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kinesiology > ankle/foot > Flashcards

ankle/foot Flashcards

week 10,11,12

1
Q

bones apart of the ankle

A

tibia
fibula
talus

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2
Q

bones apart of rearfoot

A

calcaneus
talus

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3
Q

bones apart of midfoot

A

navicular
cuboid
cuneiforms

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4
Q

bones apart of forefoot

A

metatarsals
phalanges

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5
Q

talk about the subtalar joint

A

sinus tarsi: space for thing to travel through in the foot - important role in ankle sprains
nociception proprioception
lateral ankle sprains (ATFL)
interosseous ligament
cervical ligament

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6
Q
A
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7
Q

Motion: dorsiflexion, plantar flexion
axis of rotation:
plane of motion:
definition:

A

AOR: medial lateral
POM: sagittal
definition: decreases the ankle between the leg and the dorsum of the foot
increases the above angle

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8
Q

Motion: inversion, eversion
axis of rotation:
plane of motion:
definition:

A

AOR: anterior -posterior
POM: frontal
definition: plantar surface of the foot is brought toward teh midline
opposite to inverstion

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9
Q

Motion: abduction adduction
axis of rotation:
plane of motion:
definition:

A

AOR: vertical
POM: transverse
definition: distal aspect of the foot moves away from the midline of the body
opposite of abduction

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10
Q

Motion: pronation, supination
axis of rotation:
plane of motion:
definition:

A

AOR: oblique (varies by joint)
POM: pronation - varying elemnts of eversion, abduction and dorsiflexion
supination: varying elemnts of inversion, adduction and plantar flexion
definition: foot rolling inward (in weightbearing, more weight on the medial aspect of the foot) foot rolling outward

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11
Q

proximal tibiofibular joint:
type of joint
reinforced by?

A

plane joint
reinforced by lateral collateral ligament and interosseous ligament
biceps femoris tendon and popliteus tendon also reinforce capsule

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12
Q

functions of proximal tibiofibular joint

A
  • distribute rotational forces
  • provide support to tibia
  • transit axial loads
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13
Q

distal tibiofibular joint

A

syndesmosis joint (meaning tibia and fibula are not in contact)

anterior and psoterior tibiofibular ligaments and interosseous membrane support the joint –> stable mortise

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14
Q

what are the 3 articular surfaces of the body of the talus?

A
  • a large lateral (fibular) facet
  • a smaller medial (tibial) facet
  • a trochlear (superior) facet
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15
Q

what occurs at the subtalar joint during dorsiflexon?

A

the tibia and fibula will get further apart putting more tensile load on bone =more stable joint

this doesn’t matter if its OKC or CKC

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16
Q

what is the closed packed position for talocrural joint?

A

dorsiflexion

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17
Q

why is the tibia more stable in full dorsiflexion?

A

the tibia is wider anteriorly than posteriorly which is why it’s more stable

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18
Q

the deltoid ligament is also referred too as medial collateral ligamnet. what are the fibres of the deltoid ligament? deep fibers?

A

tibonavicular fibers
tibiospring fibers
tibiocalcaneal fibers

deep fibers: anterior and posterior tibiotalar fibers

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19
Q

waht does the deltoid ligamnet resist?

A

eversion of the talocrural, subtalar and talonavicular joints

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20
Q

what make up the lateral collateral ligamentes of the ankle?

A
  • anterior talofibular ligament
  • calcaneofibular ligament (CFL)
  • posteriro talofibular ligament (PTL)
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21
Q

what lateral collateral ligamnet is protypically the first to go (accepts load first). what the second? third?

A

anterior talofibular ligamnet (ATFL)

then Calcaneofibular ligament (CFL)
then Posteiror talofibular ligament (PTFL)

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22
Q

the lateral collateral ligaments of the ankle resist?

A

inversion of the talocrural, subtalar, and talonavicular joints

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23
Q

the calcaneofibular ligamnet has a good capacity to?

A

provide stability of subtalar joint due to capsular thickening

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24
Q

osteokinematics

dorsiflexion of ankle ROM
plantarflexion of ankle ROM

A

20°

50°

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25
# arthrokinematics open kinetic chain: dorsiflexion
talus rolls anterior and glides posterior on tibia ## Footnote concave = tibia convex =talus
26
# arthrokinematics open kinetic chain plantar flexion:
talus rolls posterior and glides anterior on tibia
27
# arthrokinematics closed kinetic chain dorsiflexion
tibia rolls and glides anterior ## Footnote *tibia concave *talus convex
28
# arthrokinematics closed kinetic chin plantar flexion:
tibia rolls and glides posterior
29
a sprained ankle is nearly always what type of injury?
inversion injury, involving twisting of the weight bearing plantar flexed foot ## Footnote *the ATFl is not a robust thickening - will try to help stop ankle first but can't
30
subtalar joint is what bones?
talus and calcaneus
31
what ligaments are apart of the subtalar joint? waht do they each do/limit?
calcaneofibular ligament: limits excessive inversion tibiocalcaneal fibers of the deltoid ligament: limit excessive eversion interosseus and cervical ligaments: bind the talus to the calcaneus limit the extremes of all motions, escpecially inversion
32
what does the deltoid ligament limit?
eversion
33
what is the posterior subtalar facet
a concave facet on the under surface of the body of the talus and a convex facet on the body of the calcaneus
34
what is the anterior and middle subtalar facets?
convex facets on the inferior body and neck of talus and concave facets on the calcaneus
35
what are the facets of the subtalar joint?
anterior facet middle facet posterior facet ## Footnote * not a lot of osteokinematic motion allowed between these bones
36
what is apart of the talonavicular joint?
head of talus navicular spring ligament
37
ankle inversion subtalar joint degree of rom?
5°
38
ankle eversion subtalar joint
5°
39
eversion/inversion occur through what axis?
ap axis ## Footnote also means frontal plane
40
dorsiflexion/plantar flexion occur in what axis?
ML axis
41
abduction/adduction occurs about what axis?
vertical axis
42
what are the main components of pronation at subtalar joint?
eversion and abduction
43
what are the main components of supination at the subtalar joint?
inversion and adduction
44
the transverse tarsal joint is made of wht other joints?
talonavicular joint calcaneocuboid joint
45
the talonavicular joint is what kind of joint?
ball and socket
46
the calcaneocuboid is what kind of joint?
saddle joint
47
what is the most versatile joint in the foot? what does it allow for?
transverse tarsal joint allows the weightbearing foot to adapt to uneven surface (supination, pronation)
48
# ligaments- talonaviuclar joint the spring ligament fors what kind of sling for the had of talus? what is this important?
fibrocartilagenous sling important for support against gravity
49
what can be seen if sling/hammock of fibrocartilage is torn from talus?
can see talus move more toward the ground resulting in flat foot and pronation
50
what can contribute to flatfoot deformity?
laxity or tears ## Footnote *other ligaments reinforce the capsule
51
# ligaments - calcaneocuboid joint long and short plantar ligaments reinforce what?
plantar side of the joint, bifurcated ligaments reinforces the dorsal side ## Footnote *sling that keeps calcaneus up in space
52
what ligament reinforces the calcaneocuboid joint capsule dorsally?
dorsal calcaneocuboid ligament
53
where does pronation and supination primarily occur when teh calcaneus is fixed?
at the midfoot
54
where does pronation and supination when the calcaneus is free?
occur as a summation across both the midfoot and rearfoot
55
how do the distal intertarsal joints assist the transverse tarsal joint?
- by aiding in pronating and supinating the midfoot - provide stability across the midfoot by forming the transverse arch of the foot - though motions of these joints are small and typically not measured clinically
56
what are the extrinsic muscles of the ankle and foot from the anterior compartment of the leg?
tibialis anterior extensor digitorum longus extensor hallucis longus fibularis tertius
57
what are the extrinsic muscles of the ankle and foot from the lateral compartment of the leg?
fibularis longus fibularis brevis
58
what are the extrinsic muscles of the ankle and foot from the posterior compartment of the leg?
gastrocnemius soleus plantaris
59
what are the deep muscles of the ankle and foot from the posterior compartment of the leg?
tibialis posterior flexor hallucis longus flexor digitorum longus
60
what are the 4 layers of muscles of the plantar foot?
layer 1: abductor dignit minimi, flexor digitorum brevis, abductor hallucis layer 2: lumbricals, quadratis plantae, FDL tendon, layer 3: flexor digiti minimi, adductor hallucis, flexor hallucis brevis layer 4: PAD, DAB
61
# forefoot talk about 1st TMT joint
-only TMT joint with a well-developed capsule - mobility most notable out of all the TMT joints - functional stability is important, assists the medial longitudinal arch
62
# forefoot instability of the 1st TMT jiont can contribute to?
- hallux valgus (bunion) - OA - pes planus (flat foot)
63
# forefoot talk about the forefoot and a development of bunions
the flexor hallucis brevis muscle will pull the first toe in. there can also be hypermobility at the 1st TMT joint and this hypermobility can pull the MTP medial and the proximal phalange will need to compensate and pull the oppositeway.
64
# forefoot in the TMT joint - what to eversion occur with? what does inversion occur with?
plantar flexion dorsiflexion
65
# forefoot 2nd TMT joint ## Footnote keystone!!
wedged between the medial and laterla cuneiforms - least mobile out of all TMT joints - provides longitudinal stability throughout the foot
66
1st and 5th TMT joints are considered
most mobile
67
the axis of motion forthe 1st and 5th TMT joints is?
oblique - triplanar
68
# forefoot talk about the 3rd ray of the foot
- axis of rotaiton nearly coincides with the sagittal plane - predominant motion = dorsiflexion/plantar flexion
69
# forefoot waht is the axis for the 2nd and 4th ray of the foot?
not determined due to anatomical differences
70
# MTP how many degrees of freedom in the MTP?
two degrees of freedom: flexion (curling the toes) extension (bringing toes up) abduction (toes move away from teh second toe) adduction (toes move toward the second toe) ## Footnote *second toe is reference point for abd/add
71
flexion of the MTP joint biases what muscle?
flexor hallicus brevis
72
sesamoids of the feet
2 sesamoid bones - located on the palntar aspect of the first metatarsal head serve: 1. as anatomic pully for the flexor hallucis brevis muscle (increase moment arm of FHB) 2. protection flexor hallucis longus tendon from weightbearing trauma
73
# forefoot plantar plates: made of? what digits? what movement does it limit? attachments?
- firbrocartilaginous - digits 2-5 --> distinct plantar plates. limits hyper extension - 1st plantar plate blends to joint capsule proximally --> need more hyper extension compared to others - attach to base of proximal phalange distally - attached to one another via deep transverse metatarsal igament
74
# forefoot interphalangeal joints
the hallux has only one IP joint toes 2-5 have a PIP and DIP 1 degree of freedom: flexion and extension
75
# arches of the foot medial longitudinal arch consists of?
calcaneus talus navicular cuneiforms 1-3 metatarsals
76
# arches of the foot Lateral longitudinal arch consists of?
- calcaneus - cuboid - 4th-5th metatarsal
77
# arches of the foot what are is the primary load-bearing and shock absorbing structure of the foot?
medial longitudinal arch
78
# arches of the foot what is provides passive support to the medial longitudinal arch?
- talonaviuclar joint - plantar aponeurosis - spring ligament - interosseus talocalcaneal igament - deltoid ligament - 1st TMT joint
79
# arches of the foot what assists in load absoprtion of the medial longitudinal arch?
plantar fat pads sesamoid bones
80
plantar aponeurosis (plantar fascia) discuss location and attachment sites
superficial fibers blend with the dermis deep fibers attach on the **medial** **tubercle** of the calcaneus and continue anteriorly to attach by digitations to the **plantar plates** and then, via the plates, to the **proximal phalanx** of each toe
81
what is the windlass mechanism?
in MTP joint extension, proximal phalanges glide dorsally - pulls the plantar aponeurosis tighter - the heel and MTP joint are drawn together - arch height increases - slight supination
82
with the windlass mechanism what occurs with loaded plantar aponeurosis?
limited MTP extension - @ rest the tensile load through plantar fascia ---> limited MTP extension
83
# ankle subtalar movement: OKC and CKC calcaneus - pronation OKC and CKC calcaneus - supinatioin OKC and CKC
Pronation: open kinetic chaintalus is stable: calcaneus in eversion closed kinetic chain talus is mobile: calcaneus in eversion Supination: OKC talus is stable: calcaneus in inversion CKC talus is mobile: calcaneus in inversion
84
# ankle subtalar movement: OKC, CKC talus: pronation talus: supination
Pronation: OKC: talus is stable CKC: adduction and plantar flexion supination: OKC: talus is stable CKC: abduction and dorsiflexion
85
# ankle subtalar movement: OKC, CKC forefoot: pronation forefoot: supination
Pronation: OKC: abduction, dorsiflexion CKC: stable Supination: OKC: adduction, plantarflexion CKC: stable ## Footnote *regardless of OKC or CKC the talus is stable in open chain and talus is mobile in closed chain
86
# pronation and supination of foot osteokinematics: pronation: OKC supination: OKC ## Footnote focus is on calcaneus
pronation: calcaneal dorsiflexion, abduction, eversion supination: calcaneal plantar flexion, adduction, inversion
87
Pronation of the ankle in an open kinetic chain think: up and out movement of the foot relative to the leg
open chain pronation: dorsiflexion of calcaneus on talus abduction of calcaneus on talus eversion of calcaneus simple: calcaneus: dorsiflexion, eversion, abduction
88
Supination of the ankle in open kinetic chain think: down and in movement of the foot
open chain supination: plantar flexion of calcaneus on talus adduction of calcaneus on talus inversion of calcaneus simple: calcaneus: plantarflexion, inversion adduction
89
pronation and supination - closed kinetic chain talk about whats going on leg/foot
foot is fixed!! (primarily forefoot) - leg is moving in relation to the foot - calcaneus is still free to move around the longitudinal axis (inversion/eversion)
90
# ankle pronation - closed kinetic chain
plantarflexion of talus on calcaneus adduction of talus on calcaneus eversion of calcaneus
91
# ankle supination - closed kinetic chain
dorsiflexion of talus on calcaneus abduction of talus on calcaneus inversion of calcaneus
92
draw out table talking about pronation/supination of calcaneus, talus, tibia in a closed kinetic chain
pronation Calcaneus: eversion Talus: PF, adduction, Tibia: IR supination Calcaneus: inversion Talus: DF, abduction Tibia: ER
93
end feel for ankle: dorsiflexion plantarflexion inversion eversion
all are firm due to posterior/anterior joint capusle, muscle tension or ligaments
94
to get a true end feel of ankle dorsi/plantar flexion what needs to occur?
subtalar neutral - end roms will differ if the patient is alloedto move out of subtalar neutral. both measures may be useful and should produce a firm end feel at end range. take care to document the specific assessment ROM that was examined (neutral non neutral)
95
# ankle fractures - ottawa ankle rules radiographs indicated if pain in the malleolar zone and one of the follow: (list 5 other indicators)
1. bondy tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus 2. bony tenderness along distal 6 cm of the posterior edge of tibia/tip of medial mameolus 3. bony tenderness at teh base of the 5th metatarsal 4. bony tenderness at the navicular 5. inability to bear weight both immediately after injury and for 4 stesp during initial evaluation

kinesiology (16 decks)

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