Foot and Ankle Mechanics

Question 1

what ligament tears first?

Answer 1

anterior talofibular

-inversion sprain

Question 2

deltoid ligament

Answer 2

very strong

medial

Question 3

PTF

Answer 3

posterior talofibular

-tear when you have fracture/dislocation

Question 4

calcaneofibular

Answer 4

also in ankle

Question 5

motion of ankle?

Answer 5

more plantar flexion

Question 6

ankle most stable when?

Answer 6

dorsiflexion

Question 7

subtalar joint

Answer 7

talus on calcaneus

abduction (valgus) and adduction (varus)

talus-navicular
calcaneus - cuboid

Question 8

inversion of ankle

Answer 8

tibialis anterior and posterior
-interior muscle

increases height of medial arch
also plantar flexion

Question 9

eversion of ankle

Answer 9

exterior muscles - fibularis longus and brevis

decreased height of medial arch

dorsiflex ankle

Question 10

pronation

Answer 10

eversion
dorsiflexion
abduction

Question 11

supination

Answer 11

inversion
plantar fleion
addution

Question 12

intermetatarsal joint?

Answer 12

slides

Question 13

lateral arch

Answer 13

lateral arch
-weight bearing and elastic
firm/osseous structure

calcaneus, cuboid, 4 5 MTs

limited mobility

transmits weight and thrust to ground

Question 14

medial arch

Answer 14

more mobile and higher than alteral

calcaneus, talus, navicular, cuneiforms, 1-3 MTs

does not have firm osseous support

changes to adapt to terrain

Question 15

medial arch controls what?

Answer 15

gait**

Question 16

high medial arch

Answer 16

adduction of foot and varus calcaneus

Question 17

low medial arch

Answer 17

abducion of foot and valgus calcaneus

Question 18

transverse arches of foot?

Answer 18

maintain integrity
-flatten with weight bearing

posterior transverse - MT bases
tarsal arches

Question 19

pesplanus

Answer 19

flat feet

loss of tarsal arch

• functional - flat foot with walking
• structural - flat foot when sitting and rigid

Question 20

claw toe

Answer 20

flex flex

Question 21

hammer toe

Answer 21

flex extended

Question 22

bunion

Answer 22

medial deviation of 1st MTP with lateral deviation of proximal phalanx of hallux (great toe)

may look like gout

often problem with second MTP

Question 23

motion of ankle testing?

Answer 23

plantar flexion bigger

Question 24

subtalar joint motion?

Answer 24

adduction is more

Question 25

1st metatarsal motion?

Answer 25

extension more than flexion

Question 26

gait

Answer 26

stance phase
-heel, lateral, anterior, great toe off

swing phase

Question 27

grade 1 sprain

Answer 27

microtears in ligament

-no instability

Question 28

grade 2 sprain

Answer 28

partial tear of ligament
-severe swelling over ankle

mild instability
has an end point

Question 29

grade 3 sprain

Answer 29

complete tear

complete instability
no end point

Question 30

acute inversion of ankle?

Answer 30

inversion and plantar flexion

Question 31

TTP

Answer 31

tenderness to palpation

Question 32

arch acutely flat, check what?

Answer 32

tibialis posterior tendon

-stabilizer of foot

Question 33

ottawa ankle rules

Answer 33

not for patients under age 18

ankle series:

• posterior lateral malleolus tenderness
• posterior medial malleolus tenderness
• can’t bear weight

foot series:

• bony tenderness at base of 5th metatarsal
• bony tenderness at navicular (medial)
• can’t bear weight

Question 34

drawer test

Answer 34

for ankle as well

Question 35

talar tilt test

Answer 35

inversion/eversion of ankle

Question 36

when ankle inverts

Answer 36

fibular head posterior
lateral malleolus anterior
tibia externally rotates
femur internally rotates
ipsilateral anterior innominate
sacrum faces side of ankle sprain

Question 37

grade 1 and 2 treatment?

Answer 37

PRICE

NSAID when fracture ruled out

Question 38

grade 3 treatment?

Answer 38

PRICES

-requires surgery