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MSK II > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the two functions of the foot

A

stability and mobility

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2
Q

what is the stability function of the foot

A

to provide a stable BoS for the WB, and to provide a rigid lever for push off during gait

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3
Q

what are the mobility functions of the foot

A

dampening rotations from the proximal joints, as well as school absorption and the ability to conform to changes in terrain.

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4
Q

General structure of the foot
bones and joints
like what
which is more important, stability or mobility

A

28 bones 25 joints, and like the wrist and hand but here stability is more important than mobility

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5
Q

what bones make up the forefoot, mid foot and rear/hindfoot

A

forefoot: phalanges and metatarsals
mid foot: cuboid, cuneiform and navicular
hind: talus, calcaneous

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6
Q

true or false: it is hard to produce our DF or PF

A

true

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7
Q

where does DF and PF occur, and in what plane and what axis

A

at the talocrural joint, or ankle joint, and in the sagittal plane around the frontal axis

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8
Q

what are the normal ranges for DF and PF

A

DF 20

PF 50

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9
Q

INV and EVE occur in what plane around what axis

A

in the fontal plane, AP axis

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10
Q

Describe the motions of INV and EVE

A

INV: plantar surface towards the midline
EVE: plantar surface away from the midline

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11
Q

In what plane and around what axis does ABD and ADD occur

A

in the transverse plane, around the vertical axis.

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12
Q

Describe the motions of ABD and ADD

A

ADD: distal segment towards the midline of the body
ABD: distal segment away from the midline of the body

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13
Q

supination and pronation occur at what joint

A

subtalar joint

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14
Q

in an OKC the calcaneous moves on the … for supination and pronation

A

fixed talus/leg

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15
Q

What motions happen during OKC supination

A

calcaneous PF, INV and ADD

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16
Q

what motions happen during OKC pronation

A

calcaneous DF, EVE and ABD

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17
Q

What motions happen with CKC pronation

A

IR tibia and fibula
Talar ADD and PF
Calcaneal EVE

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18
Q

what motions happen with CKC supination

A

ER tibia and fibula
Talar ABD and DF
Calcaneal INV

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19
Q

raising the arch of the foot is like pronation or supination

A

Supination

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20
Q

What is the issue with composite triplanes motion terminology

A

orthopedics use INV and EVE and Its usually use pronation and supination, so there can be miscommunications between clinicians

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21
Q

what is the difference between valgus and varus

A

valgus is when the distal segment moves away from the midline, and varus is when the distal segment moves towards the midline

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22
Q

what are the three components of the tibiofibular joints

A

proximal, middle and distal

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23
Q

what type of joint is the proximal tibiofib joint and what motion is allowed here. what are the articulating surfaces

A

synovial, between the fibular head and the fibular articulating surface of the tibia. allows for superior and inferior fibular gliding as well as fibular rotation.

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24
Q

the middle tibiofibular joint is also known as the

A

interosseous membrane

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25
Q

what kind of joint is the distal tibiofibular joint, and what supports it. also, what are the articulating surfaces

A

syndesmosis/fibrous
distal fibula and the fibular notch of the tibia
ligaments include the anterior and posterior tibfib. that restrict motion and stabilize the mortise

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26
Q

what is the main ankle joint, and what kind of joint is it

A

the talocrural joint

synovial, modified saddle or hinge joint

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27
Q

what is the mortise made up of

A

the rectangular cavity for the talus. it is made up of the tibia, which is the roof, and the medial malleolus, and the lateral malleolus of the fibula

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28
Q

what is the tenon

A

the projection shape for the insertion into the mortise, or the trochlear of the talus

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29
Q

the tenon/talus and mortise is wider anteriorly, which means…

A

means that there is more of a congruency throughout the entire ROM, and that the tightest fit is during PF and DF.

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30
Q

what is the most congruent joint of the body

A

the talocrural joint

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31
Q

does the talocrural joint have muscular attachments or a blood supply

A

no, so this is very bad when it comes to fracturing it.

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32
Q

what is talocrural coupling. why does this happen

A

this is when the axis shifts slightly with motion, so when the foot moves, the axis and planes of that motion will change. This is because it is a uniaxial, oblique hinge joint

33
Q

what else is important about talocrural coupling, in terms of movement of the entire lower limb

A

there is movement in the talus, and then that movement will move upstream.

34
Q

describe the lower leg rotation during walking

A

there is tibial internal rotation from the heel strike to the foot flat, and then ER from the mid stance to toe off.

35
Q

what is the closed packed position of the talocrural joint. describe it

A

DF, this is where there is the most congruency and joint compression. the ligaments and the capsule are taut and it is most stable.

36
Q

what is the open pack position for the talocrural joint

A

PF, most loose

37
Q

where is the talocrural joint most stable, DF or PF

A

DF

38
Q

when doing joint mobs, you want to be in slight… why?

A

PF because this is where the most motion can happen, and where the most joint play is.

39
Q

what is the capsular pattern of the talocrural joint

A

PF is limited more than DF

40
Q

what is the deltoid ligament, resists…

A

this is the strong ligament on the inside of the foot that resists EVE and side to side movement or rotation of the mortise on the talus.

41
Q

what are the components of the deltoid ligament

A

anterior and posterior tibiotalar ligaments, tibiocalcaneal ligament and tibionavicular ligament

42
Q

are EVE sprains common, what percentage? why?

A

rare, 5-10%

the deltoid ligament is so strong and the fibula is there to protect on the outside

43
Q

True or false: there is a high risk of bony trauma with an EVE sprain

A

true, because of the medial malleolus and the fibula

44
Q

most ankle sprains occur at what ligament complex

A

the LCL

45
Q

what are the components of the LCL

A

the anterior and posterior talofibular ligaments, and the calcaneofibular ligament.

46
Q

what does the LCL counter

A

varus and INV stresses

47
Q

which is stronger the LCL or the deltoid ligament

A

the Deltoid

48
Q

of the LCL which is the strongest and weakest ligament

A

strongest is PTFL

weakest and most injured is ATFL

49
Q

what motion is the greatest risk of injuring the ATFL

A

INV and PF

50
Q

between what is the subtalar joint. what kind of joint is it

A

between the talus and calcaneous

synovial

51
Q

the subtalar joint has three articulations, which means there is…

A

triplanes motion, and that there is less rotational forces, and it helps maintain foot contact with the supporting surfaces.

52
Q

what is the LE interdependence

A

this means that motion in one segment of the leg can cause motion in other segment. For example, when you are pronated, there is ADD of the talus, and the tibia and fibula with IR.

53
Q

what is the closed packed position of the subtalar joint

A

supination, there is a locking of talocalcaneal joint surfaces, and the foot becomes a rigid lever, which is good for stability

54
Q

what is the open packed position of the subtalar joint. importance?

A

between pro and sup, and at 10 degrees of Talar PF. important because pronation is critical for mobility and chock absorption and dampening BW imposed rotational forces.

55
Q

what is the capsular pattern of the subtalar joint

A

varus is more limited than valgus

56
Q

where is the transverse tarsal joint, and what are some other names for it

A

between the hind and mid foot, also known as the mid tarsal joint and the chopart joint

57
Q

what two joints are associated with the transverse tarsal joint

A

the talonavicular joint and the calcaneocuboid joint

58
Q

what ligament is associated with the talonavicular joint and what type of joint is it

A

it is associated with the spring ligament, which is the plantar calcaneonavilcuar ligament. this ligament supports the ML arch and the joint. it is a ball and socket joint

59
Q

the calcaneocuboid joint has what ligament, and what arch does it support

A

the long plantar ligament, and supports the LL arch

60
Q

what are some of the functions of the transverse tarsal joint

A

it increases the pronation or supination at the subtalar joint, and compensates (int he forefoot) for rear foot positioning. it will allow the foot to stay on the ground regardless of what the hind foot is doing (pro/sup)

61
Q

what happens in the TTJ in early to mid stance phase

A

the TTJ and subtalar joint both pronate, to absorb BW, and shock absorption. then the TTJ will supinate to make sure there is contact between the lateral foot and the ground. This countermovement makes the normal BW throughout the forefoot, and the tibial IR in the rear foot.

62
Q

what happens in the TTJ during late stance phase

A

the subtalar and TTJ supination allows for more stability, and there is more congruency in the bones, and a locked closed pack position. This locking will allow weight transfer from forefoot during toe off.

63
Q

describe the chain of events if a patient has pes planus

A

this means that there is no arch when WB, which also means pronation at the subtalar joint. This will cause the navicular to drop, which will make it more challenging for the TTJ to supinate, and absorb some of the weight and shock. there is no counter movement so, there is not normal WB through the foot

64
Q

what kinds of joints are the tarsometatarsal joints and what are they also known as

A

Lisfranc.

these are planar synovial joints.

65
Q

what is the function of the TMT joints

A

to help the TTJ and also to maintain the forefoot contact with the ground. helps the TTJ when it cannot compensate for rear foot.

66
Q

what is a ray

A

in the first to third rays, it is the unit formed by the MT and the cuneiform, and at the 4th and 5th, just the MT

67
Q

what motion occurs at the rays

A

1st and 2nd: invert and extend and evert and flex
3rd: extends and flexes
4th and 5th: extend/evert and invert and flex.

68
Q

which ray is the least mobile

A

2nd

69
Q

what are the metatarsalpharengeal joint types and what motion do they do

A

the MTP joints are condyloid synovial and they allow for extension when the body passes over the foot, in late stance, and then flexion when returning to neutral. They also ABD and ADD with grasping as well as compressing and absorbing some forces of the MT during pro and sup.

70
Q

what are the sesamoid bones

A

they are two pea shaped bones on the plantar surface of the first MT head. They allow for a pulley for the FHB, and they also help protect the tendon o fate FHL during WB.

71
Q

where is the medial longitudinal arch

A

along the 1st MT and the curve of the calcaneous.

72
Q

what do the arches provide, how

A

stability, by not only their ligament, but also intrinsic foot muscles and the bone structure.

73
Q

what is the function of the plantar aponeurosis

A

from calcaneous to the plantar plates at MTP joints, then to the phalanges. it supports the arches, and increases stability.also has a tie and rod component and struts that are relaxed with non-WB and are tensioned with WB. when you extend the toes, the plantar fascia tightens. overpronation also loads this.

74
Q

what is pes planus

A

this is when the arch is not there during WB and there is an absent ML arch. the talus accuses the navicular to drop, which decreases the potential for the TTJ for counter motions to offset the pronation.

75
Q

what is pes cavus

A

supinated or a high arch foot that does not dissipate forces well

76
Q

what are some effects of pes planus

A

overly mobile, muscular involvement during stance, and decreased push off during gait. increased tibial IR (increased Q angle and patellar tracking problems) and then excessive mobility of ligaments and tendons that puts on too much stress and too much pronation.

77
Q

what are the effects of pes cavus

A

too much stiffness, doesn’t absorb well, and too much of a ML arch. too much supination and there is ER on the leg. can get shin splints because too much force into the leg. also increased loading on lateral structures.

78
Q

what are the injuries associated with pes planus and cavus

A 
planus:
Fascitis 
Knee pain
Patellar tendinitis 
stress fx: 2 and 3 
Cavus:
Fascitis 
Ankle INV sprain
ITBS
stress fx: 5

MSK II (2 decks)

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