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Lower Extremity Anatomy And Biomechanics > Foot And Ankle Biomechanics > Flashcards

Foot And Ankle Biomechanics Flashcards

0
Q

What kind of joint is the distal tibiofibular joint?

A

Syndesmosis joint

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1
Q

What are the functions of the foot and ankle?

A
  • shock absorption
  • a rigid lever for push off
  • adapts to uneven terrain
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2
Q

What are the joint articulations of the distal tibiofibular joint?

A

Articulation between the distal tibia and fibula

-has minimal movement

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3
Q

What are the joint articulations of the Talocrural joint?

A

Articulations been the distal tibia and fibula and the trochlea of the talus

-minimal movement

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4
Q

How many degrees of freedom are there at the talocrural joint? What is the axis of rotation at this joint?

A

1 degrees freedom
-plantarflexion and dorsiflexion

Axis of rotation:

  • 10 degrees offset in the frontal plane
  • 6 degrees offset in the horizontal plane
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5
Q

What are the three fibers of the medial deltoid ligament?

A
  • tibionavicular fibers
  • tibiocalcaneal fibers
  • tibiotalar fibers
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6
Q

What does the tibionavicular fibers restrict?

A
  • Restricts talocrural eversion and PF associated with anterior slide of talus
  • restricts talonavicular eversion and abduction
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7
Q

What do the tibiocalcaneal fibers restrict?

A

-restricts talocrural and subtalar eversion

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8
Q

What do the tibiotalar fibers restrict?

A

-restricts talocrural eversion and DF associated with posterior slide of talus

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9
Q

What are the three lateral ligaments of the talocrural joint?

A
  • anterior talofibular ligament (ATFL)
  • calcaneofibular ligament
  • posterior talofibular ligament
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10
Q

What does the posterior talofibular ligament restrict?

A

Restricts talocrural DF associated with posterior slide of the talus, inversion and abduction

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11
Q

What does the anterior talofibular ligament (ATFL) restrict?

A

Restricts talocrural PF associated with anterior slide of talus, inversion and adduction

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12
Q

What does the calcaneofibular ligament restrict?

A
  • Restricts talocrural DF associated with posterior slide of talus and inversion
  • restricts subtalar inversion
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13
Q

What is the motion observed at the Tib-Fib joint?

A

Gliding motion –> very small amount of movement

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14
Q

Arthrokinematics: Tib-Fib joint dorsiflexion

A

Distal: posterior glide
Proximal: anterior glide

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15
Q

Arthrokinematics: Tib-Fib joint plantarflexion

A

Distal: anterior glide
Proximal: posterior glide

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16
Q

Arthrokinematics: talocrural joint dorsiflexion

A

Anterior roll, posterior glide

-restricted by: posterior capsule and calcaneofibular ligament

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17
Q

Arthrokinematics: Talocrural joint plantarflexion

A

Posterior roll, anterior glide

  • convex talus, concave tib/fib
  • restricted by: anterior talofibular ligament, tibionavicular ligament, anterior capsule
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18
Q

What is the distal tibiofibular joint connected by?

A
  • anterior capsule
  • anterior and posterior tibiofibular ligaments
    - provide stability for the motise of the ankle
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19
Q

What can lack of DF at the talocrural joint result in?

A
  • increased subtalar joint pronation
  • increased knee hyperextension
  • early heel rise during gait
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20
Q

What is the closed and open position, and capsular pattern of the talocrural joint?

A

Closed: maximum dorsiflexion
Open: 10 degrees plantar flexion
Capsular pattern: plantar flexion > dorsiflexion

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21
Q

What are the joint articulations of the subtalar joint?

A

Articulation between the calcaneus and talus

-concave talus and convex calcaneus

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22
Q

What kind of joint is the subtalar joint?

A

Diarthrodial synovial joint

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23
Q

What two joints combine motions to create supination and pronation?

A

Subtalar joint and transverse tarsal joint

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24
What three motions make pronation occur?
Abduction, eversion and DF
25
What three motions combine to make supination occur?
Adduction, inversion and PF
26
What are the two subtalar joint ligaments?
- cervical talocalcaneal ligament | - interosseous talocalcaneal ligament
27
What does the cervical talocalcaneal ligament restrict?
Restricts inversion Binds the calcaneus to the talus (laterally)
28
What does the interosseous talocalcaneal ligament restrict?
Restricts eversion Binds the calcaneus to the talus (medially)
29
Arthrokinematics: subtalar joint inversion
- calcaneus glides medially - navicular glides medially Commonly occurs with PF
30
Arthrokinematics: subtalar joint eversion
- calcaneus glides laterally - navicular glides laterally Commonly occurs with DF
31
What are the closed and open positions and capsular pattern of the subtalar joint?
Closed: supination Open: pronation Capsular pattern: supination > pronation
32
What are the joint articulations of the transverse tarsal joint?
Articulations of calcaneocuboid and talonavicular joints
33
What kind of joint is the transverse tarsal joint?
Synovial saddle joint
34
How many axis of motion are there at the transverse tarsal joint?
2 axis of motion - longitudinal: inversion and eversion - oblique: flexion and extension
35
What are the ligaments associated with the talonavicular joint?
- interosseous ligament reinforces posterior capsule - dorsal talonavicular ligament reinforces capsule dorsally - spring ligament: supports longitudinal arch, prevents excessive medial and plantar movement of the talus
36
What are the joint articulations between the tarsometatarsal joints?
Articulations between the 1st, 2nd, and 3rd cuneiforms and the cuboid with the bases of the metatarsals
37
What kind of joint is the tarsometatarsal joint?
Plane synovial joint Primary movements are gliding movements
38
Which MTP is the most mobile?
The first MTP
39
What kind of joints are the Metatarsophalangeal joints?
Condyloid synovial joint
40
What are the joint articulations of the metatarsophalangeal joints?
Articulation between the metatarsals and phalanges
41
How many degrees of freedom are at the Metatarsophalangeal joints?
2 degrees of freedom - flexion and extension - abduction and adduction
42
What are the soft tissue structures associated with the Metatarsophalangeal joints?
- 2 collateral ligaments span joint and reinforce capsule: medial and lateral capsular ligaments - plantar plate connect with accessory portion of collateral ligaments: two sesamoids bones reside within flexor hallicus brevis tendon - 4 deep transverse metatarsal ligaments join joint together: provide stability to joint
43
Arthrokinematics: MTP flexion
Plantar glide, plantar roll Convex metatarsal and concave phalanx
44
Arthrokinematics: MTP extension
Dorsal glide, dorsal roll Convex metatarsal and concave phalanx
45
What is the closed and open position and capsular pattern of the MTP joints?
Closed: full extension Open: 10 degrees extension Capsular pattern: extension > flexion
46
What kind of joints are the interphalangeal joints?
Synovial hinge joints
47
How many degrees of freedom are there at the interphalangeal joints?
1 degree of freedom | -flexion and extension
48
What are the joint articulations of the interphalangeal joints?
Convex head of proximal articulating surface on concave base of distal articulation surface
49
Arthrokinematics IP flexion
Plantar glide, plantar roll
50
Arthrokinematics IP extension
Dorsal glide, dorsal roll
51
What are the closed and open positions and capsular pattern of the IP joints?
Closed: full flexion Open: slight flexion Capsular pattern: flexion > extension
52
What is the plantar fascia?
-Fibrous band that extends from the medial plantar tuberosity of the calcaneus to the MTP plantar plates, collateral ligaments and sesamoids - supports medial longitudinal arch - tight with toe extension - subjects to high loads --> running, jumping
53
What is the medial longitudinal arch supported by?
- Plantar fascia - spring ligament - short and long plantar ligaments - tibialis posterior muscle (if doesn't function correctly, foot pronates)
54
How does a normal medial longitudinal arch work?
-weight supported by plantar fascia stretch
55
What is pes planus?
"Dropped arch" - Plantar fascia overstretched - weight supported by intrinsic and extrinsic muscles - flexible pes planus is normally correctable without surgery - commonly connected to over pronation excess rearfoot varus
56
What is the Windlass mechanism?
- toe extension puts a stretch on the plantar fascia causing the foot to arch - metatarsal heads act as pulleys - aids in supination of the foot at toe off
57
What are the combined motions of the subtalar and transverse tarsal joints during stance/WB?
Decreased arch and increased rear foot pronation with increased WB
58
What are the combined motions of the subtalar and transverse tarsal joints during swing/NWB?
Increased arch and decreased rear foot pronation with decreased WB
59
What is the impact of over pronation during stance on the hip, knee, rearfoot, and midfoot?
- hip: increased internal rotation, flexion, adduction - knee: increased valgus stress - rearfoot: increased pronation (eversion) with dropping of arch - mid/forefoot: supination (inversion)
60
What are the benefits of correcting over pronation during the stance phase?
- better storing of elastic energy * windlass mechanism during gait (improved) * push off - able to grip surface Better - decreased stress transmission to other joints
61
What is the heel pad designed for?
Designed to absorb shock
62
What is the tarsal tunnel?
- medial side of foot; posterior and inferior to the medial malleolus - formed by the flexor retinaculum - contents include * posterior tibial artery and vein * tibial nerve * tibialis posterior tendon * flexor digitorum longus * flexor hallicus longus
63
What are the functions of the intrinsic muscles?
- control arch collapse during the mid stance of gait - help lift the arch during the later phases of gait (when heel is off the ground) - stabilize the forefoot during terminal stance (interosseous muscles)
64
Posterior extrinsic muscles
``` Gastrocnemius Soleus Plantaris Tibialis posterior Flexor digitorum longus Flexor hallicus longus ```
65
Anterior extrinsic muscles
Tibialis anterior Extensor hallicus longus Extensor digitorum longus Peroneus tertius
66
Lateral extrinsic muscles
Peroneus longus and brevis
67
Clinical implications: inversion ankle sprain
- tearing of the ligaments of the ankle (ATFL first to be injured) - commonly occurs through s plantar flexion and inversion injury - patients complain of pain in lateral ankle
68
Clinical implications: foot drop
- inability to DF the foot - damage to the fibular nerve, stroke/brain injury, spine problems or muscle disorders - treat with bracing, orthotics, PT
69
Clinical implications: hallux valgus
- 1st metatarsal (Ray) is adducted and Phalanges are abducted - bunion formation - caused by a hypermobile 1st metatarsal - increased pronation of the foot

Lower Extremity Anatomy And Biomechanics (12 decks)

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