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Appendicular anatomy > foot and ankle region movements > Flashcards

foot and ankle region movements Flashcards

1
Q

Weight bearing surfaces of ankle

A

trochlear surfaces of the tibia and talus

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2
Q

stabilising surfaces of the ankle joint

A

medial and lateral malleoli that grip that talus, the ankle joint is more stable in DF (closed pack position)

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3
Q

Classification of the ankle joint

A

uniaxial synovial hinge joint, 1 degree of motion, DF and PF

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4
Q

Neutral position of ankle joint

A

neutral position in standing- plantigrade

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5
Q

what ligament stabilizes the ankle joint

A

medial (deltoid) ligament and lateral ligament

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6
Q

what muscle produces dorsiflexion (produced and assisted by)

A

Agonist- tibialis anterior, Assister- extensor digitorum longus, extensor hallucis longus, peroneus tertius

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7
Q

range of motion and limited by- dorsiflexion

A

20-30° if knee extended, 35° knee flexed
limited by- tension in antagonists, posterior part of deltoid, calcaneofibular ligament, wedging of talus between malleoli

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8
Q

what muscles produce and assist plantar flexion

A

Gastrocnemius, soleus,

assisted by- tibialis posterior, peroneus longus/ brevis, flexor hallucis longus, flexor digitorum longus

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9
Q

range of motion and limited by- plantar flexion

A

50°, tension in antagonists, anterior part of deltoid lig, anterior talofibular lig

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10
Q

what are the 4 parts of the medial deltoid ligament

A

anterior and posterior tibiotalar joint, tibiocalcaneal part, tibionavicular

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11
Q

structure of the medial (deltoid) ligament

A

it is in a deltoid shape, 2 layers- deep and superficial

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12
Q

what does the medial (deltoid) ligament and lateral ligament prevent

A

medial- it prevents unwanted eversion (abduction) of the foot
lateral- inversion

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13
Q

what are the 3 lateral ligaments

A

calcaneofibular ligament, anterior and posterior talofibular ligament

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14
Q

why is the lateral ligament weaker than the medial ligament

A

each structure is individual and relatively minor= more inversion injuries

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15
Q

what is the subtalar joint

A

it is a synovial modified saddle joint (plane), it is between concave facet of inferior surface of the body of the talus and a convex anterior facet on superior surface of calcaneus, thin loose capsule and lined with synovial membrane

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16
Q

what are the 4 ligaments of the subtalar joint ligaments

A

medial talocalcaneal, posterior talocalcaneal, lateral talocalcaneal, interosseous talocalcaneal, these blend together

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17
Q

medial and posterior talocalcanean ligament

A

medial= medial- posterior talus to the sustentaculum talus, posterior= lateral talus and upper medial calcaneus

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18
Q

lateral and interosseous talocalcanean

A

lateral- deep to calcaneofibular lig, posterior talus and lateral calcaneus
intraosseous= floor of sinus tarsi, talus

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19
Q

transverse (mid) tarsal joint

A

the functional description of the- talocalcaneonavicular joint and calcaneocuboid joint. calcaneovicular (convex) joint and calcaneocuboid (concave) joint, S shaped

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20
Q

movements of the midtarsal joint

A

pronation and supination

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21
Q

what is the talocalcaneonavicular joint

A

synovial ball (head of talus) and socket (part bone/ part ligament)

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22
Q

joint surfaces of the talocalcaneonavicular joint

A

anterior- navicular, posterior- sustentaculum tali and calcaneus, medially- plantar calcaneonavicular (spring) ligament, laterally- calcaneonavicular part of bifurcate ligament

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23
Q

subtalar and midtarsal joint movements

A

inversion, plantar flexion, eversion

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24
Q

what is inversion and eversion

A

adduction of forefoot and supination (sole faces medially) plantar flexion, eversion- abduction of forefoot, pronation, dorsiflexion of ankle

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25
Q

what is the calcaneo-cuboid joint

A

synovial plane/ saddle joint anterior surface of calcaneus and posterior surface of cuboid , simple capsule lined with synovial capsule

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26
Q

calcaneo-cuboid joint ligaments

A

plantar calcaneocuboid (short plantar) ligament, bifurcate ligaments

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27
Q

what is the bifurcate ligament

A

calcaneocuboid ligament and calcaneovicular ligament, 2 bands of fibres combined to form the bifurcate ligament

28
Q

what is the short plantar ligament

A

plantar aspect of calcaneus (calcaneal tubercle), plantar aspect of cuboid

29
Q

what is the long plantar ligament- position

A

superficial to short plantar calcaneocuboid ligament, covers plantar surface of calcaneus

30
Q

what is the long plantar ligament- attachment

A

attaches posteriorly to plantar surface of calcaneus between anterior and posterior tubercles, passes forward to cuboid and base of lateral 4 metatarsals

31
Q

list of intertarsal joints

A

subtalar, midtarsal, cuneonavicular, intercuneiform, cuneocuboid, tarsometatarsal

32
Q

joints of the foot

A

intertarsal joints, intermetatarsal, metatarsophalangeal, interphalangeal

33
Q

joints of the foot classification and movements- intertarsal

A

synovial plane- gliding

34
Q

joints of the foot classification and movements- tarsometatarsal and intermetatarsal joints

A

synovial plane- gliding

35
Q

joints of the foot classification and movements- metatarsophalangeal joint

A

synovial ellipsoid, flexion/ extension, abduction/ adduction- point of rotation is second toe

36
Q

joints of the foot classification and movements- interphalangeal joint

A

flexion/ extension

37
Q

metatarsophalangeal joints- planes and axis abduction and adduction

A

abd and add- with foot in plantigrade: horizontal plane/ vertical axis,

38
Q

metatarsophalangeal joints- abduction produced by

A

abductor hallucis (great toe), ADM (little toe), dorsi interossei (2nd, 3rd, 4th)

39
Q

metatarsophalangeal joints- abduction range and limited by

A

rarely measured numerically, limited by- tension in antagonists

40
Q

metatarsophalangeal joints- adduction produced by

A

adductor hallucis (great toe), plantar interossei (3-5 toes)

41
Q

metatarsophalangeal joints- adduction range and limited by

A

top spread observed, limited by- apposition of soft tissue- other toes

42
Q

interphalangeal joints- flexion- produced by and assisted by

A

flexor hallucis longus, flexor digitorum longus, flexor digitorum brevis, assisted- flexor digitorum accessories,

43
Q

interphalangeal joints- extension produced by and assisted by

A

extensor hallucis longus, extensor digitorum longus, extensor digitorum brevis, assisted by- the lumbricals

44
Q

interphalangeal joints- range of flexion

A

PIP- 35°, DIP- 60°, IP great toe 0 90°

45
Q

interphalangeal joints- range of extension and limited by

A

PIP- 0°, DIP- 30°, IP great toe- 0°

tension of the antagonists and plantar ligaments

46
Q

functions of the foot

A

dynamic and strong support the body weight, it serves as a lever for propulsion, spring and lift for many activities, adapts to uneven surfaces, flexible/ resilient to absorb shock of weight bearing, it provides a stable base of proximal function

47
Q

foot as a lever

A

powerful muscles in posterior aspect of calve attaching to posterior aspect of calcaneus- short lever arm, to longer lever arm- to produce a machine for propulsion, the longer calcaneus= longer propulsion

48
Q

arches of the foot

A

add weight bearing capabilities and resilience of the foot, acts as a shock absorber in standing and propulsive movements, enable the foot to adapt to different surfaces and to weight change

49
Q

how is weight bearing transmitted

A

weight of the body, is transmitted from tibia to talus, then inferiorly and posteriorly to the calcaneus, then inferiorly and anteriorly. to the heads of the 2nd and 5th MT’s and sesamoid bones of great toe

50
Q

medial longitudinal arch

A

(1-2)- from calcaneum to base of great toe

51
Q

lateral longitudinal arch

A

(1-2) from calcaneum to head of 5th MT

52
Q

Transverse arch

A

(2-3)- between head of metatarsals and also between cuboid and cuneiforms

53
Q

bones of the medial longitudinal arch

A

calcaneum, navicular, medial cuneiform and first MT

54
Q

medial longitudinal arch- keystones

A

talus acts as a wedge- cannot fall between navicular and calcaneus, sustenticulum tali is a medial support, cuboid and cuneiforms are a wedge

55
Q

passive support medial longitudinal arch

A

calcaneonavicular ligament, tibialis anterior/ posterior tendon, plantar calcaneonavicular ligament (spring ligament), plantar aponeurosis (desner structure of tuberosity of calcaneus- extensive insertion), short/ plantar ligaments- resist dropping

56
Q

dynamic arch support- medial arch

A

tibialis anterior/ posterior, flexor hallucis longus, fibularis longus, intrinsic plantar muscle

57
Q

bones forming the lateral longitudinal arch

A

calcaneum, cuboid and 5th MT form the lateral longitudinal arch

58
Q

lateral longitudinal arch- keystone and passive support

A

keystone effect of talus and cuboid (wider at top than at plantar aspect- cant full through), supported by plantar ligament (short and long) and lateral aspect of plantar aponeurosis

59
Q

lateral longitudinal arch- dynamic support

A

peroneus brevis- muscles in lateral compartment of calve that wrap around the lateral malleolus, peroneus longus- under foot and inserts into medial cuneiform and proximal base of first MT tibialis anterior

60
Q

bones forming transverse arch

A

proximal and distal transverse arch, proximal- goes through cuboid and cuneiforms (keystones), distal- through head of MT’s (wider above than inferiorly)

61
Q

passive support of transverse arch

A

deep transverse metatarsal ligament, plantar ligaments supporting each junction of the ,metatarsals and phalanges, collateral ligaments at each of the interphalangeal joint, ellipsoid metatarsal phalangeal ligament

62
Q

Accessory movement- ankle joint- talocrural joint

A

longitudinal distraction, AP, PA

63
Q

Accessory movement- subtalar joint

A

distraction, rock of talus on calcaneus slide tilt medially, slide tilt laterally

64
Q

Accessory movement- tarsal joints (cuneonavicular and cuneocuboid)

A

AP movement

65
Q

Accessory movement- tarsometatarsal joints

A

AP, rotation

66
Q

Accessory movement- distal interphalangeal junction

67
Q

metatarsophalangeal and interphalangeal joints- accessory movements

A

movements described for the metatarsophalangeal MTP joint of great toe, distraction, AP, lateral and medial movement, rotation

Appendicular anatomy (20 decks)

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