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DPT Spring 2024 > Biomechanics Exam 3 > Flashcards

Biomechanics Exam 3 Flashcards

1
Q

_______= ________ joint, tibia, fibula, and talus

A

ankle; talocrural

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2
Q

_____= all the tarsal bones and joints distal to the ankle

A

foot

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3
Q

__________ ( __________ )= talus, calcaneus, subtalar joint

A

rearfoot; hind foot

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4
Q

__________= tarsal bones, transverse tarsal joint, intertarsal joints

A

midfoot

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5
Q

_________= metatarsals and phalanges with all tarsometatarsal joints

A

forefoot

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6
Q

Tibia and fibula: _______ and ________

A

anterior; posterior

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7
Q

ankle and foot: ______ and ________

A

dorsal; plantar

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8
Q

Know this!

A
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9
Q

Know this!

A
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10
Q

Talus: the trochlear surface is a rounded dome, _______ A/P, slightly concave ____/____

A

convex; ML

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11
Q

Talus: head projects ______ and slightly ______, ____degrees medial to sagittal plane

A

forward; medial; 30

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12
Q

Talus: 3 facets on the inferior surface- ______, ________, _________

_______ joint: with calcaneus

A

anterior, middle, posterior

subtalar

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13
Q

__________- largest of the tarsals

  • Impacts with heel strike
  • __________ tuberosity; achilles tendon
  • Plantar surface medial/lateral processes: intrinsics/fascia
  • Cuboid, talus
  • Sustentaculum talus- horizontal shelf (middle facet of talus)
A

calacneus

calacaneal

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14
Q

Talus: _______-_________ groove pulley for _______

A

Posterior; medial, FHL

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15
Q

_________
talus, 3 cuneiform bones
attaches to posterior tib ( _________ tuberosity)

A

navicular

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16
Q

_______, ________, ________ cuneiforms
- spacers between navicular and 3 metatarsal bones
- contributes to transverse arch

A

medial, intermediate, lateral

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17
Q

__________
6 surfaces; 3 with tarsals, 4th and 5th metatarsals (like hamate in the hand)
groove across the plantar surface- _________ ________

A

cuboid
peroneus longus

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18
Q

____________
- 5 linked tarsals and phalanges
- 2nd and 3rd rigidly connected
- Base facets (proximal), shaft (concave plantar surface), convex head
- 1st and 2 sesamoids in FHL
- 5th with prominent styloid process ( _________ _______ )

A

metatarsals
peroneus brevis

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19
Q

___________
- 14: 4 lateral have proximal/middle/distal
- Great toe: (hallux) has 2 proximal and distal
- base (proximal) shaft and head

A

phalanges

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20
Q

__________ terminology: defines movement of foot/ankle occuring @ right angles to the three standard axes of rotation

Dorsiflexion/Plantarflexion: _________ plane; ___/___ axis
Eversion/Inversion: _________ plane; ____/_____ axis
Abduction/Adduction: _________ plane/ _________ axis

A

Fundamental
sagittal; ML
frontal; AP
horizontal; vertical

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21
Q

___________ terminology: defines motions perpendicular to oblique axes

___________ (eversion/abduction/DF)
___________ (inversion/adduction/PF)

A

applied
pronation
supination

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22
Q

Proximal tibiofibular joint
_________
________/_______ to knee
head of _______ and posterior/lat region on ________ condyle of tibia
flat/slightly oval covered in ________ cartilage
_______, tendons of ______ ______, and _________ strengthen joint
___-____mm translation

A

synovial
lateral; inferior
fibula
lateral
articular
capsule; biceps femoris; popliteus
1; 3

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23
Q

Distal tibiofibular joint
_________- bound by interosseus membrane
Fibular _____ on tibia and distal ______ surface of fibula
Slight movement associated with ____________, must be stable for correct ______ joint function
___________ ligament (membrane)- strongest bond
__________ and ___________ tibiofibular ligaments

A

Syndesmosis
notch; medial
dorsiflexion
TC
Interosseus
Ant/Post

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24
Q

Talocrural joint:

Trochlea (dome) and sides of talus with mortise formed by distal _______ and ______, shape provides a major source of _________

A

tibia
fibula
stability

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25
Q

Talocrural joint:

____-____% compressive forces pass through talus and tibia, ____-____% through talus and fibula

A

90;95
5;10

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26
Q

Talocrural joint:

Lined with _____ mm of ________ cartilage protecting intra-articular _________ bone

A

3; articular; subchondral

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27
Q

3 Ligaments of lateral collateral ligaments:
A/P Talofibular
Calcaneofibular

_____% of ankle sprains

________ ankle sprains; _______ in slight inversion at heel contact and medial malleolus cannot block

A

80
Inversion
calacaneus

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28
Q

_________ ___________ LIGAMENT
Ant lat malleolus to neck of talus
Most frequently injured: inversion/adduction (IR) especially with PF (ant slide of talus)

A

Anterior Talofibular

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29
Q

______________ ligament
inf and post from apex of lat malleolus to calcaneus
Resists inversion @ TC especially with full DF (post slide of talus)

A

calcaneofibular

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30
Q

________ __________ ligament
Post lat malleolus to lat tubercle of talus – runs horizontal
Stabilizes talus in mortise
Limits abd/ER of talus (post slide of talus)

A

posterior talofibular

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31
Q

Osteokinematics: TC Joint
_____ primary degree of freedom
Axis through body of ______ and tips of both __________

Lateral is _______ and _______ to medial…. not pure ____/______ inclined 10 deg superior, 6 deg anteriorly

Due to pitch of axis: _____ slight and/eversion; _____ slight add/inversion

A

one
talus
malleoli
inferior
posterior
ML
DF
PF

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32
Q

Osteokinematics: TC joint
neutral position is the foot at ____ deg to leg

TC joint permits: ____-_____ deg of DF and ____-______ deg PF

A

90
15; 25
45;55

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33
Q

Arthrokinematics: TC joint
OC DF: Talus rolls ________ and slides _______; mortise occupied (wedged) and is _______ packed position (tibia/fib slides _______ slightly)

CC DF: tibia moves _______

A

forward
posterior
closed
apart
anteriorly

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34
Q

Arthrokinematics: TC joint

DF: ______ and _______ ligs taut; posterior tibiotalar of deltoid

A

CF; PTF

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35
Q

Extreme DF can cause distal ___________ syndesmosis injury (high _______ _______ )

A

tibiofibular
ankle sprain

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36
Q

What direction would you mobilize the talus to gain DF?

A

posterior

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37
Q

Arthrokinematics: TC Joint
OC PF: talus rolls ________ and slides ________; CC tibia moves ________

A

posteriorly; anteriorly
posteriorly

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38
Q

Arthrokinematics: TC joint

PF: ______ and ________ ligs taut

A

ATF; tibionavicular

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39
Q

Extreme PF can have _________ of distal tibia post talus or calcaneus esp with ____ ________ (rare accesory bone)

A

impingement
os trigonum

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40
Q

With arthrokinematics of TC joint, the dome of talus is wider anterior aspect of talus moves of the mortise during ________ (loose packing) thus decreasing the ankle’s bony _________

A

PF; stability

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41
Q

________ joint is between talus and calcaneus

A

subtalar

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42
Q

Subtalar joint:

______- calacaneus moves relative to a fixed talus (in mortise)

A

NWB

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43
Q

Subtalar joint:

________ ______- as in walking; leg and talus move over calcaneus (relatively fixed due to WB)

A

During WB

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44
Q

The ________ joint allows foot to assume positions that are independent of the leg (walking across a steep hill/quickly changing directions)

A

subtalar

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45
Q

Subtalar joint- posterior articulation = 70% of total area; ________ talus rest on ______ posterior facet of calacaneus, held tightly by interlocking shape, ligaments, BW, and activated muscle

A

concave; convex

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46
Q

______/_______ facets of subtalar joints smaller and nearly flat surfaces

A

anterior; middle

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47
Q

TC joint kinematics
- involving sliding motion at 3 facets (curvilinear arc)
- axis ____/_____ heel through subtalar joint in ____/_____/_____

______ deg from horizontal plane
_______ deg from sagittal plane

A

lat; post
ant/med/sup
46
16

48
Q

Subtalar WB and NWB motions:
NWB pronation: calcaneus moves into ______/_____/_____

WB pronation: calcaneus ______- talus _____/______

A

EV; AB; DF
EV; ADD; PF

49
Q

Subtalar WB and NWB motions:
NWB Supination: _____/______/______
WB Supination:
calc in- talus _____/_____

A

INV; ADD; PF
ABD; DF

50
Q

Midtarsal or Chopart’s joint (transverse tarsal joint)
1. ___________
2. ___________-

A

Talonavicular
Calcaneocuboid

51
Q

Which joint is the most versatile joint of the foot? Has how many POM?

A

transverse tarsal
3

52
Q

The _______ _______ joint allows weight bearing foot to adapt to a variety of contours

A

tarnsverse tarsal

53
Q

The transverse tarsal joint functions closely with ST joint to allow ________/________

A

supination
pronation

54
Q

__________ resembles ball and socket

  • ______ talus head and deep ______ of navicular bone and ______ ligament
A

talonavicular
convex
concavity
spring

55
Q

________ ligament is a band of _______- sustentaculum tali and navicular that is “floor and medial wall”

A

spring
fibrocartilage

56
Q

Transverse tarsal joint provides substantial ______ to medial and longitudinal column- as twisting and bending (____/_____ and _____/_____ of midfoot to rear foot)

A

mobility
Inv/EV
Flex/Ext

57
Q

Navicular ______ in talonavicular joint

Allows calcaneous to move and both _____ and ______ ______ joints provide and supination (abd/DF and add/PF) motion at this joint

Spin of the navicular around ______ head of talus- lifting the ______arch (pull of ______ ______)

Reverse with pull of _______

A

spins
ST; transverse tarsal
convex
medial
psoterior tib
peroneus

58
Q
A
59
Q
A
60
Q
A
61
Q

Know superficial deltoid ligament
tibialis posterior tendon
long plantar ligament
spring ligament

A
62
Q
A
63
Q
A
64
Q
A
65
Q
A
66
Q
A
67
Q

Medial longitudinal arch

Both lend crucial elements of ______ and ______ to foot

A

stability; resiliency

68
Q

_______ _______ is primary load-bearing and shock-absorbing structure of the foot

A

medial arch

69
Q

Bones involved with medial arch: _______, ________, _______, ________, 3 medial _______

A

calcaneus
talus
navicular
cuneiforms
metatarsals

70
Q

Without the medial arch, the large/rapid. forces of _____ would exceed physiologic ______ capacity of bones

A

running
WB

71
Q

Structures assisting load absorbing: fat _____, ______ bones (plantar base of great toe), ________ fascia attaches to overlying thick _______ (reduces ______ forces)

A

pad
sesamoid
plantar
dermis
shear

72
Q

Medial arch: forces required for quiet standing is _______ and is small compared with _______ from connective tissues

A

variable
support

73
Q

With medial arch, there are high level forces needed when stresses on arch such as: on tip toes ______/_______

A

jumping; running

74
Q

_______ ________: primary passive support for arch, dense connective tissue in superficial and deep layers, 2-2.5 mm thick, longitudinal and transverse collagen rich fibers, extremely strong – can withstand 810 N (180 lb) before permanent elongation. Blends with first layer intrinsic muscles.

A

plantar fascia

75
Q

With plantar fascia, the central bands into _______ heads blending with plantar plates/ligaments of MTP joints, flexor tendon sheaths and fascia of toes (plantar surface)

A

metatarsal

76
Q

With plantar fascia, the extension of toes stretches the central fibers of the deep fascia, adding ________ to the _______ arch (on tip toes or late push off in gait)

A

tension; medial

77
Q

With plantar fascia, ________ stance BW through talonavicular joint and spreads out to fat pads and thick dermis over metatarsal heads and heel

A

normal

78
Q

With plantar fascia, Rearfoot 2 X ________ force as forefoot….On forefoot usually >est @heads of the 2nd 3rd metatarsals

A

compressive

79
Q

During standing BW pushes talus ______- lowers arch slightly

A

inferiorly

79
Q

Tension in _______ ______ fascia acts a semi-elastic tie-rod acts like truss

A

deep plantar

80
Q

Cutting the fascia decreases arch _______ by 25%

Arch is depressed- rearfoot ______a few degrees

A

stiffness
pronates

81
Q

______ _____ or flatfoot - abnormally dropped medial longitudinal arch

A

pes planus

82
Q

pes planus can be a result of ______ _____ within midfoot or proximal forefoot and/or combined with overstretched, torn, or weak plantar fascia, spring ligament, or posterior tibialis

A

joint laxity

83
Q

Pes planus results in excessive ________ _______ (calcaneal eversion or in a valgus position)

A

subtalar pronation

84
Q

Pes planus or forefoot is often forefoot _______, ______- talus and navicular rubs against inside of foot waer (callus)

A

abduction
depressed

85
Q

Immediately after heel contact
1. calcaneuus tips into ______/_________ in response to GRF just lateral to midpoint of calacaneus

  1. head of talus pushed ________ (horizontal -add) and ______ (sagittal PF)
  2. tibia and fibula _______ rotates after heel contact
A

eversion/pronation

medially

inferiorly

internally

86
Q

__________ in stance may include weakness of muscles in LE, weakness or laxity in medial arch structures, or abnormal shape/mobility of tarsal bones

A

overpronation

87
Q

Overpronation may have excessive _____ motion in horizontal and frontal planes

A

ST

88
Q

With overpronation: the center of pressure falls more medially on the sole of the foot and after many reps during gait cycle, the tissue can show signs of ______ (local _____ and ______- fascia, talonavicular joint (keystone) and _______ tib tendon

A

stress
inflammation
posterior

89
Q

Rearfoot or forefoot fixed varus leads to overpronation, by trying to get foot to contact ground _____ joints pronates

A

ST

90
Q

Orthotics for controlling excessive pronation:

Optimizes _____ ______ alignment to reduce demand on _______ (post tib), optimizes alignment of bones/joints, changes ______ sequencing, support to ______ tissues

A

mid stance
musculature
kinematic
medial

91
Q

Lisfranc’s joints

Seperate _____ to _______
base of metatarsals and ________/_______
Least ________ (stability) at 2nd/3rd
Early midstance medial column (1st) DF -___ degrees cunefiform _____ and forces 1st ray upward- reverses before push off (peroneus)

A

midfoot; forefoot
cuneiform/cuboid
motion
5
depresses

92
Q

Forefoot joints
_____________
plantar, dorsal and interosseous ligaments
Synovial joints at 3 lateral, not 1st and 2nd

A

intermetatarsal

93
Q

Forefoot joints

_____________
Convex head of metatarsal to shallow concavity of phalanx (2.5 mm proximal to ‘web’ space of toes)
Capsule, collateral ligs, plantar plate (grooved passage for flexor tendons)
2 deg of freedom – flexion/ext and abd/add

A

metatarsophalangeal

94
Q

Great toe is known as _______ ______ or rigid/turf toe

A

hallux limitus

95
Q

Hallux limitus or turf toes
has marked limitations of _____, pain @ ______ (< ____ deg) walking need _____ deg and may adapt with walking on outside of foot

A

motion
MTP
55
45

96
Q

Great toe frequently forces __________

and can fracture ________

A

hyperextension
sesamoids

97
Q

Hallux valgus is a progressive ________ deviation of great toe and _____ of metatarsal

A

lateral
ADD

98
Q

Hallux valgus: tendons displaced are relative to joint and can promote greater ________

A

deformation

99
Q

________ ________ can cause Tightness of the achilles, incorrect footwear, excessive rearfoot valgus, instability of 1st ray can be causative and secondarily can get hammer 2nd toe, metatarsalgia, bursitis at ‘bunion’

A

hallux valgus

100
Q

The “windlass effect” contraction of the extrinsic _______ _______ muscles lift the calcaneus, therby transferring body weight forward over the _______ heads. this results in ________ of the MTP joints stretches the ______ __________ within the medial longitudinal arch. The increased tension from the _______ raises the arch and strengthens the _______ and ________. Contract of the intrinsic muscles provides additional reinforcement to the _______

A

plantar flexor
metatarsal
extension
plantar fascia
stretch
midfoot; forefoot
arch

101
Q

With pes planus, the forefoot ______ under the load of BW. Reduced ______ of the MTP limits the usefullness of windlass effect

A

sags
extension

102
Q

common fubular (peroneal) nerve
___-____

A

L4-S2

103
Q

Foot drop can happen from injury to this nerve?

A

common fibular (peroneal)

104
Q

tibial nerve
____-_____

A

L4-S3

105
Q

Anterior compartment

tendons restrained by ______-lined superior and inferior _______ retinaculum

A

synovial
extensor

106
Q

These muscles are in the ________ compartment

Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus (4 tendons)
Peroneus tertius

A

anterior

107
Q

These muscles are in the ________ compartment

Peroneus longus
Peroneus brevis

A

lateral

108
Q

Lateral fibula wrap around lateral malleolus (pulley) to 1) _______ to 5th metatarsal head 2) _______ to groove in cuboid between long/short plantar ligaments to 1st tarsometatarsal joint

A

brevis
longus

109
Q

Peroneus longus
Peroneus brevis are primary ______ and main source of active ______ to lateral ankle and stabilizes 1st ray

A

evertors
stability

110
Q

Posterior compartment

______ group: : gastrocnemius, soleus into Achilles (triceps surae) and plantaris. Soleus does not cross knee and is 2 X >er cross sectional area than gastroc

______ group: posterior tibialis (all tarsals except talus), flexor digitorum longus, flexor hallucis longus (posterior tibia/fibula and interosseus membrane)

strong ______
______ tunnel

A

superficial
deep
inversion
tarsal

111
Q

What’s the strongest tendon in the body?

A

tendon

112
Q

Intrinsic muscles:

Dorsum 1: layer extensor digitorum ______

Plantar
Layer 1: _____/______/_____
Layer 2: _____/_____
Layer 3: ______/_____/_____
Layer 4: _____/______

A

brevis
FDB/AH/ADM
QP/L
AH/FHB/FDM
PI/DI

113
Q

If soleus is weakened, it is unable to decelerate _________

Forward position of the leg shifts the _____ of BW well _____ to the knee, causing it to ______ into FLX

A

dorsiflexion
force
posterior
buckle

114
Q

Know
Post Tib
peroneus (fibularis)
ant tib
FHL
- influence at first ray/medial arch control

A
115
Q
A

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