Foot/Ankle Flashcards
1
Q
Name of ankle joint
A
Talocrural joint
2
Q
What makes up the foot?
A
All tarsal bones and joints distal to the ankle
3
Q
Components of rearfoot
A
Talus, calcaneus, subtalar joint
4
Q
Components of midfoot
A
Cuboid, navicular, cuneiforms
5
Q
What are the components of the forefoot?
A
Metatarsals and phalanges
6
Q
What percent of BW does fib support?
A
10%
7
Q
The tibia expands ___________ for what reason?
A
Distally; accommodate load (90% of BW)
8
Q
Distally, is the tibia facing more medial or lateral?
A
Lateral
9
Q
Tibia has _________ of the long axis which leads to “toe out”
A
Torsion
10
Q
Name all of the tarsal bones
A
Talus, calcaneus, navicular, cuboid, 3 cuneiforms
11
Q
What structures joins the foot to the leg?
A
Talus
12
Q
Bone that lacks muscular attachments
A
Talus
13
Q
The talus is 70% covered by ______________________
A
Articular cartilage
14
Q
Direction that the head of the talus projects
A
Forward and slightly medially
15
Q
What part of the talus articulates with the calcaneus?
A
Articular facets on inferior surface
16
Q
Largest tarsal bone
A
Calcaneus
17
Q
Attachment for achilles
A
Calcaneus
18
Q
Attachment site for post tib
A
Navicular tuberosity
19
Q
How many sides does the cuboid have?
A
6
20
Q
How many sides of cuboid articulate with adjacent tarsal bones?
A
3
21
Q
Metatarsals are _________ on plantar side
A
Concave
22
Q
Describe the shape of the head/base of metatarsals AND where they are located
A
Head: convex; distal
Base: concave; proximal
23
Q
How many phalanges are there in one foot?
A
14
24
Q
What plane does DF/PF occur in?
A
Sagittal
25
Plane that inversion/eversion occurs in
Frontal
26
Plane that abd/adduction occurs in
Transverse
27
AOR of pronation/supination
Oblique
28
Pronation/supination = ________ motion
Triplanar
29
3 movements that make up pronation
DF, eversion, abduction
30
3 motions that make up supination
PF, inversion, adduction
31
Where is there more tibfib joint movement?
Distally
32
Parts of tib/fib that make up proximal TFJ
Head of fib + lateral tib
33
What type of joint is the proximal TFJ?
Synovial
34
Why is there not a lot of movement at prox TFJ?
To ensure force from biceps femoris and LCL are transferred effectively from fib to tib
35
Parts of tib/fib that make up distal TFJ
Fibular notch of tib and distal fib
36
Distal TFJ joint type
Syndesmosis (fibrous union)
37
What limits movement in the distal TFJ?
Ligamentous support
38
Components of ligamentous support of distal TFJ
1. Interosseous ligament
| 2. A/P tibfib ligs
39
Movement of distal TFJ
Rotation and translation in 3 planes
40
Restricted TFJ mobility has been associated with _____________________
Ankle pain
41
Parts of talus/distal TFJ that make up talocrural joint
Trochlear dome and sides of talus AND mortis
42
90-95% of ______________ forces pass through _______________
Compressive; talus and tib
43
3mm of articular cartilage can compress by ___________ to ______________
30-40%; absorb force
44
Talocrural joint has a ________ reinforced by ligs
Capsule
45
4 ankle ligs
1. Deltoid
2. ATFL
3. PTFL
4. CFL
46
Purpose of deltoid lig (2)
1. Limit excessive eversion
| 2. Check extreme ranges of motion
47
3 LCLs
ATFL, PTFL, CFL
48
LCLs control __________ stress
Varus (inversion)
49
ATFL purpose
Check inversion with PF
50
CFL purpose
Inversion with DF
51
PTFL purpose
Stabilizes talus in mortise
52
Which ligs (lateral or medial) are more prone to injury?
LCLs
53
Most commonly injured ankle lig
ATFL
54
How many DOF at talocrural joint?
1 - DF/PF
55
Axis of talocrural joint
Oblique
56
Close packed position of talocrural joint
DF
57
DF occurs with slight __________ and ___________
Abduction and eversion
58
Minimum DF ROM for normal function
10 degrees
59
Normal DF ROM
10-20 degrees
60
PF occurs with slight ___________ and _________
Adduction and inversion
61
Normal PF ROM
20-50 degrees
62
What causes the obliqueness of the talocrural axis?
Lateral malleolus is more inferior - AOR runs through distal tip of each malleoli
63
Roll/glide of talus in DF
Talus rolls anteriorly, glides posteriorly
64
Roll/glide of talus in PF
Talus rolls posteriorly, glides anteriorly
65
What forms the subtalar joint?
Posterior, middle and anterior facets of calcaneus and talus
66
What is the subtalar joint primarily stabilized by?
CF and deltoid ligaments
67
Define subtalar neutral
Neither inversion or eversion looking at subtalar joint
68
Close packed position of subtalar joint
Supination
69
Describe motion of subtalar joint
Triplanar motion about a single oblique axis (uniaxial)
70
Motions of subtalar joint
Supination and pronation
71
Components of supination at subtalar joint
Inversion and adduction
72
Components of pronation at subtalar joint
Eversion and abduction
73
ROM differences in eversion/inversion at subtalar joint
Inversion 2x eversion
74
Two joints that make up the transverse tarsal (midtarsal) joint
Talonavicular joint
| Calcaneocuboid joint
75
3 components of the talonavicular joint
Convex talus, concave navicular, spring lig
76
Mobility of talonavicular joint
Twisting of midfoot relative to rearfoot
77
2 components of calcaneocuboid joint
Anterior distal calcaneus and proximal cuboid
78
Which of the transverse tarsal joints is more mobile?
Talonavicular joint
79
Transverse tarsal joint rarely functions in ____________
Isolation
80
Usually functions with subtalar joint
Transverse tarsal joint
81
In open chain, mid tarsals augment ___________________
Inversion/eversion
82
Transition between hindfoot and forefoot
Transverse tarsal joint
83
Adds to overall ROM of pronation/supination
Transverse tarsal joint
84
How many AOR does transverse tarsal joint have?
2
85
Two AORs of transverse tarsal joints and movements that occur there
Longitudinal AOR: inversion/eversion
| Oblique AOR: abd/DF and add/PF
86
What is the role of the distal intertarsal joints?
Amplifies pronation and supination
87
What makes up the distal intertarsal joints?
Navicular and cuneiforms, intercuneiform
88
Articulation between the bases of the metatarsals and the distal surface of the 3 cuneiforms and the cuboid
Tarsometatarsal joints
89
What type of joints are the TMT joints?
Synovial
90
Purpose of TMT joints
Position MTs and phalanges relative to WB surface
91
TMT joints are often called
Lisfranc's Joints
92
More mobility @ ________________ in PF and DF
Medial and lateral MTs
93
head of metatarsal is _____________
Convex
94
Distal on proximal MTP joint movement is
Concave-on-Convex
95
and type of DOF of MTP joints
Flex/ext, abd/add (2)
96
Digit used to reference abd/add
2nd digit
97
Describe hallux rigidus
Limitations in hyperextension of 1st MTP - interferes with normal gait pattern in toe off
98
1st MTP extends ________ than 2nd-5th MTP
Less
99
How many proximal and distal interphalangeal joints are there?
5 proximal, 4 distal
100
DOF of IP joints
1 - flex/ext
101
IP joints serve to... (2)
1. Smooth the weight shift to opposite foot during gait
| 2. Maintain stability
102
What bones make up the medial longitudinal arch?
Calcaneus, talus, navicular, cuneiforms, and associated 3 MTs
103
What is the reasoning behind the structure of the MLA?
Loadbearing/shock absorption
104
What reinforces the bony arch of the MLA?
Plantar fascia + extrinsic muscles
105
Concave "instep" of medial foot
MLA
106
O+I of plantar fascia
Calcaneus --> proximal phalanx of each toe
107
What increases tension in the plantar fascia?
Active or passive toe extension
108
Where does BW fall during normal WB?
At midfoot, around the talonavicular joint
-then distributed through the MLA
109
What does MLA do during gait cycle?
Cyclically rises and falls
110
Describe the rearfoot shock absorption function
WB depresses talus inferiorly flattening MLA - results in slight rearfoot pronation
111
What forms the transverse arch?
Intercuneiform and cuneocuboid joint complex
112
What does transverse arch do during WB?
Flattens, allowing weight distribution across all 5 MT heads
113
Rearfoot inversion = tibial __________
ER
114
Rearfoot eversion = tibial ______
IR
115
3 roles of ankle plantarflexors and supinators
1. Decelerate forward tib translation during gait (ecc)
2. Accelerate body forward/upward (con)
3. Stabilize knee extension
116
2 primary evertors
Peroneus longus/brevis
117
When are DF most active?
Mid to late stance
118
Purpose of DF?
Decelerate the rate and extent of supination at subtalar jt
119
Role of peroneus
Provide active lateral ankle stability
120
Describe plantar fasciitis
Heel pain, greatest in AM, decreases with walking but increases again with prolonged walking
121
Hook of bone that develops in calcaneus
Heel spur
122
Heel spurs most often seen in
Middle aged men and women
123
Heel spurs likely coincident with
Plantar fasciitis
124
A bunion on the big toe
Hallux valgus
125
Lateral deviation of hallux relative to midline of body
Hallux valgus
126
Sign/symptom of hallux valgus
Inflammed or painful MTP
127
OA/limited motion at the 1st MTP
Hallus rigidus
128
Term for abnormally dropped MLA
Pes planus
129
Pes planus associated with ______________________
Midfoot/proximal forefoot laxity
130
3 things that could be weak in pes planus
Plantar fascia, spring lig, post tib
131
Abnormally high MLA
Pes cavus
132
Associated with rearfoot varus
Pes cavus
133
A pt with pes cavus is more vulnerable to ________________ associated with _____________
Stress fractures; increased rigidity
134
In a lateral ankle sprain, the ___________ is most often the main lig affected
ATFL
