Foot And Ankle

Question 1

What ligaments stabilize the distal fibs fibular joint? (3 main)

Answer 1

Anterior inferior tibiofibular lig.
Posterior inferior tibiofibular lig.
Interosseous membrane

Question 2

What motion occurs at the Talocrural joint? (Tibiotalor joint)

Answer 2

Flexion extension

Question 3

Subtalar joint (calcaneus talus) what motion happens here?

Answer 3

Inversion / eversion

Question 4

What stabilizes the medial ankle ?

Answer 4

Medial malleolus

Deltoid ligament

Question 5

What 3 main lig. Stabilize the lateral ankle?

Answer 5

Anterior talofibular lig.
Posterior talofibular lig.
Calcaneofibular lig.

Question 6

What is more common; lateral or medial ankle Spain?

Answer 6

Lateral

-lateral malleolus protects ankle from eversion, less stretch of medial ligaments

Question 7

What motion occurs at mid foot joint line?

Answer 7

Adduction/abduction

Question 8

Difference between pes Planus and over pronation of foot
Vs
Difference in pes cavus and over supination of the foot?

Answer 8

Pes planus = flattening of the arch - Achilles’ tendon not affected

Pronation = walking on internal aspect of foot, do to bending at sub Talar joint
-Achilles will bend away From center line

Pes cavus = large arch in foot due to tight spring ligament and others
Achilles would be straight

Supination = walking on outside of foot
Achilles would bend towards medial

Question 9

Observation for ankle foot (5 things) ?

Answer 9

1) General survey
2) Postural observation
- pes planus
- pes cavus
- Genu varus/valgus
- atrophy
- attitude
3) Shoes
- change to wear patterns
4) Gait
5) area specific
- swelling bruising, oedema, pitting, callus, blister bites, nail abnormalities, hammer toe, mallet toe, claw toe,

Question 10

What are trophic changes + what are examples in the feet?

Answer 10

Changes resulting from interruption of nerve supply

• abnormalities of skin, hair, nails, subcutaneous tissue, bone, peripheral nerve lesion
• can result in a decrease blood supply to are = more damage

Question 11

Ankle/foot Range of motion:
(Talocurual motion)
(Subtalar motion)
(Midtarsal motion) 
\+ toes

Answer 11

Talocrural

• dorsiflexion: 20*
• Plantar Flexion: 50*

Subtalar:

• inversion 5*
• eversion 5*

Midtarsal:
-forefoot adduction 20*
Forefoot abduction 10*

Toes
-abduction/adduction, dorsiflexion/plantarflexion

Question 12

Static bony palpation of foot/ankle?

Answer 12

Medial:
-first metatarsophalengeal joint
-first cuneiform
-navicular tubercle 
-head of talus 
-medial malleolus 
Lateral:
-firth metatarsalphalngeal joint 
-styloid process of fifth metatarsal 
-cuboid 
-calcaneus 
-sinus tarsi area
-dome of talus 
-lateral malleolus 
Hind foot + plantar surface
-dome of calcaneus 
-sesamoid bones 
-metatarsal heads

Question 13

Soft tissue palpation ankle/foot?

Answer 13

Head of first metatarsal bone
-for swelling, redness (bunion)

Medically over talar head:

• spring lig and tibialis posterior
• callous formation with prominent talus in pes planus

Medial malleolus region:

• deltoid ligament
• tibialis posterior
• flexor digitorum longus tendon
• posterior tibial artery
• flexor hallucinate longus tendon

Dorsum of foot

• Tibialis anterior
• extensor hallucinate longus
• dorsal pedal artery
• Extensor digitorum longus

Lateral malleolus region

• anterior talofibular ligament
• extensor digitorum brevis muscle
• calcaneofibular ligament
• posterior talofibular ligament
• peroneus longus and brevis tendon

Calcaneus region

• Achilles tendon
• retrocalcaneal bursa + calcaneus bursa

Plantar surface

• heel spur
• Plantar fascia
• Morton’s neuroma

Question 14

Joint play of foot?

Answer 14

• P-A/A-P glide tibiotalar joint
• Inversion/eversion Subtalar joint
• Dorsal-plantar/ plantar-dorsal movement of remaking small joints (individual tarsal bones (navicular, cuboid, cuniforms)
• Sheering of the metatarsal joints