Foot and Ankle Flashcards
1
Q
Hindfoot
A
Talus and calcaneus
2
Q
Midfoot
A
Navicular, cuboid, cuneiforms
3
Q
Forefoot
A
Metatarsals and phalanges
4
Q
Which malleolus runs more distal?
A
Lateral
5
Q
Talus articulations
A
No muscle attachments
Articulates with tibia, calcaneus, fibula, and navicular
6
Q
Calcaneus articulations
A
Achilles
Intrinsic ms. and plantar fascia
Cuboid and talus
7
Q
Navicular proximal articulation
A
Concave surface with head of talus at talonavicular
8
Q
Navicular distal articulation
A
Contains 3 facets that articulate with 3 cunieforms
9
Q
Navicular tuberosity attachment
A
Tibialis posterior
10
Q
Which tarsals contribute to transverse arch?
A
Cuneiforms
11
Q
Cuboid distal articulations
A
Bases of 4th and 5th metatarsals
12
Q
Cuboid proximal articulation
A
Calcaneus
13
Q
Cuboid medial articulation
A
Lateral cuneiform and navicular
14
Q
Cuboid muscle attachment
A
Fibularis longus
15
Q
Hindfoot Joints
A
TIbiofibular
Talocrural (ankle)
Subtalar (talocalcaneal)
16
Q
Tibiofibular joint OP and CP
A
OP-PF
CP-Max DF
17
Q
Talocrural (ankle) joint OP and CP
A
OP-10° PF midway between inv and ev
CP- Max DF
18
Q
Talocrural (ankle) joint Capsular Pattern
A
PF>DF
19
Q
Subtalar (talocalcaneal) Joint OP and CP
A
OP-midway between extreme ROM
CP- Max DF
20
Q
Midfoot joints
A
Transverse tarsal (midtarsal)
Tarsometarsal
21
Q
Transverse tarsal (midtarsal) joints OP and CP
A
OP-Midway between extreme ROM
CP-supination
22
Q
Tarsometatarsal joints OP and CP
A
OP-midway between extreme ROM
CP- Supination
23
Q
Forefoot Joints
A
Metatarsophalangeal
Interphalangeal
24
Q
Metatarsophalangeal joints OP and CP
A
OP-10° extension
CP-full extension
25
Interphalangeal joints OP and CP
OP- Slight flexion
CP- Full extension
26
Neurovascular structure
(Ant. Compartment)
Deep fibular (peroneal) nerve
Anterior tibial artery
27
Neurovascular structure
(Post. Compartment)
Tibial nerve
Post. Tibial artery
Fibular (peroneal) artery
28
Neurovascular structure
(Lat. Compartment)
Superficial fibular (peroneal) nerve
Perforating branches of anterior tibial and fibular arteries
29
Muscles anterior to ankle jt. axis
DF torques at ankle
30
Muscles posterior to ankle jt. axis
PF torques at ankle
31
Muscles medial to STJ axis
Supination torques at STJ
32
Muscles lateral to STJ axis
pronation torques at STJ
33
Anterior Compartment muscles
Tibialis Anterior
Extensor Hallucis Longus
Extensor Digitorum Longus
Peroneus Tertious
Strong DF
All important in gait
34
Tibialis Anterior mvmt
DF
Supination of STJ and TTJ
35
Lateral Compartment muscles
Primary pronators at STJ
Peroneus Longus
Peroneus Brevis
36
Posterior Compartment muscles
PF
Gastroc
Soleus
Tibialis posterior
Flexor Digitorum Longus
Flexor Hallucis Longus
Plantaris
Peroneus Longus
Peroneus Brevis
37
Gastroc and Soleus mvmts
Lock foot into rigid lever via supination of STJ and TTJ
Eccentric control of DF
38
Gastric fibers (type 2)
generates and shuts off tension quickly
39
Soleus (type 1)
prevents postural swaying too far forward
40
Gastroc is tight when
DF is limited with knee extension and increased with knee flexion
41
Soleus is tight when
Df is limited with knee extension and flexion
42
Tom
Dick
And
Nervous
Harry
Tibialis Posterior
Flexor Digitorum Longus
Tibial Artery
Tibial Nerve
Flexor Hallucis Longus
43
Intrinsic Muscles functions
stabilizes toes during gait
dynamic supporters of transverse and longitudinal arches during gait
44
Anterior Compartment Concentric
DF of ankle for foot clearance during swing
45
Anterior Compartment Eccentric
Controlled PF to prevent foot slap at initial contact
46
Posterior Compartment Eccentric
to control progression of tibia over foot (DF)
47
Posterior Compartment Isometric
allow a rigid forefoot during heel off
48
Lateral Compartment Eccentric
at heel off to counter supination and to stabilize first ray at heel off
49
Medial Compartment Eccentric
from initial contact to mid stance to control pronation
50
Which arch is the highest and most important
Medial longitudinal arch
51
Medial longitudinal arch contents
calcaneus, talus, navicular, cuneiforms, three metatarsals
52
Lateral longitudinal arch contents
calcaneus, cuboid, lateral two metatarsals
53
Transverse arch contents
cuboid, cuneiforms, bases of metatarsals
54
Which ligament supports the medial longitudinal arch
Spring ligament
55
Medial arch runs from
Calcaneus to metatarsal heads
56
Lateral arch runs from
Calcaneus to metatarsal heads
57
Which ligament supports the lateral longitudinal arch
Long plantar ligament
58
Arches function
Protect neurovascular structure on plantar surface
Shock absorption
Store energy
59
Medial ligaments (Ankle Joint)
(Deltoid Ligaments)
Tibionavicular
Tiobiocalcaneal
Posterior tibiotalar
Anterior tibiotalar
60
Lateral ligaments (Ankle Joint)
Anterior talofibular
Calcaneofibular
Posterior talofibular
61
Tibionavicular ligament (Ankle Joint)
Limits eversion
62
Tibiocalcaneal ligament (Ankle Joint)
Limits eversion
63
Posterior tibiotalar ligament (Ankle Joint)
Limits eversion
Limits DF
64
Anterior tibiotalar ligament (Ankle Joint)
Limits eversion
Limits PF
65
Anterior talofibular ligament (Ankle Joint)
Limits anterior displacement of talus
Limits inversion
Limits PF
66
Calcaneofibular ligament (Ankle Joint)
Limits inversion
Limits DF
67
Posterior talofibular ligament (Ankle Joint)
Limits posterior displacement of talus
Limits DF
68
Subtalar Joint ligaments
Medial & Lateral talocalcaneal ligament
Interosseous (talocalcaneal) ligament
69
Medial talocalcaneal ligament attachments (ST Joint)
connects medial tubercle of talus with sustentaculum tali
70
Medial talocalcaneal ligament (ST Joint)
Limits anterior translation of talus
Limits eversion
71
Lateral talocalcaneal ligament attachments (ST Joint)
connects lateral process of talus to lateral surface of calcaneus
72
Interosseous (talocalcaneal) ligament (ST Joint)
has an anterior and posterior band (cervical ligament)
stabilizes subtalar joint
73
Transverse tarsal joint ligaments
Talonavicular ligament
Bifurcate ligament
Spring ligament
Long and short plantar ligaments
74
Talonavicular ligament (Transverse tarsal joint)
stabilizes talonavicular joint
Limits PF and inversion of navicular
75
Bifurcate ligament portions (Transverse tarsal joint)
Calcaneonavicular ligament (medial)
Calcaneocuboid ligament (lateral)
76
Bifurcate ligament (Transverse tarsal joint)
stabilize TTJ and taught in supination
77
Spring ligament (Transverse tarsal joint) attachments
connects navicular to sustentaculum tali
78
Spring ligament (Transverse tarsal joint) functions
Acts as a sling for head of talus, becomes taut during pronation
limits navicular PF
79
Long plantar ligament (Transverse tarsal joint)
forms tunnel for FL tendon
80
Long and Short plantar ligaments (Transverse tarsal joint)
Both limit depression of longitudinal arch
81
Role of plantarflexors in stabilizing knee during extension
Decelerate DF mid-late stance
82
What knee deformity would be present in someone with PF spasticity and why?
Genu recurvatum, biases knee extension
common in CP
83
What muscles work with the soleus to prevent the knee from buckling during mid-late stance phase?
Hip extensors
84
Symptoms of PF paralysis
cannot rise on toes
impaired gait
awkward and slow stair climbing
running and jumping all but impossible
85
Tibial nerve severence
Unable to PF
86
Isolated paralysis of TA
limited DF
87
calcaneus valgus
<90°
common in flat feet with collapse in arch
medial breakdown of shoes
88
calcaneus varus
>90°
Lateral breakdown of shoes
89
Pes planus
dropped/low medial longitudinal arch
90
Pes Planus signs
rearfoot valgus posture
forefoot abduction
callus on adjacent skin
91
Pes planus causes
Joint laxity in midfoot or proximal forefoot
Overstretched, torn, or weakened plantar fascia, spring ligament, and TP tendon
92
Pes cavus
raised medial longitudinal arch
93
Pes cavus signs
Rearfoot varus (inversion)
Forefoot valgus (eversion)
94
Foot and ankle problems associated with pes cavus
Hammer or claw toes
Calluses on metatarsal heads side or heel
95
Claw toe
Hyperext. of MTP jt.
Flex. of PIP and DIP jts. of all toes
Often with pes cavus
96
Hammer toe
Hyperext. of MTP jt.
Flex. of PIP jt.
Hyperext. of DIP jt.
Usually 2nd toe
97
Equinis Foot
sole is permanantly flexed so walking is done on toes w/o touching heel to ground
98
Metatarsus adductor
Metatarsal bones are turned toward middle of body
99
Tophi
Crystal deposits in tissues around jt.
1st MTPJ is 1st affected in gout
100
Hallux Valgus
Excessive adduction of 1st metatarsal
Lateral dislocation of MTPJ exposes metatarsal head as lump or "bunion"
101
Corns
Smaller than calluses
Hard center surrounded by inflamed skin
Found in non and weight bearing parts
102
Hard corns
Dorsum
103
Soft corn
Between 4th and 5th toes
104
Calluses
Larger and harder
Rarely painful
Found on weight bearing area
105
Hallux Limitus "Rigidus"
Inability to bend great toe, leads to shortened toe off
Toe off carried by lat. 4
106
Hallux Limitus "Rigidus" impact on walking
Lack of 45° hallux extension leads to walking on outer surface of foot OR with foot pointed outward and "rolling over" medial arch of foot
107
Muscles impacted by Anterior Compartment Syndrome
TA, EHL, EDL
108
Signs of Anterior Compartment Syndrome
Hematomas within mm
Swelling within ant. compartment
Necrosis of mm and n
Foot drop
109
Plantar Fascia/Aponeurosis location
Apex toward heel and base toward toes
110
Plantar Fascia/Aponeurosis function
Maintain longitudinal arch
Provide origins of superficial plantar muscles
Protect plantar vessels and nerves from compression
