Ankle: Anatomy 5 Flashcards
Flat foot postures (or pes planus) generally fall into two categories. What are they?
- supple flat foot
- rigid flat foot
What is a supple flat foot?
arch collapses during WB activities but is present when unloaded
What is a rigid flat foot?
Arch is absent in both WB and unloaded positions
Flat foot: related factors
Femoral version
Anteversion
Flat foot: related factors
Weakness in what muscles?
- hip external rotators
- posterior glute med
- posterior tibialis
- peroneus longus
- hip abductors
Flat foot: related factors
Tightness where
- medial hamstrings
- dorsiflexion
Flat foot: related factors
Bony/structural factors
- tibia varum
- forefoot varus
- femoral anteversion
Flat foot: related factors
Body comp
Obesity
Flat foot: associated injuries or conditions
- Plantar fasciitis
- Interdigital neuroma
- Shin splints
- Sesamoiditis
- Tarsal tunnel syndrome
- Patellofemoral dysfunction
- Tibial rotation disorders
Pes cavus: more or less common than flat foot deformity?
Less common
Pes cavus: Common neuromuscular pathology found in which age groups?
Children
Elderly
Pes cavus: Related factors
Femoral version
Retroversion
Pes cavus: Related factors
bony
- Decreased calcaneal eversion
- high degree of tibia varum
- femoral retroversion
- congenital foot deformities (club foot)
Pes cavus: Related factors
Muscular imbalance with stronger (what group)
Subtalar joint invertors
Pes cavus: Associated injuries or conditions
- metatarsalgia
- stress fx
- peroneal tendonitis
- ITBS
- lateral ankle sprain
- LBP
- sesamoiditis
- plantar fasciitis
This nerve is often stretched as a result of inversion injury to the ankle
Superficial peroneal nerve
What nerve runs through the tarsal tunnel?
Posterior tibial nerve
Which nerve on the anterior aspect of the foot is often compressed at the extensor retinaculum?
Deep peroneal nerve
Components of the arches of the foot
- keystone
- posterior pillar
- anterior pillar
- tie rod
Where is the keystone in the arch of the foot?
At the peak of the arch
Medial longitudinal arch:
What is the keystone?
Talar head
Medial longitudinal arch:
What is the posterior pillar?
Calcaneus
Medial longitudinal arch:
What is the anterior pillar?
- sesamoids
- heads of metatarsals 1-3
Medial longitudinal arch:
What is the tie rod?
Plantar fascia
Why do clinicians commonly treat medial arch pain pathology passively?
High degree of passive stability
Recent evidence suggest that active structures play a large role in medial arch support and clinicians are encouraged to focus on what treatment modalities?
Both intrinsic and extrinsic muscle strengthening
Medial arch: extrinsic strengthening
Which muscles?
Posterior tibialis
Triceps surae
Lateral longitudinal arch:
What is the keystone?
Cuboid
Lateral longitudinal arch:
What is the posterior pillar?
Calcaneus
Lateral longitudinal arch:
What is the anterior pillar?
Heads of metatarsals 4-5
Lateral longitudinal arch:
What is the tie rod?
Plantar fascia
Transverse arch:
What is the keystone?
Middle cuneiform
Transverse arch:
What is the lateral pillar?
Cuboid
Transverse arch:
What is the medial pillar?
Medial cuneiform
Transverse arch:
What is the tie rod?
Peroneus longus tendon
Anterior compartment: which muscle group
Dorsiflexors
Lateral compartment: which muscle groups
Pronators
Deep posterior compartment: which muscle groups?
Subtalar supinators
Also thought to raise medial arch
anterior compartment: what are the ankle dorsiflexors?
- tibialis anterior
- EHL
- EDL
- peroneus tertius
Intrinsic muscles of the feet serve what functions?
- IP joint flexion
- arch support
- propulsion
Lateral compartment: what are the muscles that perform pronation?
- peroneus longus
- peroneus brevis
Deep posterior compartment: which muscles are the subtalar supinators (also thought to raise medial arch)?
- FDL
- FHL
- posterior tibialis
