Ankle and Foot Flashcards
what stabilizes the proximal tibiofibular joint?
- joint capsule
- anterior tibiofibular ligament
- posterior tibiofibular ligament
what stabilizes the distal tibiofibular ligament?
- No joint capsule
- A/P tibiofibular ligament
- Interosseus membrane
what is injured during a high ankle sprain?
distal tibiofibular joint
what motions are available at the proximal and distal tibiofibular joint?
- A/P glide
- S/I glide
- IR/ER
what is the open pack position for the tibiofibular joint?
10° plantarflexion
where is the deltoid ligament and what does it limit?
medial ankle
limits eversion/pronation
what is the lateral collateral ligament of the ankle made up of?
3 ligaments:
- anterior talofibular ligament
- calcaneofibular ligament
- posterior talofibular ligament
what does the lateral collateral ligament of the ankle limit?
inversion and supination
what muscles limit eversion/pronation of the ankle?
tibialis posterior
flexor hallucis longus
flexor digitorum longus
what muscles limit inversion/supination at the ankle?
Fibularis longus and brevis
what muscles limit dorsiflexion at the ankle?
gastrocnemius and soleus
what muscles limit plantarflexion at the ankle?
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
what is the most stable position for the ankle?
dorsiflexion (wider base is wedged between the tibiofibular motise)
describe the osteokinematics with the arthrokinematics of the talocrural joint
Dorsiflexion = anterior roll with posterior glide
Plantarflexion = posterior roll with anterior glide
what is the arthrokinematic rule during OKC motion at the talocrural joint?
convex talus moves on concave tibiofibular mortise
what is the open pack position and capsular pattern for the talocrural joint?
open pack = 10º plantarflexion w/neutral inversion/eversion
capsular pattern = loss of plantarflexion greater than dorsiflexion
in what position is the foot more stable/mobile?
pronation = more mobile
supination = more stable
what is the purpose of pronation at the ankle?
allows more mobility which allow for:
- a decrease in impact from weight-bearing forces
- dampen superimposed rotational motions
- the ankle to adapt to changes in supporting surfaces and terrains
what is the purpose of supination at the ankle?
allows the arches to be stable enough to allow for:
- distribution of weight through the foot for proper weight bearing
- convert the flexible foot to a rigid lever
what is the function of the plantar fascia?
tightens up when the toes are extended to provide support to the medial longitudinal arch.
aids in the windless effect
describe the osteology and joint type of the subtalar joint
talus on calcaneus
made up of 3 ovoid synovial joints
what moves on what during weight bearing at the subtalar joint?
talus moves on calcaneus
during weight bearing, what motions couple to allow for supination?
- calcaneus inverts
- talus abducts
- talus dorsiflexes
- tibiofibular lateral rotation
during weight bearing, what motions couple to produce pronation?
- calcaneus everts
- talus adducts and plantarflexes
- tibiofibular medial rotation
what moves on what during non-weight bearing motions at the subtalar joint?
calcaneus moves on the talus
during non-weight bearing motions, what movements couple together to produce supination at the subtalar joint?
calcaneus adduction, inversion, and plantarflexion
during non-weight bearing motions, what movements couple together to produce pronation at the subtalar joint?
calcaneus abduction, dorsiflexion and eversion
what is a valgus movement at the calcaneus?
calcaneal eversion
what is a varus movement at the calcaneus?
calcaneal inversion
how would pronation at the subtalar joint impact the joints higher up?
medial rotation of knee and hip
how would supination at the subtalar joint impact joints above?
lateral rotation of hip and knee
what is the open pack position and capsular pattern for the subtalar joint?
open pack = mid inversion/eversion and mid plantarflexion/dorsiflexion
no capsular pattern
what joints make up the transverse tarsal joint?
talonavicular joint
calcaneocuboid joint
what is the open pack position for the transverse tarsal joint?
midrange of supination/pronation
describe the osteokinematics of the MTP joints
flexion/extension
abduction/adduction
what is the arthrokinematic rule for the MTP joints?
Concave on Convex
roll and glide in same direction
what is the open pack position and capsular pattern for the MTP joints?
open pack = 10° extension
capsular pattern: 1st MTP extension > flexion
2-5 loss of flexion
what is hallux limitus
Turf Toe
a condition marked by gradual and significant limitation in motion along with articular degeneration and pain
what is hallux valgus
bunion deformity
progressive lateral deviation of great toe
what is the main function of the IP joints?
maintain stability by pressing against the ground in standing
what is the arthokinematic rule for the IP joints?
Concave on Convex
roll and glide in same direction
what is pes planus?
“flat feet”
abnormally dropped medial longitudinal arch
what are some possible causes of pes planus?
assocaited with over stretched, torn or weakened plantar fascia, spring ligament, and/or tibialis posterior tendon
what is pes cavus?
over supination
abnormally raised medial longitudinal arch
what are some possible causes for pes cavus?
associated with excessive rearfoot varus (inversion)
what is the rol of the posterior tibialis tendon during gait?
decelerates pronation rearfoot in loading response
this results in gradual and controlled lowering of medial longitudinal arch and absorbs some of the impact from loading
