ankle and foot Flashcards

1
Q

what is the function of the foot?

A
  • base for support
  • shock absorber
  • adapt to uneven surface
  • propulsion
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2
Q

what area is supported by three arches?

A
  • plantar vault
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3
Q

what part of the plantar vault contacts the ground?

A
  • big toe, little toe and calcaneal tuberosity
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4
Q

where is the medial arch?

A
  • inside of foot
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5
Q

what bones form the medial arch?

A
  • calcaneus, talus, navicular, medial cuneiform and metatarsal 1
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6
Q

what are the characteristics of the medial arch?

A
  • highest arch
  • doesn’t contact the ground
  • flexible
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7
Q

what is the medial arch supported by?

A
  • plantar aponeurosis which acts as a supporting beam between two pillars
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8
Q

what ligament supports head of talus?

A
  • spring ligament
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9
Q

what three bones make up the lateral arch?

A
  • calcaneus
  • cuboid
  • metatarsal 5
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10
Q

what are the features of the lateral arch?

A
  • flat
  • more rigid
  • in contact with ground
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11
Q

what two tendons maintains curvature in lateral arch?

A
  • fibularis longus tendon and tibialis posterior
  • crosses under sole of foot
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12
Q

what muscle stabilises curvature of lateral arch?

A
  • transverse head of adductor longus
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13
Q

what makes up the anterior transverse arch?

A
  • formed by head of five metatarsals
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14
Q

what are the features of the anterior transverse arch?

A
  • flat
  • contacts ground
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15
Q

what supports the anterior transverse arch?

A
  • tibialis posterior
  • plantar ligament
  • deep transverse metatarsal
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16
Q

what is the staple type of support? give an example

A
  • bound together underneath to prevent them being separated by weight
    e.g. anterior transverse arch; metatarsals heads connected by deep transverse ligaments
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17
Q

what is the tie beam of support? give an example

A
  • connects two ends together and prevents separation when weightbearing
    e.g. plantar fascia extends from calcaneus to metatarsals
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18
Q

describe what plantar fascia is

A
  • thick fibrous tissue that spans the length of foot
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19
Q

what is the sling type of support? give an example

A
  • supported from above so when it contracts it pulls upwards to help support or raise arch
    e.g. peroneus longus has a long tendon and wraps around foot and attaches to bones underneath to support lateral
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20
Q

what is inversion?

A
  • sole of foot faces inwards
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21
Q

what is eversion?

A
  • sole of foot faces outwards
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22
Q

what is it called when the foot moves in all three planes?

A
  • tri- planar
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23
Q

what movement does inversion involve?

A
  • plantarflexion, adduction, supination
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24
Q

what movement does eversion involve?

A
  • dorsiflexion, abduction, pronation
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25
Q

what are the properties of plantar vault?

A
  • flexible so shock absorber
  • rigid to act as propulsive lever
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26
Q

describe heel strike in relation to the weight and arches

A
  • foot comes down from air so hits down on heal
  • weight is through calcaneus
  • arches are raised as no weight through
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27
Q

describe stance phase in relation to vault and arches

A
  • move forward and bring weight over foot
  • vault flattened= shock absorber
  • to ensure arches don’t cause damage muscles contract to stop further flattening
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28
Q

what are the muscles called that contract to stop further flattening?

A
  • plantar tighteners
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29
Q

describe heel off stage ; why is the foot rigid

A
  • weight goes through the foot so don’t want to collapse= plantar tighteners contract further so rigid body
  • rigid as caught between 2 forces; bodyweight down + plantar flexors raise foot
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30
Q

describe toe off and the mechanism it involves

A
  • big toe extends ; tightens plantar fascia which reinforces medial arch
  • windlass mechanism
  • toe flexors push on ground to help toes push off
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31
Q

what are the three sections of the foot?

A
  • hind foot, mid foot, fore foot
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32
Q

what movements happen on the floor?

A
  • can transfer weight medially or laterally so foot adapts
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33
Q

what is the difference between pronation and supination

A

pronation= weight transfers medially
supination= weight transfers laterally

34
Q

describe pronation in hindfoot

A
  • plantarflexes, adduct, pronates
  • medial arch flattens
35
Q

describe pronation in forefoot

A
  • dorsiflexes, abducts, supinates
36
Q

describe supination in hindfoot

A
  • dorsiflexors, abducts, supinates
  • medial arch rises
37
Q

describe supination in forefoot

A
  • plantarflexes, adducts, pronates
38
Q

where do extrinsic muscles originate from and what do points where muscles attach give rise to?

A
  • originates off of tibia, fibula and cross over ankle joint+ attach to foot
  • give rise to other actions that may contribute to
39
Q

what are extrinsic muscle compartments separated by?

A
  • thick fascia
  • osseous membrane between fibula and tibia
40
Q

why are extrinsic muscles dangerous?

A
  • if injured you can get compression as blood can’t move
41
Q

describe anterior compartment of ankle

A
  • at the front so allows dorsiflexion as lift foot up at the front
42
Q

where do both extensor digitorum longus and extensor hallucis longus cross? what action do they allow?

A
  • cross ankle joint at the front
  • allow dorsiflexion
  • insert onto toes
43
Q

origin, insertion and action of extensor digitorum longus (anterior)

A

o- proximal anterior shaft of fibula
I- middle and distal phalanges 2nd-5th
a- extends toes, dorsiflex ankle, evert foot

44
Q

origin, insertion and action of extensor hallucis longus (anterior)

A

o- anterior surface of fibula
I- base and dorsal centre of distal phalanx of big toe
a- extends big toe, dorsiflexes ankle

45
Q

where do tibialis anterior and fibularis tertius cross over? what action do they allow?

A
  • cross over talocrural joint
  • attach onto tarsal bones of foot
  • contribute to inversion/ eversion
46
Q

origin, insertion and action of tibialis anterior (anterior)

A

o- lateral condyle of tibia and interosseous membrane
I- underside of medial cuneiform and first metatarsal
a- ankle dorsiflexor and inversion

47
Q

origin, insertion and action of fibularis tertius (anterior)

A

o- distal anterior fibula
I- dorsum shaft of 5th metatarsal
a- forefoot eversion, weak dorsiflexor

48
Q

describe posterior compartment of ankle- what movement can occur

A
  • muscles attach to back of lower leg and cross over back of ankle joint
  • plantar flexion
49
Q

origin, insertion and action of tibialis posterior (posterior)

A

o- posterior tibia and fibula
I- navicular bone, all cuneiform bones, 2nd- 4th metatarsal
a- plantarflexion, inversion

50
Q

origin, insertion and action of flexor digitorum longus (posterior)

A

o- proximal ulna
I- base of distal phalanx of 2-5
a- flexes distal phalanges, plantar flexors, inversion

51
Q

origin, insertion and action of flexor hallucis longus (posterior)

A

o- distal shaft of fibula
I- plantar surface distal phalanx
a- flexes big toe, plantar flexors

52
Q

origin, insertion and action of popliteus (posterior)

A

o- lateral femoral condyle
I- posterior tibia
a- internal rotation

53
Q

origin, insertion and action of soleus (posterior)

A

o- extensive from tibia, fibula and interosseous membrane
I- posterior calcaneus
a- plantarflexes

54
Q

origin, insertion and action of gastrocnemius (posterior)

A

o- medial/ lateral femur condyles
I- posterior calcaneus
a- plantarflexes

55
Q

origin, insertion and action of plantaris (posterior)

A

o- lateral supracondylar femur
I- posterior calcaneus
a- weakly assists plantar

56
Q

what is the triceps surae?

A
  • superficial muscles collectively; gastrocnemius, soleus and plantaris
  • share common tendon which attaches onto calcaneus
57
Q

what is the function of triceps surae

A
  • provides propulsion when walking or running
58
Q

describe plantaris

A
  • vestigial muscle contains longest tendon that attaches into calcaneus
59
Q

describe lateral compartment and the movements produced

A
  • inversion and eversion
  • tibialis anterior and posterior support inversion as tendons attach to medial side to produce supination
  • fibularis tertius involved in pronation
60
Q

origin, insertion and action of fibularis brevis (peroneus) lateral

A

o- lower lateral fibula
I- tuberosity on base of 5th metatarsal
a- forefoot eversion, ankle plantarflexor

61
Q

origin, insertion and action of fibularis longus (lateral)

A

o- lateral fibula
I- 5th metatarsal
a- plantarflex, everts foot

62
Q

why is there no medial compartment?

A
  • tibialis anterior and posterior do equivalent movement on medial side into inversion
63
Q

describe intrinsic muscles

A
  • start and finish on foot itself
64
Q

origin, insertion and action of extensor digitorum brevis (dorsal)

A

o- anterior part of upper calcaneum
I- extensor, expansion of 2nd, 3rd +4th toes
a- extends toes

65
Q

origin, insertion and action of extensor hallucis brevis (dorsal)

A

o- superior aspect of calcaneus
I- base of proximal phalanx of big toe
a- extends big toe

66
Q

origin, insertion and action of dorsal interossei (lateral)

A

o- shafts of all metacarpals
I- proximal phalanges
a- adduct toes 3,4,5 towards 2nd toe ; contributes to flexion

67
Q

describe plantar intrinsic foot muscles

A
  • underside of foot
  • contains four layers
  • first layer most superficial
68
Q

origin, insertion and action of adductor hallucis (first layer)

A

o= medial tubercle of calcaneus
I= proximal phalanx of great toe
a= abducts great toe

69
Q

origin, insertion and action of flexor digitorum brevis (first layer)

A

o= medial tubercle of calcaneus
I= middle phalanges of lateral four
a= flexes lateral four

70
Q

origin, insertion and action of abductor digiti minimi (first layer)

A

o= medial and lateral calcaneal tuberosity
I= lateral side of proximal phalanx of 5th toe
a= flexes and abducts 5th toe; supports lateral arch

71
Q

origin, insertion and action of quadratus plantae (second layer)

A

o= medial and lateral sides of calcaneus
I= tendons of flexor digitorum longus
a= assists flexor digitorum longus to flex toes 2-5 when ankle is plantarflexed

71
Q

origin, insertion and action of lumbricals (second layer)

A

o= tendon of flexor digitorum longus
I= dorsal digital expansions of toes 2-5
a= maintains extension

72
Q

origin, insertion and action of flexor hallucis brevis (third layer)

A

o= medial and lateral side of cuboid bone and cuneiform bone
I= medial and lateral side of first phalanx of great toe
a = flexion of hallux and big toe

73
Q

origin, insertion and action of adductor hallucis (third layer)

A

o= two heads; oblique= 2,3,4 metatarsal
I= plantar metatarsophalangeal ligaments
a= adducts great toe

74
Q

origin, insertion and action of flexor digitorum minimi (third layer)

A

o= base of 5th metatarsal
I= lateral side of proximal phalanx of 5th digit
a= flexes metatarsophalangeal joint of 5th digit

75
Q

origin, insertion and action of plantar interossei (fourth layer)

A

o= base and medial side of metatarsals 3-5
I= proximal phalanges 3-5
a= adduct digits 3-5 towards 2nd; flex and extend digits 3-5

76
Q

what is plantar aponeurosis?

A
  • strong piece of fascia which sits on top of all layers
  • helps support arch shape of foot
77
Q

what ligament originates at tibia and extends to calcaneus? what does the ligament control?

A
  • tibiocalcaneal
  • controls abduction of talus
78
Q

what ligament connects talus and tibia on medial side? what does it control ?

A
  • anterior tibiotalar
  • controls eversion
79
Q

what ligament connects malleolus to navicular? what does it prevent?

A
  • tibionavicular
  • becomes tenser with plantarflexion abduction
  • prevents eversion of hindfoot
80
Q

what ligament connects calcaneus and fibula? what is its roles?

A
  • calcaneofibular
  • provides lateral stabilisation to ankle joint and subtalar joint
  • primary restraint to inversion in neutral/ dorsiflexed position
81
Q

what ligament originates from anterior edge of lateral malleolus of fibula ad attaches to neck of talus? what does it resist?

A
  • anterior talofibular
  • resists inversion and plantarflexion of ankle