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Winter 2023 - Essential Biomechanics and Kinesiology > Ankle/Foot- Wk11 ( Ch14) > Flashcards

Ankle/Foot- Wk11 ( Ch14) Flashcards

1
Q

Explain the following terms for the ankle and foot: pronation

A

eversion+abduction+dorsiflexion

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2
Q

Explain the following terms for the ankle and foot: supination

A

inversion, adduction, plantar flexion

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3
Q

For each ligament give the motion restricted: ATFL

A

inversion, adduction (IR), plantar flexion

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4
Q

For each ligament give the motion restricted: PTFL

A

abduction, inversion, dorsiflexion

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5
Q

For each ligament give the motion restricted: CFL

A

inversion, dorsiflexion

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6
Q

For each ligament give the motion restricted: Deltoid

A

eversion, abduction, dorsiflexion, plantar flexion

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7
Q

What are the arthrokinematics for open chain and closed chain: Talocrural DF

A

anterior roll and posterior slide

anterior roll and slide

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8
Q

What are the arthrokinematics for open chain and closed chain: Talocrural PF

A

posterior roll and anterior slide

posterior roll and slide

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9
Q

What are the arthrokinematics for open chain and closed chain: Subtalar Pronation

A

horizontal plane rotation of calcaneus on talus or talus on calcaneus respectively; sliding movements

don’t worry about it

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10
Q

What are the arthrokinematics for open chain: Talonavicular pronation and supination

A

spin of concave navicular

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11
Q

How does the tibia move with subtalar: pronation and supination

A

pronation: IR of tibia
supination: ER of tibia

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12
Q

What is subtalar neutral ?

A

“ideal” foot position; calcaneus and leg in-line

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13
Q

Calcaneovalgus ?

A

calcaneus angles away from midline

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14
Q

Calcaneovarus ?

A

calcaneus angles toward midline

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15
Q

Forefoot Valgus ?

A

excessive eversion of forefoot

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16
Q

Forefoot Varus ?

A

Excessive inversion of forefoot

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17
Q

What are the active and passive stabilizers of the medial longitudinal arch ?

A

Active: TA, TP, Fibularis Longus

Passive: calcaneus, talus, navicular, cuneiforms, medial 3 metatarsals;
plantar fascia, spring ligament, 1st tmt joint
plantar fat pads

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18
Q

How does the arch move during the gait cycle ?

A

During most of the stance phase the arch lowers slightly
by late stance, the arch rises as the subtalar joint supinates

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19
Q

Explain what is meant by the following terms: supination and pronation twist

A

supination twist: twisting of the forefoot in supination direction
pronation twist: twisting of the forefoot in pronation direction

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20
Q

How does the windlass mechanism work and what happens if it is not working properly ?

A

as the toes extend during PF; the plantar fascia becomes taut and adds stability to medial longitudinal arch

loss of PF ROM even with maximal muscular effort.

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21
Q

How does fibularis longus help to raise the transverse arch of the foot ?

A

by providing dynamic stabilization through the muscles course;

balancing muscular force, slight supination of rear foot in conjuction with TP as the heel rises.

“functional sling”

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22
Q

How will a tight gastroc affect the knee and ankle ?

A

less knee extension may impact gastroc length tension relationship

tight gastroc will limit dorsiflexion of ankle needed for PF

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23
Q

What is special TP as it pertains to the gait cycle ?

A

resists pronation and assists w/ supination; decelerate pronation by eccentrically contracting

24
Q

What action do the plantar flexors have if the foot is fixed to the ground ?

A

-soleus may help prevent subtle postural sway
- gastroc is more suited for explosive PF
- both PF the talocrural joint

  • support of medial longitudinal arch
  • keep foot balanced between eversion and inversion
25
Q

What similarities do you see between the intrinsics of the hand and foot ?

A

FDS and FDP schema
interossei actions
pathology similarities

26
Q

Explain how foot pronation could affect joints up the rest of the leg? Supination ?

A

pronation: could lead to IR and knee valgus; patellofemoral pain syndrome

supination: tibial ER, knee varus

generalized muscle fatigue
painful overuse syndrome

27
Q

Explain how the following conditions affect the ankle and foot during walking: pes cavus and planus

A

cavus: less contacting surface; callous formation on metatarsal heads; cannot absorb impact of running and walking

planus: exaggerated valgus posture; cannot dissipate load through foot; inccreased muscular activity during quiet standing; pain, bone spurs, plantar fasciitis

28
Q

How does pes planus differ from AAFFD ?

A

AAFFD results mainly from TP and strain related injuries; and is acquired

Pes planus has more to do with lax plantar fascia and can be present early in life

29
Q

Explain the pathomechanics of PT tendon dysfunction.

A

TP is active during most of the gait cycle and can therefore become tired
-arch lowers
- progressive inflammation becomes incapacitating
- muscle weakness, poor gait mechanics, hindfoot eversion and pronation

30
Q

Explain plantar fasciitis to a patient.

A

pain along the sole of the foot.
caused by increase pronation and supination, poor footwear, obesity, weak intrinsics

31
Q

How does a hallux valgus develop ?

A

develops due to possible rupture of MCL and altered line of pull of muscles that normally abduct hallux

32
Q

What happens with an injury to this nerve: deep fibular

A

drop foot orr pes equinus ( PF contracture)
paralysis of dorsiflexors
PF contractures develop
adaptive shortening of achilles tendon

33
Q

What happens with an injury to this nerve: superficial fibular nerve

A

paralysis of fibularis longus and brevis; pes varus ( inverted foot )

34
Q

What happens with an injury to this nerve: common fibular nerve

A

mixed deep and superficial signs ( pes equinovarus )

35
Q

What happens with an injury to this nerve: tibial nerve

A

loss of PF torque
pes calcaneus ( fixed dorsiflexion posture )
pes valgus ( pronation deformity )
pes calcaneovalgus

“clawing” of toes
MTP hyperextension, flexion of IP joints

36
Q

Compare and contrast the mechanism of injury and structures damaged during: high ankle sprain and inversion ankle sprain

A

high ankle: extreme DF splays mortoise causing injury to multiple ligaments, can also be due to closed chain abduction and ER torque to talus, IR on fixed foot

inversion: full PF= OPP for TCJ
slackens ligaments
unstable
increased likelihood of inversion sprains

37
Q

Why are patients with an ankle sprain more likely to incur reccuring sprains and what can therapists due to help ?

A

mechanical restrictions like anterior laxity of talus in mortoise; degenerative changes but also possible mechanoreceptor dysfunction

address joint instability, fibularis muscle strengthening, single and double limb whole body balance.

38
Q

ROM Norm for: Plantarflexion

A

50

39
Q

ROM Norm for: Dorsiflexion

A

20

40
Q

ROM Norm for: Eversion

A

15

41
Q

ROM Norm for: Inversion

A

35

42
Q

ROM Norm for: 1st MTP flexion and extension

A

flexion: 45
ext: 70

43
Q

What is the OPP and CPP of the: Talocrural joint

A

OPP: 10 degrees PF, midway between max inversion and eversion
CPP: max DF

44
Q

What is the OPP and CPP of the: Subtalar

A

OPP: midway between extremes of ROM
CPP: Supination

45
Q

What is the OPP and CPP of the: Midtarsal ( Transverse Tarsal )

A

OPP: midway between extremes of ROM
CPP: Supination

46
Q

What is the OPP and CPP of the: Tarsometatarsal joint

A

OPP: midway between extremes of ROM
CPP: Supination

47
Q

OIIA: Tibialis Anterior

A

O:Lateral condyle and superior half of lateral surface of tibia and interosseous membrane
I:Medial and inferior surfaces of medial cuneiform and base of 1st metatarsal
I:Deep fibular nerve (L4, L5)
A:Dorsiflexes ankle joint and inverts subtalar joint

48
Q

OIIA: EHL

A

O:Middle part of anterior surface of fibula and interosseous membrane
I:Dorsal aspect of base of distal phalanx of great toe (hallux)
I:Deep fibular nerve (L5, S1)
A:Extends great toe and dorsiflexes ankle joint

49
Q

OIIA: EDL

A

O:Lateral condyle of tibia and superior three quarters of medial surface of fibula and interosseous membrane
I:Middle and distal phalanges of lateral four digits
I:Deep fibular nerve (L5, S1)
A:Extends lateral four digits and dorsiflexes ankle joint

50
Q

OIIA: Fibularis Tertius

A

O:Inferior third of anterior surface of fibula and interosseous membrane
I:Dorsum of base of 5th metatarsal
I:Deep fibular nerve (L5, S1)
A:Dorsiflexes ankle joint and aids in eversion of subtalar joint

51
Q

OIIA: Fibularis Longus

A

O:Head and superior two thirds of lateral surface of fibula
I:Base of 1st metatarsal and medial cuneiform
I:Superficial fibular nerve (L5, S1, S2)
A:Everts subtalar joint and weakly plantarflexes ankle joint

52
Q

OIIA: Fibularis Brevis

A

O:Inferior two thirds of lateral surface of fibula
I:Dorsal surface of tuberosity on lateral side of base of 5th metatarsal
I:Superficial fibular nerve (L5, S1, S2)
A:Everts subtalar joint and weakly plantarflexes ankle joint

53
Q

OIIA: Gastrocnemius

A

O:Lateral head: lateral aspect of lateral condyle of femur
Medial head: popliteal surface of femur; superior to medial condyle
I:Posterior surface of calcaneus via calcaneal tendon
I:Tibial nerve (S1, S2)
A:Plantarflexes ankle joint when knee joint is extended; raises heel during walking; flexes knee joint

54
Q

OIIA: Soleus

A

O:Posterior aspect of head and superior quarter of posterior surface of fibula; soleal line and middle third of medial border of tibia; tendinous arch extending between the bony attachments
I:Posterior surface of calcaneus via calcaneal tendon
I:Tibial nerve (S1, S2)
A:Plantarflexes ankle joint independent of position of knee; stabilizes ankle joint

55
Q

OIIA: Plantaris

A

O:Inferior end of lateral supracondylar line of femur; oblique popliteal ligament
I:Posterior surface of calcaneus via calcaneal tendon
I:Tibial nerve (S1, S2)
A:Weakly assists gastrocnemius in plantarflexing ankle joint

56
Q

OIIA: Tibialis Posterior

A

O:Interosseous membrane; posterior surface of tibia inferior to soleal line; posterior surface of fibula
I:Tuberosity of navicular, cuneiform, cuboid, and sustentaculum tali of calcaneus; bases of 2nd, 3rd, and 4th metatarsals
I:Tibial nerve (L4, L5)
A: Plantarflexes ankle joint; inverts foot; maintains medial longitudinal arch

57
Q

OIIA: FDL

A

O:Medial part of posterior surface of tibia inferior to soleal line; by a broad tendon to fibula
I:Bases of distal phalanges of lateral four digits
I:Tibial nerve (S2, S3)
A:Flexes lateral four digits; plantarflexes ankle joint; supports longitudinal arches of foot

Winter 2023 - Essential Biomechanics and Kinesiology (16 decks)

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