Exam 1 - Foot & Ankle Complex Flashcards

1
Q

What are the 2 main functions of the foot/ankle complex?

A
  • Stable base of support

- Shock absorption

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2
Q

Bones of the ankle

A
  • distal tibia
  • distal fibula
  • talus
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3
Q

What 2 bones make a mortise?

A

Fibula and tibia, held together by interosseous membrane

- allow talus to pass through

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4
Q

What forms a malleoli?

A

Ends of tibia & fibula

- L. little hammer

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5
Q

Hindfoot

A

Talus and calcaneus

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6
Q

Mid-foot

A

3 cuneiforms, navicular, cuboid

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7
Q

Forefoot

A

Metatarsals & phalanges

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8
Q

Tarsals

A

7 bones

- Gr. tarsos, any flat surface

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9
Q

Metatarsals

A

Gr. Meta, after

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10
Q

Phalanges

A
  • Gr. phalanx, line of battle
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11
Q

Joints

A

4 mains

  • ankle
  • subtalor
  • tarsometatarsal
  • metatarsalphalangeal
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12
Q

2 motion of the ankle

A

Plantarflexion (point) - 50 degrees

Dorsiflexion - 30 degrees

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13
Q

Talus

A
  • wider anteriorly
  • narrower posteriorly
  • often fractured in dislocations of the ankle
  • upward arterial supply
  • prone to necrosis with severe injury
    - avascular necrosid
    “Snowboarder’s Fracture”
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14
Q

Subtalar Joint

A

“Below the ankle”

  • between talus and calcaneus
  • calcaneum = L. Heel
  • inversion: 30 degrees
  • eversion: 10 degrees
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15
Q

Subtalar Neutral

A
  • in the middle
  • “optimally aligned foot”
  • best stress distribution
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16
Q

Tarsometatarsal Joint

A

3 cuneiforms and cuboid with metatarsals

- helps regulate positions of the foot

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17
Q

Metatarsopharangeal Joint

A

“MTP”

  • 5 joints
  • primarily flexion and extension
  • hinge to allow heel to rise while toes stabilize
    - gait
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18
Q

6 main movements

A
  • plantarflexion
  • dorsiflexion
  • inversion
  • eversion
  • pronation
  • supination
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19
Q

Pronation

A

Foot rolls inwards
- eversion
- dorsiflexion
P. E. D.

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20
Q

Supination

A
  • Foot rolls outward
  • inversion
  • plantarflexion
    S.I.P.
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21
Q

Ligaments

A
~60
Main ligaments
1. Interosseous membrane 
2. Deltoid ligament
3. Anterior Talofibular Ligament
4. Plantar Calcaneonavicular Ligament
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22
Q

Interosseous membrane

A

Tibia to fibula
Force distribution
Shock attenuation
High ankle sprain

23
Q

Deltoid Ligament

A

Connects tibia to talus, calcaneus, and navicular bone

  • strong
  • bone often fails before ligament ruptures
24
Q

Anterior talofibular ligament

A

ATF or ATFL

  • fibula to talus
  • most often sprained
  • plantarflexion and inversion injury
25
Q

Plantar calcaneonavicular ligament

A

Aka spring Ligament
Helps support medial longitudinal arch
- helps prevent overpronation

26
Q

Arches

A
  • Longitudinal
    Medial
    Lateral
  • Transverse
  • Function: add stability & shock absorption
  • supported by ligaments, shapes of bones, tendons, and muscles
27
Q

Muscles

A

28
Q

Plantarflexors

A

5 main muscles

  • gastrocnemius
  • plantaris
  • soleus
  • flexor hallucinating longus
  • flexor digitorum longus

GPSFF

29
Q

Gastrocnemius

A

PA: posterior condyles of femur
DA: common insertion via Achilles
A: plantarflexes foot

30
Q

Soleus

A

PA: proximal posterior tibia along soleal line
DA: Achilles
A: plantarflexes foot

31
Q

Plantaris

A

PA: distal posterior femur
DA: posterior calcaneus
A: plantarflexes foot

32
Q

Flexor hallucis longus

A

PA: distal 2/3 of posterior fibula
DA: base of distal phalanx of the great toe, plantar surface
A:plantarflexes foot and big toe

33
Q

Flexor digitorum longus

A

PA: distal 1/2 of posterior tibia
DA: base of distal phalanges of digits 2-5
A: plantarflexes foot & toes 2-5

34
Q

Dorsiflexors

A

3 main:

  • tibialis anterior
  • extensor digitorum longus
  • extensor hallucis longus
35
Q

Everters

A
  • peroneus longus
  • peroneus brevis
  • peroneus tertius

EVERTERS= PERONEUS

36
Q

Peroneus longus

A

PA: head and proximal 1/2 of fibula, lateral side
DA: cross plantar surface of foot to attach 1st cuneiform & 1st metatarsals
A: everts foot

37
Q

Peroneus brevis

A

PA: distal 1/2 of lateral side of fibula
DA: tuberosity of lateral side of 5th metatarsal
A: everts foot

38
Q

Peroneus tertius

A

PA: distal 1/3 of anterior surface of fibula
DA: dorsal surface of base of 5th metatarsal
A: everts foot

39
Q

Inverters

A
  • tibialis anterior

- tibialis posterior

40
Q

Tibialis Anterior

A

PA: superior 2/3 of anterolateral tibia
DA: base of 1st metatarsal of 1st digit & cuneiform
A: dorsiflexes & inverts foot

41
Q

Tibialis Posterior

A

PA: lateral side of posterior tibia proximally
DA: navicular tuberosity, 3 cuneiforms, cuboid, metatarsals 2-4
A: inverts foot

42
Q

Injuries

A

43
Q

Ankle Sprain

A
  • most common orthopedic injury
44
Q

Ankle Sprain - inversion with plantarflexion

A
  • tear ATF

- severe inversion may fracture distal fibula

45
Q

Ankle Sprain - eversion

A
  • tear delt ligament

- rare

46
Q

Plantar fasciitis

A

Inflammation of plantar fascia
- fascia tears usually near its calcaneus attachment
“Pain worst with 1st few steps in the morning”
- microtearing
- slow to heal
- restriction in dorsiflexion ROM

47
Q

Plantar fasciotomy

A
  • can cause collapsed foot
48
Q

Fibular fracture

A
  • caused by excessive inversion
  • ambulation is often still possible
    15% of BW on fibula
    85% on tibia
  • surgical options
    Open reduction and internal fixation
49
Q

Achilles tendinitis

A
  • 1-2” above attachment to calcaneus
  • critical zone of avascularity
  • pronation increases length on Achilles
  • rupture
    • violent start or stop
    • over 30 yrs old
    • audible snap
50
Q

Shin splints

A
  • anterior tibialis tension
  • repetitive micro trauma to tibia and it’s muscular attachments
  • microtears to tibialis posterior
    muscle or soleus (medial tibial pain)
  • microtears to peroneal muscles (lateral tibial pain)
51
Q

Causes of shin splints

A
Excess probation 
Poor shock absorption 
Poor foot alignment 
Sudden increase in activity 
Muscle imbalances
Poor warm up
Poor conditioning 
Tight Achilles
Toe running
Tension on tibia
52
Q

Sever’s Disease

A

Pull on Achilles’ tendon on calcaneal insertion

  • growing children
  • pain in heel
53
Q

Posterior tibial tendinitis

A
  • increased pronation

- wringing effect of post tibial tension

54
Q

Talus fracture

A

Talus avascular necrosis

  • following fracture or dislocation
  • inverted arterial supply
  • no muscular attachments