
14 degrees
23 degrees
In dorsiflexion, head of talus rolls ______ while body of talus glides ________ in mortise
dorsally
plantarly
normal DF is _____ degrees
20
Is DF or PF close packed?
Dorsiflexion
Dorsiflexion is limited by active/passive tension in ______
gastroc/soleus
normal PF ROM is ____ degrees
50 degrees
in plantarflexion, loose packed occurs when _______
posterior body of talus is in contact
what talocrural motion has a higher incidence of ankle sprains?
plantar flexion
because it’s loose packed
PF is limited by tension in ____, ______, and ______
anterior tibialis
EHL
EDL
sustentaculum tali is on what bone? medial or lateral?
calcaneus
medial
medial ankle is protected by _____, _____ and ____
posterior tibialis
FHL
FDL
lateral ankle is protected by ____ and ____
fib long
fib brev
Talus is wider distally or proximally?
distally
Dorsiflexion causes ____ rotation of tib-fib
medial
in WB, mortise rotates over talus, tib fib joint adjusts to widen around distal talus
Plantarflexion causes ____ rotation of tib-fib
lateral
in WB, mortise rotates over talus, tib fib joint adjusts to widen around distal talus
what articulates in subtalar joint?
calcaneus and talus
In the proximal part of the subtalar joint, _____ talus on ____ calcaneus
concave
convex
Largest face (75% of ST forces) helps resist rotation
In the distal/medial part of subtalar joint, ____ facet of inferior body and neck of talus on 2 ___ facets of calcaneus
convex
concave
Tarsal canal is formed by sulcus in both bones (talus and calcaneus)
& runs from ______ to _____ (lateral to medial)
sinus tarsi
sustentaculum tali
name the Subtalar ligaments
- calcaneofibular ligament
- anterior and posterior talofibular lig
- lateral and interosseous talocalcaneal lig
- cervical ligament
- deltoid ligament
Which subtalar lig is the strongest?
Cervical ligament
Subtalar axis inclined _____ degrees dorsally and distally and inclined ______ medially
42 degrees
16 degrees
Subtalar NWB SUPINATION coupled motions = calcaneal ____, ____, _____ flexion
Adduction
Inversion (varus)
Plantar
Subtalar NWB PRONATION coupled motions = calcaneal ____, ____, _____ flexion
Abduction
Eversion (valgus)
Dorsi
WB pronation = calcaneal ____, talar ____, ____ flexion, Tib-fib _____ rotation
Eversion
Adduction
Plantar
Medial
WB supination = calcaneal ____, talar ___, ____ flexion, and Tib-fib ___ rotation
Inversion
Abduction
Dorsi
Lateral
Calcaneal Inv and Ev are measured as angles between ______ midline of leg and _____ calcaneus
Posterior
Posterior
Calcaneal Inv = ____ degrees
20-30
Calcaneal Ev = ____ degrees
5-10
When in bilateral stance, ____ degrees of Eversion
3.5 degrees
Gait requirements
* ___ degrees of Inv at heel strike then Ev
* then ____ degrees of Inv during push off
3 degrees
5.5 degrees
subtalar close packed = ____
Supination
stable foot position
Subtalar open packed = _____
Pronation
flexible foot position
____ and ____ form S shaped transverse tarsal joint line
Talonavicular
Calcaneocuboid
T/F: navicular and cuboid are immobile in weightbearing
True
talus and calcaneus move on them
Talonavicular joint:
Distal ____ head of talus w/
_____ proximal aspect of navicular
Convex
Concave
The plantar calcaneonavicular ligament is also called the ____ ligament
Spring ligament
Spring ligament goes from sustentaculum tali to ______
Plantar aspect of navicular bone
Medial segment of spring ligament function is ______
Sling to hold head of talus
Lateral segment of spring ligament resists _____ _____
tensile forces
Talonavicular medially reinformed by _____ ligament
Deltoid
Talonavicular laterally reinforced by _____ ligaments
Bifurcate
Calcaneocuboid joint is linked to ____ joint in WB
Subtalar
Calcaneocuboid joint has it’s own capsule with lateral band of ____, _____, ______, and ______
Bifurcate
Dorsal CC lig
Plantar CC lig
Long plantar lig
What is the key to transverse tarsal stability and lateral longitudinal arch
Long Plantar lig
It runs from calcaneus across cuboid to bases of 2-4 MT
The transverse tarsal axis inclines up ____ degrees from transverse plane
15 degrees
The transverse tarsal axis angles ____ medially from sagittal plane allowing for the TRIPLANAR motions of ____/____
9 degrees
Supination/Pronation
Talus & calcaneus moving on navicular & cuboid mostly in Inv/Eversion
Oblique axis of Transverse tarsal axis is _____ medial to sagittal plane and ____ supinated to transverse plane
57 degrees
52 degrees
- also allows Sup/pron of talus & calcaneus
- mostly in DF/PF and ADD/ABD
When assessing midfoot motion, need to put hindfoot in _____ to unlock the transverse tarsal joint
pronation
Lateral rotation of tibia will impose hindfoot _______ with relative ______ of forefoot
Supination
Pronation
(slide 30)
Which ligaments sprain easily in excessive supination?
Lateral
Medial Rotation of tibia imposes hindfoot _____
Pronation
the transverse tarsal adjusts forefoot to maintain base of support
1st TMT Joint is formed by
base of 1st MT with medial cuneiform (own capsule)
2nd and 3rd TMT are formed by
base of 2nd and 3rd MT with 2nd and 3rd cuneiform (share a capsule)
4th and 5th TMT are formed by
base of 4th and 5th MT with cuboid (share a capsule)
stare
and understand this