Foot Joints Flashcards by Chelsea Musgrave

What are the 3 divisions of joints of the foot?

Hindfoot (Rearfoot)
Midfoot
Forefoot
* difficult to examine — because of strong structures with limited mobility

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What joints are in the Hindfoot (Rearfoot)?

Tibiofibular Joint
Talocrural Joint
Subtalar (Talocalcaneal) Joint

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Tibiofibular Joint
(Inferior/Distal)

Type: Fibrous/Syndesmosis
Support:
• Anterior Tibiofibular
• Posterior Tibiofibular
• Inferior Transverse Ligaments
• Interosseous Ligaments
Movement:
• small amount of spread during dorsiflexion
* fibula to move up/down during dorsiflexion + plantarflexion
Innervation:
• Deep Peroneal
• Tibial Nerves

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What occurs during Dorsiflexion at the ankle?

Fibula to move superiorly — putting stress on both inferior tibiofibular joint (ankle) + superior tibiofibular joint (knee)

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Talocrural (Ankle) Joint

Joint: Uniaxial - Modified Hinge
• Synovial Joint: Talus, Tibial Plafond, Medial Malleolus -Tibia, Lateral Malleolus - Fibula
• Articular Cartilage: compressed 30-40% in response to peak physiologic loads
Innervation
• Tibial Nerve
• Deep Peroneal Nerve
Purpose: Stability - DF

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What movements are the Talocrural Joint responsible for?

• Anterior/Posterior (DF/PF)
* Most Stable: DF due to joint congruency + ligamentous tension
DOF: 1 — DF/PF

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Talus

Shape: DF - wedged b/w malleoli = allowing little or no inversion/eversion
(provided natural stability to the ankle)
* wider anteriorly/posteriorly

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Tibiofibular Joint - Positions

Resting Position: PF
Closed Packed: Maximum DF
Capsular Pattern: Pain when joint is stressed

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Talocrural (Ankle) Joint - Positions

Resting Position: 10 degrees PF — midway b/w inversion/eversion
Closed Packed: Maximum DF
Capsular Pattern: PF/DF

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Subtalar Joint - Positions

Resting Position: midway b/w extremes of ROM
Closed Packed: Supination
Capsular Pattern: Limited ROM (Varus/Valgus)

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What ligaments support the Talocrural joint?

Medial Side:
• Deltoid
• Medial Collateral Ligament

Lateral Side
• Anterior Talofibular Ligament

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What are the 4 separate ligaments that are included within the deltoid/medial collateral ligament?

• Tibionavicular
• Tibiocalcaneal
• Anterior Tibiotalar
• Posterior Tibiotalar Ligament

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What movement does the tibionavicular, tibiocalcaneal, posterior tibiotalar ligaments resist?

Resist: Talar Abduction

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What movement does the anterior talofibular ligament support ?

Stability: against excessive inversion of talus

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What movement does the posterior talofibular ligament resist?

Resist:
• Ankle DF
• Adduction (Tilt)
• Medial Rotation
• Medial Translation - Talus

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What movements does the calcaneofibular ligament provide stability?

Stability: maximum inversion ankle and subtalar joints

What ligaments are the most commonly injured by a lateral inversion ankle sprain?

• Anterior talofibular ligament : requires lowest maximal load to result in failure of the lateral ligaments
* highest strain to failure of entire lateral group
• Calcaneofibular ligament

Subtalar (Talocalcaneal) Joint

Joint: Synovial Joint
* DOF: 3 —Gliding/Rotation
Normal Varus/Valgus ROM:
20-45 Degrees
Axis: angle 41 degrees inclined vertically from transverse plane
* 23 degrees medially from longitundinal reference of foot

What ligaments support the Subtalar (Talocalcaneal) Joint?

• Lateral Talocalcaneal
• Medial Talocalcaneal
• Interosseous Talocalcaneal — limit Eversion
• Cervical — limit Eversion

What occurs when there is injury (sprain/fracture) to the Subtalar Talocalcaneal Joint?

Subtalar/Talocrural Joint: hypomobile — talus has no muscles attaching to it
• Medial Rotation Leg: valgus (outward) movement of Calcaneus
• Lateral Rotation Leg: varus (inward) movement of Calcaneus

Midfoot (Midtarsal) Joint

Movement: allow only a minimal amount — allow significant movement to enable the foot to adapt to many positions w/o putting undue stress on joints

Chopart Joint

Midtarsal joints — b/w talus/calcaneus and navicular/cuboid

Midfoot (Midtarsal) Joint - Positions

Resting Position: midway b/w extremes ROM
Close Packed Position: Supination
Capsular Pattern: DF/PF, Adduction, Medial Rotation

Midfoot (Midtarsal) Joints

• Talocalcaneonavicular
• Cuneonavicular
• Cuboideonavicular
• Intercuneiform
• Cuneocuboid
• Calcaneocuboid

Talocalcaneonavicular Joint

Joint: Ball/Socket Synovial DOF: 3 Movement: Gliding/Rotation Closed Pack Position: Supination

What ligaments support the Talocalcaneonavicular Joint?

• Dorsal Talonavicular Ligament • Bifurcated Ligament • Plantar Calcaneonavicular (Spring) Ligament

Cuneonavicular Joint

Joint: Plane - Synovial Joint Close Packed Position: Supination Movements: Gliding/Rotation

Cuboideonavicular Joint

Joint: Fibrous Close Packed Position: Supination Movements: Slight Gliding/Rotation

Intercuneiform Joints

Joint: Plane - Synovial Joint Closed Pack Position: Supination Movements: Slight Gliding/Rotation

Cuneocuboid Joint

Joint: Plane - Synovial Joint Close Packed Position: Supination Movement: Slight Gliding/Rotation

Calcaneocuboid Joint

Joint: Saddle Shaped Closed Pack Position: Supination Movement: Gliding - conjunct rotation

What are the ligaments that support the calcaneocuboid joint?

• Bifurcated Ligament • Calcaneocuboid Ligament • Long Plantar Ligaments

Tarsometatarsal (Lisfranc) Joint

Joint: Plane - Synovial Joint Closed Packed Position: Supination Movements: Gliding

Tarsometatarsal Joint - Positions

Resting Position: midway b/w extremes of ROM Close Packed Position: Supination Capsular Pattern: None

Metatarsophalangeal Joint - Positions

Resting Position: 10 degree extension Close Packed Position: Full Extension Capsular Pattern: • Hallux (Big Toe): Extension/Flexion • 2-5th Toe: Variable

Interphalangeal Joint - Positions

Resting Position: Slight Flexion Close Pack Position: Full Extension Capsular Pattern: Flexion/Extension

Intermetatarsal Joint (4 Joints)

Joint: Plane-Synovial Fluid Close Packed Position: Supination Movement: Gliding

Metatarsophalangeal Joints (5 Joints)

Plane: Condyloid - Synovial Joint DOF: 2 Close Pack Position: Full Extension Capsular Pattern: Variable - lateral four joints and more limitation of extension/flexion for the hallux (big toe) Resting Position: 10 degrees of extension Movement: Flexion/Extension/

Interphalangeal Joints

Joint: Synovial Hinge Joints DOF : 1 Closed Pack Position: Full Extension Capsular Pattern: Flexion/Extension Resting Position: Distal/Proximal IP: Slight Flexion Movements: Flexion/Extension