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Movement Analysis II > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

0
Q

midfoot

A

5 tarsal bones - navicular, cuboid, 3 cuneiforms

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1
Q

Rearfoot

A

2 tarsal bones - calcaneus and talus

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2
Q

forefoot

A

metatarsals and phalanges

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3
Q

medial column of foot

A

1st ray
2nd ray
3rd ray

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4
Q

lateral column of foot

A

4th ray

5th ray

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5
Q

1st ray

A

functional unit of 1st metatarsal and 1st cuneiform

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6
Q

2nd ray

A

functional unit of 2nd metatarsal and 2nd cuneiform

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7
Q

3rd ray

A

functional unit of 3rd metatarsal and 3rd cuneiform

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8
Q

4th ray

A

4th metatarsal

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9
Q

5th ray

A

5th metatarsal

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10
Q

1st & 5th ray

A

most MOBILE

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11
Q

2nd & 3rd ray

A

most STABLE

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12
Q

talus

A

70% covered with articular cartilage, most fractured bone in foot, can develop AVN like scaphoid - fractures are mostly intra-articular and need ORIF
VEX - anterior-posterior (dictates arthrokinematics)
CAVE - slightly medial-lateral

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13
Q

major joints of the foot and ankle

A

talocrural
subtalar
transverse tarsal

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14
Q

Axis in foot and ankle

A

NO medial-lateral, anterior-posterior, or superior-inferior

ONLY oblique

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15
Q

OPEN CHAIN

pronation

A

calcaneus dorsiflexion
calcaneus ABduction
calcaneus eversion

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16
Q

OPEN CHAIN

supination

A

calcaneus plantarflexion
calcaneus ADDuction
calcaneus inversion

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17
Q

in subtalar OPEN CHAIN movement

A

ONLY calcaneus moves

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18
Q

CLOSED CHAIN

pronation

A

calcaneus eversion
talus ADDuction
talus plantarflexion
talus medial rotation

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19
Q

CLOSED CHAIN

supination

A

calcaneus inversion
talus ABduction
talus dorsiflexion
tibial lateral rotation

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20
Q

in subtalar CLOSED CHAIN movement

A

calcaneus is locked to the ground, movement from tibia and talus with slight movement from calcaneus

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21
Q

tibia rotates with every step so…

A

compressive forces go all the way up the kinetic chain

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22
Q

ankle is ALL

A

triflexion, so everything relates to pronation and supination

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23
Q

talocrural joint

A

between tibia (trochlea) and sides of talus
‘mortise’ - fits like lock and key
thin capsule
angled about 10º frontal plane and 6º horizontal plane
1 degree of freedom - dorsiflexion/plantarflexion

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24
Q

talocrural joint

dorsiflexion

A

(pronation)
superior surface of talus rolls anterior and slides posterior
calcaneofibular ligament taut

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25
Q

talocrural joint

plantarflexion

A

(supination)
superior surface of talus rolls posterior and slides anterior
anterior talofibular ligament taut

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26
Q

tibionavicular fibers

A

taut in full plantarflexion

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27
Q

to increase dorsiflexion at talocrural joint

A

dorsal (posterior) slide of talus

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28
Q

to increase plantarflexion at talocrural joint

A

anterior slide of talus

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29
Q

talocrural joint ligaments

A

deltoid ligament

‘outside’

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30
Q

deltoid ligament

A 
talocrural joint
MCL - 4 parts
anterior tibiotalar
posterior tibiotalar
tibionavicular
tibiocalcanela
*resists EVERSION sprains*
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31
Q

‘outside’ ligaments

A 
talocrural joint
LCL - 3 parts
anterior talofibular
posterior talofibular
calcaneofibular
*resists INVERSION sprains*
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32
Q

anterior talofibular ligament

A

most commonly sprained ligament in body

33
Q

subtalar joint

A

between talus & calcaneus

34
Q

subtalar joint pronation & supination NWB

A

calcaneus moves on fixed talus

35
Q

subtalar pronation & supination WB

A

talus & tibia rotate on more stable calcaneus

36
Q

subtalar joint articulation

A

posterior concave facet of talus articulates with posterior convex facet of calcaneus

37
Q

subtalar joint AOR

A

42º horizontal plane & 16º sagittal plane

38
Q

subtalar pronation

OPEN CHAIN

A

everson & ABduction of calcaneus (DF)

39
Q

subtalar supination

OPEN CHAIN

A

inversion & ADDuction of calcaneus (PF)

40
Q

pes planus

A

flat arch - navicular closer to ground

41
Q

pes cavus

A

high arch

42
Q

no arch

A

navicular touches the ground, tibialis anterior becomes long and weak, need midfoot reconstruction to raise navicular

43
Q

transverse tarsal joint/midtarsal joint

A

Chopart’s joint
Talonavicular joint & calcaneocuboid joint
During WB, pronation & supination of midfoot region allows foot to adapt to uneven sufaces
works with STJ to control most of pronation and supination

44
Q

pronation & supination at TTJ/MTJ

A

occur as navicular spins TNJ as calcaneus held firmly fixed

45
Q

combination of rotations at both STJ and TTJ

A

account for most pronation and supination of the foot

46
Q

3 factors that complicate function of TTJ

A

1 - 2 separate axes of rotation
2 - movement different during WB vs NWB
3 - stabilizing function of the TTJ at midfoot is influenced by the position of the subtalar joint

47
Q

2 AOR on TTJ

A

longitudinal

oblique

48
Q

longitudinal axis

A

primary movement eversion/inversion

49
Q

oblique axis

A

motion a combo of:
DF/AB (pronation)
PF/AD (supination)

50
Q

combining movements of longitudinal and oblique axes

A

TRUE pronation & supination

51
Q

primary concentric pronator

A

fibularis (peroneus) longus

contributes to lowering of medial side of foot & raising of lateral side

52
Q

fibularis (peroneus) longus

A

actions: eversion
Inserts on lateral aspect of medial cuneiform & 1st metatarsal, runs under foot
Keeps 1st ray on ground even when foot supinated
need for balance & proprioceptive input of joint

53
Q

primary concentric supinator

A

tibialis posterior

will initiate spin of navicular & spring ligament around convex head of talus

54
Q

tibialis posterior

A

action: plantarflexion & inversion
Attaches to medial side of foot
eccentric control of pronation

55
Q

plantar fascia primary support

A

medial longitudinal arch

56
Q

active toe extension stretches…

A

central plantar fascia

57
Q

plantar fascia supported by…

A

active muscle force

passive force from elasticity and tensile strength CT and bone shape

58
Q

flat foot is risk for…

A

plantar faciitis

59
Q

just after heel strike (STJ/TTJ)

A

STJ pronates unlocking TTJ so TTJ can adapt to ground for mobility to transfer weight from lateral to medial

60
Q

late stance (SJ/TTJ)

A

STJ supinates locking TTJ creating rigid stable base for push off to propel LE for swing

61
Q

if tibialis posterior weak concentrically

A

NO supination during latter parts of stance phase

62
Q

tibialis tendinitis

A

runners develop from over use, poor footwear, training, or musculoskeletal control

little eccentric control

63
Q

in posterior tibial tendon dysfunction

A

muscles weak - posterior hip muscles, glut med and max, gemelli brothers

muscles short - gastroc, soleus, hammies, TFL, rec fem

64
Q

locking of midfoot PRONATION

A

axes STJ/MTJ PARALLEL

MORE mobility

65
Q

locking of midfoot SUPINATION

A

axes of STJ/MTJ NOT parallel

LESS mobility

66
Q

windlass mechanism

A

when standing, pull big toe up, arch should rise - normal

if not, issue with medial-longitudinal plantar arch systems can cause issues with toe off

67
Q

functions of foot during gait

A

provide stable base of support

allow transverse plane rotation of LE when foot fixed to supporting surface

68
Q

pronation occurs during

A

initial contact - INCREASE FOOT MOBILITY

69
Q

supination occurs during

A

terminal stance - increase FOOT STABILITY

70
Q

rearfoot pronation CLOSED CHAIN

A

internal/medial tibial rotation
talus glides inward (ADD) and downward (PF)
calcaneal EV

medial TFJ compression
during inital contact

71
Q

rearfoot supination CLOSED CHAIN

A

tibial external/lateral rotation
talus glides outward (AB) and upward (PF)
calcaneal IN

lateral TFJ compression
during terminal stance

72
Q

1st ray - loading phase gait

A

dorsiflexion

eversion

73
Q

1st ray - propulsion phase gait

A

plantarflexion

inversion

74
Q

altered mobility 1st ray leads to

A

excess rearfoot pronation/supination, development of bunions

75
Q

posture of forefoot relative to rearfoot

A

major source of abnormal foot motion leads to excessive or inadequate rearfoot motion

76
Q

if forefoot moving too much

A

mobilize hypomobile rearfoot

stabilize hypermobile forefoot

77
Q

anterior muscles

A

tibialis anterior
EHL
EDL
peroneus/fibularis tertius

deep peroneal nerve

78
Q

lateral muscles

A

peroneus/fibularis longus
peroneus/fibularis brevis

siperficial peroneal nerve

79
Q

posterior muscles

A 
gastrocnemium
soleus
tibialis posterior
FHL
FDL
popliteus

tibial verve

Movement Analysis II (4 decks)

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