Foot And Ankle Flashcards
Crucial that the foot is ———- to provide an appropriate BOS
Stable
Foot functions as a ———- ————
Pushing off when walking, running or jumping
Rigid lever
The foot must also be ———- enough to accommodate and adapt to uneven terrain & —————- ———-when foot hits the ground
Mobile
Absorb shock
The ankle complex includes what jts
Proximal tibiofibular joint Distal tibiofibular joint Talocrural joint (ankle joint)
The foot includes what jts
Talocalcaneal joint (subtalar joint) Transverse Tarsal Joint (Talonavicular,Calcaneocuboid) Tarsometatrsal joints Metatarsophalangeal joints Interphalengeal joints
What are the 3 functional segments of the foot?
Hindfoot (rearfoot) -Talus -Calcaneus Midfoot -Navicular -Cuboid -3 cuneiform bones Forefoot -Metatarsals -Phalanges
The proximal tibiofibular jt is a ——- jt and the distal tibiofibular jt is a ——— jt
Plane synovial
Synarthrosis
Unlike the proximal tibiofibular jt, the distal tibiofibular jt does not have a….
Instead it is stabilized by an
Jt capsule
Interosseous membrane
What is a high ankle sprain
Injury in the distal tibiofibular jt when the talus of forcefully laterally rotated within the ankle mortise
Closed packed position of the proximal/distal tibiofibular jt
Max dorsiflexion
Open packed position of the proximal/distal tibiofibular jts
10 deg plantar flexion
Describe the talocrural jt
Hinge jt between the ankle mortise (tibia/fibula) and talus
What are the passive structures of the talocrural jt
Medial collateral (deltoid) lig Lateral collateral lig
Describe the deltoid lig
Extremely strong lig that helps limit eversion/pronation
The lateral collateral lig at the ankle is a combo of what ligs
Anterior talofibular lig
Calcaneofibular lig
Posterior talofibular lig
Function of the lateral collateral lig at the ankle
Limit inversion/supination
What active structures limit plantar flexion
Tib anterior
Extensor hallucis Longus
Extensor digitorum Longus
What active structures limit dorsiflexion
Gastric and soleus
What active structures assist the MCL
Tib posterior
Flexor hallucis Longus
Flexor digitorum Longus
What active structures assist the LCL
Fibularis Longus and brevis
The trochlear surface of the talus is wider where?
Anteriorly
Describe the osteo and Arthrokinematics of the talocrural jt
Dorsiflexion- anterior roll and posterior glide
Plantarflexion- posterior roll and anterior glide
What is the closed packed position the talocrural jt
Max dorsiflexion
What is the open packed position of the talocrural jt
10 deg plantar flexion
What is the capsular pattern of the talocrural jt
Plantarflexion > dorsiflexion
Pronation allows for __________, while full supination __________ the bones of the foot
Mobility
Locks
What are the three plantar arches of the foot?
These arches are fully integrated to _______ the dynamic function of the foot.
Medial, longitudinal, and transverse
Enhance
The __________ arch is typically higher than the _________ arch
Medial
Lateral
What helps stabilize/support plantar arches
Shape of bones, ligaments, and muscles.
Describe how the plantar arches help mobility of the foot
Allows the foot to ….
Dampen impact of weight-bearing forces
Dampen superimposed rotational motions
Adapt to changes in supporting surfaces and terrain
The plantar arches help stabilize the foot to allow
Distribution of weight through the foot for proper weight-bearing
Convert the flexible foot to a rigid lever
Describe the plantar fascia
Runs almost entire length of foot and important for arch support
From beginning to end of stance during gait tension in plantar fascia increases
Windlass effect
the manner by which the plantar fascia supports
the foot during WB activities
Pew planud is also called
Flat feet
Describe the subtalar jt
3 plane type synovial jt between the talus and calcaneus
The subtalar jt has 3 articulations. What are they and which is the largest?
Posterior, anterior, and medial
Posterior
Describe the subtalar jt axis
Axis is approximately half way between longitudinal and vertical
This oblique axis results in triplanar motion
What are the main motions at the subtalar jt
Inversion/eversion
Add/abd
What motions are coupled at the subtalar jt to result in supination in an open kinetic chain
Inversion
Adduction
Slight PF
What motions are coupled at the subtalar jt to result in pronation in an open kinetic chain
Eversion
Abduction
slight DF
Valgus movement of the calcaneus is also described as
Pronation
Varus movement at the subtalar jt is also called
Inversion and adduction
What motions can be observed at the subtalar jt
Inversion/eversion
Abd/add
Slight DF/PF
What motions can the Calcaneus do in wt bearing
Inversion/eversion
In closed chain supination, the calcaneus ——— and in pronation ———-
Inverts
Everts
In Wbing subtalar pronation leads to ______________ of the leg that may influence knee and/or hip
Medial rotation of the leg
In Wbing subtalar supination leads to ————————— of the leg that may influence knee and/or hip
Lateral rot
What is the closed packed position of the subtalar jt is
Full eversion
Open packed position of the subtalar jt
Mid inversion/eversion and mid PF/DF
The rom of the subtalar jt is
5* inversion and eversion
The transverse tarsal jt is a
Modified ovoid jt between the talonavicular and calcaneocuboid
Coupled motion at the transverse tarsal jt results in
Sup/pron
Function of the transverse tarsal jt
Add to supination/pronation ROM of subtalar joint
Compensate at the forefoot for hindfoot position in closed chain
What is the closed packed position of the transverse tarsal jt
Supination
Open packed position of the transverse tarsal jt is
Mid range of supination / pronation
Each metatarsal jt has its own …..
Unique axis of motion
Functions of the tarsometstarsal jt
Regulates position of the forefoot in relation to wt bearing surface
Substantial weight-bearing pronation of the hindfoot results in ___________ of the transverse tarsal joint to counter rotate the forefoot. To remain On the ground, the TMT jts mus undergo counteracting __________
Supination
Supination twist
Full subtalar supination results in __________ at the transverse tarsal joint!
At this point, the forefoot must perform a _________ in order to maintain contact with the ground
Supination
Pronation twist
Describe the metatarsalphalangeal jt
Condyloid jt btw Convex heads of metatarsals and concave base of proximal phalanges
Function of the metatarsalphalangeal jt
weight bearing function is to primarily allow the foot to rotate over the toes through MTP extension (metatarsal break) when rising on toes or during walking
Osteokinematics of metatarsalphalangeal jts
Flex/ext
Abd/add
Arthrokinematics of flex/ext at metatarsalphalangeal jt
Flexion: Plantar roll and glide
Extension: Dorsal roll and glide
Arthrokinematics of add/abd at metatarsalphalangeal jt
Abduction: Roll and glide same direction (reference point is second toe)
Adduction: Roll and glide same direction (reference point is second toe)
Closed packed position of the metatarsalphalangeal jt
Full ext
Open packed position of the metatarsalphalangeal jt
10 deg ext
Capsular pattern of metatarsalphalangeal jt
1st MTP Extension>flexion; 2-5 loss of flexion
Describe Hallux limitus
Posttraumatic condition marked by gradual and significant limitation of motion, articular degeneration and pain
Turf toe is the most common MOI (forceful flexion) causing
Hallux limitus
Describe hallux valgus (bunion)
Progressive lateral deviation of great toe
Function of interplalangeal jts of the toes
Maintain stability by pressing against the ground in standing
Describe Osteokinematics and Arthrokinematics of the IP jts of the toes
Flexion: plantar roll and glide
Extension: dorsal roll and glide
What is the difference between pies planus and peas cavus
Planus- dropped medial longitudinal arch
Cavus- raised medial longitudinal arch
—————— or ————— in stance places excessive demands on tibialis posterior
Causing…
Excessive or rapid pronation
Tendinopathy, muscle fatigue
Function of Tibialis Posterior in Stance Phase of Ambulation
Decelerates pronating rearfoot in loading response
———Results in gradual and controlled lowering of medial longitudinal arch & Absorbs some of the impact from loading
