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Good MI3 > Ankle and Foot > Flashcards

Ankle and Foot Flashcards

2
Q

Name the bones of the ankle and foot

A

tibia, fibula, talus, calcaneus, navicular, cuboid, medial cuneiform, middle cuneiform, lateral cuneiform, metatarsals, phalanges, sesamoids

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3
Q

Arches of the foot

Transverse

A

broad transverse arch formed at the levels of the tarsals and metatarsals

 - proximal transverse arch is half-dome with its apex on the medial side
 - distal transverse arch highest at 2nd MT, though is quite deformable.
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4
Q

Arches of the foot

Longitudinal - Medial

A

higher than the longitudinal arch, but more deformable
apex is superior aspect of the talar trochlea and the posterior and anterior bases are the calcaneus and the MT heads 1-3 respectively.

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5
Q

Arches of the foot

Longitudinal - Lateral

A

more resistant to flattening than the medial arch
apex is the superior aspect of the calcaneus and the posterior and anteriors bases are the tuberosity of the calcaneus and the MT heads 4-5.

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6
Q

Factors contributing to bony stability in the foot

2nd metatarsal on the middle cuneiform

A

do later

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7
Q

Factors contributing to bony stability in the foot

Cubonavicular joint

A

do later

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8
Q

Factors contributing to bony stability in the foot

Talocrural joint

A

do later

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9
Q

Inferior tibiofibular joint

Classify the inferior tibiofibular joint

A

syndesmosis - fibrous

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10
Q

Inferior tibiofibular joint

Osteokinematics

A

conjunct movement only in response to movement at the ankle

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11
Q

Inferior tibiofibular joint

Arthrokinematics

A

anterior posterior glides (minimal)

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12
Q

Inferior tibiofibular joint

Capsular pattern

A

Pain when mortise is splayed

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13
Q

Inferior tibiofibular joint

Resting position

A

approximatley 10 deg plantar flexion

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14
Q

Inferior tibiofibular joint

Close packed position

A

weight-bearing dorsiflexion of the talocrural joint provides the greatest ligament tension

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15
Q

Inferior tibiofibular joint

Articular surfaces

A

medial aspect of distal fibula - convexarticular facet

fibular notchon medial aspect of tibia - concave articular facet

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16
Q

Inferior tibiofibular joint

Articular cartilage

A

Syndesmosis with minimal articular cartilage

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17
Q

Inferior tibiofibular joint

Joint capsule

A

no articular capsule; the capsule if the talocrural joint projects proximally to the inferior joint margin

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18
Q

Interosseus Membrane

A

oblique fibrous band connecting the medial border of the fibula with the lateral border of the tibia.
Divides the lower limb into an anterior and a posterior compartment and increases the area available for muscle attachment
a large, ovoid opening at the proximal end of the membrane transmits the anterior tibial artery
a foramen for the perforating branch of the peroneal artery exists at the dfistal aspect of the membrane
the distal border of the membrane blends with the interosseous ligament of the inferior tibiofibular joint

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19
Q

Inferior tibiofibular joint

Ligaments

A

Anterior tibiofibular ligament
Interosseous ligament
Posterior tibiofibular ligament

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20
Q

Inferior tibiofibular joint

Neurology - segmental

A

L4, L5, S1, S2

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21
Q

Inferior tibiofibular joint

Neurology - peripheral

A

branches from the deep peroneal, saphenous and tibial nerves

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22
Q

Inferior tibiofibular joint

Vascular - arterial

A

perforating branch of the peroneal artery and branches from the medial malleolar rami of the anterior nad posterior tibial arteries

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23
Q

Talocrual joint

Articular surfaces

A

mortise joint
dome of the talus
- convex anterior/posterior
- concave medial/lateral
posterior aspect of the dome is narrower than the anterior aspects
corresponding facets of the distal tibia and the fibula are reciprocally curved
articulates posteriorly with the inferior transverse tibiofibular ligaments

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24
Q

Talocrual joint

Arthrology - capsule

A

loose, thin anteriorly and posteriorly
supported on each side by collateral ligaments
posterior- blends with the inferior transverse ligament
surrounds joint, attaching to the borders of the articular surfaces of the tibia, malleoli and talus (except neck)
extends superiorly to the inferior tobiofibular joint

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25
Q

Talocrual joint

Arthrology - ligaments

A

deltoid ligament
anterior talofibular ligament
calcaneofibular ligament
posterior talofibular ligament

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26
Q

Talocrual joint

Articular supply - segmental

A

L4, L5, S1, S2

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27
Q

Talocrual joint

Articular supply - peripheral

A

branches from the deep peroneal and tibial nerves

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28
Q

Talocrual joint

Vascular supply - arterial supply

A

branches of the dorsalis pedis artery
perforating branches of the peroneal artery
branches from the lateral malleolar and medial malleolar rami of the anterir and posterior tibial arteries
branches of the malleolar rami of the anterior tibial and peroneal arteries

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29
Q

Talocrual joint

Classification

A

synovial
compound (includes the inferior tibiofibular joint and there are also two articulating surfaces/facets; one on the distal tibia and one on the distal fibula)
modified sellar

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30
Q

Talocrual joint

Degrees of motion

A

one

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31
Q

Talocrual joint

Osteokinematics - mechanical axis

A

oblique transverse axis (slopes 10 deg inferiorly from medial malleolus to lateral malleolus) through the body of the talus

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32
Q

Talocrual joint

Osteokinematics - Movements

A

Dorsiflexion / Plantar flexion

 - impure swing about an obliwue transverse axis in the saggital plane
 - conjunct external rotation (slight abduction and eversion) of the talus with dorsiflexion and conjunct internal rotation (slight adduction and inversion) of the talus with plantar flexion
 - approx 26 deg dorsiflexion and approx 48 deg plantar flexion
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33
Q

Talocrual joint

Arthrokinematics - Accessory glides

A

Dorsiflexion - posterior glide (with conjunct external rotation) of the talus on the tibia and fibula

Plantarflexion - anterior glide (with conjunct internal rotation) of the talus on the tibia and fibula

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34
Q

Talocrual joint

End feel

A

Capsular, dorsiflexion may be a soft tisue stretch

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35
Q

Talocrual joint

Resting position

A

10 deg plantar flexion

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36
Q

Talocrual joint

Close packed position

A

full dorsiflexion

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37
Q

Subtalar joint

Osteology - general

A

the subtalar joint is the functional unit formed by the anterior and posterior articulations between the talus and the calcaneus

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38
Q

Subtalar joint

Osteology - articular surfaces

A

Posterior joint
- posterior superior facet of the calcaneus (convex)
- posterior inferior facet of the talus (concave)
Anterior joint
- articular facet of the talar head is convex
- anterior talar fecet of the calcaneus is concave
- this joint often has bipartite articular facets

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39
Q

Subtalar joint

Arthrology - capsule

A

poster joint: short fibres attached to the joint margins
anterior joint: thin, pooly defined capsule except posteriorly, where the anterior aspect of the interosseus ligament forms the capsule
the anterior joint is continuous with the talonavicular joint and the whole complex may be termed the talocalcaneonavicular joint

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40
Q

Subtalar joint

Arthrology - ligaments

A 
interosseuos talocalcaneal
cervical ligament
medial talocalcaneal ligament
lateral talocalcaneal ligament
posterior talocalcaneal ligament
41
Q

Subtalar joint

Arthrology - bursas

A

one many exist in the sinus tarsi
one intervenes between the posterior aspect of the calcaneus and the deep aspect of the Achilles tendon (retrocalcaneal bursa)

42
Q

Subtalar joint

Arthrology - fat pad

A

adipose tissue protecting the calcaneus

43
Q

Subtalar joint

Neurology - segmental

A

L4, L5, S1, S2

44
Q

Subtalar joint

Neurology - peripheral

A

branches from the medial plantar nerve

45
Q

Subtalar joint

Vascular supply - arterial

A

calcaneal branches of the peroneal artery

branches of the medial and lateral plantar arteries

46
Q

Subtalar joint

General

A

functional unit formed by the anterior and posterior articulations between the talus and thr calcaneus

47
Q

Subtalar joint

Classification

A

synovial
compound
anterior and posterior joint articular shape is modified oviod; functionally operate together as a modifed sellar joint

48
Q

Subtalar joint

Degrees of freedom

A

one (triplanar motion termed pronation and supination)

49
Q

Subtalar joint

Osteokinematics - mechanical axis

A

running from the posterolateral calcaneus in an anterior, medial and superior (oblique) direction through the superomedial talus
axis is 42 deg off the horizontal and 16 deg off the midline (averages)

50
Q

Subtalar joint

Osteokinematics - movements

A

Pronation / Supination

 - impure swing in the frontal plane about an oblique axis
 - given the orientation fo the axis, only two fo the three main components of pronation and supination are readily evident at the subtalar joint (calcaneus can only DF/PF very slighty relative to the talus)
 - inversion ROM exceeds eversion ROM by nearly double
 - pronation has the main components of eversion and abduction of the calcaneus
 - supination has the main components of inversion and adduction of the calcaneus
51
Q

Subtalar joint

Arthrokinematics - accessory glides associated with physiological movements

A

Open kinetic chain
Pronation:
- lateral glide of the anterior calcaneal facet on the talus
- medial glide of the posterior calcaneal facet on the talus
Supination:
- medial glide of the anterior clcaneal facet on the talus
- lateral glide of the posterior calcaneal facet on the talus

52
Q

Subtalar joint

End feel

A

Capsular

53
Q

Subtalar joint

Capsular pattern

A

greater limitation of supination than pronation

54
Q

Subtalar joint

Resting position

A

mid-position

55
Q

Subtalar joint

close pack position

A

end range pronation and supination

56
Q

Talonavicular joint

Osteology - Articular surfaces

A

proximal surface of the navicular is concave

lateral head of the talus is convex

57
Q

Talonavicular joint

Arthrology - capsule

A

incomplete, thickened posteriorly and continuous with the capsule of the anterior subtalar joint

58
Q

Talonavicular joint

Arthrology - ligament

A 
dorsal talonavicular ligament
plantar calcaneonavicular (spring) ligament
calcaneonavicular portion of the bifurcate ligament
59
Q

Talonavicular joint

Neurology - segmental

A

L4, L5, S1

60
Q

Talonavicular joint

Neurology - peripheral

A

branches from the medial plantar nerve

61
Q

Talonavicular joint

Vascular - arterial

A

branches of the medial plantar artery

medial tarsal branches of the dorsal pedis artery

62
Q

Talonavicular joint

Classification

A

synovial
compound (the anterior subtalar joint communicates with this joint)
modified oviod

63
Q

Talonavicular joint

Degrees of motion

A

two

64
Q

Talonavicular joint

Osteokinematics - mechanical axes

A

Oblique

Longitudinal

65
Q

Talonavicular joint

Osteokinematics - mechanical axes: oblique

A

directed anteriorly and superiorly 52 deg from the horizontal plane, and medially directed 57 deg from the longitudinal plane
Movements about the axis:
- pronation (DF, ABD components)
- inversion (PF, Add componetns)

66
Q

Talonavicular joint

Osteokinematics - mechanical axes: longitudinal

A

directed anteriorly and superiorly 15 deg from the horizontal plane, and medially directed 9 deg from the longitudinal plane
Movements about the axis:
- pronation (eversion component)
- supination (inversion component)

67
Q

Talonavicular joint

Arthrokinematics - accessory glides: open kinetic chain

A

pronation - plantar glide with conjunct internal rotation

supination - dorsal glide with conjunct external rotation of the navicular on the talus

68
Q

Talonavicular joint

Arthrokinematics - accessory glides: closed kinetic chain

A

pronation - relative dorsal glide with conjunct external rotation of the navicular on the talus as the talus decends and moves into a pronated position during weight bearing (fanning)
supination - relative plantar glide with conjunct internal rotation of the navicular on the talus as the talus acends and moves into a supinated position for push off (folding)

69
Q

Talonavicular joint

End feel

A

capsular

70
Q

Talonavicular joint

capsular pattern

A

limitation of supination greater than pronation (also with a loss of DF component of pronation while ABD and EV remain full)

71
Q

Talonavicular joint

Resting position

A

mid-position

72
Q

Talonavicular joint

close pack position

A

supination

73
Q

Calcaneocubiod joint

Classification

A

synovial
simple
articular surfaces are unmodified sellar; functionally operates as a modified sellar due to the strong union of the cubiod to the navicular

74
Q

Calcaneocubiod joint

Degrees of motion

A

two (components of the triplanar motion of pro/sup)

75
Q

Calcaneocubiod joint

Osteokinematics - mechanical axes

A

Oblique

Longitudinal

76
Q

Calcaneocubiod joint

Osteokinematics - mechanical axes: oblique

A

directed anteriorly and superiorly 52 deg from the horizontal plane, and medially directed 57 deg from the longitudinal plane
Movements about the axis:
- pronation (DF, ABD components)
- inversion (PF, Add componetns)

77
Q

Calcaneocubiod joint

Osteokinematics - mechanical axes: longitudinal

A

directed anteriorly and superiorly 15 deg from the horizontal plane, and medially directed 9 deg from the longitudinal plane
Movements about the axis:
- pronation (eversion component)
- supination (inversion component)

78
Q

Calcaneocubiod joint

Arthokinematics - assessory glides

A

Open kinetic chain / Closed kinetic chain
pronation - dorsal glide with conjunct internal rotation of the cuboid on the calcaneus (fanning)
supination - plantar glide with conjunct external rotation of the cuboid on the calcaneus (folding)

79
Q

Calcaneocubiod joint

End feel

A

capsular

80
Q

Calcaneocubiod joint

capsular pattern

A

limitation of supination greater than pronation (also with a loss of DF component of pronation while ABD and EV remain full)

81
Q

Calcaneocubiod joint

resting position

A

mid-position

82
Q

Calcaneocubiod joint

close packed position

A

supination

83
Q

Calcaneocubiod joint

osteology - articular surfaces

A

proximal surface of the cuboid:
- cuboid is concave in a plantar/dorsal direction
- convex in a medial/lateral direction
distal lateral facet of the calcaneus - reciprocally curved

84
Q

Calcaneocubiod joint

Arthrology - capsule

A

attaches to the articular margins

85
Q

Calcaneocubiod joint

Arthrology - ligaments

A

Dorsal calcaneocuboid ligament
calcaneocuboid portion of the bifurcate ligament
long plantar ligament
short plantar ligament

86
Q

Calcaneocubiod joint

Arthrology - bursa

A

subcalcaneal bursa

87
Q

Calcaneocubiod joint

Neurology - segmental

A

S1, S2

88
Q

Calcaneocubiod joint

Neurology - peripheral

A

branches from the lateral plantar nerve

89
Q

Calcaneocubiod joint

Vascular - arterial

A

calcaneal branches of the peroneal artery
lateral tarsal branches of the dorsalis pedis artery
branches of the lateral plantar arteries

90
Q

Muscles of plantarflexion

A

Gastrocnemius, soleus, plantaris (weak), FHL, FDL, Tib. post, peroneus longus, peroneus brevis.

91
Q

Muscles of dorsiflexion

A

Tib. ant, EHL, EDL, peroneus tertius,

92
Q

Planes and axis of dorsiflexion and plantar flexion

A

saggital plane about a transverse axis

93
Q

Planes and axis of eversion and inversion

A

frontal plane about a sagittal axis

94
Q

Planes and axis of abduction and adduction

A

transverse plane about a vertical axis

95
Q

triplanar motion of pronation

A

eversion, abduction and dorsiflexion

96
Q

triplanar motion of supination

A

inversion, adduction, and plantar flexion

Good MI3 (6 decks)

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