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EPHE 355 - Final Exam > Lower Leg, Ankle, and Foot > Flashcards

Lower Leg, Ankle, and Foot Flashcards

1
Q

Which malleoli is more inferior?

A

Lateral Malleoli

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2
Q

Which lower leg bone bears 90% of the weight?

A

Tibia bears 90%

Fibula bears 10%

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3
Q

`The tibia is rotated ____ about a vertical axis proximal to distal

A

laterally

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4
Q

The tibia has a prominent ___ malleolus

A

medial

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5
Q

The Fibula has a prominent ____ malleolus

A

lateral

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6
Q

How does the fibula sit compared to the medial malleolus?

A

more posterior

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7
Q

What makes up the hind foot?

A

talus and calcaneus

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8
Q

What makes up the midfoot?

A

navicular, cuboid, and the three cuneiforms

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9
Q

What makes up the forefoot?

A

metatarsals and phalanges

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10
Q

The ___ bone has no muscle attachments

A

talus

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11
Q

How much of the talus is covered with articular cartilage?

A

> 50%

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12
Q

The superior aspect of the head of the talus is ___ shaped

A

dome

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13
Q

What is the mortis?

A

the space between the distal end of the tibia and the head of fibula

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14
Q

Inferiorly, the talus articulates with what?

A

the three facets of the calcaneus

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15
Q

The anterior aspect of the talus articulates with what?

A

the navicular

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16
Q

the medial and lateral aspects of the talar body articulate with what?

A

the medial and lateral malleoli

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17
Q

What is the largest and strongest tarsal bone?

A

calcaneus

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18
Q

What protects the calcaneus?

A

a thick fat pad

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19
Q

The calcaneus attaches to the __ ___ on posterior aspect

A

achilles tendon

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20
Q

The calcaneus articulates with the ___ anteriorly

A

cuboid

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21
Q

What foot bone does the tibialis posterior insert onto? What side of the foot is this bone on?

A

navicular; medial

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22
Q

What is the name of the group of 3 wedge shaped foot bones?

A

cuneiforms

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23
Q

Posteriorly, what does the cuboid bone articulate with? Medially? Anteriorly?

A

the calcaneus
the lateral cuneiform
4th and 5th metatarsals

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24
Q

How are the heads of the metatarsals shaped?

A

convex

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25
Q

What side of the metatarsals are concavely arched? What is good about this?

A

plantar side; facilitates increased load absorption

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26
Q

Which metatarsal has two sesamoids? What is their purpose?

A

first metatarsal (just posterior to head) - this is where the flexor hallucis brevis inserts (increases mechanical advantage)

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27
Q

What tendon runs between the two sesamoids?

A

FTL

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28
Q

How many phalanges does the foot have?

A

14 (big toe has 2 and the others all have 3)

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29
Q

What type of bones are the foot phalanges?

A

Still considered long bones even though they are so small - this is because of their shape and they fact that they have growth plates

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30
Q

What types of joints are the proximal and distal tibiofibular joints?

A

Proximal: planar/gliding
Distal: amphiarthrotic fibrous syndesmosis

31
Q

Proximal TF joint: What movement occurs during dorsiflexion? Plantarflexion?

A

Dorsi - head of fibula moves superiorly

Plantar - head moves inferiorly

32
Q

How are the malleoli held together?

A
  • anterior and posterior ligaments
  • interosseous membrane
  • interosseous ligament
33
Q

Is there movement at the distal TF joint?

A

its debated that there is some movement at this syndesmosis

34
Q

joints of the hind foot? (2)

A

talocrural

subtalar

35
Q

joints of the mid foot? (6)

A 
talonavicular
calcaneocuboid
cubonavicular
cuneonavicular 
intercuneiforme
cuneocuboid
36
Q

joints of the forefoot?

A

tarsometatarsal
metatarsophalangeal
interphalangeal

37
Q

Talocrural Joint:

  • bones
  • classification
  • DOF
  • movements
  • osteokinematics
A 
Tibia/Fibula with Talus
Hinge Joint
1 DOF
Plantarflex/Dorsiflex
Swing
38
Q

Subtalar Joint:

  • bones
  • classification
  • DOF
  • movements
  • osteokinematics
A
  • Talus and Calcaneus
  • Ant+Post subtalar joints together make modified sellar joint
  • 1 DOF
  • Eversion, inversion, pronation, supination
  • covered later…
39
Q

Subtalar joint - what facets are concave and which are convex?

A

Anterior and Middle = concave

Posterior = convex

40
Q

Why might you get a hard end feel at the talocrural joint?

A

if the head of the talus gets shimmied forward

41
Q

Is the trochlea of the talus male or female at the talocrural joint?

A

male

42
Q

Talocrural joint: The medial and lateral surfaces articulate with what?

A

the medial and lateral malleoli

43
Q

Talocrural joint: more wide anteriorly or posteriorly?

A

anteriorly

44
Q

The tibia and fibula forms a strong socket (m or f?) for the trochlea of the wedge-shaped talus bone

A

female

45
Q

Talocrural joint arthrokinematics: Dorsiflexion? Plantarflexion?

A

Dorsi - talus glides posteriorly

Plantar - talus glides anteriorly

46
Q

Talocrural axes of motion? Where does majority occur?

A

motion in all three planes even though it only has one DOF

majority occurs in sagittal plane with some movement in frontal and transverse planes

47
Q

Plantar flexion: Degrees and End Feel?

A

50

firm

48
Q

Dorsiflexion (in sitting - knee flexed): Degrees and End Feel?

A

20-30

firm

49
Q

What makes up the anterior subtalar joint and what are their shapes?

A
  • Head of talus (convex)

- middle and anterior facets of calcaneus (concave)

50
Q

What makes up the posterior subtalar joint and what are their shapes?

A
  • Posterior facet of talus (concave)

- Posterior facet of calcaneus (convex)

51
Q

Supination of the foot is a combination of what 3 movements?

A
  • inversion
  • adduction
  • plantar flexion
52
Q

____ and ___ are triplanar movements

A

supination and pronation

53
Q

Movements at ankle: Supination if open chain includes what movements?

A

all calcaneal movement - includes inversion, adduction, and plantarflexion

54
Q

Movements at ankle: Supination if closed chain includes what movements?

A

includes inversion of calcaneus AND talar abduction and dorsiflexion

55
Q

Movements at ankle: Pronation if open chain includes what movements?

A

all calcaneal movement - includes eversion, abduction, and dorsiflexion

56
Q

Movements at ankle: Pronation if closed chain includes what movements?

A

includes calcaneal eversion AND talar adduction and plantar flexion

57
Q

Effect of pronation on the kinetic chain?

A

medial rotation of lower leg and femur

58
Q

Effect of supination on the kinetic chain?

A

lateral rotation of lower leg and femur

59
Q

Why do we care about the effects of overpronation or oversupination on the kinetic chain?

A

because injuries that happen in a closed kinetic chain will have effects in different places

60
Q

What ligaments provide lateral stability at the ankle?

A

The anterior and posterior talofibular ligaments and the calcaneofibular ligaments

61
Q

What lateral ligament is the most commonly torn one?

A

anterior talofibular ligament

62
Q

How do you test the integrity of the ATFL?

A

Put the ankle in plantar flexion and inversion - this is the same way it would have been strained, all you need to think about is “how would I stretch this” and then you know how to test the integrity

63
Q

What is the medial ligamentous support for the ankle?

A

the deltoid ligament

64
Q

What are the collateral ligaments of the ankle?

A

Deltoid and three lateral ligaments (ATFL, PTFL, and CFL)

65
Q

What shape is the midtarsal joint and what does i split?

A

S-shaped; splits hind and mid-foot

66
Q

What type of joints are the tarsometatarsal joints?

A

gliding joints - there is more movement at the 4th and 5th digit, similar to the hand!

67
Q

What movements occur at the tarsometatarsal joints?

A

flexion/extension

supination/pronation

68
Q

What movements occur at the metatarsophalangeal joints and what type of joints are they?

A

Ellipsoid
Flexion/Extension
Abduction/Adduction

69
Q

What movements occur at the Interphalangeal joints and what type of joints are they?

A

Hinge

Flexion/Extension

70
Q

What bones do the bases of the 5 metatarsals articulate with?

A

cuboid and 3 cuneiform bones

71
Q

Which of the tarsometatarsal bones are the most mobile? What do they articulate with?

A
  • 4th and 5th
  • average 9 degrees of dorsi/plantar flexion and 11 degrees of inversion/eversion
  • articulate with cuboid
72
Q

ROM for MCP joints in flexion and extension compared to MTP joints?

A

90 degrees of flexion and 0-30 degrees of hyperextension at MCP

flexion is only 30-45 degrees and hyperextension is 90 degrees

73
Q

what do we have so much more hyperextension at our MTP compared to MCP joints?

A

so that we can walk! when you are in late stance phase you need to have a large range of hyperextension to help with push off and force production = mechanical advantage!

74
Q

How is the ab/adduction movements and muscular control of the toes compared to the hand?

A

less and less!

EPHE 355 - Final Exam (2 decks)

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