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Kinesiology Term 1 > Ankle and Foot Complex > Flashcards

Ankle and Foot Complex Flashcards

1
Q

Ankle/Foot Complex

A

Adaptations that optimize its primary role to bear weight

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2
Q

The complementing structures of the ankle/foot complex permit:

A

Both stability and mobility, depending on current needs

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3
Q

What does the foot need to do in order for pushing off when walking, running, or jumping?

A

Be stable to provide an adequate base of support and to function as a rigid lever

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4
Q

Why does the foot need to be mobile?

A

To adapt to uneven terrain, absorb shock as the foot hits the ground, and control forces imposed by the more proximal joints of the lower extremity

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5
Q

How many bones and component joints?

A

28 Bones; 25 Joints

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6
Q

3 Functional Segments of the Foot

A

Rearfoot (posterior): Calcaneus and Talus
Midfoot (middle): Cuboid, Navicular, Cuneiforms
Forefoot (anterior): Metatarsals and Phalanges

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7
Q

Motions of the Foot

A

Dorsiflexion / Plantarflexion
Inversion / Eversion
Abduction / Adduction

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8
Q

Dorsiflexion / Plantarflexion

A

Sagittal plane around a coronal axis

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9
Q

Inversion / Eversion

A

Frontal plane around a longitudinal axis

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10
Q

Abduction / Adduction

A

Transverse plane around a vertical axis

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11
Q

Motion at the Toes

A

Sagittal plane around a coronal axis
Flex: toes down
Ext: toes up

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12
Q

Pronation / Supination of the Foot

A

Occur around an axis that lies at an angle to each of the axes for “cardinal” motions

Composite Motions = Combination of the other motions

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13
Q

Non-weightbearing Pronation

A

DF, EV, ABD

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14
Q

Non-weightbearing Supination

A

PF, INV, ADD

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15
Q

Valgus

A

Increase in medial angle between two bones

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16
Q

Calcaneovalgus

A

An increase in the medial angle between the calcaneus and posterior leg

> 180 deg

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17
Q

Varus

A

Decrease in the medial angle between two joints

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18
Q

Calcaneovarus

A

A decrease in the medial angle between the calcaneus and posterior leg

<180 deg

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19
Q

Ankle Joint: Talocrural Joint
Type of Joint

A

~Synovial Hinge Joint
~1 DOF: DF/PF
~Proximal articular surfaces:
–>Concave mortise:
—–>Distal tibia (tibia plafond)
—–>Malleoli: Medial (tibia), Lateral (fibular)

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20
Q

How many degrees of DF is needed for normal gait?

A

10 degrees

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21
Q

Ankle Joint:
Talocrural Joint

A

Ankle mortise is adjustable
~Proximal TFJ
~Distal TFJ
~Interosseous membrane

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22
Q

Ankle
Proximal Tibiofibular Joint

A

~Plane synovial joint between:
—>Head of fibula and Posterolateral aspect of tibia
~Most common pattern
—>Convex tibial facet
—>Concave fibular facet

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23
Q

Ankle
Distal Tibiofibular Joint

A

~Syndesmosis between:
—>Concave tibial facet
—->Convex fibular facet
~Separated by fibroadipose tissue

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24
Q

Ankle
Interosseous membrane

A

~Directly supports both articulations - Prox. and Dist. TFJ

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25
Q

Ankle Mortise adjustability

A

~Inherently stable
—>Boney congruency
—>Ligamentous support
~Requires mobility for normal function:
—>Primarily due to FIBULA (transmits <10% weightbearing forces)

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26
Q

Ankle Distal Articular Surface

A

~Body of Talus has 3 facets
1. Lateral/fibular: larger
2. Medial/tibial: smaller
3. Trochlear/superior: Convex and Central groove (slight angle)
~Wider anteriorly: Wedge-shape

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27
Q

Ankle Joint Structure

A

~Capsule: fairly weak (anteriorly and posteriorly)
~Medial CL
~Lateral CL
~Superior Peroneal Retinaculum

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28
Q

Ankle Medial Collateral Ligament
“Deltoid Ligament”

A

~Fan-shaped
~Extremely Strong
~Checks eversion and pronation

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29
Q

Lateral Collateral Ligament

A

~3 Bands
1. Anterior talofibular
2. Posterior talofibular
3. Calcaneofibular
~Weaker
~Checks inversion and supination

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30
Q

Superior Peroneal Retinaculum

A

~Lies close to parallel to the CFL
~Reinforces CFL

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31
Q

Talocrural Joint
Oblique Joint Axis

A

~Downward angulation from medial to lateral of 14 degrees from transverse plane
~Rotated 23 degrees from the frontal plane

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32
Q

Talocrural Joint
Shape of Talus

A

~Wedge-shaped (wider anteriorly)
~Through DF, the talus will “wedge” into the mortise (separates tibia and fibula)
~Supports and enhances stability

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33
Q

Talocrural Joint
Closed-Pack position

A

Max DF

34
Q

Talocrural Joint
Open-Pack position

A

10 deg PF

35
Q

Talocrural Joint
Arthrokinematics

A

Open Chain: Convex on Concave

Closed Chain: Concave on Convex

36
Q

Talocrural Joint
Joint Function

A

~Overall AMOUNT of motion and PLANES of motion is variable
~Important:
-Observed limitation in DF Post injury and surgery
~Prox. TFJ:
-Concave fibular facet
-Convex tibial joint
~Dist. TFJ:
-Convex fibular head
-Concave tibial facet

37
Q

Allow fine tuning for normal ROM in all 3 planes

A

Proximal and Distal Tibiofibular Joints

38
Q

Subtalar Joint
3 Plane Articulations

A

~Posterior
~Anterior and Middle
~Tarsal Canal

39
Q

Subtalar Joint
Posterior

A

~Largest, receives 75% force transmission
~Concave talar facet
~Convex Calcaneal facet

40
Q

Subtalar Joint
Anterior and Middle

A

~Smaller
~Each have a convex talar facet
~Each have a concave calcaneal facet

41
Q

Subtalar Joint
Tarsal Canal

A

~Creates 2 separate joint cavities
~Posterior articulation: individual capsule
~Anterior and middle articulations: share capsule with talonavicular joint
~Sinus Tarsi: large end of canal
—>anterior to fibular malleolus

42
Q

Subtalar Joint
Cervical Ligament

A
  • Strongest
  • Lies anterior to sinus tarsi
  • Joins neck of talus to neck of calcaneus
43
Q

Subtalar Joint
Interosseous talocalcaneal ligament

A

Lies medially in tarsal canal
Runs obliquely from talus to calcaneus

44
Q

Subtalar Joint Function

A

Axis of motion:
* 42° inclination up from the
transverse plane
* 16° medially from an AP axis
* Therefore motion crosses all
3 planes

45
Q

Subtalar Joint Function

A

2 DoF commonly described:
* Inversion/eversion
* Varus/valgus
* Pronation/supination
* Pronation and supination=component motions of 3 cardinal
planes

46
Q

Subtalar Joint Arthrokinematics

A

Posterior: concave talus on convex calcaneus *
Anterior and middle: convex talus on concave calcaneus

47
Q

Supination Non-Weightbearing

A

Calcaneal inversion
Calcaneal adduction
Calcaneal plantarflexion

48
Q

Supination Weightbearing

A

Calcaneal inversion
Talar abduction
Talar dorsiflexion

49
Q

Pronation Non-Weightbearing

A

Calcaneal eversion
Calcaneal abduction
Calcaneal dorsiflexion

50
Q

Pronation Weightbearing

A

Calcaneal eversion
Talar adduction
Talar plantarflexion

51
Q

Foot Posture
Pes Planus (Flatfoot)

A

Hyper-Pronation

52
Q

Foot Posture
Pes Cavus (high arch)

A

Hyper-Supination

53
Q

Subtalar Joint
Closed Chain Implications

A

~Subtalar supination
* Tibiofibular lateral rotation
~Subtalar pronation
* Tibiofibular medial rotation

54
Q

Subtalar Joint
ROM

A
  • Subtalar Neutral
  • Controversial
  • Normal: 3.5° valgus
  • Calcaneal eversion (valgus) 5-10°
  • Calcaneal inversion (varus) 20-30°
  • Pronation/Supination
  • Difficult to measure
55
Q

Subtalar Joint
Open-Packed position

A

Inversion/Plantarflexion

56
Q

Transverse Tarsal Joint
“Transverse Tarsal” or “Chopart” Joint

A

Formed by: Talonavicular and Calcaneocuboid Joints

57
Q

Transverse Tarsal Joint
Talonavicular Joint

A
  • “ball” head of talus
  • “socket” formed anteriorly by concavity in
    navicular, inferiorly by anterior and
    middle calcaneal facets
  • Plantar calcaneonavicular ligament
  • “spring ligament”
  • Sustentaculum tali to inferior navicular
  • Continuous medially with portion of deltoid
    ligament and joins bifurcate ligament laterally
  • Important passive stabilizer to medial
    longitudinal arch
58
Q

Transverse Tarsal Joint
Calcaneocuboid Joint

A

Anterior calcaneus
* Posterior cuboid
* Reciprocal saddle-shaped
* Reinforced via:
* Joint capsule
* Bifurcate ligament
* Dorsal CCL, short plantar ligament
* Long plantar ligament
* Supports TTJ and lateral longitudinal
arch

59
Q

Joint Function:
Transverse Tarsal Joint

A

Motion is described as the talus and
calcaneus MOVING TOGETHER ON the
navicular and cuboid
~Longitudinal axis
~Oblique axis

60
Q

Transverse Tarsal Joint
Longitudinal axis

A
  • Inclined 15° from the transverse
    plane
  • Inclined 9° medially from sagittal
    plane
  • Triplanar-
    supination/pronation
  • IV/EV moments
    predominate
61
Q

Transverse Tarsal Joint
Oblique axis

A
  • Inclined 52° superiorly from
    transverse plane
  • Inclined 57° from the sagittal plane
  • Triplanar-
    supination/pronation
  • DF/PF and ABD/ADD
    predominate
62
Q

Transverse Tarsal Joint
Big Picture

A

Subtalar joint and Transverse Tarsal joints are mechanically linked
* Transitional link between:
* Rearfoot
* Forefoot
* Purpose:
* Add to the supination/pronation ROM of subtalar joint
* In WBIng or NWBing
* Compensate the forefoot for rearfoot position

63
Q

Transverse Tarsal Joint
Open-Packed position

A

Pronation

64
Q

Transverse Tarsal Joint
Closed-Packed position

A

Full Supination

65
Q

Tarsometatarsal Joints

A
  • Plane, synovial Joints
  • Between distal row of tarsals and bases of
    metatarsals
  • 1st TMT: own joint capsule
  • 2nd -3rd ; 4th -5th : share joint capsules
  • Deep Transverse Metatarsal Ligament:
  • Prevents excessive splaying of the metatarsal
    heads
66
Q

Joint Function:
Tarsometatarsal Joints

A

Ray: functional unit
* 1-3: metatarsal + associated cuneiform
* 4-5: metatarsal alone

67
Q

Joint Function:
Tarsometatarsal Joints Axis of Motion

A
  • First Ray: oblique
  • DF is coupled with IV and ADD
  • PF is coupled with EV and ABD
  • Fifth Ray: oblique
  • DF coupled with EV and ABD
  • PF coupled with IV and ADD
  • Third Ray: close to coronal axis
  • DF/PF
68
Q

Joint Structure: Metatarsophalangeal Joints

A
  • Condyloid, synovial joints
  • 2 DOF:
  • extension/flexion (DF/PF)
  • ABD/ADD
69
Q

Metatarsophalangeal Joints
Arthrokinematics

A

Convex: metatarsal head
Concave: base of proximal
phalange

70
Q

Metatarsophalangeal Joints
1st Metatarsal

A

2 sesamoid bones
Anatomical pulley for Flexor Hallucis Brevis

71
Q

Metatarsophalangeal
Joints Supported by:

A

Plantar plates
Joint capsule
Collateral ligaments

72
Q

Joint Function:
Metatarsophalangeal
Joints

A
  • Metatarsal Break
  • Hinge or “break” point
  • Located at the metatarsal heads as they move into
    extension
  • 36-65° overall during gait
  • Approx 60-70° at first MTP alone
  • Occurs as the heel rises and the metatarsal heads +
    toes remain weightbearing
  • Convex metatarsal heads move on concave
    phalanges
  • Around an oblique axis
73
Q

Joint Structure: Interphalangeal Joints

A

Synovial, hinge joints
1 DOF: Ext/Flex
Great toe: 1 IP joint
Toes 2-5: 2 IP joints each
Essentially each phalanx is identical in structure to hand

74
Q

Plantar Arches
3 Arches

A
  1. Medial longitudinal arch
    * Largest
    * Apex: talus
  2. Lateral longitudinal arch
    3.Transverse arch
    * Apex at the distal metatarsals: second metatarsal
    * Apex at the TMT joints: middle cuneiform
75
Q

Plantar Arches

A

Arthrology contributes to first level of stability
* Medial longitudinal arch support:
* Spring ligament, interosseous TC ligament, deltoid ligament, plantar
aponeurosis
* Lateral longitudinal arch support:
* Long and short plantar ligaments

76
Q

Function: Plantar Arches

A

~Mobility
* Dampen impact of weightbearing forces
* Dampen rotational motions
* Adapt to surface changes
~Stability
* Allow distribution of weight through the foot for proper weightbearing
* Convert to a rigid lever in gait

77
Q

Function: Plantar Arches
Plantar Aponeurosis (plantar fascia)

A

Runs length of the foot
* Metatarsal heads act as pulleys:
* During extension tension is placed on the
plantar aponeurosis
* With progression, heel and MTPs are
drawn closer together
* Longitudinal arch height increases
* Contributes to supination of the foot
(rigid lever for push off)
* Called the: windlass mechanism

78
Q
A
79
Q

Muscular Contributions
To Arches

A

~Posterior tibialis
* Most consistent function in medial
longitudinal arch support
~Plantar intrinsics
* Active in quiet bilateral stance and in gait

80
Q

Muscular Contributions
To the Ankle and Foot

A
  • No muscle acts on one joint in isolation
  • Position of the muscle relative to the axis dictates
    function
  • Anterior to talocrural:
  • DF moments
  • Posterior to talocrural
  • PF moments
  • Medial to subtalar:
  • Supination moments
  • Lateral to subtalar:
  • Pronation moments

Kinesiology Term 1 (8 decks)

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