Lecture 10 - Midtarsal & Ankle Joints Flashcards

1
Q

Which joints make up the Midtarsal Joint?

What are it’s 2 axes?

A

Talonavicular & Calcaneocuboid joint

Function via 2 axes: longitudinal & oblique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the anatomical structure of Midtarsal joint

A

TN joint: ball & socket more motion

CC joint: saddle shaped, provides stability to lateral column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List ligaments of MTJ

A
  1. plantar calcaneocuboid
  2. long plantar
  3. calcaneonavicular (spring)
  4. bifurcate ligaments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the MTJ axes of motion

A

Longitudinal Axis = 9° from SP, 15° from TP (average motions)
- Mostly frontal plane motion
- Absorbs rearfoot rotation, generally functions opposite to STJ; LA pronates when STJ supinates
- 10° of motion
• Oblique Axis = 57° from SP & 52° from

TP (average motions)

  • 10° motion
  • Mostly sagittal plane & transverse plane motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List relationship of the STJ to MTJ

A

Elftman described interrelationship of MTJ axes;

  • When parallel (to eachother) have maximal motion (pronation)
  • When convergent have less motion (supination)

STJ pronation increases MTJ motion = foot flexible (unlocks foot)

STJ supination decreases MTJ motion = foot rigid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In ‘Normal’ foot, fully pronated MTJ at both axes does what?

A

Locks forefoot on rearfoot, with the plantar surface of Ffoot parallel // to Rfoot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Traditional Thinking/ Theory of MTJ?

A

ROM impossible to measure clinically

Categorise into normal, hypermobile or restricted (subjective to clinician)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Recent MTJ research indicates?

A
  • Calcaneocuboid & Talonavicular joints should be classifies as separate joints
  • Axes continually moving in gait, average motion similar to averages reported
  • Motion between cuboid & navicular could be significant
  • STJ, CC & TN cannot be separated functionally
  • Single axis of motion may be more kinematically sound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which structures for the ankle joint?

A

Articulation between talus, distal tibia & fibula form ‘ankle mortice’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List medial ligaments of ankle joint

A

Deltoid (tibionavicular, tibiospring & deep posterior tibiotalar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List lateral ligaments of the ankle joint

A

Anterior & posterior talo-fib & calcaneo-fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Axis of motion of AJ?

A

8° from FP & 15° from TP

Axis moves during gait like wobbly axle on a wheel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Action of AJ?

A

Plantarflexion/ Dorsiflexion with small adduction & abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Minimum AJ ROM required for gait?

A

10° dorsiflexion & 20° plantarflexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List motion of AJ in gait

A
  • Heel contact
  • Starts to PF from a 5° DF position to 10° PF position midway through contact. From here it DF
  • Midstance
  • At start of midstance, AJ is 5° PF & DF until 10° DF at end of phase
  • Propulsion
  • As heel lifts, PF occurs until 20° PF at toe off
  • Swing phase
  • Rapid DF to a 5° DF position to allow for foot clearance in swing phase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly