Ankle-Foot Flashcards
How does the fibular head move with dorsiflexion?
Superior, lateral, anterior motion
There is slight (internal/external rotation of the foot in standing.
External
Where in the ankle is a primary area for swelling during a sprain?
Sinus tarsi
What are the four major joints of the ankle and foot?
- Talocrural
- Subtalar
- Talonavicular
- Calcaneocuboid
What happens in pronation of the foot?
Eversion
Abduction
Dorsiflexion
What happens in supination of the foot?
Inversion
Adduction
Plantar flexion
(Add Plants In Soup)
What kind of joint is the distal tibiofibular joint?
Synarthrodial
Convex fibula, concave fibular notch of the tibia
What are high ankle (or syndesmotic) sprains caused by?
Extreme and sudden dorsiflexion (landing from a jump). Rotational component included at times
What type of wooden joint used by carpenters does the ankle resemble?
Mortise joint
What is the loose-packed position of the talocrural joint?
Full plantarflexion
What is the close-packed position of the talocrural?
Full dorsiflexion
What are the medial collateral ligaments of the ankle?
Deltoid ligament
- Tibionavicular fibers
- Tibiocalcaneal fibers
- Tibiotalar fibers
What motion does the medial collateral ligaments of the ankle limit?
Eversion
What is the most frequently ligament injured in the ankle?
Anterior talofibular ligament
What motion does the anteriortalofibular ligament resist?
Excessive inversion of the ankle
What are the lateral collateral ligaments of the ankle?
- Anterior talofibular
- Calcaneofibular
- Posterior talofibular
What motion does the calcaneofibular ligament resist?
Inversion across talocrural and subtalar joints
What motion does the posteriortalofibular ligament resist?
Excessive abduction of talus, especially when combined with dorsiflexion
What is the ROM for dorsiflexion? Plantarflesion?
20; 50
What happens to the talus and collateral ligaments in dorsiflexion?
Talus rolls forward and slides posteriorly; posterior fibers become taut (cacaneofibular ligament, posterior tibiotalar)
What happens to the talus and collateral ligaments in plantarflexion?
Talus rolls backward and slides anteriorly; anterior fibers become taut (anterior talofibular lig, tibionavicular lig, anterior tibiotalar)
During non weight-bearing (open chain) the [calcaneus/talus] moves on the [calcaneus/talus].
Calcaneus; talus
During weight-bearing (closed chain) ________ moves on the [calcaneus/talus].
Talus and leg; calcaneus
Posterior articulation of the calcaneus and talus consist of a [concave/convex] facet of talus with a [concave/convex] facet of calcaneus.
Concave; convex
Which articulation is a PT normally focused on when performing mobilization techniques to increase flexibility of the rearfoot?
Posterior articulation
What are the ligaments of the subtalar joint?
Calcaneofibular, tibiocalcaneal, interosseous, and cervical ligaments
What limits eversion of subtalar joint?
Tibiocalcaneal fibers of deltoid ligament
What limits inversion of subtalar joint?
Calcaneofibular, cervical, and interosseous ligaments
In the subtalar joint there is a _____ arc of movement.
Curvilinear
What is the close-packed position of subtalar joint?
Supination
What is the loose-packed position of the subtalar joint?
Pronation
What is the neutral position of the subtalar joint?
When the calcaneus us is placed in a position that exposes lateral and medial sides of talus equally
What is the ROM for inversion of the subtalar joint? eversion?
22; 12
Why is the ROM for inversion in the subtalar joint so much greater than eversion?
There is a bony block of the lateral malleolus and thick deltoid ligament
What is the strong functional relationship between the transverse tarsal and subtalar joints?
Combined, they control most of the pronation and supination of the entire foot
What are the two articulations of the transverse tarsal joint?
Talonavicular joint and calcaneocuboid joint
What does the spring ligament in the talonavicular joint cause?
Laxity in pronated feet
What do the long and short plantar ligaments of the calcaneocuboid joint do?
Reinforce the plantar side of the joint, and provide structural stability to the lateral side of the foot
How many axes of rotation are at the subtalar joint?
1
How many axes of rotation are at the transverse tarsal joint?
2 (longitudinal and oblique)
What effect on the mid foot does movement at the transverse tarsal joint have?
Makes the mid foot very adaptable in shape
What does the tibialis posterior muscle do in supination?
Raises the navicular and medial arch
What does the fibularis longus muscle do during pronation?
Lowers the medial arch and raises lateral arch
What is the keystone you’re looking for in the breakdown of the medial longitudinal arch of the foot?
Talonavicular joint
What is the primary passive support of the medial longitudinal arch?
Plantar fascia
What motion adds tension to the medial longitudinal arch?
Extension of the big toe
What is a secondary line of support of the medial longitudinal arch that provides its support actively?
Tibialis posterior and fibularis longus muscles (strengthening of these muscles will not be enough for long term arch support)
How are compression forces distributed on the foot?
60% in rearfoot
30% in forefoot
10% in midfoot
Body depresses the talus _____, and ______ the medial longitudinal arch
inferiorly; flattens
Tension in the ____________ acts as a semi-elastic tie-rod that yields slightly under load; allows only a marginal drop; absorbs body weight
Deep plantar fascia
What is the primary load bearing and shock absorption structure of the foot?
Medial longitudinal arch
What joint does body weight fall near?
Talonavicular
Chronically dropped or abnormally low medial longitudinal arch
Pes Planus
Does rigid or flexible yes planus require surgery?
Rigid does; flexible usually is orthoses
Abnormally high medial longitudinal arch; places metatarsal heads more perpendicular to the ground
Pes cavus
What does abnormal pronation of the subtalar joint lead to in the hip? in the knee? in the rear foot? in the mid and forefoot?
Internal rotation, flexion, adduction;
Increased values stress;
Pronation w/ low medial long. arch;
Supination
What is the keystone of the transverse arch?
intermediate cuneiform
Of the rays of the foot, which is the greatest in mobility?
1st ray
A true joint does not form between the ____ and _____ metatarsals
first and second
What is the proper name for “turf toe”
Hallux limitus/rigidus
Progressive lateral deviation of the first toe
Hallux valgus
Hallux valgus is excessive ____ of the first tarsometatarsal joint, and ____ of the MTP joint (relative to the body)
adduction; abduction
