Lower Leg, Ankle, Foot Lecture Flashcards

1
Q

Hindfoot

A

Inferior tib fib
Talocrural
Subtalar (talocalcaneal)

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2
Q

Midfoot

A
Talocalcaneonavicular
Cuneonavicular 
Cuboideonavicular
Intercuneiform
Cuneocuboid
Calcaneocuboid
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3
Q

Forefoot

A

Tarsometatarsal
Intermetatarsal
Metatarsophalangeal
Interphalangeal

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4
Q

Inferior tib fib

A

(Hindfoot)
Fibrous syndesmoses
1-2 mm spread w/ DF - superior glide of fibula

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5
Q

Tibfib resting

A

Plantar flexion

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6
Q

Tibfib closed pack

A

Max DF

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7
Q

Tibiofibular capsular pattern

A

Pain on stress

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8
Q

Talocrural joint

A

Uniaxial, modified hinge, synovial

Med and lat malleolus w/ talus
Med doesn’t extend as far down
Branches of tibial and deep fibular nerves

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9
Q

The talus is wider

A

Anteriorly

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10
Q

Ankle dorsiflexion and plantar flex ROM

A

DF 20

PF 50

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11
Q

Talocrural open pack

A

10 deg PF

Midway b/n max inversion and eversion

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12
Q

Talocrural closed pack

A

Full DF

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13
Q

Talocrural capsular pattern

A

PF, DF

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14
Q

Talocrural - deltoid / medial collateral ligament

A

Tibionavicular
Tibiocalcaneal
Posterior tibiotalar
Anterior tibiotalar

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15
Q

Talocrural lateral ligaments

A

ATFL
Posterior talofibular lig
Calcaneofibular lig

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16
Q

Subtalar joint

A
3 seperate planar articulation
Triplanes motion around a single axis
Important for dampening rotational forces imposed by BW
Gliding and rotation are main motions 
May become hypomobile after injury 
No muscles attach to the talus
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17
Q

Subtalar joint axis

A

42 deg upward and anteriorly from transverse plane

Medically included 16 deg

Results in triplanar motion around 1 axis

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18
Q

Subtalar primary motions

A

Supination and pronation - composite motions in three planes that cannot and do not occur independently

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19
Q

NWB motion (Subtalar)

A

Talus stable

Calcaneus and foot move around talus

20
Q

NWB supination

A

Calcaneal adduction
Inversion
Plantar flexion

21
Q

NWB pronation

A

Calcaneal abduction
Eversion
Dorsiflexion

22
Q

Closed chain Subtalar

A

Calcaneous no longer able to accomplish all 3 components of movement

  • can still invert and evert
  • proximal Tatar segment now moves on fixed calcaneus
23
Q

Closed chain supination

A

Talus- abducts, dorsiflexion
Calcaneus - inversion or varus

Tibiofibular lateral rotation

24
Q

Closed chain pronation

A

Talus - adduction, plantar flexion
Calcaneus - eversion or valgus

Tibiofibular medial rotation (10 deg)

25
Q

Talocalcaneonavicular

A

Convex head of talus and concave navicular
-plantar calcaneonavicular ligament depends it
Talus acts as ball bearing between mortise, calcaneus, and navicular

26
Q

Talocalcaneonavicular axis

A

Essentially the same as subtalar

27
Q

Key joint to foot function

A

TCN

28
Q

Joints forming single elastic unit

A

Distal to TCN

-moves in response to and compensates for movement of talus and calcaneus

29
Q

Midtarsal joint types

A

Cuneonavicular - plane synovial

Cuboideonavicular - fibrous joint

Intercuneiform - plane synovial

Cuneocuboid - plane synovial

Slight gliding and rotation at these

30
Q

Midtarsal joints resting

A

Midway b/n extremes of ROM

31
Q

Midtarsal joints closed back

A

Supination

32
Q

Midtarsal joints capsular

A

DF, PF, Add, IR

33
Q

TMT joint

A

Plane synovial

Gliding

34
Q

TMT closed pack

A

Supination

35
Q

Intermetatarsal joint

A

Plane synovial

Gliding

36
Q

Intermetatarsal closed pack

A

Supination

37
Q

MTP joint

A

Condyloid synovial
2 deg freedom
F/E, Ab/Ad

38
Q

Interpalangeal joint

A

Synovial hinge

1 deg free

39
Q

Interpalangeal resting

A

Slight flex

40
Q

Interphalangeal closed pack

A

Full extension

41
Q

Interphalangeal capsular

A

Flexion, extension

42
Q

Foot loading

A

Walking = 1.2xBW
Running = 2xBW
Jumping (2ft) = 5xBW

43
Q

Ankle sprain grade 1

A
  • ant drawer
  • Tamar tilt

No or little limp

Usually ATFL

44
Q

Ankle sprain grade II

A
  • or + ant drawer
  • Talar tilt

Limp w/ walking
Unable to toe raise or hop or run

Complete tear ATFL, partial calcaneo-fibular

45
Q

Ankle sprain grade III

A

+ ant drawer and talar tilt
Diffuse swelling around Achilles

Unable to WB, sig pain inhibition

Complete tear ATFL and calcaneofibular

46
Q

Ottawa ankle rules

A

Bone tenderness at: posterior tip of medial malleolus, posterior tip of lateral malleolus, base of 5th MT, navicular

Or
Pt cannot WB after injury or during exam (4 steps)