KINES: Ankle and Foot Flashcards
how many bones make up the ankle and foot complex
28 bones
tibia, fibula
talus, calcaneus, cuboid, navicular, 3 cuneiforms
5 MTT, 14 phalanges
how many joints in one extremity
25 joints
aka the forgotten joint
proximal TF joint
type of joint of superior TF joint
plane synovial
significance of superior TF joint to knee pain
malalignments in this joint can lead to chronic knee pain
type of joint of inferior TF joint
syndesmosis - only allows small movement bcs connected by fibrous tissue
what forms the hindfoot
fibula. tibia, talus and calcaneus
what forms the midfoot
tarsal bones
what forms the forefoot
MTT and phalanges
what makes up the talocrural jont
distal tibia and fibula and talar bone
type of joint of talocrural jont
hinge - dflex and pflex
CPP of talocrural jont
full dflex
OPP of talocrural jont
10 deg pflex midway eversion/inversion
what is the ankle mortis
distal tibia and fibula - lateral and medial malleoli
sa talocrural joint toh
proximal aspect of body of talus
trochlea
3 articular surfaces of talus
large lateral facet - fibula
small medial facet tibia
dome - superior facet for tibia
what is the fick’s angle
in normal angle naka toe out bcs of tibial ER
what is the cause of fick’s angle
lateral malleolus is more distal and posterior kaya mapapa ER yung orientation ng tibia
normal value of fick’s angle
12-18 degrees
normal value of fick’s angle in children
5 degrees
assessment for fick’s angle
look at posterior view - dpat 3 toes lng kita
more than 3 = + excessive ER of tibia
what is the talocrural axis
oblique orientation of talocrural joint - kaya 3 planes ang dflex and pflex
value for talocrural axis
14 deg
cause of talocrural axis
kase mas mababa lateral malleoli or tibia kaya oblique if cconnect medial to lateral malleoli
coupled movement of talocrural in non WB
DF w eversion
PF w inversion
coupled movement of talocrural in WB
DF w inversion and IR
PF w eversion and ER
DOF of talocrural joint
DF/PF - 1
what is subtalar joint
betw talus and calcaneus
type joint of subtalar
plane - inversion/eversion - but complex
what makes the subtalar joint complex
large posterior articulation = concave talus and convex calcaneus
small anterior articulation = 2 convex facets of talus and calcaneus
what is the sinus tarsi
houses the proprioceptive center sa lateral subtalar joint - reccuring inversion/eversion injury = diminished proprioceptive ability
what is tarsal canal
on lateral of foot; funnel shaped
large end of sinus tarsi
anterior to lat malleolus
small end of sinus tarsi
below medial malleolus
what is the sustentaculum tali
bony prominence palpable close to smaller end or sinus tarsi - landmark
what makes up the transverse tarsal joint
calcaneocuboid joint and talonavicular joint
function of transverse tarsal joint
S shaped - abd and add of forefoot
what is the oblique axis of tranverse tarsal joint
from navicular tub to center of calcaneus oblique sha = motions occur in 3 planes
composite motions of transverse tarsal in non WB
supination - calcaneal adduction, inversion and pflex
pronation - calcaneal abduction, eversion and dflex
composite motions of transverse tarsal in WB
supination - calcaneal inversion; talar abd and dflex and tibiofibular ER
pronation - calcaneal eversion, talar add and pflex and tibiofibular IR
what forms the tasrometatarsal joint
tarsals, cuboid and 3 cuneiforms and base of MTT
articulation of 1st TMT
medial cuneiform
articulation of 2nd and 3rd TMT
middle cuneiform and lateral cuneiform
articulation of 4th and 5th TMT
cuboid
significance of tasrometatarsal joint
if may problem sa WB supination and pronation the TMT will adapt through twisting movements
supination and pronation twist
explain supination twist
as hindfoot pronates - medial arch will flat and dflex of rays so para ma maintain yung contact magg iinvert or supination tiwst to compensate the flast arch
explain pronation twist
hindfoot supinates - medial arch will be greater 1st and 2nd ray pflex 4th and 5th ray dflex
to maintain contact foot goes eversion or pronation twist to compensate
type of joint of MTP joint
condyloid - convex MTT and concave phalanges
what is index plus
1st MTT longer than the rest
what is index minus
aka mortons foot - second MTT longer than rest
prone to stress fracture
what is index plus-minus
1st and 2nd MTT equal in length
DOF of MTP joint
2 - flex/ex, abd/add
what is metatarsal break
MTP extends during walking to propel forward
what is hallux rigidus
interferes w metatarsal break bcs not much ext happens
what is hammer toe
excess ext of MTP tas flex IP joints
di nmn na aaffect metatarsal break but pressure of MT heads result to skin breakbown
ligaments that get injured in high ankle sprain
crural tibiofibular interosseous
anterior and posterior tibiofibular
tibiofubular interosseous
3 band of LCL
ATFL
PTFL
CFL
mechanism of injury for ATFL
inversion pflex
mechanism of injury for PTFL
dflex eversion
mechanism of injury for CFL
inversion on neutral; sometimes in minimal dflex
weakest among LCL
ATFL and PTFL is rarely torn
ligaments of MCL
deltoid ligament
anterior and posterior tibiotalar
calcaneotibial
tibionavicular
function of MCL
restrict eversion or valgus force
between LCL and MCL what is stronger
MCL due to number of bands and close fibers
describe stability of subtalar joint
relies mroe on bone config pero may lateral ligs naman
lateral ligs of subtalar joint
calcaneofibular
lateral talocalcaneal
cervical
interosseous talocalcaneal
strongest of the lateral ligs of subtalar joint
cervical
main passive stabilizer of medial longitudinal arch
spring or plantar calcaneonavicular ligament
lig of talonavicular joint
spring or plantar calcaneonavicular ligament
lig of calcaneocuboid joint
calcaneocuboid ligament - lateral
dosral calcaneocuboid - dorsal
plantar calcaneocuboid - plantar
long plantar - plantar and lateral arch
anterior compartment muscles
tib anterior
extensor digitorum longus and hallucis
peroneus tertius
posterior compartment muscles - spuerficial
gastrocs and soleus - triceps surae
plantaris
posterior compartment muscles - deep
flexor digitorum longus and hallucis longus
tib post
lateral compartment muscles
peroneus longus and brevis
dorsal compartment muscles
extensor digitorum brevis
plantar compartment muscles - spuerficial
abd hallucis and digiti minimi
flexor digitorum brevis
plantar compartment muscles - second
lumbrical and quadratus plantae
plantar compartment muscles - third
flexor hallucis brevis and digit minimi
add hallucis
plantar compartment muscles - deepest
interossei - 4 dorsal and 3 plantar
function of arches in WB
adapts to surfaces and makes foot more rigid for weight distribition
key stone of medial arch
talus
dynamic support of medial arch
extrinsic and intrinsic muscles
passive support of medial arch
spring, interosseous talocalcaneal, deltoid, plantar
keystone of lateral arch
cuboid
passive support of lateral arch
long and short plantar
support of transverse arch
deep transverse MTT
keystone of transverse arch
middle cuneiform
what is plantar aponeurosis
from medial tub of calc to proximal phalanx of each toe
importance of plantar apo
keeps integrity or arches bcs of tension
what is windlass effect
tension of plantar fascia due to MTP hyper ex - draws hindfoot and MT together - raises arch
benificial during push off when plantar fascia is taut also stretches achilles = stretch reflex of gastroc - more efficient propel forward
relate pes planus of windlass effect
limits MTP ext - dec windlass and lenthened plantar fascia
what is plantar fasciatis
common in flat foot
inflammation of plantar fascia usually during 1st step in morning - sa calc or medial arch
what is trabecular system
100% of weight from leg is recieved by talus
talus - calc - mid and forefoot
pressure in quiet stance is distributed equally to the hindfoot and forefoot - wlaking and running more pressure
