FOOT/ANKLE Flashcards

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1
Q

osteoarthritis

A

increased risk of fall
cartilaginous surfaces break down

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2
Q

osteoporosis

A

decreased bone density and mass: bone disease
structure and quality of bone changed

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3
Q

osteopenia

A

step before osteoporosis

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4
Q

osteomalacia

A

soft bone: disruption of osteoclast/osteoblast cycle: turn over isnt correct: new layer form does not mineralize properly and lays down like cartilage (can happen at any age vitamin D and calcium deficiencies

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5
Q

above talocrural joint, what are the directions?

A

superior/inferior, anterior/post

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6
Q

below talocrural joint, directions are;

A

proximal/distal, dorsal/plantar

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7
Q

the foot allows for stability for _____and mobility for_______

A

stability for rigid foot during push off and mobility for shock absorption in uneven terrain

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8
Q

rearfoot (hindfoot) is what two bones?

A

talus and calcaneus

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9
Q

what is a chopart amputation?

A

amputation at talus/calcaneus: everything else chopped off

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10
Q

Lisfranc amputation is

A

cutting off all the metatarsals

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11
Q

Midfoot three bones are

A

Navicular
Cuboid
Three cuneiform

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12
Q

Forefoot bones include

A

metatarsals and phalanges

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13
Q

Pronation is what three motions?

A

dorsiflexion
eversion
abduction

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14
Q

Supination is what three composite motions?

A

plantarflexion
inversion
adduction

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15
Q

Calcaneovalgus is pron/sup?

A

pronation

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16
Q

Calcaneovarus is pron/sup?

A

supination

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17
Q

three motions of the foot complex

A

Three Motions
DF and PF (talocrural)
INV and EV (subtalar)
ABD and ADD (subtalar, forefoot)
Flexion and Extension (toes)

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18
Q

proximal tibiofibular joint anatomically belongs to the ___ but functionally part of the ____

A

Anatomically belongs to the knee; functionally to the ankle/foot

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19
Q

proximal tib-fib joint works like a wrench how?

A

if fibula gets loose, less stability at the ankle

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20
Q

The distal tibiofibular joint is what type of joint?

A

syndesmosis union: no joint capsule, ligaments only

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21
Q

function of talocrurual joint is dependent on stability of the

A

tibiofibular joint

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22
Q

what ligaments are a part of the Distal tibiofibular joint

A

Anterior and posterior tib-fib ligaments
Interosseous ligaments

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23
Q

proximal injury of tibiofibular joint: what kind of trauma can lock prox tibfib joint?

A

inversion trauma
hypermobility of prox tibfib joint can lead to common fib nerve injury

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24
Q

distal tibiofibular injury can lead to

A

Injury to syndesmosis can lead to widening of “mortise” = instability at talocrural joint (tearing)

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25
Q

TALOCRURAL JOINT SLIDE 9

A
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26
Q

Talocrural joint is composed of what three ligaments?

A

medial collateral ligament
lateral collateral ligament
additional support from extensor retinaculum

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27
Q

medial collateral ligament (deltoid) inserts at

A

navicular talus, calcaneus

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28
Q

lateral collateral ligament is composed of what three ligaments?

A

anterior talofibular
posterior talofib
calcaneofibular ligament

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29
Q

lateral collateral ligament helps limit what motions?

A

inversion and supination
(weaker)

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30
Q

talocrural axis is at what angle?

A

oblique
inclined down laterally 14 degrees, posteriorly 23 degrees

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31
Q

toe out of 20 degrees is due to what?

A

talocrural oblique axis (joint formation/orientation)

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32
Q

What is the motion of the head of talus in dorsiflexion?

A

rolls dorsally, glides plantarly
closed packed position*

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33
Q

if gastrocnemius is tight, what motion is limited?

A

dorsiflexion with knee extension

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34
Q

normal DF range is

A

20 degrees

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35
Q

head of talus in plantarflexion normal motion is

A

rolls plantarly, glides dorsally
*small amount of talar rotation (abd/add) or talar tilt (eversion/inversion) may occur

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36
Q

loose packed position in ankle is

A

plantarflexion (only posterior body of talus is in contact

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37
Q

normal range of motion of PF is

A

50 degrees

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38
Q

Plantar flexion has higher/lower incidence of ankle sprains?

A

higher

39
Q

plantarflexion is limited by what ligaments?

A

anterior tibialis, EHL, EDL

40
Q

medial ankle plantar flexion is protected by

A

post tib, FHL, FDL

41
Q

lateral ankle plantarflexion is protected by

A

fib long and brevis

42
Q

the taus is wider distally/proximally?

A

wider distally: improves stability

43
Q

in weightbearing, the mortise rotates over the talus. The tib-fib joint adjusts to widen around the distal talus in dorsiflexion HOW

A

medial rotation

44
Q

tib-fib joint widens in plantarflexion by rotating med/lat?

A

lateral rotation

45
Q

lateral facet is larger/smaller than medial at talocrural joint?

A

Fibula moves more and adjusts by superior/inferior gliding and medial/lateral rotation at proximal and distal tib-fib joints

46
Q

subtalar joint’s primary role is what?

A

lessen rotational forces of body weight

47
Q

proximal subtalar joint has a convex/concave talus on convex/concave calcaneus?

A

Proximal: concave talus on convex calcaneus – largest facet (75% of ST forces)

48
Q

subtalar joint (talar and calcaneus) runs in what directions?

A

distalmedial–proximallateral
anteromedial—-posterolateral

49
Q

tarsal canal is what?

A

Tarsal canal formed by sulcus in both bones (talus and calcaneus), runs from sinus tarsi (lateral) to sustentaculum tali (medial)

50
Q

what are the subatalar ligaments?

A

Calcaneofibular ligament
Anterior and posterior talofibular ligaments
Lateral and interosseous talocalaneal ligament
Cervical ligament (strongest component)
Deltoid ligament
Additional support from extensor retinaculum

51
Q

SLIDE 19

A
52
Q

nonweight bearing composite motions for supination:

A

calcaneal adduction, inversion, plantarflexion

53
Q

nonweightbearing composite motions of pronation:

A

calcaneal ABD, EV, DF
EV sometimes referred to as valgus, INV as varus
WB Motion

54
Q

with weightbearing, pronation is what motions:

A

WB Pronation = calcaneal EV, Talar ADD and PF
Tib-fib Med Rot (follows talus b/c mortise)

55
Q

with weightbearing, supination is calcaneal ___ and talar ___ and _____
tib-fib ___ rotation

A

calcaneal INV, Talar ABD and DF, Tib-fib Lat Rot

56
Q

In the sagittal plane, what motions are there in the ankle?

A

DF and PF

57
Q

In transverse plane, what are the motions of the ankle?

A

abduction and adduction

58
Q

Pronation is associated with pes

A

planus and pliable foot

59
Q

subtalar neutral is what?

A

talus is centrally located in mortise
*used to find if patient is in calcaneal valgus or varus
*often used to isolate measurement of ankle DF

60
Q

In bilateral stance, calcaneus is at___ degrees of eversion

A

3.5 degrees of eversion

61
Q

For gait, calcaneal ___ degrees of ___ at heel strike than ____, then ____ degrees of inversion during push off

A

3 deg of INV at heel strike then EV
Then 5.5 deg of INV during push-off

62
Q
A
63
Q

close packed position of subtalar joint is supination or pronation?

A

supination (stable)
open-packed: pronation (flexible)

64
Q

In weightbearing, subtalar joint absorbs what plane rotations?

A

Subtalar absorbed the LE transverse plane rotations

65
Q

what joint divides hindfoot from mid and forefoot?

A

transverse tarsal joint
Talonavicular and calcaneocuboid form S shaped transverse tarsal joint line

66
Q

navicular and cuboid are ___ during weightbearing (mobile/immobile)

A

IMMOBILE
talus and calcaneus move on them

67
Q

The talus in weightbearing also can be considered to act as a ball bearing between what three joints?

A

The tibiofibular mortise superiorly
The calcaneus (the subtalar joint) plantarly
The navicular bone (the talonavicular joint) distally

68
Q

Capsule of subtalar also encloses

A

Talonavicular Joint
Distal convex head of talus with concave proximal aspect of navicular

69
Q

SLIDE 25 and 26 and 27

A
70
Q

transverse tarsal axis is angled HOW

A

Longitudinal axis inclines up 15° from transverse plane
Angles 9°medially from sagittal plane allowing triplanar motion of SUP/PRO
oblique axis: 57 degrees medial to sagittal plane and 52 degrees supinated to transverse plane

71
Q

transverse tarsal joint is mechanically linked to ____ in weightbearing supination/pron

A

subtalar

72
Q

medially rotating tibia imposes subtalar ____

A

pronation

73
Q

If you have mobility in your foot, forefoot will twist in ___ direction during weightbearing pronation

A

opposite direction (adjust forefoot according to changing terrains)

74
Q

The 4th and the 5th TMT articulate with ___

A

cuboid and share a capsule

75
Q

1st TMT is made of

A

1st MT and medial cuneiform

76
Q

2nd and 3rd MT formed by

A

2nd and 3rd cuneiform and share capsule (stronger and more restricted in motion)

77
Q

forefoot varus/valgus is seen in

A

non-weightbearing

78
Q

forefoot varus is associated with excessive ____ of hindfoot

A

pronation
Seen in non-weightbearing subtalar neutral as varus
Will evert in standing/weightbearing

79
Q

In late stance phase of walking, ______ is key motion so foot can pass over toes
Metatarsal heads and toes help balance bodyweight

A

extension!

80
Q

metatarsaphalangeal joints is a ____ type of joint with ____ degrees of freedom

A

Condyloid synovial with 2 degrees of freedom (FLX/EXT and ABD/ADD)
FLX/EXT > ABD/ADD
Extension > Flexion

81
Q

sesamoid bones on plantar aspect of 1st MTP is anatomically pulley for ____ and protects ___ tendons in weightbearing

A

FHB
protects FHL in weightbearing

82
Q

1st MTP has ____ deg of EXT, ____deg of FLX
____ deg of EXT used in walking

A

1st MTP has ~82 deg of EXT, 17 deg of FLX
42 deg of EXT used in walking

83
Q

Excessive EXT at MTP can result in _____deformity

A

hammer toe

84
Q

stiff 1st MTP results in ___

A

hallux rigidus

85
Q

ankle plantarflexion contraction contributes to ____- and lock hindfoot/midfoot into rigid lever for push off

A

supination

86
Q

minimal MTP flexion is needed for _______

A

most weightbearing activities

87
Q

1st MTP adduction minimal ____ degrees during gait

A

15 degrees adduction
If larger valgus: hallux valgus deformity

88
Q

ectrodactyly

A

missing toes IPs
(polydactyly: added toes)

89
Q

longitudinal arch attaches posteriorly to ___ and ant to ____

A

Posteriorly attached to calcaneus and anteriorly to MET heads

90
Q

transverse arch: easiest to see at TMT joint, reduced at MET heads
what is keystone bone?

A

medial cuneiform

91
Q

what bone is the keystone in longitudinal arches?

A

talus

92
Q

mobility function of arches

A

Accept weight during early stance and adapt to various surfaces
Requires flexibility to
Dampen impact of weightbearing forces
Dampen superimposed rotational motions
Adapt to changes in support surface

93
Q

stability function of arches

A

Requires stiffness for
Distribution of weight through foot
Convert flexible foot to rigid lever for gait

94
Q
A