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Biomechanics > Ankle & Foot > Flashcards

Ankle & Foot Flashcards

1
Q

static & dynamic functions of foot and ankle

A
  • support base for upright posture w/ minimal effort
  • transition of mobile adaptor (absorb shock) to rigid lever (impart thrust)
  • sensory / proprioceptive function
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2
Q

Ankle Contents (bones & joints)

A

Bone: tibia, fibula, talus

Joint: talocrural, proximal and distal tibiofibular

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3
Q

Rearfoot contents (bone and joints)

A

bone: calcaneus & talus
joint: subtalar (talocalcaneal)

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4
Q

Midfoot contents (bone & joints)

A

Bone: navicular, cuboid, cuneiforms

Joint: transverse tarsal, distal intertarsal

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5
Q

Forefoot (bone & joints)

A

Bone: metatarsal and phalangeal
Joint: TMT, InterMT, MTP, IP

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6
Q

fibula osteology

A

(proximal fibular & lateral malleolus)

  • comprises lateral ankle
  • attachment side for ligament
  • implicated in fractures .
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7
Q

tibia osteology

A

expanded size distally to accommodate load

  • medial malleolus
  • fibular notch
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8
Q

Ankle Mortis of Talus

A

when you DF, the talus moves back into this joint & causes the tib & fib to seperate

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9
Q

Open Kinetic Chain Motions of Ankle & Foot

A

PF & DF

Inversion & Eversion

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10
Q

Closed Kinetic Chain motions of ankle & foot

A

squatting = DF

walking downhill/stepping/heel raises = PF

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11
Q

PF & DF axis and plane of motion

A

medial - lateral axis

sagittal plane

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12
Q

Inversion & Eversion axis and plane of motion

A

anterior-posterior axis

frontal plane

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13
Q

abduction and adduction axis and plane of motion

A

vertical axis

horizontal plane

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14
Q

oblique axis of rotation

A

triplanar motion

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15
Q

supination axis and plane of motion

A

oblique axis

plane: inversion, ADD, PF

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16
Q

pronation axis & plane of motion

A

oblique axis

plane: eversion, ABD, DF

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17
Q

DF ROM

A

10-20 degree

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18
Q

PF ROM

A

30-50 degree

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19
Q

Eversion/Inversion ROM

A

approx 40 degree

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20
Q

what is inversion limited by

A

subtalar interosseous ligament (stabilized supinated foot)

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21
Q

what is eversion limited by

A

eversion limited by bony obstruction on both side

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22
Q

Proximal Tib-Fib Ankle joint

A
  • synovial joint
  • articulation b/w head of fibula and posterolateral lateral condyle of tibia
  • stabilization of anterior and posterior ligaments
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23
Q

Distal Tib-Fib Ankle Joint

A
  • syndesmotic joint
  • articulation b/w convex medial fibula and concave fibular notch on tibia
  • stabilization of interosseous membrane, anterior and posterior tibiofibular ligaments
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24
Q

anterior and posterior tibiofibular notch

A
  • stabilizer to splaying of ankle mortise during DF
  • limits ER
  • limits fibular mobility on tibia
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25
Q

interosseous membrane

A
  • force dissipation

- stabilizer of splaying of ankle mortise

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26
Q

Talocrural Joint

A
  • synovial hinge joint

- capable of sustaining weight bearing forces

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27
Q

Anterior Talofibular ligament

A
  • reisist PF, Inversion, ADD
  • anterior translation of talus on mortise

(lateral ankle sprain)

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28
Q

Calcaneofibular ligament

A

-resist inversion, DF
-resist subtalar inversion
(2nd most common inversion ankle sprain)

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29
Q

Posterior talofibular ligament

A
  • resist DF, ABD, Inversion

- posterior translation of talus on mortise

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30
Q

deltoid ligament

A

-resist eversion

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31
Q

Special medial ligaments and what they resist

tibiotalar, tibionavicular, tibiocalcaneal

A

-tibiotalar: EV, DF

-tibionavicular:
TCJ - EV & PF
TNJ - EV & AB

-tibiocalcaneal
STJ EV

32
Q

Talocrural Joint Arthrokinematics PlantarFlexion

“Fixed Shank”

A 
convex = talus 
concave = tib/fib complex

convex on concave - roll & slide in opposite direction

33
Q

Talocrural Arthrokinematics Dorsiflexion “Fixed Shank”

A

roll: counter-clockwise from lateral view
slide: posterior slide of taluss

34
Q

DF & ankle mortise

A

talus fill mortise and spread malleoli apart

  • creates tight grip on talus
  • strong ligament & tendon support
35
Q

PF & ankle mortise

A

talus leaves mortise and malleoli come together

-loose grip w/o ligamentous support = unstable

36
Q

non-weight bearing DF/PF

A

dorsiflexion accomponied by external rotation (25/2.5)

plantar flexion includes IR (35/1)

37
Q

weight bearing DF/PF

A

DF - includes eversion/ IT

PF - includes Inversion & ER of tibia

38
Q

ATF Test

A

anterior drawer

-put pt in PF / anterior displacement of talus

39
Q

Talar Tilt

A

positive finding = pain

-talus tilts or gaps excessively compared to uninjured side

stabilize tib/fib while other hand on heel - rounding foot into inversion

40
Q

Major articulations within the foot

A 
subtalar joint
transverse tarsal joint 
tarsometatarsal
MTP 
IP
41
Q

subtalar joint is stabilized by

A

-interosseous ligament: EV
-deltoid: EV
-cervical: INV
CFL: INV

42
Q

Open Chain of subtalar

A
  • Supination: calcaneal inversion, PF, ADD

- Pronation: calcaneal eversion, DF, ABD

43
Q

Closed Chain of subtalar

A

Supination: calcaneal inversion, talar DF & ABD

  • MLA elevation
  • role up the chain

Pronation: calcaneal eversion, talar PF, and ADD

  • MLA depression
  • role up the chain
44
Q

function of subtalar joint

A

main interconnection between mobility of foot mechanism & stability of ankle/leg

-allows for adaptive positioning

45
Q

Midfoot is stabilized by

A

medial longitudinal arch, specialized ligaments, joint capsule and muscle

heavily reliant on STJ

46
Q

Talonavicular

A
  • convex head of talus
  • concave navicular bone

ball and socket like

inferior support by spring ligament

greater degree of joint play/mobility

47
Q

calcaneocuboid

A

articulation of anterior calcaneus and proximal cuboid

  • support by long and short plantar ligaments
  • little movement
48
Q

plantar calcaneonavicular ligament

A

shock absorbing = spring ligament

  • main supporter of medial longitudinal arch of support
  • excessive prolonged pressure leads to permanent stretch
  • lowered longitudinal arch (fallen arch)
49
Q

Medial Foot & Ankle Ligaments

A
  • plantar aponeurosis
  • long plantar ligament
  • short plantar ligament
50
Q

Mutli-axis functional mobility

A 
parallel = mobile adapter 
divergent = rigid lever

longitudinal and oblique axis contribute to pronation & supination

51
Q

middle functional segment

A

transverse tarsal arch held together by interosseous ligament ; flattens on weight bearing

foot elasticity: accommodate uneven surfaces

52
Q

what muscle eccentrically impacts arch?

A

tibialis posterior

53
Q

Foot locomotion supination

A

subtalar inversion, forefoot ADDuction and PF

54
Q

foot locomotion pronation

A

subtalar eversion, forefoot ABD, DF

55
Q

foot locomotion: running

A

heel strike: rearfoot inversion

foot rolls forward: forefoot contact; supination (Inversion, PF, ADD)

Mid-stance: eversion, abduction and beginning of d-flex
(pronation - prolongs foot contact with ground)

56
Q

tarsometatarsal joint

A

permit gliding and sliding

57
Q

medial tarsometatarsal

A

most ROM

no ligamentous restriction

58
Q

intermed. tarsometatarsal

A

2nd cuneiform shorter in length
2nd MT is longest & wedged
strongest joint; little ROM

59
Q

lateral tarsometatarsal

A

intermediate ROM

60
Q

MTP joint (forefoot)

A

largest ROM of any joints (flexion/extension)

  • important in propulsion
  • knuckle like joint
61
Q

IP joint

A
  • greater mobility
  • hinge (big toe can hyperextend)
  • reinforced with plantar and collateral ligaments
62
Q

1st MTP

A

integral to static and dynamic mobility task
- force generation; efficiency

(heel lift / propulsion)

63
Q

Windlass Mechanism

A

tension from plantar fasciae when digits are extended

  • extension of MTP creates tension in plantar fascia
  • role of overpronation
64
Q

intrinsic muscles

A

plantar surface of foot
strong in central portion
supports arch

65
Q

extrinsic support muscles

A

helps maintain arch, stabilize joints, shock absorption (quiets landing)
control toes

66
Q

where do major muscles pass malleoli?

A

PF: gastroc & soleus
DF: tibialis anterior, EHL, & EDL
Inver/Sup: TA, TP, FHL, FDL
Ever/Pron: peroneus brevis and peroneus longus

67
Q

MOVERS malleoli

A

act as pulley - alter angle of pull for muscles

68
Q

force plate gait sensors

A

initial peak = heel hits

second peak = pushing off

69
Q

posterior tibialis dysfunction

A
  • role in maintaining supination & MLA
  • elevated arch in supination
  • going into PF,carried ADD & inversion

if person is pronated, there will be a change in the ability to maintain arch

70
Q

orthotics

A

support surrounding arch structures and limit pronation moment at foot/ankle complex

71
Q

pes planus

A

low arch
flexible lever = push off
progressive loading of supporting ligaments of MLA

72
Q

Pes Cavus

A 
high arch 
shortens foot length 
pressure of metatarsal head 
toes claw 
bear more weight on heel
73
Q

Heel height effect on MT heads

A

3/4 inch heel - 22% increase

2 inch heel - 57% increase

3 1/4 inch - 76% increase

74
Q

Hallux Valgus

A
  • distal end outward (proximal inward)
  • 2nd most frequent forefoot surgery
  • 94% of cases are women
75
Q

bunion

A

medial side of foot at 1st MP joint

sesamoid shift and thicken MT head

76
Q

March fracture

A

“Stress fracture”
hairline fracture across 2nd MT

occurs because 2nd metatarsal joint has little movement and not accustomed to stress level or repetition. (runners)

Biomechanics (7 decks)

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