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Intro to Biomechanics > Functional Joints of the Foot (Part 1) > Flashcards

Functional Joints of the Foot (Part 1) Flashcards

1
Q

Prime directives of foot function

A
  • Must get flat on the ground

- Must become a rigid lever

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2
Q

Foot flat on the ground acts as

A
  • Mobile adaptor
  • Shock absorber
  • Accomplished with pronation
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3
Q

Foot becomes a rigid lever with

A
  • Resupination
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4
Q

Ankle joint characteristics

A
  • One of the most stable joints
  • The Ankle Mortise
  • Hinge joint
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5
Q

Ankle joint axis

A
  • Passes through two points just inferior to malleoli
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6
Q

Ankle as a hinge joint

A
  • “ginglymus”

- Allow flexion and extension in one plane

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7
Q

Ankle joint structures

A
  • Tibial plafond
  • Fibula
  • Talus
  • Ankle joint syndesmosis
  • Collateral ligaments
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8
Q

Ankle joint syndesmosis

A
  • Anterior/posterior tibial-fibular ligament

- Interosseous ligament

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9
Q

Tibial plafond inferior surface

A
  • Smooth articulation with talus
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10
Q

Tibial plafond anterior surface

A
  • Covered with extensor tendons and ankle joint capsule
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11
Q

Tibial plafond posterior surface

A
  • Groove for posterior tibialis muscle
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12
Q

Tibial plafond lateral surface

A
  • Fibular notch

- Attachment for interosseous membrane

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13
Q

Tibial plafond medial surface

A
  • Medial malleolus

- Anterior colliculus

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14
Q

Fibular notch

A
  • Location of tibiofibular joint

- Tibial plafond component

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15
Q

Distal fibula

A
  • Forms the lateral malleolus
  • Provides attachments for collateral ligaments
  • Not a weight bearing bone
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16
Q

Ankle joint mortise

A
  • Strong syndesmosis
  • Distal projection of malleoli
  • Collateral ankle joint ligaments
  • Dynamic approximation
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17
Q

Strong syndesmosis of ankle joint mortise

A
  • Prevents “spreading”

- Extra-articular stability

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18
Q

Distal projection of malleoli on ankle joint mortise

A
  • Intra-articular stability

- Prevent rotation

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19
Q

Dynamic approximation of ankle joint mortise

A
  • Posterior tibialis

- Support at foot strike thru midstance

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20
Q

Ankle mortise ligaments

A
  • Anterior tibial fibular ligament
  • Posterior tibial fibular ligament
  • Transverse ligament
  • Interosseous ligament
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21
Q

Transverse ligament (ankle mortise)

A
  • Some consider it a distal portion of the posterior tib-fib lig
  • Deepens the posterior distal rim of the tibia
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22
Q

Interosseous ligament (ankle mortise)

A
  • Progresses proximally into the syndesmotic membrane
  • Acts as a “spring” allowing slight malleolar separation
  • Continous with the tib-fib ligaments
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23
Q

Talar trochlea

A
  • 3 articular facets
  • Surface convex
  • Slight concavity medially
  • Wider anteriorly
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24
Q

Medial articular surface of talus

A
  • Articulation with tibia

- Tear drop shaped

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25
Q

Lateral articular surface of talus

A
  • Articulation with fibula

- Triangular shaped

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26
Q

Lateral collateral ligaments (3 distinct bands)

A
  • Anterior Talofibular
  • Calcaneofibular
  • Posterior Talofibular
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27
Q

Anterior talofibular ligament attachments

A
  • Anterior inferior border of the lateral malleolus

- Insert onto talar body

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28
Q

Anterior talofibular ligament

A
  • Primary collateral when foot is plantarflexed and inverted
  • Most commonly ruptured
  • Positive anterior drawer sign
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29
Q

Calcaneofibular ligament attachments

A
  • From anterior border of malleolus

- Courses slightly posterior and inferior to insert deep to the peroneal tendon sheaths

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30
Q

Calcaneofibular ligament support

A
  • Extracapsular

- Supports both AJ and STJ

31
Q

Calcaneofibular ligament

A
  • Primary collateral when foot is in dorsiflexed position
32
Q

Posterior talofibular ligament

A
  • Very strong ligament
  • Runs nearly horizontal
  • Rarely injured
33
Q

Posterior talofibular ligament attachments

A
  • Inserts on lateral tubercle of posterior aspect of talus
34
Q

Ankle sprain types

A
  • Inversion-plantarflexion
  • Inversion-dorsiflexion
  • High ankle sprains
35
Q

Inversion-plantarflexion ankle sprain

A
  • Most common

- Anterior talo-fibular ligament

36
Q

Inversion-dorsiflexion ankle sprain

A
  • Calcaneal-fibular ligament

- Evaluate cervical and interosseous ligament of subtalar joint

37
Q

High ankle sprains

A
  • Involve syndesmosis

- Uncommon

38
Q

Angular relationship of lateral collaterals

A
  • In plantarflexion, ATF closely parallels fibula

- CFL- ATFL = 112 +/- 14 degrees on the right

39
Q

Anterior drawer sign

A
  • Assesses stability of the ATF
  • Must compare to the contralateral limb
  • May not be reliable with acute injury due to edema
40
Q

Positive clinical findings of anterior drawer test (ruptured ATF)

A
  • Performed with ankle in 10-20 degrees plantarflexion

- Anterior displacement of talus relative to tibial plafond

41
Q

Talar tilt

A
  • Inversion-stress test
  • Compare to contralateral limb
  • More than 10 degrees significant
    Subtalar tilt
  • Evaluates calcaneofibular ligament
42
Q

Medial collateral ankle ligaments

A
  • Deltoid ligament

- Superficial and deep layers

43
Q

Superficial medial collateral ligaments

A
  • Tibio-navicular (anterior) slip
  • Calcaneo-tibial (central) slip
  • Posterior talo-tibial (posterior) slip
44
Q

Deep medial collateral ligaments

A
  • Anterior talo-tibal (anterior deep) slip

- Posterior talo-tibial (posterior deep) slip

45
Q

Ankle ligaments retinaculum

A
  • Superior Extensor
  • Inferior Extensor
  • Flexor
  • Peroneal
46
Q

Ankle joint axis

A
  • 8° from transverse plane

- 15° from frontal plane

47
Q

Ankle joint movement

A
  • Primarily sagittal plane

- Dorsiflexion/Plantarflexion

48
Q

Ankle joint neutral position

A
  • 90° to lower leg
49
Q

Ankle joint range of motion

A
  • 10° dorsiflexion

- 20° plantarflexion

50
Q

Subtalar joint characteristics

A
  • Classically described as a hinge joint
  • May be some screw-like motion as well
  • Pronatory/Supinatory axis
  • Dictates movement of the rearfoot (influences position of forefoot)
51
Q

Subtalar joint anatomy

A
  • Articulation between talus and calcaneus

- 3 articular facets (posterior, middle, anterior)

52
Q

Subtalar joint posterior facet

A
  • Largest facet
  • Has its own joint capsule
  • Convex on calcaneal side
  • Concave on talar side
53
Q

Higher calcaneal inclination angle in relation to posterior facet of subtalar joint

A
  • Higher calcaneal inclination angle = more horizontal posterior facet
54
Q

Average calcaneal inclination angle

55
Q

Lower calcaneal inclination angle in relation to posterior facet of subtalar joint

A
  • Lower calcaneal inclination angle = more vertical posterior facet
56
Q

Subtalar joint middle facet

A
  • Between sustentaculum tali and inferior talar neck
  • Concave on calcaneal side
  • Convex on talar side
57
Q

Subtalar joint anterior facet

A
  • Anterior and lateral to middle facet

- Continuous with middle facet in ~2/3 of population

58
Q

Ligaments of the subtalar joint (cruciate ligaments of the foot)

A
  • Cervical ligament

- Interosseous talocalcaneal ligament

59
Q

Cruciate ligaments of the foot function

A
  • Provide primary stability to the subtalar joint

- Rupture may result in subtalar joint dislocation

60
Q

Cervical ligament

A
  • Strongest ligament connecting the talus and calcaneus

- Roughly parallel to the calcaneofibular ligament

61
Q

Cervical ligament attachments

A
  • Runs from the medial aspect of the sulcus calcanei
  • Courses obliquely superior, anterior and medial
  • Inserts onto the talar neck
62
Q

Interosseous talocalcaneal ligament

A
  • Arises from sulcus calcanei close to the capsule of the posterior talocalcaneal joint
  • Fibers run obliquely upward and medially to insert onto the sulcus tali
63
Q

Subtalar joint axis

A
  • 16° from sagittal plane

- 42° from transverse plane

64
Q

Subtalar joint movement

A
  • Pronation/supination
65
Q

Subtalar joint neutral position

A
  • 2/3 range of motion – inversion
  • 1/3 range of motion – eversion
  • Ideally perpendicular to the ground
66
Q

Subtalar joint total range of motion

67
Q

Direction of subtalar joint axis

A
  • Runs MAD
  • From… Lateral, posterior and proximal aspect of the heel
  • To… Medial, anterior, distal
  • Exits foot at the dorsal medial aspect of the talar neck
68
Q

Subtalar joint range of motion measurement

A
  • Measurement taken in relation to bisection of the posterior aspect of calcaneus
69
Q

Normal values of subtalar joint range of motion

A
  • 30° total range of motion
  • 2/3 inversion: 1/3 eversion
  • Basis of calculation of subtalar joint neutral position
70
Q

Pronation of STJ in OKC

A
  • With reference to the talus:
  • Dorsiflexion
  • Eversion
  • Abduction
71
Q

Supination of STJ in OKC

A
  • With reference to the talus:
  • Plantarflexion
  • Inversion
  • Adduction
72
Q

Open kinetic chain subtalar joint motion

A
  • DorsEvAb (pronation mnemonic)
  • No axial load
  • Distal segment free to move upon fixed proximal segment
73
Q

Pronation of STJ in CKC

A
  • Distal segment is fixed
  • Plantarflexion of talus
  • Adduction of talus
  • Eversion of calcaneus
74
Q

Supination of STJ in CKC

A
  • Distal segment is fixed
  • Dorsiflexion of talus
  • Abduction of talus
  • Inversion of calcaneus

Intro to Biomechanics (8 decks)

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