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POTH 225: BIOMECHANICS > lecture 6: biomecs of the foot and ankle > Flashcards

lecture 6: biomecs of the foot and ankle Flashcards

1
Q

what are th ebones of the lower leg

A

tibia
fibula

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2
Q

what two bones form the ankle mortise

A

tibia and fibula

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3
Q

the tibia and fibila create what projections at the ankle

A

medial and lateral malleolus

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4
Q

whta is the mortise

A

U shaped to allow the talus

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5
Q

wht bones of the foot make uo the hindfit

A

talus
calcaneus

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6
Q

what bones make up the midfootq

A

navicualr (medial), cuboid and cuneiform (3x)

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7
Q

what bones make up the forefoot

A

metarsal and phalanges

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8
Q

bulk of ankle motion causes at what part of the foot

A

hind foot

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9
Q

what sits in the mortise

A

hindfoot

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10
Q

what are the 3 joints of the ankle/foot

A

ankle (talocrural)
subtalar
distal tibiofibular (syndesmosis)

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11
Q

what are the bone articulations of the talocrural joint

A

tibia/fibula with talus

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12
Q

what are the bone articulations of the subtalar joint

A

talus with calcaenus

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13
Q

what are the bone articulations of the distal tibiofibular joint

A

tibia with fibula (stabilizing joint)

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14
Q

what is the foot motion in the sagital plane

A

dorsiflex/plantar flexion (sometimes called flexion/extension

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15
Q

what is the foot motion in the frontal plane

A

eversion/inversion

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16
Q

what is the foot motion in the transveres plane

A

abduction/adduction

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17
Q

true or false: eversion and inversion of the foot occurs in the transverse plane

A

false, frontal

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18
Q

eversion/inversion of the foot is sometimes called wjat

A

supination/pronation or aductoon./abdctuon

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19
Q

abduction/addiction is sometimes called wat

A

internal/external rotation or varus/valgus

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20
Q

true or false: the axis of movement in the foot do not line up with cardinal planes

A

true, therefore triplanar motion

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21
Q

what does it mean that the anle has triplanar motion

A

can move in all three planes at the same time

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22
Q

what is suppination a combo of

A

plantarflexion,
inversion
adduction

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23
Q

plantarflexion,
inversion
adduction

is associated with pronation or supination

A

supination

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24
Q

what is pronation a combo of

A

dorsiflex
eversion
abduction

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25
Q

dorsiflex
eversion
abduction

is assocaition with pronation or supination

A

pronation

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26
Q

supination is associated with a rigid or flexible foot

A

rigit

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27
Q

pronation is associated with a rigid or flexible foot

A

flexible

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28
Q

supination causes eleveation or lowering of the medial long arch

A

rigid foot
elevation of medial long arch

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29
Q

pronation causes eleveation or lowering of the medial long arch

A

lowering
flexible foot

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30
Q

true or false: tibia rotations are not coupled with foot movements

A

false

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31
Q

tibia internal rotation is assocaited with foot pronation or supination

A

foot pronation (eversion and abduction)

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32
Q

tibia external rotation is assocaited with foot pronation or supination

A

supination (inversion, adduction)

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33
Q

why is it importance that the tibia rotation are coupled with foot movements

A

helps transmit force effectively (even dispersion of forces)

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34
Q

what type of joint is the ankle/ talocrural joint

A

hinge

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35
Q

how many degrees of freedom in the talocrural joint

A

1 or 6 (because triplanar)

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36
Q

what is the movement at the talocrural joint

A

dorsiflexion
plantarflexion

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37
Q

what is the axis of the talocrural joint

A

axis runs (from medial side) lateral, inferior and ppsterior
might move during movement

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38
Q

area of contact in the talocrural joint increases or decreases with incrasing force and why

A

area of contact increases with increasing force (helps distribute stress)

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39
Q

in dorsi flexion, the contact area moves anterior and the tibia translates BLANK wrt to talus

A

anterior

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40
Q

in dorsi flexion, the contact area moves anterior and the talus translates BLANK wrt to tibia

A

posterior

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41
Q

in plantar flexion, the contact area moves posterior and the tibia translates BLANK wrt to talus

A

posterior

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42
Q

in plantar flexion, the contact area moves posterior and the talus translates BLANK wrt to tibia

A

anterior

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43
Q

subtalar joint invovles what two bones

A

talus and calcaneous

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44
Q

what is the function of the subtalar joint

A

translate motion between foot and tibia (walk on uneven ground, pivot)

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45
Q

what type of joint is the subtalar joint

A

hinge (mitered) or multi axial ???

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46
Q

what is the axis of the subtail joint

A

from medial side, runs lateral posterior and inferior

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47
Q

what are the movements possible at the subtalar joint

A

inversion/eversion
abduction/adduction

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48
Q

how does oatis 2009 describe the subtalar joint

A

hinge or mitered hintge

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49
Q

how does maceira 2015 describe subtalar joint

A

anterior/middle = ovoid/bean or two seperate
posterior = talus is concave, calcaneous convex
anterior - talus is convex, calcaneous is concave

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50
Q

how does jastifier 2014 describe the subtalar joint

A

posterior - talus is concave, calcaenous convex
anterior - talus is convex, calcenous is concave

mitered hinge

can not be described AS A SIMPLE MACHIEN

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51
Q

whst is the max range for dorsiflexion

A

10-20

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52
Q

whst is the max range for plantarflex

A

35-55

53
Q

whst is the max range for inversion (with adduction)

A

20-30

54
Q

whst is the max range for eversion (with abduction)

A

4-28

55
Q

how do midfoot and forefoot contribute to the entire motion

A

contribute to the entire motion of the foot in all planes

56
Q

understand the sagital angle ankle graph

A

.

57
Q

does the ankle start in dorsiflexion or plantar and why

A

dorsi flexion to clear the ground

58
Q

why does the sagital angle get closer to plantar flexion from 0-20 degrres

A

starts in dorsiflexion to clear the ground but becomes more plantar for full ground contact

59
Q

why does the foot dorsi angle increase from 20-50 degrres

A

foot is fixed in closed chain dorsiflexion

60
Q

why is there a steep decrease in dorsi (incrase in planar flexion) from 40-60

A

pushing off (toe off) to start the swing phase

61
Q

why does dorsiflexion incrase after toe off

A

dorsi flexo to clear foot and prepare for ground cotnact

62
Q

understanf the frontal angle graph for the anklr

A

.

63
Q

why does eversion (with pronation) icnrease during increased ground contact

A

want more pronation (flexible foot) when youre hitting the grounf to absorpt shock

64
Q

as you get closer yo toe off, do you want more inversion or eversion

A

more inversion (and supination) for a rigid foot to propel forward

65
Q

where is there greatest pressure points on the foot

A

heel and ball of foot
greatest pressure on the 2nd metatarsal

66
Q

true ro false, greates pressure on 1st metatarsal

A

false, second

67
Q

what is the function of lateral colalteral lig

A

resist inversion/varus stress

68
Q

what is the function of the medial collateral lig (deltoid)

A

resist eversion/valgus stress

69
Q

true or false: lateral collateral lig strain is more commen

A

true

70
Q

true or false: medial collateral lig protects against inversion/varus stress

A

false, eversion and valgus

71
Q

what are the components of the medial longitudinal arch

A

calcaneous, talus, navicular, medial cuneiform and 1st metatarsal

72
Q

what are the compoents of the lateral long arch

A

calcanous, cuboid and 5th metatarsal

73
Q

what are the compoents of teh tranverse arch

A

cuboid, cuneiforms and metarsals

74
Q

what are the 3 functions of the foot arches

A

protect nerves, vessels, and muscles on plantar surface
absrob shock
release stored energy

75
Q

what gives support to the arches

A

boney shape
ligaments
msucles
plantar fasica

76
Q

why does arch height decrease from 0-50% of gait cycle

A

arch length dropping goes with pronation
allows for shock absorption (during ground contact)

77
Q

why does arch height increase from 60% of gait cycle

A

arch length increases, more supination and a rigid foot needed for propulsion

78
Q

what is a high medial long arch called

A

pes cavus

79
Q

what is a flat foot, low med long arch called

A

pes planus

80
Q

what is pes cavus

A

high medial long arch

81
Q

what is pes planus

A

flat foot, low med long arch

82
Q

what is the issue with pes cavus (hgih med long arch)

A

rigid foot
less able to absorb shock

83
Q

you are less able to absoprt shock with pes planus or cavus

A

cavus

84
Q

what is the issue with pes planus (flat foot, low med long arch)

A

mobile foot, more able to attenuate shock but higher demand of soft tissue to support arch

85
Q

with pes cavus where are the highest peak pressures

A

higher peak pressure on the 1st, 4th and 5th metarsal and lateral heel

86
Q

true or false: in pes cavus there is higher peak pressure on the 1st, 2nnd and 5th metarsal and lateral heel

A

false, not second, but 4th

87
Q

with pes planus, where is there higher peak pressure

A

higher peak pressures on hallux and 2nd toe

88
Q

according to oatis, is there a clear injury pattern based on foot type

A

no

89
Q

according to menz et al, pes planus or cavus is assocaited with arch pain

A

pes planus

90
Q

according to dixon 2019, military recreuits with high arch had what injuries

A

assocaited with 2nd metatarsal stress fractures

91
Q

according to williams and el, in runners iwth a high arch, what are common injuries

A

stress fracture 5th metatarsal, increased boney injurie

92
Q

according to williams and el, in runners iwth a low arch, what are common injuries

A

more soft tissue injuries (tendinitus) stress fractures in 2 or 3 metatarsal

93
Q

according to the vertical GRF and % stance graph, those with a high arch looked like what in the graph

A

higher arch have greater load/GRF (less ability to absorb shock)

94
Q

according to the vertical GRF and % stance graph, what was the corrleation with rate = force/time

A

lower arch people have lower GRF and lower loading rate

95
Q

where does the plantar fascia attache

A

attaches from calcaneous tuberosity to metatarsal, phalanges and ligaments

96
Q

plantar fascia may be stretched with low or high arch

A

low arch

97
Q

plantar fasica has great BLANK stress

A

tensile

98
Q

what is the function of the plantar fascia

A

arch support
windlass effect

99
Q

what is the windlass effect

A

supinated (rigid) foot during push off

1st toe (big) extends and streches the plantar fascia
plantar fascia supportsd arch (passive stability)

100
Q

wht is plantar fascitis

A

inflammation where plantar fascia attaches to the calcaneous

101
Q

what are the symptoms of plantar fasicits

A

pain in the medial heel
worse in morning, first few steps

102
Q

wht are the risk factors for plantar fascitis

A

non athletes: body mass index?, arch height?

athletes: lower med long arch (increased stress on plantar fascia)

103
Q

motion control shoes are used for what type of arch

A

low arch (pronated)

104
Q

low arches are pronated or supianted

A

pronated

105
Q

in a motion control show, is there stiffer or more flexible material in sole

A

stiffer

106
Q

what is medial posting in motion control sjoes

A

denser material to prevent pronation

107
Q

cushion shoes are for high or low arch

A

high arch (supinated)

108
Q

high arches are supinated or pronated

A

supinated

109
Q

in cushion shoes, are there stiffer or flexible soles

A

more flexible

110
Q

do cushion does have medial posting

A

no

111
Q

what were the results of the study between motion control vs cushion shoes

A

motion control sjoes prevented injury but more in runners with pronated feet

112
Q

what type of foot strike is recommended for running

A

forefoot strike running is recommended

113
Q

what is the problem with rearfoot strike during running

A

increase in loads/rate of loading
lead to more injuries

114
Q

why is rear foot strike not recommeded for running

A

increases the vertical GRF faster than midfoot

115
Q

what do minimalist shoes allow

A

allow foot to absorb loads, not the shoes

116
Q

what is the hypothesis for minilist shoes

A

encourage midfoot landing which reduces ground reaction force compared to tradiotional shoes

117
Q

why is there controversy if minimalist shoes decrease injury

A

increase in injury and or pain with minimalist footwear for new users
(same training but removing what your body is used to)

118
Q

true or false: minimalist shoes showed no difference in ankle hip and knee angles and moments

A

true

119
Q

there is an icnrease in vertical loading rate with minimalist shoes in novice or pro users

A

novice

120
Q

what muscles form the achilles tendon

A

gastroc and soleus (plantarflexors)

121
Q

true or false, the achilies tendon has a large plantar flexion moment

A

yes there is an icnreased leverage because of the calcaneous

122
Q

when does the achilies tend to rupture more and why

A

more frequent in middle aged
=less active, decreased blood flow, increased stiffness, decreased collagen strength

123
Q

what is the strongest dorsiflexor

A

tibialis anterior

124
Q

what are the dorsiflexors supplied by

A

deep peroneal nerve

125
Q

weakness in tib ant leads to what

A

foot drop (need dorsiflex to prevent tripping over foot)

126
Q

how can you get foot drop

A

damage to peroneal nerve (fibular fracture surgery)

central nervous condition (ex: stroke)

127
Q

what is the treatment for foot drop

A

ankle foot orthosis
electrical muscle stim

128
Q

understand the stroke graph about the sagital ankle angle

A

POTH 225: BIOMECHANICS (15 decks)

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