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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
What similarities do you see between the intrinsics of the hand and foot ?
FDS and FDP schema interossei actions pathology similarities
26
Explain how foot pronation could affect joints up the rest of the leg? Supination ?
pronation: could lead to IR and knee valgus; patellofemoral pain syndrome supination: tibial ER, knee varus generalized muscle fatigue painful overuse syndrome
27
Explain how the following conditions affect the ankle and foot during walking: pes cavus and planus
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
How does pes planus differ from AAFFD ?
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
Explain the pathomechanics of PT tendon dysfunction.
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
Explain plantar fasciitis to a patient.
pain along the sole of the foot. caused by increase pronation and supination, poor footwear, obesity, weak intrinsics
31
How does a hallux valgus develop ?
develops due to possible rupture of MCL and altered line of pull of muscles that normally abduct hallux
32
What happens with an injury to this nerve: deep fibular
drop foot orr pes equinus ( PF contracture) paralysis of dorsiflexors PF contractures develop adaptive shortening of achilles tendon
33
What happens with an injury to this nerve: superficial fibular nerve
paralysis of fibularis longus and brevis; pes varus ( inverted foot )
34
What happens with an injury to this nerve: common fibular nerve
mixed deep and superficial signs ( pes equinovarus )
35
What happens with an injury to this nerve: tibial nerve
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
Compare and contrast the mechanism of injury and structures damaged during: high ankle sprain and inversion ankle sprain
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
Why are patients with an ankle sprain more likely to incur reccuring sprains and what can therapists due to help ?
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
ROM Norm for: Plantarflexion
50
39
ROM Norm for: Dorsiflexion
20
40
ROM Norm for: Eversion
15
41
ROM Norm for: Inversion
35
42
ROM Norm for: 1st MTP flexion and extension
flexion: 45 ext: 70
43
What is the OPP and CPP of the: Talocrural joint
OPP: 10 degrees PF, midway between max inversion and eversion CPP: max DF
44
What is the OPP and CPP of the: Subtalar
OPP: midway between extremes of ROM CPP: Supination
45
What is the OPP and CPP of the: Midtarsal ( Transverse Tarsal )
OPP: midway between extremes of ROM CPP: Supination
46
What is the OPP and CPP of the: Tarsometatarsal joint
OPP: midway between extremes of ROM CPP: Supination
47
OIIA: Tibialis Anterior
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
OIIA: EHL
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
OIIA: EDL
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
OIIA: Fibularis Tertius
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
OIIA: Fibularis Longus
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
OIIA: Fibularis Brevis
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
OIIA: Gastrocnemius
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
OIIA: Soleus
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
OIIA: Plantaris
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
OIIA: Tibialis Posterior
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
OIIA: FDL
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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