ankle - tarsometatarsal

Question 1

what is the joint type of the tarsometatarsal

Answer 1

planar synovial joint of distal row of tarsal bones with base of metatarsals

Question 2

what is the function of the tarsometatarsal

Answer 2

regulate position of the forefoot in relation to the weight bearing surface, contributes to this motion with end-range subtalar motion

Question 3

supination twist

Answer 3

substantial weight bearing pronation of the hindfoot results in supination of the transverse tarsal joint to counter rotate the forefoot

if supination is not sufficient, the entire forefoot will also supinate

Question 4

pronation twist

Answer 4

full subtalar supination results in supination at the transverse tarsal joint as well

forefoot must pronate in order to maintain contact with ground

Question 5

deformities of 1st MTP joint - hallux limitus (turf toe)

Answer 5

posttraumatic condition

limitation of motion, articular degeneration and pain, impacts walking

MOI: forceful hyperextension

Question 6

deformities of 1st MTP joint - hallux valgus (bunion)

Answer 6

progressive lateral deviation of first toe

lateral dislocation

Question 7

plantar fascia

Answer 7

main role in supporting medial longitudinal arch in weight bearing

Question 8

windlass effect

Answer 8

PF contraction lifts calcaneous

BW is transferred over the metatarsal heads –> extension of MTP joint

stretches the PF supporting the medial longitudinal arch

strengthens midfoot

Question 9

pes planus

Answer 9

abnormal dropped medial longitudinal arch–> joint laxity in midfoot or proximal forefoot

Question 10

what is pes planus associated with

Answer 10

overstretched, torn or weekend plantar fascia, spring ligament and tibialis posterior tendon

Question 11

what does pes planus compromise

Answer 11

ability to support and dissipate loads

Question 12

rigid pes planus

Answer 12

flat on ground or when foot off ground

Question 13

flexible pes planus

Answer 13

flat on ground only when standing, arch in foot when foot off ground

Question 14

what does the navicular drop test clinically asses

Answer 14

medial longitudinal arch

Question 15

navicular drop test

Answer 15

measurement of distance btw navicular tuberosity and ground in subtalar joint neutral and with relaxed foot posture

normal: 7 mm

Question 16

pes cavus

Answer 16

less common, abnormal raised medial longitudinal arch

associated w excessive rearfoot varus or forefoot valgus

Question 17

what active structures support the foot w a heel raise

Answer 17

sling formed by fibularis longus and tibialis posterior supports transverse and medial longitudinal arch

net effect = slight supination

Question 18

function of tibialis posterior in stance phase of ambulation

Answer 18

decelerates pronating rearfoot in loading response

excessive or rapid pronation in stance places excessive braking demands on tib posterior

acts to supinate rearfoot in mid-to-late stance to provide a stable foot for toe off