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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
Ankle Mortise adjustability
~Inherently stable --->Boney congruency --->Ligamentous support ~Requires mobility for normal function: --->Primarily due to FIBULA (transmits <10% weightbearing forces)
26
Ankle Distal Articular Surface
~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
27
Ankle Joint Structure
~Capsule: fairly weak (anteriorly and posteriorly) ~Medial CL ~Lateral CL ~Superior Peroneal Retinaculum
28
Ankle Medial Collateral Ligament "Deltoid Ligament"
~Fan-shaped ~Extremely Strong ~Checks eversion and pronation
29
Lateral Collateral Ligament
~3 Bands 1. Anterior talofibular 2. Posterior talofibular 3. Calcaneofibular ~Weaker ~Checks inversion and supination
30
Superior Peroneal Retinaculum
~Lies close to parallel to the CFL ~Reinforces CFL
31
Talocrural Joint Oblique Joint Axis
~Downward angulation from medial to lateral of 14 degrees from transverse plane ~Rotated 23 degrees from the frontal plane
32
Talocrural Joint Shape of Talus
~Wedge-shaped (wider anteriorly) ~Through DF, the talus will "wedge" into the mortise (separates tibia and fibula) ~Supports and enhances stability
33
Talocrural Joint Closed-Pack position
Max DF
34
Talocrural Joint Open-Pack position
10 deg PF
35
Talocrural Joint Arthrokinematics
Open Chain: Convex on Concave Closed Chain: Concave on Convex
36
Talocrural Joint Joint Function
~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
Allow fine tuning for normal ROM in all 3 planes
Proximal and Distal Tibiofibular Joints
38
Subtalar Joint 3 Plane Articulations
~Posterior ~Anterior and Middle ~Tarsal Canal
39
Subtalar Joint Posterior
~Largest, receives 75% force transmission ~Concave talar facet ~Convex Calcaneal facet
40
Subtalar Joint Anterior and Middle
~Smaller ~Each have a convex talar facet ~Each have a concave calcaneal facet
41
Subtalar Joint Tarsal Canal
~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
Subtalar Joint Cervical Ligament
* Strongest * Lies anterior to sinus tarsi * Joins neck of talus to neck of calcaneus
43
Subtalar Joint Interosseous talocalcaneal ligament
Lies medially in tarsal canal Runs obliquely from talus to calcaneus
44
Subtalar Joint Function
Axis of motion: * 42° inclination up from the transverse plane * 16° medially from an AP axis * Therefore motion crosses all 3 planes
45
Subtalar Joint Function
2 DoF commonly described: * Inversion/eversion * Varus/valgus * Pronation/supination * Pronation and supination=component motions of 3 cardinal planes
46
Subtalar Joint Arthrokinematics
Posterior: concave talus on convex calcaneus * Anterior and middle: convex talus on concave calcaneus
47
Supination Non-Weightbearing
Calcaneal inversion Calcaneal adduction Calcaneal plantarflexion
48
Supination Weightbearing
Calcaneal inversion Talar abduction Talar dorsiflexion
49
Pronation Non-Weightbearing
Calcaneal eversion Calcaneal abduction Calcaneal dorsiflexion
50
Pronation Weightbearing
Calcaneal eversion Talar adduction Talar plantarflexion
51
Foot Posture Pes Planus (Flatfoot)
Hyper-Pronation
52
Foot Posture Pes Cavus (high arch)
Hyper-Supination
53
Subtalar Joint Closed Chain Implications
~Subtalar supination * Tibiofibular lateral rotation ~Subtalar pronation * Tibiofibular medial rotation
54
Subtalar Joint ROM
* Subtalar Neutral * Controversial * Normal: 3.5° valgus * Calcaneal eversion (valgus) 5-10° * Calcaneal inversion (varus) 20-30° * Pronation/Supination * Difficult to measure
55
Subtalar Joint Open-Packed position
Inversion/Plantarflexion
56
Transverse Tarsal Joint "Transverse Tarsal" or "Chopart" Joint
Formed by: Talonavicular and Calcaneocuboid Joints
57
Transverse Tarsal Joint Talonavicular Joint
* “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
Transverse Tarsal Joint Calcaneocuboid Joint
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
Joint Function: Transverse Tarsal Joint
Motion is described as the talus and calcaneus MOVING TOGETHER ON the navicular and cuboid ~Longitudinal axis ~Oblique axis
60
Transverse Tarsal Joint Longitudinal axis
* Inclined 15° from the transverse plane * Inclined 9° medially from sagittal plane * Triplanar- supination/pronation * IV/EV moments predominate
61
Transverse Tarsal Joint Oblique axis
* Inclined 52° superiorly from transverse plane * Inclined 57° from the sagittal plane * Triplanar- supination/pronation * DF/PF and ABD/ADD predominate
62
Transverse Tarsal Joint Big Picture
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
Transverse Tarsal Joint Open-Packed position
Pronation
64
Transverse Tarsal Joint Closed-Packed position
Full Supination
65
Tarsometatarsal Joints
* 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
Joint Function: Tarsometatarsal Joints
Ray: functional unit * 1-3: metatarsal + associated cuneiform * 4-5: metatarsal alone
67
Joint Function: Tarsometatarsal Joints Axis of Motion
* 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
Joint Structure: Metatarsophalangeal Joints
* Condyloid, synovial joints * 2 DOF: * extension/flexion (DF/PF) * ABD/ADD
69
Metatarsophalangeal Joints Arthrokinematics
Convex: metatarsal head Concave: base of proximal phalange
70
Metatarsophalangeal Joints 1st Metatarsal
2 sesamoid bones Anatomical pulley for Flexor Hallucis Brevis
71
Metatarsophalangeal Joints Supported by:
Plantar plates Joint capsule Collateral ligaments
72
Joint Function: Metatarsophalangeal Joints
* 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
Joint Structure: Interphalangeal Joints
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
Plantar Arches 3 Arches
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
Plantar Arches
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
Function: Plantar Arches
~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
Function: Plantar Arches Plantar Aponeurosis (plantar fascia)
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
79
Muscular Contributions To Arches
~Posterior tibialis * Most consistent function in medial longitudinal arch support ~Plantar intrinsics * Active in quiet bilateral stance and in gait
80
Muscular Contributions To the Ankle and Foot
* 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 (16 decks)

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