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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
Q

What three motions make pronation occur?

A

Abduction, eversion and DF

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25
Q

What three motions combine to make supination occur?

A

Adduction, inversion and PF

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26
Q

What are the two subtalar joint ligaments?

A
  • cervical talocalcaneal ligament

- interosseous talocalcaneal ligament

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27
Q

What does the cervical talocalcaneal ligament restrict?

A

Restricts inversion

Binds the calcaneus to the talus (laterally)

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28
Q

What does the interosseous talocalcaneal ligament restrict?

A

Restricts eversion

Binds the calcaneus to the talus (medially)

29
Q

Arthrokinematics: subtalar joint inversion

A
  • calcaneus glides medially
  • navicular glides medially

Commonly occurs with PF

30
Q

Arthrokinematics: subtalar joint eversion

A
  • calcaneus glides laterally
  • navicular glides laterally

Commonly occurs with DF

31
Q

What are the closed and open positions and capsular pattern of the subtalar joint?

A

Closed: supination
Open: pronation
Capsular pattern: supination > pronation

32
Q

What are the joint articulations of the transverse tarsal joint?

A

Articulations of calcaneocuboid and talonavicular joints

33
Q

What kind of joint is the transverse tarsal joint?

A

Synovial saddle joint

34
Q

How many axis of motion are there at the transverse tarsal joint?

A

2 axis of motion

  • longitudinal: inversion and eversion
  • oblique: flexion and extension
35
Q

What are the ligaments associated with the talonavicular joint?

A
  • 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
Q

What are the joint articulations between the tarsometatarsal joints?

A

Articulations between the 1st, 2nd, and 3rd cuneiforms and the cuboid with the bases of the metatarsals

37
Q

What kind of joint is the tarsometatarsal joint?

A

Plane synovial joint

Primary movements are gliding movements

38
Q

Which MTP is the most mobile?

A

The first MTP

39
Q

What kind of joints are the Metatarsophalangeal joints?

A

Condyloid synovial joint

40
Q

What are the joint articulations of the metatarsophalangeal joints?

A

Articulation between the metatarsals and phalanges

41
Q

How many degrees of freedom are at the Metatarsophalangeal joints?

A

2 degrees of freedom

  • flexion and extension
  • abduction and adduction
42
Q

What are the soft tissue structures associated with the Metatarsophalangeal joints?

A
  • 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
Q

Arthrokinematics: MTP flexion

A

Plantar glide, plantar roll

Convex metatarsal and concave phalanx

44
Q

Arthrokinematics: MTP extension

A

Dorsal glide, dorsal roll

Convex metatarsal and concave phalanx

45
Q

What is the closed and open position and capsular pattern of the MTP joints?

A

Closed: full extension
Open: 10 degrees extension
Capsular pattern: extension > flexion

46
Q

What kind of joints are the interphalangeal joints?

A

Synovial hinge joints

47
Q

How many degrees of freedom are there at the interphalangeal joints?

A

1 degree of freedom

-flexion and extension

48
Q

What are the joint articulations of the interphalangeal joints?

A

Convex head of proximal articulating surface on concave base of distal articulation surface

49
Q

Arthrokinematics IP flexion

A

Plantar glide, plantar roll

50
Q

Arthrokinematics IP extension

A

Dorsal glide, dorsal roll

51
Q

What are the closed and open positions and capsular pattern of the IP joints?

A

Closed: full flexion
Open: slight flexion
Capsular pattern: flexion > extension

52
Q

What is the plantar fascia?

A

-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
Q

What is the medial longitudinal arch supported by?

A
  • Plantar fascia
  • spring ligament
  • short and long plantar ligaments
  • tibialis posterior muscle (if doesn’t function correctly, foot pronates)
54
Q

How does a normal medial longitudinal arch work?

A

-weight supported by plantar fascia stretch

55
Q

What is pes planus?

A

“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
Q

What is the Windlass mechanism?

A
  • 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
Q

What are the combined motions of the subtalar and transverse tarsal joints during stance/WB?

A

Decreased arch and increased rear foot pronation with increased WB

58
Q

What are the combined motions of the subtalar and transverse tarsal joints during swing/NWB?

A

Increased arch and decreased rear foot pronation with decreased WB

59
Q

What is the impact of over pronation during stance on the hip, knee, rearfoot, and midfoot?

A
  • hip: increased internal rotation, flexion, adduction
  • knee: increased valgus stress
  • rearfoot: increased pronation (eversion) with dropping of arch
  • mid/forefoot: supination (inversion)
60
Q

What are the benefits of correcting over pronation during the stance phase?

A
  • better storing of elastic energy
    • windlass mechanism during gait (improved)
    • push off
  • able to grip surface Better
  • decreased stress transmission to other joints
61
Q

What is the heel pad designed for?

A

Designed to absorb shock

62
Q

What is the tarsal tunnel?

A
  • 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
Q

What are the functions of the intrinsic muscles?

A
  • 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
Q

Posterior extrinsic muscles

A 
Gastrocnemius 
Soleus 
Plantaris
Tibialis posterior
Flexor digitorum longus
Flexor hallicus longus
65
Q

Anterior extrinsic muscles

A

Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus
Peroneus tertius

66
Q

Lateral extrinsic muscles

A

Peroneus longus and brevis

67
Q

Clinical implications: inversion ankle sprain

A
  • 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
Q

Clinical implications: foot drop

A
  • inability to DF the foot
  • damage to the fibular nerve, stroke/brain injury, spine problems or muscle disorders
  • treat with bracing, orthotics, PT
69
Q

Clinical implications: hallux valgus

A
  • 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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