Foot and Ankle 2 Flashcards

1
Q

Plantar Ligaments

A

Short (plantar calcaneocuboid):
- From plantar calcaneus to cuboid

Long

  • From plantar calcaneus to to cuboid and bases of metatarsals 3,4,5
  • Superficial to short plantar ligament

Support lateral column of foot

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2
Q

Plantar Fascia

A
  • Supports medial longitudinal arch
  • Calcaneus to proximal phalanges
  • Acts as a tie rod, keeping anterior and posterior portions of foot together under weight bearing stress

Tightens with dorsiflexion of digits, as heel rises during walking (imparts stability)

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3
Q

Plantar fasciitis

A
  • Irritation of plantar fascia at attachment to calcaneus
  • May see associated spur formation
  • Key to decreasing stress on plantar fascia = increase gastroc and soleus flexibility
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4
Q

Arches

A
  • Medial and lateral longitudinal arches
  • Transverse metatarsal arch (distal intertarsal joint)

Maintained by:

  1. Bony architecture of foot
  2. Ligaments of the foot
  3. Intrinsic musculature
    * Dynamic support from posterior tib and fibular longus

Arches increase the strength of the feet

Arches develop with weight bearing (not present at birth)

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5
Q

Static Weightbearing under foot

A

Rearfoot: Shared between calcaneal tubercles

Forefoot: Shared across metatarsal heads

  • 1st MT bears 2x weight compared to others
  • Greater cross sectional area (than rearfoot?)

Changes with various foot types

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6
Q

Weightbearing under foot during gait

A

Initial Contact: Loading of lateral calcaneus
Midstance: WB progresses anterior and medial under the foot
Roll Off: WB is transferred medially to hallux at toe off

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7
Q

“Too many toes sign”

A

Calcaneal/ rearfoot valgus - appears pronated

- can see toes when looking from behind

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8
Q

Tibialis Anterior

A
  • Tibia to dorsal/ medial 1st cuneiform and MT
  • OKC: Ankle inv/DF
  • CKC: Decelerates ankle PF during loading response
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9
Q

Extensor Hallucis Longus

A
  • Fibula to distal phalanx of hallux
  • OKC: Extends great toe, assists with ankle inv/df
  • CKC: Controlled loading of medial column during loading response
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10
Q

Extensor digitorum longus

A
  • Tibia and fibula to distal phalanges of lesser digits
  • OKC: Extends toes and assist with eversion/ DF
  • CKC: Controls ankle PF during loading response
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11
Q

Peroneus Longus

A
  • Fibula to plantar base of 1st cuneiform and 1st ray
  • OKC: Ankle eversion, PF
  • CKC: Maintains stability of 1st ray, prevents excessive inversion/ supination, and forms sling to support cuboid
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12
Q

Peroneus Brevis

A
  • Fibula to base of 5th metatarsal styloid process
  • OKC: Eversion, assists with PF
  • CKC: Helps transfer weight from lateral to medial portion of the foot
  • Checks rapid inversion
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13
Q

Gastroc

A
  • Femoral condyles to posterior calcaneus
  • OKC: PF, assists with knee flexion
  • CKC: Deceleration of CKC DF, Heel rise and ankle PF

More likely to strain than soleus b/c two joint

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14
Q

Soleus

A
  • Posterior tibia and fibula to posterior calcaneus
  • OKC: Ankle PF
  • CKC: Decelerate DF, Assist in heel rise
  • Active postural muscle (prevents tibia from translating forward)
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15
Q

Thompson Test

A

For Achilles tendon integrity

  • Pt prone
  • Examiner applies a squeeze to the calf of the pt’s affected leg

Positive: nonresponse during squeeze

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16
Q

Matles Test

A

For achilles tendon integrity

  • Pt lies prone with foot over end of plinth
  • Pt actively flexes knee to 90 degrees

Positive: Foot falls into neutral or slight DF

17
Q

Tibialis Posterior

A
  • Posterior tibia and fibula to plantar navicular and most tarsals
  • OKC: Ankle inversion/ PF
  • CKC: Primary decelerator of pronation

Supports medial longitudinal arch, especially if pt’s arch collapses a lot with weight bearing/ has a more flexible arch

18
Q

Flexor Digitorum Longus

A
  • Tibia to distal phalanges 2-5
  • OKC: Flexion of digits, assists with INV/ PF
  • CKC: Stabilizes digits on ground, assists in ankle pf/inv for balance
19
Q

Where to Tibialis posterior, FDL, FHL run?

A

Tarsal tunnel, around medial malleolus

20
Q

When are the intrinsic muscles of the foot most active?

A

During late stance, as heel is rising off the ground

There are 4 layers of intrinsic muscles of foot