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Magee > Foot anatomy and biomechanics > Flashcards

Foot anatomy and biomechanics Flashcards

1
Q

inferior Tibiofibular joint allows dorsi and planter flexion by

A

Spreading (1-2 mm)

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2
Q

Which ligaments of Talocrural joint check eversion and inversion?

A

Medial side (eversion): Deltoid ligament (ant. Tibiotalar, Post Tibiotalar, Tibiocalcaneal, Tibionavicular)

Lateral side (inversion) Anterior Talofibular (most injured, checks excessive inversion with plantarflexion), posterior Talofibular (checks excessive dorsiflexion), calcaneofibular (2nd M/C injured, checks inversion)

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3
Q

Talocrural osteokinematics, athrokinematics, resting position, closed pack position capsular pattern, end feel

A 
1 degree, planter flexion/dorsiflexion
Convex talus, concave tibia and fibula
Resting: 10 degree of plantar
Closed pack: Extreme dorsi
Capsular Plantar>dorsi
End feel: firm
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4
Q

Which ligament check inversion and eversion at subtalar joint?

A

Subtalar joint: Talus and Calcaneum

Cervical ligament check inversion
Interosseous talocalcaneal ligament: eversion

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5
Q

Which joint is compound ball and socket jt among Midfoot?

A

Talocalcaneonavicular:
navicluar and spring ligament =socket
Talus=ball

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6
Q

what is the another name for spring ligament

A

plantar calcaneonavicular ligament

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7
Q

what is the importance of spring ligament

A

it maintains the arch of the foot

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8
Q

what is the name of the joint collectively called at mid tarsal joint?

A

Chopart’s joint (Talus-calcaneous and navicular -cuboid)

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9
Q

what is the name of the collective joints in the forefoot (cuts horizontally across the foot)

A

Lisfranc’s joint (Tarso metatarsal joint 3 cuneiform+cuboid)

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10
Q

What structure enhances the stability of Lisfranc’s joint

A

cuneiform mortise (articulation of the base of 2nd metatarsal with the mortise formed by the intermediate cuneiform and sides of the medial and lateral cuneiform. It is stronger and more restricted)

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11
Q

What is unique about intermetatarsal joint?

A

1st metatarsal bone is not connected with that of the second by any ligament (in this respect, the great toe resembles the thumb)
There is a small bursa between great toe and the second

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12
Q

What involves supination of the foot

A

Inversion (calcaneus at subtalar)
Adduction (forefoot)
Plantar flexion (subtalar and midtarsal joint)
Lateral rotation of lower leg (relative to the foot)

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13
Q

What involves pronation of the foot

A

Eversion (calcaneus at subtalar)
Abduction (forefoot)
Dorsiflexion (subtalar and midtarsal joints)
Medial rotation of the lower leg (relative to the foot)

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14
Q

What happens to ROM, movement and muscles at subtalar pronation and supination

A

Subtalar pronation ->increase ROMat mid tarsal joint -> creates flexibility and decrease med long arch, subtalar joint is less stable, more muscle work is needed

Subtalar supination ->decrease ROM at mid tarsal joint -> creates rigidity and increase med long arch, subtalar joint is stable and less muscle work is needed

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15
Q

Progressive stabilization at talocrural joint and superior/inferior tibiofibular joint

A
  1. Initial contact: Talocrural joint is in dorsiflexion and is stable
  2. Load response: ankle moves to plantar flexion and less stable
  3. Midstance: increses dorsiflexion and stable. Tib fib move forward over anterior wider wedge of talus causes tibu fib joint to spread adding stability. Fibula moves speriorly and laterally, and is checked with resistance by the interosseous membrane, pulling membrane taut.
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16
Q

what is the arches for

A
  1. shock absorption
  2. adjustment to terrain :balance
  3. Propel the body forward
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17
Q

How the arches of the feet are maintained?

A
  1. wedging of the interlocking tarsal and metatarsal bones
  2. Tightening of the ligaments of the plantar aspect of the foot
  3. intrinsic and extrinsic muscles of the foot and their tendons, which help to support the arches
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18
Q

What Medial longitudinal arch consists of

A

Calcaneal tuberosity, the talus, the navicular, three cuneiforms and the 1st, 2nd and 3rd metatarsal bones

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19
Q

Stabilizing structure of medial longitudinal arch

A
  1. Tib ant, Tib post (overwork and weak if the arch is dropped), FDL, FHL, abductor hallusis, and Flextor digitorum brevis
  2. Spring ligament
  3. plantar fascia
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20
Q

What does Lateral longitudinal arch consist of

A

More stable and less adjustable
Calcaneus, cuboid, 4th and 5th metatarsals
Cuboid is the key stone for lateral ark. It is wedged

21
Q

Structures stabilizing lateral longitudinal arch

A
  1. Peronii muscles, abductor digiti minimi, Flexor digitorum brevis
  2. Short and long palntar ligaments
  3. plantar fascia
22
Q

What does Transverse arch consist of

A

tarsal, post metatarsal and anterior metatarsal

Navicular, cuneiforms, cuboid and metatarsal bones

23
Q

Stabilizing structure of transverse arch

A

1 Tibialis posterior, Tib ant, Fibularis longus

2 Plantar fascia

24
Q

what is Gait cycle

A

the time interval or sequence of motions occurring between two consecutive initial contacts of the same foot (3 steps)

25
What is step
1/2 of gait cycle (foot contact of one foot to foot contact of the other foot)
26
What is stride length
linear distance in the plane of progression between successive points of foot to floor contact of the same foot or distance of gait cycle
27
Terminology of traditional terminology and Rancho los Amigos (RLA)terminology
Stance phase Traditional 1. Heel strike 2. Foot flat 3. mid stance 4. heel off 5. toe off Rancho los amigos (RLA) 1. Initial contact 2. Loading response 3. Mid stance 4. Terminal stance 5. preswing Swing phase Traditional: 6. Acceleration 7. Mid swing 8. Decceleration Rancho los Amigos (RLA); 6. initial swing 7. Mid swing 8. terminal swing
28
observation of the hindfoot varus
calcaneus: inversion Hind foot: eversion, rigid ROM: Decreased pronation ->decreased supination for propulsion Present as in ankle: Pes cavus Present as in knee: Genu Varum May contribute to: Plantar fasciitis, shin splints, Hamstring strain, knee pathlogy
29
Observation of hindfoot valgus
``` Calcaneus: eversion Hindfoot: mobile, excess pronation ROM: decreased supination ROM Presents as in ankle: Pes Planus (medial longitudinal arch is decreased) Presents as in knee: Genu Valgum Less likely to cause pathology May contribute to Tib post problem ```
30
observation of forefoot varus
Forefoot: inversion (on the hind foot) Medial longitudinal arch: decreased Resemble as : pes Planus In gait: completely pronated (medial aspect of foot in contact with ground) contribute to Patellofemoral syndrome, shin splints, plantar fasciitis
31
observation of forefoot valgus
Forefoot: eversion (n the hindfoot) medial longitudinal arch increased Resemble as: Pes Cavus In stance: completely supinated=lateral aspect of the foot is in contact with ground Contributes to: lateral ankle sprains, ITB friction syndrome, plantar fasciitis
32
Observation Pes Planus
``` Medial longitudinal arch decreased Calcaneal eversion (HF valgus) Metatarsal abduction (Forefoot varus), Subtalar dorsiflexion ``` Causes: congenital, trauma, muscle weakness, ligament laxity/sprain, postural, shortened muscle, dropping of talus
33
How to deifferenciate congenital/rigid flatfoot and Acquired or flexible flatfoot
Ask patient to stand on tiptoes if arch appears =flexible flatfoot (functional) if arch remain flat = rigid flatfoot (structural)
34
Observation of Pes Cavus
``` AKA hollow foot or rigid foot Longitudinal arch accentuated Soft tissues of the sole of the foot are shortend and bones alter in shape Possible claw toes Hind foot Varus Forefoot Valgus little ability to absorb shock May contribute to OA at Tarus ```
35
what is Bunion at 1st digit called
Pump bump or runner's bump
36
What does bunion of 5th Digit called
Tailor's bunion
37
Antalgic gait/painful gait
self protected gait Stance phase on the affected leg is shorter in duration (trying to remove weight as quickly as possible) Swing phase on the unaffected side is shorter in duration
38
Lack of dorsiflexion
Steppage gait Deep peroneal nerve or paralyzed dorsi flexors, lifting knee higher in midswing Sciatica, CMT
39
Weak gluteal medius
Circumducted gaite/Trendelenburg's or Lurching gait | common with Advanced OA
40
Swing leg outward and ahead in a circle (medially rotated)
Hemiplegic gait/AKA neurogenic or flaccid gait
41
Spastic paralysis of hip adductors
Scissor gait | Cerebral palsy
42
Shuffling or short rapid steps
Festinating gait | Perkinsonian gait
43
has to use hands to pick up leg
Femoral nerve injury
44
What does Introsseous tibiofibular do?
Interosseous Tibiofibular (Anterior tibiofibular and posterior tibiofibular) Prevent excess gapping of joint and posterior glide Carries more axial load (17%)
45
Stance phase joint action - hip, knee, ankle/foot
Initial contact: Hip Flex, Knee Full ext., Foot Dorsiflextion and supination Load response: Hip Flex decreasing, Knee flex, Foot: plantar flexion and pronation Mid stance: Hip: Neutral, Knee: Slightly flexed, Foot: Slightly dorsiflex, neutral Preswing Hip: Ext. Knee: slightly flex Foot: plantar flex, supination (rigid to push off) Terminal stance: extention
46
Stance phase muscle action
Initial contact Hip: Glut max (ecc), Knee: Quad (ecc) to stabilize, Ankle: Ant. component (ecc) Load response Hip: Glut max (con), knee: Quads (con), Ankle: Gastroc (ecc), Deep comp. (ecc) to control pronation Mid stance Hip: Iliopsoas (ecc), Glut med stabilize, Knee: Gastroc (ecc) takes over for quads to prevent excessive knee ext, Ankle: gastroc (ecc) Terminal stance Hip: Iliopsoas (ecc), Knee: Gastroc (con) start of knee flex, Ankle: Gastroc (con) Preswing Hip: iliopsoas ecc to resist hip extensionand adductor mag to control and stabilize pelvis, Knee: Quads (ecc), Ankle/foot: Gastroc (con)
47
Swing phase joint action
Initial Swing Hip: slight flexion 0-15 to 30 degree Knee: Increase flexion Ankle: Plantar flex to 20 dorsi flex and pronation Midswing Hip: flexion Knee flexion Ankle: neutral in slight supination(to clear ground) Terminal swing Hip: increasing flexion Knee: decreasing flexion to near full extension and slight lat rot of tibia Ankle: dorsiflexion to clear ground
48
Swing phase Muscle action
Initial swing Hip: Hip flexors (con), Contralateral glute med (con) Knee: Hamstrings (con) Ankle: Dorsiflexor (con) Mid swing Hip: Hip flexors Glut med (ecc) Knee: Guads (con) and Ham (ecc) Ankle: Dorsiflexors (isometric) Terminal swing Hip: Glut max (ecc) to slow hip flexion Knee: quads (conc) and hamstrings (ecc) Ankle: dorsiflexors (isometric)
49
other components of walking gait
knee (tibial rotation) Hip (vertical, horizontal and rotational movement) Pelvis (vertical, horizontal and rotational movement) Muscles of the leg, thigh and trunk

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