Exam 2 Flashcards
Functions of the patella
Act as an anatomical pulley for the quad
Decrease friction between quad tendon and femoral condyles
Pattern of patella contact
20 degrees - inferior pole
90 degrees - superior and medial/lateral border (except odd facet)
Greater than 90 - odd facet starts to come into contact
135 degrees -only at medial and lateral border
Joint reaction forces of patella
Joint angle
Quad force
Normal value for Q angle
10-15 degrees
Ways to increase Q angle
Femoral anteversion
Pronation of foot
Increased valgus
Ways to increase lateral tracking of patella
VMO weak Tight ITB Increased valgus Femoral anteversion Lateral tibial torsion Pronation of foot
Functions of ankle
Stable base of support (support weight in a variety of postures with little muscular and energy requirements)
Acts as a rigid level for push off
Function segments of ankle (and what is part of each of them)
Hindfoot (calcaneus and talus)
Midfoot (navicular, cuboid, and cuneiforms)
Forefoot (metatarsals and phalanges)
Movements in supination
Plantar flexion, add, inversion
Movements in pronation
Dorsiflexion, abduction, eversion
Ligaments of superior tibiofibular joint
Anterior tibiofibular
Posterior tibiofibular
Ligaments of inferior tibiofibular joint
Anterior tibiofibular
Posterior tibiofibular
Interosseous membrane
Crural tibiofibular interosseous ligament
Joint injured when say high ankle sprain
Inferior tibiofibular because the tibia and fibula separate more than normal
Support (ligaments) of talocrural joint
Ligaments of inferior tibiofibular
MCL - deltoid
LCL - anterior and posterior talofibular; calcaneofibular
Extensor and peroneal retinacula
Anterior talofibular stressed with what movements
PF, inv, medial rotation
Calcaneofibular stressed with what movements
DF and inverted
Posterior talofibular stressed with what movements
DF, inv, lateral rotation
Axis for talocrural joint (and angles)
M/L axis
14 degrees inferiorly
23 degrees posteriorly
Primary movement at talocrural joint
PF/DF
Arthrokinematics of talocrural in NWB
Convex on concave
Arthrokinematics of talocrural in WB
Concave on convex
Structures that limit DF
Soft tissue, soleus, posterior joint capsule
Structures that limit PF
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Structures that protect medial aspect of ankle
MCL
Tibialis posterior
Flexor hallucis longus
Flexor digitorum longus
Structures that protect lateral aspect of ankle
LCL
Peroneus longus
Peroneus brevis
Articulations of subtalar joint
Posterior talocalcaneal
Anterior & Medial talocalcaneal
Lateral support of subtalar joint
Calcaneofibular ligament
Lateral talocalcaneal ligament
Cervial ligament (strongest)
Interosseous talocalcaneal
Medial support of subtalar joint
Deltoid ligament
Subtalar axis (and angles)
Starts pure A/P
Inclined upward 42 degrees
Inclined medially 16 degrees
Primary motions at subtalar joint (ratio?)
Equal amount of abd/add and inv/ev (4:4:1)
Arthrokinematics of subtalar joint in NWB
Posterior talocalcaneal - convex on concave
Anterior/Middle talocalcaneal - concave on convex
Subtalar neutral
Point at which calcaneus is inverted 2x as much as it everts
Motions of calcaneus during gait
3 degrees of inv at heel strike, then everts 2 degrees in stance, then goes back to inversion
Transverse tarsal joint
Talonavicular
Calcaneocuboid
Ligaments of talonavicular joint
Spring ligament - inferiorly
Deltoid ligament - medially
Bifurcate ligament - laterally
Dorsal talonavicular
Ligaments of calcaneocuboid joint
Dorsal calcaneocuboid
Lateral branch of bifurcate ligament
Short plantar
Long plantar ligament
Longitudinal axis of midtarsal joint
Almost pure A/P
Inclined up 15 degrees
Angled medially 9 degrees
Oblique axis of midtarsal joint
Starts A/P
Angled medially 57 degrees
Angled superiorly 52 degrees
Motions that occur at midtarsal joint
Inversion/Eversion - longitudinal
PF/DF and abd/add - oblique
Functions of midtarsal joint
Add to pronation/supination of hindfoot
Help compensate for hindfoot position
1st TMT articulation
1st metatarsal with medial cuneiform
2nd TMT articulation
2nd metatarsal with articulation middle cuneiform and sides of medial/lateral cuneiform
3rd TMT articulation
3rd metatarsal with lateral cuneiform
4th and 5th TMT articulation
4th and 5th metatarsal with cuboid
Functions of TMT joints
Form arches
Regulate position of MT and phalanges in relation to WB
Help compensate if midfoot cannot do so
Index +
First toe longest
Index + -
First and second toes are equal in length
Index -
Second toe is longest
Function of MTP
Allow foot to hinge at toes so heel may rise off ground
Function of sesamoid bones
Serve as anatomical pulley for FHB
Protect tendon of FHL
Absorbs WB force
Function of plantar plates
Protect the WB surface of the metatarsal heads
Contribute to stability of MTP joints
Withstands compressive loads
Bones that make up lateral longitudinal arch
Calacaneus
Cuboid
Metatarsals
Bones that make up medial longitudinal arch
Calcaneus Talus Navicular Medial cuneiform Metatarsal
Bones that make up transverse arch
Cuboid and cuneiform
Metatarsal heads
Ligaments that support medial arch
Spring, Interosseous talocalcaneus, and deltoid
Ligaments that support lateral arch
Long and short plantar ligaments
Muscles that pass posterior to talocrural joint
Gastroc Soleus Tibialis posterior FDL FHL
Muscles that pass anterior to talocrural joint
Anterior tibialis
EHL
EDL
Perones tertius
Function of intrinsic muscles of foot
Stabilizer of toes (resist MTP extension)
Dynamic supporters of transverse and longitudinal arch