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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
Q

What is step

A

1/2 of gait cycle (foot contact of one foot to foot contact of the other foot)

26
Q

What is stride length

A

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
Q

Terminology of traditional terminology and Rancho los Amigos (RLA)terminology

A

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
Q

observation of the hindfoot varus

A

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
Q

Observation of hindfoot valgus

A 
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
Q

observation of forefoot varus

A

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
Q

observation of forefoot valgus

A

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
Q

Observation Pes Planus

A 
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
Q

How to deifferenciate congenital/rigid flatfoot and Acquired or flexible flatfoot

A

Ask patient to stand on tiptoes
if arch appears =flexible flatfoot (functional)
if arch remain flat = rigid flatfoot (structural)

34
Q

Observation of Pes Cavus

A 
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
Q

what is Bunion at 1st digit called

A

Pump bump or runner’s bump

36
Q

What does bunion of 5th Digit called

A

Tailor’s bunion

37
Q

Antalgic gait/painful gait

A

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
Q

Lack of dorsiflexion

A

Steppage gait
Deep peroneal nerve or paralyzed dorsi flexors, lifting knee higher in midswing
Sciatica, CMT

39
Q

Weak gluteal medius

A

Circumducted gaite/Trendelenburg’s or Lurching gait

common with Advanced OA

40
Q

Swing leg outward and ahead in a circle (medially rotated)

A

Hemiplegic gait/AKA neurogenic or flaccid gait

41
Q

Spastic paralysis of hip adductors

A

Scissor gait

Cerebral palsy

42
Q

Shuffling or short rapid steps

A

Festinating gait

Perkinsonian gait

43
Q

has to use hands to pick up leg

A

Femoral nerve injury

44
Q

What does Introsseous tibiofibular do?

A

Interosseous Tibiofibular
(Anterior tibiofibular and posterior tibiofibular)
Prevent excess gapping of joint and posterior glide
Carries more axial load (17%)

45
Q

Stance phase joint action - hip, knee, ankle/foot

A

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
Q

Stance phase muscle action

A

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
Q

Swing phase joint action

A

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
Q

Swing phase Muscle action

A

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
Q

other components of walking gait

A

knee (tibial rotation)
Hip (vertical, horizontal and rotational movement)
Pelvis (vertical, horizontal and rotational movement)
Muscles of the leg, thigh and trunk

Magee (16 decks)

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