Ankle 5 Flashcards
Metatarsophalangeal Joints (MTP)
Joint type
condyloid synovial joints
- more degrees of motion
Metatarsophalangeal Joints (MTP)
Movements
DF/PF and abduction/adduction
MTP
DF>PF: Important in gait to permit
foot to pass over toes
Stability provided by
joint capsule, plantar plates, collateral ligaments, and deep transverse metatarsal ligament
MTP
Allow WB foot to rotate over toes through
MTP extension (metatarsal break)
MTP
Plantar plate protects
metatarsal heads during WB
MTP
Sesamoid bones add protection to
plantar surface of great toe’s metatarsal head
Sesamoid bones can be inflamed in people who do alot of
flexion –> dancers
IP Joint Function
- Smooth weight shift to opposite foot in gait
- Help maintain stability by pressing against the ground in standing
Paralysis of PFs
Cannot ____
Gait is ______
Stair climbing is ______
Running and jumping are all but _______
rise on toes
severely impaired
awkward and slow
but impossible
Tibial Nerve Severance
unable to PF
Isolated Paralysis of TA
DF possible, but with limited range
Calcaneal Varus
> 90 deg
will have excessive wear on lateral sides of shoes
Calcaneus Valgus
<90°; flat feet: collapse of medial longitudinal arch, medial malleolus is closer to the ground
Pes Planus
- Dropped/abnormally low medial longitudinal arch
- Rearfoot valgus posture
- Forefoot abduction
- Callus on the adjacent skin
Pes Planus
Negatively impacts
windlass effect
Pes planus causes
- Joint laxity within the midfoot or proximal forefoot regions
- Overstretched, torn, or weakened plantar fascia, spring ligament, and TP tendon
Pes Planus
Can Develop
plantar fasiciitis, TP Tendonitis, Tarsal tunnel syndrome, medial knee pain, back pain
Pes Planus
Lower Extremity
pronated foot, IR tibia, genu valgus, IR femur
Pes Cavus
Less force absorption when
walking, running, other loading activities
Pes Cavus
Abnormally raised ______
Rearfoot _______
Forefoot _______
medial longitudinal arch
Varus (inversion)
Valgus (eversion)
Foot and ankle problems associated with pescavus
- Hammer toes (bent toes) or claw toes (toes clenched like a fist)
- Calluses on the metatarsal heads, side or heel excessive pressure on toes
Claw Toe
Hyperextension of ____
Flexion ______
Often with _____
MTP
PIP and DIP of all toes
Pes cavus
Hammer Toe
Hyperextension of ______
Flexion of ______
Usually _______
MTP joint, DIP
PIP
2nd toe
Equinus Foot
- A congenital deformity of the foot in which the sole is permanently flexed so that walking is done on the toes without touching the heel to the ground “equinus” = horse.
Equinus Foot
Shortened Muscles
posterior compartment
- Metatarsus Adductor
- Metatarsal Bones are turned toward
the middle of the body
Metatarsus Adductor
crowdedness of the toes
Tophi
Crystal deposits in tissues around joint
Hyperuricemia
Tophi
1st MTPJ is
1st affected in gout
Pain, inflammation, swelling
Hallux Valgus (Bunions)
Associated with
Excessive adduction of the 1st metatarsal
Hallux Valgus Pain on
medial aspect of toe
Corns
Smaller than ______
Hard center surrounded by _____
calluses
inflamed skin
Corns can be hard or soft
Hard example
Soft example
dorsum of foot (hard)
Soft (between 4th and 5th)
Calluses
- Larger and harder
- Rarely painful
- Found on area that bear weight
Hallux Limitus “Rigidus”
Inability to bend great toe leading to
shortened toe off
Hallux limitus “rigidus” affects
windlass effect
Hallux Limitus “Rigidus” toe off carried out by
lateral 4 toes
Hallux limitus rigidus can lead to walking
- on the outer surface of foot OR with the foot pointed outward and “rolling over” the medial arch of the foot
Walking requires about
45 degrees of extension at the first MTPJ
- Anterior Compartment Syndrome
- Involves
TA, EHL, and EDL
Anterior Compartment Syndrome
_________ within mm
May cause swelling within _________
Can lead to _______ of muscles and nerves
hematoma
anterior compartment
necrosis
Anterior Compartment Syndrome
Can eventually lead to _____
Seen after _______________
foot drop
prolonged march in armed forces personnel
