gross final Flashcards
sesamoid bone which is found imbedded in the lateral head of the origin of the gastrocnemius
fabella
Calcaneal Tendon Reflex tests for the segmental innervation of
S1 and S2
enters the plantar surface of the foot, it divides into the medial and lateral plantar nerves
Tibial Nerve
Tibial Nerve segmental innervation
L4-S3
unable to flex toes
Weakened plantar flexion
Weakened inversion of the foot
Damage to the Tibial Nerve
larger of the two terminal branches of the popliteal artery
as the vessel enters the plantar surface of the foot it divides into the medial and lateral plantar arteries
Posterior Tibial Artery
a condition in which there a narrowing or occlusion of the posterior tibial artery and/or its branches
Peripheral Arterial Disease (Intermittent Claudication)
the tibia and fibula are connected by two joints what are they?
superior and inferior tibiofibular joints
articulations of this joint are the head of the fibula with the fibular articular facet
classified as plane gliding joint
nerve supply is from the common fibular
Superior (Proximal) Tibiofibular Joint
Ligaments Associated with the Superior (Proximal) Tibiofibular Joint
Anterior and Posterior Tibiofibular
connects the shaft of the fibula and tibia
Interosseous Membrane
articulation of the joint is the fibular notch of the tibia and the lateral malleolar facet of the fibula
a synovial joint but a fibrous joint and classified as a syndesmosis
nerve supply to the joint comes from the deep fibular and tibial
Inferior (Distal) Tibiofibular
Ligaments Associated with the Inferior (Distal) Tibiofibular
Anterior and Posterior Tibiofibular
articulation associated with the joint are the distal end of the tibia, lateral malleolar fossa
of the fibula and the body of the talus
classified as ginglymus
nerve supply to the joint comes from the deep fibular and tibial nerves
ANKLE JOINT (TALOCRURAL)
Ligaments Associated with the ANKLE JOINT (TALOCRURAL)
Capsular Ligament
a very strong ligament which attaches proximally to the medial malleolus of the tibia it consists of four distinct portions 1. anterior tibiotalar 2. tibionavicular 3. tibiocalcaneal 4. posterior tibiotalar
Deltoid or Medial Ligament
on the lateral side of the joint are three distinct ligaments which all attach proximally to the lateral malleolus of the fibula the three distinct ligaments are the: 1. anterior talofibular 2. calcaneofibular 3. posterior talofibular
Lateral Ligaments
most vulnerable and commonly damaged ligament of the ankle joint
anterior talofibular
(calcaneofibular may also be damaged)
injury almost always occurs due to an inversion type of injury
this refers to a sprain at the inferior tibiofibular joint (syndesmosis)
these types of injuries are usually far more significant and severe than a classic ankle sprain and require a
greater period of rehabilitation
High Ankle Sprain
a fracture that occurs when the foot is forcibly everted (externally rotated)
- tearing of the deltoid ligament, which may lead to an avulsion fracture
of the medial malleolus - a fracture of the shaft of the fibula
- fracture of the lateral malleolus
Pott’s Fracture (Fracture Dislocation of the Ankle)
Function of the Foot
Supports body weight
Provides leverage for locomotion
Serves as a spring to absorb shock. ie. running and jumping
the function of the aponeurosis is to:
- hold the parts of the foot together
- help protect the plantar surface of the foot from injury
- help support the longitudinal arches of the foot
overuse injury that causes pain at the medial aspect of the calcaneus and along the medial longitudinal
arch
(first step pain)
Plantar Fascitis
known as Jogger’s Foot is a condition in which the tibial nerve and/or the medial plantar nerve are
compressed as they pass deep to the flexor retinaculum
Tarsal Tunnel Syndrome
this is used to test for L4, L5, S1 and S2
the lateral aspect of the plantar foot is stroked with a blunt object, beginning at the calcaneal tuberosity
(heel) and crossing toward digit one
the response of this reflex test is flexion of all the digits
Plantar Nerve Reflex
if the response from the plantar nerve reflex test is abnormal (positive), digits 2-5 will abduct and digit
one will extend
THE BABINSKI RESPONSE
could also be indicative of
brain injury
Babinski response is normal in infants,
a condition in which the plantar nerves are compressed between the heads of the metatarsals and the
transverse metatarsal ligaments
Morton’s Neuroma (Intermetatarsal or Interdigital Neuroma)
JOINTS OF THE FOOT
- subtalar (talocalcaneal)
- calcaneocuboid
- talonavicular
flexion and extension of the digits are associated with what joints
metatarsophalangeal and the interphalangeal
a very strong ligament which runs from the sustentaculum tali to the tuberosity of the navicular
it is the major support of the medial longitudinal arch, especially when downward forces of body weight
are applied to the talus bone
Plantar Calcaneonavicular Ligament (Spring Ligament)
runs from the plantar surface of the calcaneus to the cuboid and the base of the 3rd, 4th, and 5th
metatarsals
this ligament is also important in maintaining the medial longitudinal arch of the foot
Long Plantar Ligament
a foot deformity that is characterized by lateral deviation of the MP joint of digit one
in some individuals the deviation is so extreme that digit one may overlap digit two (inferiorly or
superiorly)
Hallux Valgus
usually caused by pressure of footwear and/or arthritis of the foot, but the condition can be congenital
common in females and the incidence increase with age
a common deformity of the 2nd and 3rd digits, which can be congenital or due to wearing poorly fitting
shoes
Hammer Toe
as its name indicates this condition is associated with playing sports on artificial grass surfaces
the condition is a hyperextension injury at the MP joint of digit one and is due to damage of the plantar
capsular ligament of the joint
Turf Toe
a structural foot deformity that is almost always present at birth
the talus bone is usually malformed and this leads to a shortening and contracture of muscles and
ligaments
Club Foot (Talipes Equinovarus)
the term used for a normal foot with normal arches
the footprint will show five digits plus the anterior and posterior part of the foot, with a narrow strip
joining them
the main load of the foot will be on the calcaneus
Pes Rectus
term used to designate a foot in which there in an inadequacy in the structures which maintain the medial
longitudinal arch and the arch becomes depressed and collapses
a flat appearance to the foot is normal before the age of two or three and is due to the large amounts of
subcutaneous adipose tissue in the plantar surface of the foot
as the child gets older and begins to walk, this fat is absorbed and the arch becomes normal
Pes Planus
in which the arch is lacking in weight bearing but appears normal in a foot which is not weight bearing
usually due to loose or degenerative ligaments
common in childhood
usually resolves with age, as the ligaments grow and mature
the condition occasionally persists into adulthood and may or may not be symptomatic
Flexible Flat Foot
lacks the arch even when non-weight bearing
usually due to bone deformities, such as fusion of adjacent tarsal bones
condition can be congenital or acquired
Rigid Flat Foot
is likely to be a secondary consequence of damage to a ligament (i.e. spring ligament) or atrophy of a
muscle (i.e. tibialis posterior)
common in older individuals due to weight gain or arthritis
Acquired Flat Foot (“fallen arches”)
a condition in which the medial longitudinal arch is unduly high
the term “clawfoot” is often used to describe this condition
most cases are due to muscle imbalance from a condition such as polio
Pes Cavus
when bending backward, the………………..and………………….. are brought into
action and prevent the body from falling backward
anterior hip, abdominal muscles
when bending forward, the……….,……………and……………… are brought into play
and prevent the body from falling forward
gluteal, hamstring and spinal muscles
the nerve supply to the Iliofemoral joint
femoral, obturator and sciatic nerves
it prevents abduction at the hip joint
it is extrinsic and acts like a rope
Pubofemoral
prevents hyperextension and abduction at the joint
it is extrinsic and acts like a rope
Ischiofemoral
an intrinsic ligament which is formed by the acetabular labrum as its bridges the acetabular notch
Transverse Acetabular Ligament
a weak intrinsic ligament which function mainly to conduct a blood vessel to the head of the femur
Capitis Femoris Ligament (Ligament of the Head of the Femur)
articulating surfaces of the tibial condyles are often referred to as
lateral and medial tibial
plateaus
nerve supply of the knee joint is supplied by the
femoral, obturator, common fibular and tibial nerves
forms a loose fibrous investment of the joint, completely surrounding it
there are a number of openings found in the anterior aspect of the capsular ligament, which allows the
synovial membrane to pass through and form several bursae, which are clinically significant
Capsular Ligament
lies between the patella and the skin
subcutaneous prepatellar
lies between the tibial tubercle and the skin
subcutaneous infrapatellar
which is found between the ligamentum patella and the
tibial tubercle
deep infrapatellar
lies between the femur and the common tendon of
insertion of the quadriceps
suprapatellar
this is the anterior ligament of the joint and represents the original distal common tendon of insertion of
the quadriceps
4
runs from the apex of the patella to the tibial tubercle
it plays an important role in maintaining the alignment of the patella relative to the articular surface of
the femur
Ligamentum Patella
these ligaments are taut when the joint is fully extended and thus contribute to stability when standing
Collateral Ligaments
located on the lateral side of the joint
is superficial and separate from the articular capsule of the joint
attaches from the lateral epicondyle of the femur (proximally) to the head of the fibula (distally)
it functions as a wall and prevent lateral movement (abduction) at the joint
Lateral (Fibular) Collateral
is located on the medial side of the joint
it blends with the articular capsule and is directly attached to the medial meniscus
it attaches to the medial epicondyle of the femur (proximally) and to the medial side of the tibia, just
below the medial condyle (distally)
it functions as a wall and prevents medial movement (adduction) at the joint
Medial (Tibial) Collateral
found on the posterior aspect of the joint
they both function as walls to prevent hyperextension of the joint
they also stabilize the posterior aspect of the joint
Oblique and Arcuate Popliteal
these are two very strong ligaments which cross each other like an “X” in the center of the joint
they are named anterior and posterior according to their tibial attachments
they are the main bonds between the femur and tibia
Cruciate Ligaments
