Foot/Ankle Flashcards

1
Q

Name of ankle joint

A

Talocrural joint

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2
Q

What makes up the foot?

A

All tarsal bones and joints distal to the ankle

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3
Q

Components of rearfoot

A

Talus, calcaneus, subtalar joint

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4
Q

Components of midfoot

A

Cuboid, navicular, cuneiforms

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5
Q

What are the components of the forefoot?

A

Metatarsals and phalanges

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6
Q

What percent of BW does fib support?

A

10%

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7
Q

The tibia expands ___________ for what reason?

A

Distally; accommodate load (90% of BW)

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8
Q

Distally, is the tibia facing more medial or lateral?

A

Lateral

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9
Q

Tibia has _________ of the long axis which leads to “toe out”

A

Torsion

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10
Q

Name all of the tarsal bones

A

Talus, calcaneus, navicular, cuboid, 3 cuneiforms

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11
Q

What structures joins the foot to the leg?

A

Talus

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12
Q

Bone that lacks muscular attachments

A

Talus

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13
Q

The talus is 70% covered by ______________________

A

Articular cartilage

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14
Q

Direction that the head of the talus projects

A

Forward and slightly medially

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15
Q

What part of the talus articulates with the calcaneus?

A

Articular facets on inferior surface

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16
Q

Largest tarsal bone

A

Calcaneus

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17
Q

Attachment for achilles

A

Calcaneus

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18
Q

Attachment site for post tib

A

Navicular tuberosity

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19
Q

How many sides does the cuboid have?

A

6

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20
Q

How many sides of cuboid articulate with adjacent tarsal bones?

A

3

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21
Q

Metatarsals are _________ on plantar side

A

Concave

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22
Q

Describe the shape of the head/base of metatarsals AND where they are located

A

Head: convex; distal
Base: concave; proximal

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23
Q

How many phalanges are there in one foot?

A

14

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24
Q

What plane does DF/PF occur in?

A

Sagittal

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25
Q

Plane that inversion/eversion occurs in

A

Frontal

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26
Q

Plane that abd/adduction occurs in

A

Transverse

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27
Q

AOR of pronation/supination

A

Oblique

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28
Q

Pronation/supination = ________ motion

A

Triplanar

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29
Q

3 movements that make up pronation

A

DF, eversion, abduction

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30
Q

3 motions that make up supination

A

PF, inversion, adduction

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31
Q

Where is there more tibfib joint movement?

A

Distally

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32
Q

Parts of tib/fib that make up proximal TFJ

A

Head of fib + lateral tib

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33
Q

What type of joint is the proximal TFJ?

A

Synovial

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34
Q

Why is there not a lot of movement at prox TFJ?

A

To ensure force from biceps femoris and LCL are transferred effectively from fib to tib

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35
Q

Parts of tib/fib that make up distal TFJ

A

Fibular notch of tib and distal fib

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36
Q

Distal TFJ joint type

A

Syndesmosis (fibrous union)

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37
Q

What limits movement in the distal TFJ?

A

Ligamentous support

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38
Q

Components of ligamentous support of distal TFJ

A
  1. Interosseous ligament

2. A/P tibfib ligs

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39
Q

Movement of distal TFJ

A

Rotation and translation in 3 planes

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40
Q

Restricted TFJ mobility has been associated with _____________________

A

Ankle pain

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41
Q

Parts of talus/distal TFJ that make up talocrural joint

A

Trochlear dome and sides of talus AND mortis

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42
Q

90-95% of ______________ forces pass through _______________

A

Compressive; talus and tib

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43
Q

3mm of articular cartilage can compress by ___________ to ______________

A

30-40%; absorb force

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44
Q

Talocrural joint has a ________ reinforced by ligs

A

Capsule

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45
Q

4 ankle ligs

A
  1. Deltoid
  2. ATFL
  3. PTFL
  4. CFL
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46
Q

Purpose of deltoid lig (2)

A
  1. Limit excessive eversion

2. Check extreme ranges of motion

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47
Q

3 LCLs

A

ATFL, PTFL, CFL

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48
Q

LCLs control __________ stress

A

Varus (inversion)

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49
Q

ATFL purpose

A

Check inversion with PF

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50
Q

CFL purpose

A

Inversion with DF

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51
Q

PTFL purpose

A

Stabilizes talus in mortise

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52
Q

Which ligs (lateral or medial) are more prone to injury?

A

LCLs

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53
Q

Most commonly injured ankle lig

A

ATFL

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54
Q

How many DOF at talocrural joint?

A

1 - DF/PF

55
Q

Axis of talocrural joint

A

Oblique

56
Q

Close packed position of talocrural joint

A

DF

57
Q

DF occurs with slight __________ and ___________

A

Abduction and eversion

58
Q

Minimum DF ROM for normal function

A

10 degrees

59
Q

Normal DF ROM

A

10-20 degrees

60
Q

PF occurs with slight ___________ and _________

A

Adduction and inversion

61
Q

Normal PF ROM

A

20-50 degrees

62
Q

What causes the obliqueness of the talocrural axis?

A

Lateral malleolus is more inferior - AOR runs through distal tip of each malleoli

63
Q

Roll/glide of talus in DF

A

Talus rolls anteriorly, glides posteriorly

64
Q

Roll/glide of talus in PF

A

Talus rolls posteriorly, glides anteriorly

65
Q

What forms the subtalar joint?

A

Posterior, middle and anterior facets of calcaneus and talus

66
Q

What is the subtalar joint primarily stabilized by?

A

CF and deltoid ligaments

67
Q

Define subtalar neutral

A

Neither inversion or eversion looking at subtalar joint

68
Q

Close packed position of subtalar joint

A

Supination

69
Q

Describe motion of subtalar joint

A

Triplanar motion about a single oblique axis (uniaxial)

70
Q

Motions of subtalar joint

A

Supination and pronation

71
Q

Components of supination at subtalar joint

A

Inversion and adduction

72
Q

Components of pronation at subtalar joint

A

Eversion and abduction

73
Q

ROM differences in eversion/inversion at subtalar joint

A

Inversion 2x eversion

74
Q

Two joints that make up the transverse tarsal (midtarsal) joint

A

Talonavicular joint

Calcaneocuboid joint

75
Q

3 components of the talonavicular joint

A

Convex talus, concave navicular, spring lig

76
Q

Mobility of talonavicular joint

A

Twisting of midfoot relative to rearfoot

77
Q

2 components of calcaneocuboid joint

A

Anterior distal calcaneus and proximal cuboid

78
Q

Which of the transverse tarsal joints is more mobile?

A

Talonavicular joint

79
Q

Transverse tarsal joint rarely functions in ____________

A

Isolation

80
Q

Usually functions with subtalar joint

A

Transverse tarsal joint

81
Q

In open chain, mid tarsals augment ___________________

A

Inversion/eversion

82
Q

Transition between hindfoot and forefoot

A

Transverse tarsal joint

83
Q

Adds to overall ROM of pronation/supination

A

Transverse tarsal joint

84
Q

How many AOR does transverse tarsal joint have?

A

2

85
Q

Two AORs of transverse tarsal joints and movements that occur there

A

Longitudinal AOR: inversion/eversion

Oblique AOR: abd/DF and add/PF

86
Q

What is the role of the distal intertarsal joints?

A

Amplifies pronation and supination

87
Q

What makes up the distal intertarsal joints?

A

Navicular and cuneiforms, intercuneiform

88
Q

Articulation between the bases of the metatarsals and the distal surface of the 3 cuneiforms and the cuboid

A

Tarsometatarsal joints

89
Q

What type of joints are the TMT joints?

A

Synovial

90
Q

Purpose of TMT joints

A

Position MTs and phalanges relative to WB surface

91
Q

TMT joints are often called

A

Lisfranc’s Joints

92
Q

More mobility @ ________________ in PF and DF

A

Medial and lateral MTs

93
Q

head of metatarsal is _____________

A

Convex

94
Q

Distal on proximal MTP joint movement is

A

Concave-on-Convex

95
Q

and type of DOF of MTP joints

A

Flex/ext, abd/add (2)

96
Q

Digit used to reference abd/add

A

2nd digit

97
Q

Describe hallux rigidus

A

Limitations in hyperextension of 1st MTP - interferes with normal gait pattern in toe off

98
Q

1st MTP extends ________ than 2nd-5th MTP

A

Less

99
Q

How many proximal and distal interphalangeal joints are there?

A

5 proximal, 4 distal

100
Q

DOF of IP joints

A

1 - flex/ext

101
Q

IP joints serve to… (2)

A
  1. Smooth the weight shift to opposite foot during gait

2. Maintain stability

102
Q

What bones make up the medial longitudinal arch?

A

Calcaneus, talus, navicular, cuneiforms, and associated 3 MTs

103
Q

What is the reasoning behind the structure of the MLA?

A

Loadbearing/shock absorption

104
Q

What reinforces the bony arch of the MLA?

A

Plantar fascia + extrinsic muscles

105
Q

Concave “instep” of medial foot

A

MLA

106
Q

O+I of plantar fascia

A

Calcaneus –> proximal phalanx of each toe

107
Q

What increases tension in the plantar fascia?

A

Active or passive toe extension

108
Q

Where does BW fall during normal WB?

A

At midfoot, around the talonavicular joint

-then distributed through the MLA

109
Q

What does MLA do during gait cycle?

A

Cyclically rises and falls

110
Q

Describe the rearfoot shock absorption function

A

WB depresses talus inferiorly flattening MLA - results in slight rearfoot pronation

111
Q

What forms the transverse arch?

A

Intercuneiform and cuneocuboid joint complex

112
Q

What does transverse arch do during WB?

A

Flattens, allowing weight distribution across all 5 MT heads

113
Q

Rearfoot inversion = tibial __________

A

ER

114
Q

Rearfoot eversion = tibial ______

A

IR

115
Q

3 roles of ankle plantarflexors and supinators

A
  1. Decelerate forward tib translation during gait (ecc)
  2. Accelerate body forward/upward (con)
  3. Stabilize knee extension
116
Q

2 primary evertors

A

Peroneus longus/brevis

117
Q

When are DF most active?

A

Mid to late stance

118
Q

Purpose of DF?

A

Decelerate the rate and extent of supination at subtalar jt

119
Q

Role of peroneus

A

Provide active lateral ankle stability

120
Q

Describe plantar fasciitis

A

Heel pain, greatest in AM, decreases with walking but increases again with prolonged walking

121
Q

Hook of bone that develops in calcaneus

A

Heel spur

122
Q

Heel spurs most often seen in

A

Middle aged men and women

123
Q

Heel spurs likely coincident with

A

Plantar fasciitis

124
Q

A bunion on the big toe

A

Hallux valgus

125
Q

Lateral deviation of hallux relative to midline of body

A

Hallux valgus

126
Q

Sign/symptom of hallux valgus

A

Inflammed or painful MTP

127
Q

OA/limited motion at the 1st MTP

A

Hallus rigidus

128
Q

Term for abnormally dropped MLA

A

Pes planus

129
Q

Pes planus associated with ______________________

A

Midfoot/proximal forefoot laxity

130
Q

3 things that could be weak in pes planus

A

Plantar fascia, spring lig, post tib

131
Q

Abnormally high MLA

A

Pes cavus

132
Q

Associated with rearfoot varus

A

Pes cavus

133
Q

A pt with pes cavus is more vulnerable to ________________ associated with _____________

A

Stress fractures; increased rigidity

134
Q

In a lateral ankle sprain, the ___________ is most often the main lig affected

A

ATFL