m9: leg, ankle, & foot Flashcards

1
Q

Support of the body’s weight.

Control and stabilization of the leg on the planted foot.

Adjustments to irregular surfaces.

Compensation for more proximal segment malalignment or pathomechanics.

Elevation of the body, as in standing on the toes, climbing, or jumping.

Shock absorption in walking, running, or landing from a jump.

Operation of machine tools.

Substitution for hand functions in persons with upper extremity amputations or muscle paralysis.

A

FUNCTIONS OF THE ANKLE AND FOOT

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2
Q

Bones of the Ankle and Foot:

A

Tibia
Fibula
Tarsals
Metatarsals
Phalanges

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3
Q

Medial bone of the leg

“Shin bone”

90% weight-bearing

Medial malleolus

A

TIBIA

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4
Q

Lateral bone of the leg

Essentially considered as a nonweightbearing bone (Brunnstrom)

10% weight-bearing (Brunnstrom)

It takes no part in the transmission of body weight (Snell)

Carries 17% of the axial load (Magee)

Lateral malleolus

A

FIBULA

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5
Q

3 SECTIONS OF THE ANKLE AND FOOT

A

HINDFOOT (REARFOOT)
MIDFOOT
FOREFOOT

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6
Q

Calcaneus
Talus

A

HINDFOOT
(REARFOOT)

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7
Q

Navicular
Cuboid
Medial, Intermediate and Lateral cuneiform

A

MIDFOOT

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8
Q

Metatarsals
Phalanges

A

FOREFOOT

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9
Q

The foot assumes a slight toe-out position

This angle is approximately _ to _ from the _ axis of the body, developing from _ in children

A

FICK ANGLE

12° to 18° ; sagittal ; 5°

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10
Q

The first metatarsal (1) is longer than the second (2), with the others (3, 4, and 5) of progressively decreasing lengths, so that 1 > 2 > 3 > 4 > 5. This can result in an _ type foot

_%

A

INDEX PLUS TYPE

Egyptian type foot

69%

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11
Q

The first metatarsal is equal in length to the second metatarsal, with the others progressively diminishing in length, so that 1 = 2 > 3 > 4 > 5. This results in a _ type foot

_%

A

INDEX PLUS-MINUS TYPE

squared

9%

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12
Q

The second metatarsal is longer than the first and third metatarsals. The fourth and fifth metatarsals are progressively shorter than the third, so that 1 < 2 > 3 > 4 > 5. This results in a _ or _ type foot

_%

A

INDEX MINUS TYPE

Morton’s or Greek

22%

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13
Q

JOINTS

A

HINDFOOT (REARFOOT)
MIDFOOT
FOREFOOT

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14
Q

“Plantar fascia”

It begins _ on the medial tubercle of the calcaneus and continues anteriorly to attach by digitations to the plantar plates and then, via the plates, to the proximal phalanx of each toe.

A

PLANTAR APONEUROSIS
posteriorly

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15
Q

Hindfoot joints

A

Distal tibiofibular joint
Talocrural (ankle) joint
Subtalar or talocalcaneal joint

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16
Q

Midfoot joints

A

Talocalcaneonavicular joint
Cuneonavicular joint
Cuboideonavicular joint
Intercuneiform joint

Other:
Chopart joint
Cuneocuboid
Calcaneocuboid

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17
Q

Forefoot joints

A

Tarsometatarsal joint
Intermetatarsal joint
Metatarsophalangeal joint
Interphalangeal joint

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18
Q

Tibiofibular joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: Plantar flexion
CPP: Maximum dorsiflexion
CP: Pain when joint is stressed

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19
Q

Talocrural joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: 10° plantar flexion, midway between inversion and eversion
CPP: Maximum dorsiflexion
CP: Planter flexion, dorsiflexion

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20
Q

Subtalar joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: Midway between extension of ROM
CPP: Supination
CP: Limited ROM (valgus, varus)

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21
Q

Between fibular notch at the lower end of tibia and the lower end of the fibula.

_ joint

No _

A

Tibiofibular joint

Fibrous joint

No capsule

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22
Q

Tibiofibular joint ligaments
I
A
P
I

A

Interosseus ligament
Anterior tibiofibular ligament
Posterior tibiofibular ligament
Inferior ligament

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23
Q

Talocrural joint

“_ joint” = _ _ and _

Uniaxial

_ _ joint

_ DOF

Motion:

A

“Ankle joint” = Ankle mortise and talus

Modified hinge joint

1 DOF

Dorsiflexion and plantarflexion

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24
Q

Talocrural joint ligaments

A

MCL
LCL

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25
Q

Subtalar joint

_ joint

_ DOF

Motion:

A

Synovial

3 DOF

Gliding and rotation

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26
Q

Subtalar joint ligaments
L
M
I
C

A

Lateral talocalcaneal ligament
Medial talocalcaneal ligament
Interosseous talocalcaneal ligament
Cervical ligament

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27
Q

Midfoot

Resting position:
Close packed position:
Capsular pattern:

A

RP: Midway between extremes of ROM
CPP: Supination
CP: Dorsiflexion, plantar flexion, adduction, medial rotation

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28
Q

“ tarsal joints”
“Midtarsal joints”
Refers collectively to the midtarsal joints between the:
Talus-calcaneus
Navicular-cuboid

A

Chopart joint

29
Q

Talocalcaneonavicular joint

_ joint

3 DOF

Motion:

A

Ball and socket joint

3 DOF

Gliding and rotation

30
Q

Talocalcaneonavicular joint ligament
D
B
P

A

Dorsal talonavicular ligament
Bifurcated ligament
Plantarcalcaneonavicular (spring) ligament

31
Q

Cuneonavicular joint

_ joint

Motion:

A

Plane synovial joint

Slight gliding and rotation

32
Q

Cuboideonavicular joint

_ joint

Motion:

A

Fibrous joint

Slight gliding and rotation

33
Q

Intercuneiform joint

_ joint

Motion:

A

Plane synovial joints

Slight gliding and rotation

34
Q

Cuneocuboid joint

_ joint

Motion:

A

Plane synovial joints

Slight gliding and rotation

35
Q

Calcaneocuboid joint

_ joint

Motion:

A

Saddle shape joint

Gliding with conjuct rotation

36
Q

Calcaneocuboid joint ligaments
B
C
L

A

Bifurcated ligaments
Calcaneocuboid ligament
Long plantar ligaments

37
Q

Tarsometatarsal joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: Midway between extremes of ROM
CPP: Supination
CP: None

38
Q

Metatarsophalangeal joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: 10° extension
CPP: Full extension
CP: Big toe: extension. flexion
Second to fifth toe: variable

39
Q

Interphalangeal joint

Resting position:
Close packed position:
Capsular pattern:

A

RP: Slight flexion
CPP: Full extension
CP: Flexion, extension

40
Q

Taken together, these joints are referred to as
“_ joint”
_ joint

A

Tarsometatarsal joint

Lisfranc joint

Plane synovial joint

41
Q

Intermetatarsal

_ intermetatarsal joints

_ joint

Allows _

A

4

Plane synovial

gliding

42
Q

Metatarsophalangeal

_ metatarsophangeal joints

_ joints

_ DOF

4 Motions:

A

5

Condyloid

2 DOF

Flexion, extension, abduction and adduction

43
Q

Interphalangeal joint

_ joint

_ DOF

2 Motions:

A

Synovial hinge joint

1 DOF

Flexion and extension

44
Q

2 Ligaments

A

MCL
LCL

45
Q

Deltoid MCL

_ (resist talar abduction)

3 ligaments:
TN
TC
PTT

A

Superficial

Tibionavicular ligament
Tibiocalcaneal ligament
Posterior tibiotalar ligament

46
Q

Deltoid MCL

_
Anterior tibiotalar ligament

Resists:

Lateral _ of the talus
Lateral _ of the talus

A

Deep

Lateral translation of the talus
Lateral rotation of the talus

47
Q

3 LCL

A

Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament

48
Q

Anterior talofibular ligament

Resists _ of _
MC injured (lateral ankle sprain)

A

Resists inversion of talus

49
Q

Posterior talofibular ligament

Resists ankle _, _ (tilt), _ rotation and _ translation of the _

A

Resists ankle DF, adduction (tilt), medial rotation and medial translation of the talus

50
Q

Calcaneofibular ligament

Resists maximum _ at the _ and _ joints.
_ MC injured (lateral ankle sprain)

A

Resists maximum inversion at the ankle and subtalar joints.
2nd MC injured (lateral ankle sprain)

51
Q

5 Anterior muscles

A

TA
EDL
PT
EHL
EDB

52
Q

2 Lateral muscles

A

PL
PB

53
Q

3 Posterior muscles (superficial)

A

GAS
PLA
SOL

54
Q

4 Posterior muscles (deep)

A

POP
FDL
FHL
TP

55
Q

3 Sole of the foot muscles (1st layer)

A

ABH
FDB
ABDM

56
Q

2 Sole of the foot muscles (2nd layer)

A

QP
L

57
Q

3 Sole of the foot muscles (3rd layer)

A

FHB
ADH
FDMB

58
Q

2 Sole of the foot muscles (4th layer)

A

DI
PI

59
Q

Dorsum of the foot

A

EDB

60
Q

“Plantar fascia”
It begins _ on the medial tubercle of the calcaneus and continues anteriorly to attach by digitations to the plantar plates and then, via the plates, to the proximal phalanx of each toe.

A

Plantar aponeurosis

posteriorly

61
Q

3 Arches of the foot

A

Medial longitudinal arch
Lateral longitudinal arch
Arch

62
Q

Medial longitudinal arch

BONE
LIGAMENT
TENDON

A

Talus (keystone)
Navicular
Calcaneus
Cuneiforms
1st, 2nd, 3rd Metatarsals

Spring ligament (Plantarcalcaneo navicular ligament)
Proximal attachment: Sustentaculum tali

Tibialis posterior tendon

63
Q

Lateral longitudinal arch

BONE
LIGAMENT
TENDON

A

Calcaneus
Cuboid (keystone)
4th and 5th Metatarsals

Long plantar ligament

Peroneus longus tendon

64
Q

Arch

BONE
LIGAMENT

A

3 cuneiform
Intermediate/Middle cuneiform (keystone)
Cuboid
1st-5th Metatarsal (bases)

Intrinsic muscles of the foot

65
Q

Arch

A. At the level of the _ tarsals.
B. At the level of the _ of the metatarsals.

A

A. anterior
B. middle

CU, cuboid
LC, lateral cuneiform
MC, middle cuneiform
MeC, medial cuneiform.

66
Q

FOOT LOADING DURING GAIT

Walking
Running
Jumping (from height of 60 cm [2 feet])

A

1.2 times the body weight
2 times the body weight
5 times the body weight

67
Q

A sprained ankle is nearly always an _ injury, involving twisting of the weight-bearing _ foot.

The person steps on an uneven surface and the foot is forcibly inverted or lands on an inverted foot from a vertical jump.

_ ligament sprains occur in running and jumping sports, particularly basketball (70–80% of players have had at least one sprained ankle).

The lateral ligament is injured because it is much weaker than the medial ligament and is the ligament that resists inversion at the talocrural joint.

The _ _ ligament—part of the lateral ligament—is most vulnerable and most commonly torn during ankle sprains, either partially or completely, resulting in instability of the ankle joint.

A

ANKLE SPRAIN

inversion injury; plantarflexed foot

Lateral ligament sprains

anterior talofibular ligament

68
Q

Inflammation of the _ _

Often caused by an _ mechanism

It may result from running and high-impact aerobics, especially when inappropriate footwear is worn.

It causes pain on the plantar surface of the foot and heel.

The pain is often most severe after sitting and when beginning to walk in the morning.

A

PLANTAR FASCIITIS

plantar fascia

overuse mechanism