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EPHE 355 > Leg, Ankle, Foot > Flashcards

Leg, Ankle, Foot Flashcards

1
Q

how many bones in teh foot

A

26

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2
Q

how much for body weight does tibia bear

A

90%

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3
Q

fibula bears how much body weight

A

10%

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4
Q

which side of Talocrural joint how more bony support and which has more ligamentous support

A 
lateral = bony 
medial = ligementous
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5
Q

what bones made the rear foot

A

calcaneus, talus

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6
Q

what bones make the mid foot

A

tarsals: cuboid, cuneiforms (3), navicular

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7
Q

what bones Make the forefoot

A

metatarsals and phalanges

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8
Q

what bones made the lateral longitudinal arch

A

teh calcaneus, talus, cuboid,, 4th and 5th metatarsals

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9
Q

what bones makes the medial longitudinal arch

A

the calcaneus, talus, navicular, cuneiforms, and 1st, 2nd and 3rd metatarsals

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10
Q

where is teh transverse arch (proximal)

A

medio - lateral under cuboid and cunieforms

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11
Q

where is the distal transverse arch

A

medio-lateral under the middle of the metatarsals

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12
Q

three main parts of talus and do muscles attach?

A

no muscles attached

head, neck, body

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13
Q

what does the talus articulate with (3 articular surfaces of talus)

A

inferiorly: three facets of calcaneus
anteriorly: navicular
medial and lateral: medial and lateral malleoli of tib / fib

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14
Q

function of talus for force transmission

A

translate horizontal to vertical and vertical to horizontal

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15
Q

how to palpate talar dome

A

just distal to tip/fib articulation

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16
Q

what is the sinus tarsi

A

tunnel between talus and calcaneus bones

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17
Q

what structures run through the groove in the posterior/medial aspect of the talus ?

A 
Tom Dick And Harry 
Tibialis posterior 
Flexor digitorum 
Artery, Nerve (tibial)
Flexor Hallucis Longus
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18
Q

what structure is located on bottom of calcaneus for shock absorption

A

fat pad

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19
Q

which cuneiform articular which which metatarsals

A

lateral - 3rd
intermediate - 2nd
medial - 1st

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20
Q

what bone do cuneiforms sit on top of

A

navicular

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21
Q

what muscle passes through groove in inferior aspect of teh cuboid, what does this muscle do

A

Peroneus Longus, make a right turn and supports transverse arch

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22
Q

what does the cuboid articulate with

A

posterior: calcaneus
medially: lateral cuneiform
anteriorly: fourth and fifth metatarsals

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23
Q

which metatarsal has the least mobility

A

2nd

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24
Q

what inserts on the tuberosity at the base of teh 5th metatarsal and what is it called when this is broken off and how does that happen

A

peroneal brevis
jones fracture
ankel sprain is the cause

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25
Q

what is the function of the concave shape of the shafts of teh metatarsals

A

increased load absorption

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26
Q

what is the function of the sesamoid bones on teh posterior surface of teh 1st metatarsal ahead

A

increase moment arms for the flexor Hallucis Brevis

provide a guide for the the tendon of the flexor Hallucis Longus

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27
Q

how many phalanges in each toe

A

1st: 2

2-5: 3

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28
Q

what motion occurs at the Talocrural joint

A

plantar flexion and dorsi flexion

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29
Q

what motion occurs at the subtalar joint

A

inversion/eversion (internal and external rotation)

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30
Q

what motions create pronation in OKC

A

dorsiflexion, abduction, eversion

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31
Q

what motions create supination in OKC

A

plantarfelxion, adduction, inversion

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32
Q

what motion create supination in CKC

A

dorsiflexion, abduction, inversion

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33
Q

what motion create pronation in CKC

A

plantar flexion, adduction, eversion

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34
Q

ROM for plantar and dorsi flexion

A

plantar - 50

dorsi - 20-30

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35
Q

closed packed position of the proximal tibiofibular joint

A

full dorsi flexion

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36
Q

what type of joint is the promixal tibofibular joint

A

synovial

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37
Q

what type of joint is the distal tibiofibular joint

A

syndesmotic

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38
Q

what occurs at the distal tibiofibular joint when dorsiflexion occurs

A

joint widens to accommodate talus

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39
Q

soft tissues associated with proximal tibiofibular

A

biceps femoris
popliteus
lateral collateral
tibiofibular

40
Q

ligament associated with distal tibiofibular

A

Interosseus membrane and ligament, anterior and posterior tibiofibular ligaments

41
Q

direction of axis and type of joint: talocrucual

A

oblique hinge through saggital and frontal planes

axis runs through malleoli: medial is more anterior than lateral

42
Q

closed packed position of Talocrural joint

A

full dorsiflexion

43
Q

Talocrural ligaments

A 
tibiofibular 
lateral collateral 
anterior Talofibular (over sinus tari to talus neck)
calcaneofibular 
posterior Talofibular 
medial collateral
44
Q

medial collateral ligament –> main name
what are the four parts of it
what structures to they run between

A

Deltoid lig.

anterior tibiotalor:
Medial malleolus to anteriomedial talus

tibiocalcaneal:
medial malleolus to sustaculum tali

tibionavicular:
medial malleolus to navicular

posterior tibiotalar:
medial malleuolus to posteriomedial talus

45
Q

how many DOF of subtalar joint what direction is the axis

A

one DOF

almsot pure AP, but fun from calcaneus to 1st metatarsal

46
Q

ROM of inversion/eversion

A

inversion: 20
eversion: 30

47
Q

motion at the subtalar joint inferences ability of teh mid food and forefoot to be either:

A

mobile or rigid

48
Q

passive stability of the subtalar joint is from

A

2 capsules
interosseous ligament
cervical ligaments

49
Q

what is important about the cervical ligament

A

it is a proprioceptive centre

50
Q

what is the transverse tarsal joint

A

collective mid tarsal joints between teh talus and calcaneus and the navicular cuboid

51
Q

what is the function of the transverse tarsal joint

A

effects movement of the forefoot and hind foot

unlocks foot to lower longitudinal arch during pronation and locks to lift during supination

52
Q

at what joint within the midtarsal joint does most of the mid tarsal joint movement occur

A

at the Talonavicular joint

almost like a ball and socket joint

53
Q

is there much movement at the Calcaneocuboid joint?

A

no

54
Q

how many axis of motion at the transverse tarsal joint? what are they?

A

2
longitudinal (inversion/eversion)
oblique (DF + abdn/ PF+addn)

55
Q

how are these axis positioned compared to one another in supination and in pronation? when are they most mobile? when are they locked?

A

parallel when in pronation = mobile

crossed when in supination = locking

56
Q

closed packed position of transverse tarsal joint

A

full supination

57
Q

what is the Calcaneocuboid joint supported by ligament wise

A

the short and long plantar ligaments

58
Q

what is the Talonavicular joint supported by ligament wise

A

“spring ligament” plantar calcaneonavicular

59
Q

which metatarsals are the most mobile

A

4th and 5th

60
Q

what is a ray in the foot

A

refers to the cuneiform, metatarsal and respective phalanges

61
Q

which ray with teh central reference for the foot

A

the 2nd ray

62
Q

what is the function of the transverse metatarsal ligaments and where it is location

A

provide stability and restrict motion between the metatarsals
located at the metatarsal phalangeal joints

63
Q

what kind of movements occur at the inter tarsal joints

A

planter and dorsal glides

64
Q

movements and type of joint at metatarsal phalangeal joint

A

synovial biaxial
flex ex
ad/ab

65
Q

what is minimum extension needed at MTP joints for Normal walking

A

65 degrees

66
Q

interphalangeal joints: what type, what movement

A

synovial

only flex/ex

67
Q

what ligaments support IP joints

A

collateral ligaments

68
Q

close packed position of IP joints

A

full extension

69
Q

superficial posterior muscles of the lower leg

what is the group name of these muscles

A

gastroc
soleus
plantaris
triceps surae

70
Q

what percent of torque in plantar flexion comes from triceps surae

A

80%

71
Q

deep posterior muscles group of the lower leg

A

posterior tibialis
flexor digitorum longus
flexor Hallucis Longus

72
Q

what goes through the tarsal tunnel and what is the tarsal tunnel covered by

A

flexor retinaculum

posterior tibialis, flexor digitorum longus, flexor Hallucis Longus, tibial nerve and artery

73
Q

lateral lower leg muscles

A

Peroneus Longus

Peroneus brevis

74
Q

which of the lateral lower leg muscles in stronger and what structure in teh foot does it support

A

Peroneus Longus

transverse arch

75
Q

where does the Peroneus Longus travel and insert

A

passes behind lateral malleolus, through groove on cuboid and insert onto base of 1st metatarsal

76
Q

where does Peroneus Brevis insert

A

base of fifth metatarsal

77
Q

function of lateral lower leg muscles

A

foot eversion
stabilize arches
stabilize first ray against ground and facilitate transfer of body weight from lateral aspect to medial aspect of the foot

78
Q

what innervates the lateral lower leg muscles

A

peroneal nerve

79
Q

anterior lower leg muscles and functions

A 
tibialis anterior (dorsiflex ankle, control pronation)
extensor Hallucis Longus (extend toes, exert ankle)
extensor digitorum longus (etend toes)
80
Q

intrinsics muscles of the foot - organization

A

four layers on plantar surface
layers 1 and 2 on calcaneus
layers 3 and 4 on metatarsals
two muscles on dorsal side

81
Q

function of intrinsic muscles of the foot

A

stability and balance
supporters of transverse arch
support medial and longitudinal arch

82
Q

main role of abductor Hallucis

A

support longitudinal arch

83
Q

1st layer of of plantar foot consists of and originates at

A

O: Calcaneal tuberosity
Made of: abductor digiti minimi, flexor digitorum brevis, abduction hallucis
immediately deep to plantar fascia

84
Q

2nd layer of plantar foot originated where and is made of

A

O: calcaneal tuberosity
made of: Quadratus Plantae and lumbircals pedis, tendon of flexor Hallucis Longus, tendon of flexor digitorum Longus, lumbricals

85
Q

3rd layer of foot originates from and made of

A

O: metatarsal shafts

Made of: flexor digiti minimi, adductor hallucis and flexor hallucis brevis

86
Q

4th layer of foot originates from and is Made of

A

O: metatarsal shafts

made of: plantar interossei (3) and Dorsal interossei (4), tendon for Peroneus Longus and tibialis posterior

87
Q

in CKC pronation what bone is moving on that bone

A

talus moves on calcaneus

88
Q

function of arches of the foot

A

allow foot to adapt to the ground, absorb forces, provide weight bearing surface, assist pronation and supination

89
Q

weight distribution among calcaneus and metatarsal heads in the foot

A

50/50

90
Q

what parts of the foot experience the most force during gait

A

heel and great toe

91
Q

what is the windlass mechanism

A

extension occurs in the metatarphalalngea joint before before toe off. this pulls the plantar fascia and pulls the calcaneus and the metatarsal heads together. this heights the longitudinal arch, forces flexion position and creates a soldi structural support. intrinsic muscles actively contract to provide further stability.

92
Q

what is pes planus

A

rigid or inflexible foot
no arch at all
cause increased medial rotation
increases stress on muscles that control pronation
with pronation, the tibia rotates medially, causing knee flexion and valgus positioning
results in femoral adduction and medial rotation with resultant hip flexion

93
Q

what is pes cavus

A

high medial longitudinal arch
rigid foot - poor shock absorber
forces not transmitted proximally
associated with lateral lower extremity rotation, varus knee
- extended knees, abducted and laterally rotated thighs and extended hips

94
Q

what is hammer toe

A

affects the PIP
muscular imbalance causing tightening of passive structures
arthritis, pes cavus

95
Q

what is hallux rigidis

A

contact burning, throbbing or aching
tenderness over MTP
limited flex/ex of great toe due to osteoarthritis; foot abnormality, unusually long 1st MTP, forefoot pronation, trauma

EPHE 355 (5 decks)

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