Leg and ankle Flashcards
3 functions of lower leg, ankle and foot
Impact absorption and Adaptation to uneven surfaces
Propulsion: act like a flexible lever
Support: act like a rigid structure that holds up the entire body
medial ligament of the feet
tibiocalcaneus, tibionavicular, plantar calcanei-navicular, anterior tibionavicular, post tibiotalar,
lateral ligament of the feet
post talofibular, ant talofibular, calcaneofibular, interosseao talocalcaneao, dorsal calcaneocuboid
posterior ligament of the feet
post tibiofibular, posterior talofibular, deltoid ligament
anterior ligament of the feet
dorsal talonavicular, dorsal talar lig, bifurcate lig
what are the 3 joints of the hind foot + leg + mvt and ligament involve
Tibiofibular joint -> Ant and post tib-fib
Talocrural joint -> DF and PF
med\lat lig
Subtalar joint (Talocalcanean) -> Gliding\rotation
tibiofibular joint : resting position, closed pack position and capsular pattern
Resting position:Plantar flexion
Close packed position: max dorsiflexion
capsular pattern: pain when joint is stressed packed position:
talocrural ankle joint: resting position, closed pack positon, capsular pattern
Resting position: 10 plantar flexion, midway between inversion and eversion
Close packed position: Maximum dorsiflexion
capsular pattern: plantar flexion, dorsiflexion
subtalar joint: resting position, closed pack positon, capsular pattern
resting position: midway between extreme ROM
closed packed position: supination
caspular pattern: limited ROM valgus and varus
joint of mid foot
Talocalcaneonavicular
Cuneonavicular
Cuboideonavicular
Intercuneiform
Cuneocuboid
Calcaneocuboid
fonction of mid foot joint
All the joints work together to allow the foot to adapt to many positions, but individually, each joint has limited movement.
midtarsal joint: resting position, closed packed position, capsular pattern
resting position: Midway between extremes of range of motion (ROM)
Close packed position: Supination
Capsular pattern: Dorsiflexion, plantar flexion, adduction medial rotation
Forefoot joint
tarsometatarsal (lisfranc joint) , intermetatarsal, metatarsophalangeal
what is the first symptom someone with a lisfranc injury have ?
can’t do plantar flexion while weightbaring (calf raise)
what is the name of the injury occurring at the tarsometatarsal joint
lisfranc
tarsometatarsal joint: resting position, closed packed position, capsular pattern
RP: midway between extremest ROM
CPP: supination
CP: none
metatarsophalangeal joint: resting position, closed packed position, capsular pattern
RP: 10 extension
CPP: full extension
CP: big toe extension, flexion and second to fifth toe variable
interphalangeal joint:resting position, closed packed position, capsular pattern
RP: slight flexion
CPP: full extension
CP: flexion, extension
interphalangeal joint:resting position, closed packed position, capsular pattern
RP: slight flexion
CPP: full extension
CP: flexion, extension
what do we need to observe when assessing a foot injury (during walking)
open chain -> swing phase look to see if talus is fixed
closed chain -> stance phase look to see if talus adapt
what do we need to observe when assessing a foot injury (during walking)
open chain -> swing phase look to see if talus is fixed
closed chain -> stance phase look to see if talus adapt
how munch weight is taking by the heel when normally standing and how munch by the metatarsal head
50 to 60 and 40 to 60
what is the typical angle of the toe when standing
12 to 18 degree from sagittal axis of the body vs 5 in child
the medial longitudinal arch is support by what and form by what
form by Calcaneal tuberosity, talus, navicular, 3 cuneiforms, 1-3 MT
supporter by: tib. Ant. and Post. Flex. Digi. Long\brevis
Flex. Hallux long., Abd. Hallucis, plantar fascia, spring big
lateral longitudinal arch is form by and supported by
form by Calcaneus, cuboid, 4-5 metatarsal
supported by peroneus longus \ brevis \tertius, Abd dig. minimi, Flex. digi. Brevis, plantar fascia, long/short plantar
transverse arch is support and form by
form by: Navicular, cuneiforms, cuboid, and metatarsal bones
supported by: Tib. Post, Tib ant. , Peroneus longus ,Plantar fascia
what happened during single leg support if the glut min and med is weak
the pelvis will drag down and shift center of gravity
what is the normal gait
Heel contact in slight (Hip) LR with knee extended (up to 5° flex), foot is supinated
during the mid stance the foot move to a supinate or pronate position
pronate
during the push off the foot need to supinate or pronate
supinate
do to weakness in which muscle the hip drop during walking
glut med
due to weakness in which muscle the trunk stay in a extension position when walking
glut max
due to weakness in which muscle there’s a limitation in the push off phase
plantar flexor
ROM needed to descend and walking up stair
descend: full dorsiflexion
walk up; doors at 10o and 20 to 25o plantar flexion
which test is done in order to measure the ankle dorsiflexion
ankle lunge test
what are the active WB mat
A, Plantar flexion.
B, Dorsiflexion.
C, Supination.
D, Pronation.
E, Toe extension.
F, Toe flexion.
Active NWB met
A, Plantar flexion.
B, Dorsiflexion.
C, Supination.
D, Pronation.
E, Toe extension.
F, Toe flexion.
G, Toe abduction.
H, Toe adduction.
passive NWB met
Talocrural DF/PF
Subtalar In/Ev
lMid-Tarsal Ad/Abd
Toe F/E, Ad/Abd
resisted isometric met of lower leg, ankle, foot
A, Knee flexion. B, Dorsiflexion. C, Plantar flexion. D, Supination. E, Pronation. F, Toe extension.
what are the chronic special tests of lower leg
Neutral position of Talus (WB, NWB)
Fig
Leg-heel alignment
Tibial torsion
Feiss line
Leg length
“Too-many-toes
what are the acute special test
Drawer
Kleiger
Squeeze
what is test with ant drawer test
ant. talofibular ligament
what does kleiger test
tib fib ligament (high syndemsosis lig), deltoid lig
what test can we use to test a syndesmosis injury
distal tibiofibular compression test
what is test during talar tilt
laxity in medial and lateral lig
which test is testing arterial blood supply and consist of
burger’s
leg elevated 45, sit over edge positif is return of blood longer than 2 minutes
what does a lack of reflex in Achille can indicate
possible spine issue
which muscle do we test if we want to test reflex in lower leg
Achille and tib post
what is the name of the test for nerve
tinel’s sign
where does medial plantar nerve can get compresse or intrape
under spring lig (calauaneonavicualr lig)
where does post tibial nerve can get compress
under flexor retinaculum
where does deep perioneal nerve can get pinched
superior extensor retinaculum or inferior extensor retinaculum
where does lateral + medial branch of deep perineal nerve can get pinched
lat: extensor tendon
med: hallucis longus brevis tendon
which nerve can be pinched by the fascia in the foot
sup peroneal nerve
which nerve can be stretch during inversion
sural nerve, superficial peroneal
which mvt can stretch the sural nerve
inversion
where do we palpate in the Ottawa ankle rule
Posterior edge, tip of lat.Malleolus
Base of 5th
Posterior edge, tip of med. Malleolus
Navicular
