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Y1 - LEA- Quiz 7/8 > Q7-2. Rearfoot > Flashcards

Q7-2. Rearfoot Flashcards

1
Q

where does the leg become the foot?

A

talus and inferior is considered the foot (anatomically), but talus acts like a leg bone

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2
Q

which bone of the foot acts like a leg bone?

A

talus

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3
Q

2 main *functions of foot and ankle

A

(1) mobile, pronating adaptor, and (2) rigid lever arm

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4
Q

2 main *movements of the foot/ankle

A

pronation and supination

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5
Q

movements associated with “mobile pronating adaptor” function of foot/ankle

A

dorsiflexion, ABduction, eversion

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6
Q

movements associated with “rigid lever arm (supination)” function of foot/ankle

A

plantarflexion, ADduction, inversion

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7
Q

common name for peritalar subluxation

A

acquired adult flat foot deformity

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8
Q

subtalar joint: bones and articulating surfaces

A
  • talus:
    • anterior/middle facets: on inf aspect of talar head/neck
    • posterior facet: on inf aspect of talar body
  • calcaneus:
    • anterior/middle facet: on sup aspect of sustentaculum tali
    • posterior facet: on sup aspect of calcaneal body
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9
Q

which of the 6 facets (3 articulating surfaces) does most of the work?

A

the posterior facet does most of the work;

more distinct/localized and well defined

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10
Q

from anatomic perspective, how many facets in subtalar joint?

A

6 total facets

(2 anterior, 2 middle, 2 posterior)

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11
Q

from functional perspective of subtalar joint, which 2 facets are most important?

A

posterior facets

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12
Q

describe the posterior facets of the subtalar joint

A
  1. plane in medial –> to lateral direction
  2. calcaneal facet is CONVEX, and talar facet is CONCAVE along its axis
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13
Q

subtalar joint:

type of joint and motion

A
  1. type of joint: plane, synovial w/ gliding motion
  2. mvmt:
    • Inversion/Eversion
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14
Q

subtalar joint:

OPEN chain vs. CLOSED chain kinetics

A
  • OPEN chain:
    • calcaneus DORSIflexes/ ABducts/ Everts
    • talus relatively plantarflexes, adducts, and inverts
  • CLOSED chain
    • calcaneus EVERTS
    • talus plantarflexes and adduts
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15
Q

with movement of subtalar joint, does the rest of the foot move along w/ the calcaneus or the talus?

A

along w/ the calcaneus

(remember: talus acts functionally more like leg bone)

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16
Q

subtalar joint:

ligaments

A

“Plus Lots More, In Case”

  • Capsular
    1. Posterior talocalcaneal
    2. Lateral talocalcaneal
    3. Medial talocalcaneal
  • Extracapsular
    1. Interosseus talocalcaneal
    2. Cervical
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17
Q

posterior talocalcaneal ligament (PTCL)

of subtalar joint

A
  1. Y-shaped lig running from superior surface of calcaneus –> to each post talar processes
  2. Forms groove for FHL tendon (flexor hallucis longus)
  3. Capsular lig
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18
Q

lateral talocalcaneal ligament (LTL):

describe

A
  1. capsular lig of subtalar joint
  2. runs parallel and deep to the calcaneofibular lig (CFL) from the lateral talar process to the lateral surface of the calcaneus
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19
Q

medial talocalcaneal ligament (MTL):

describe

A
  1. capsular ligament of subtalar joint
  2. from medial tubercle of the posterior talar process to the posterior end of the sustentaculum tali and medial calcaneus
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20
Q

interosseus talocalcaneal ligament (ITL):

describe

A
  1. larger laterally, smaller medially
  2. a strong, flat band from sulcus calcanei and sulcus tali
  3. “fills space” of the sinus tarsi
    • blends w/ stem of the inferior extensor retinaculum
    • important blood flow in/around talus
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21
Q

sinus tarsi:

describe

A
  • a large triangular space between anterior/middle and posterior facets
    • Sinus tarsi creates small hole medially and relatively wide hold laterally
    • Connection b/w medial and lateral aspects of foot
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22
Q

cervical ligament:

describe

A
  1. runs b/w the lateral edge of the sinus tarsi to the lateral aspect of the neck of the talus
  2. lateral to the interosseus talocalcaneal ligament
  3. “strongest” connection b/w the subtalar joint
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23
Q

what ligament (anteriorly) creates this potential space

A

cervical ligament anteriorly

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24
Q

which ligaments (laterally and medially) cross and support the subtalar joint?

A
  1. calcaneofibular ligament (laterally)
  2. tibiocalcaneal ligament (medially)
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25
Q

calcaneocuboid joint:

bones and articular surfaces

A
  • calcaneus (anterior)
  • cuboid (posterior surface)
26
Q

calcaneocuboid joint:

type of joint and motion at joint

A
  1. synovial, saddle (sellar) joint
  2. not much, some “give” with the lateral column, but mostly works as a unit w/ the transverse tarsal joint)
27
Q

what type of motion occurring at the calcaneocuboid joint

A
  • not much
  • some “give” w/ the lateral column, but mostly works as a unit w/ the transverse tarsal joint
28
Q

which ligaments hold the calcaneocubiod joint together?

A
  • dorsal calcaneocuboid ligament
  • lateral calcaneocuboid ligament (which is part of dorsal)
  • plantar calcaneocuboid lig
  • long plantar lig
  • bifurcate lig
29
Q

dorsal calcaneocuboid ligament:

course and characteristics

A
  • runs between the lateral surface of the calcaneus and dorsal surface of the cuboid
  • weak
  • capsular lig
30
Q

plantar calcaneocuboid ligament:

course and description

A
  • runs from anterior tubercle of the calcaneus (and the depression anterior to the calcaneus)
  • to the plantar surface of the cuboid (proximal/posterior to the promontory)
31
Q

long plantar ligament:

course and description

A
  • course
    • runs from the plantar surface of the calcaneus (b/w the tubercle and the tuberosity)
    • continues on to the promontory of the cuboid
    • and even further to the bases of the 2nd, 3rd, and 4th (and sometimes 1st and 5th) met bases
  • extracapsular
  • “longest” ligament in the foot, and one of the “strongest” ligaments in the body
32
Q

which ligament “Grabs onto promontory” and continues to MTs, forming space for fibularis longus

A

long plantar ligament

33
Q

which ligament forms the “peroneal sheath” enclosing the tendon of the peroneus longus?

A

long plantar ligament

34
Q

which ligament is separated from the LONG PLANTAR LIGAMENT

A

physically separated from the calcaneocuboid ligament

35
Q

bifurcate ligament:

course and characteristics

A
  • attaches the calcaneus to both the cuboid and the navicular;
    • begins at lateral end of the sulcus calcanei and splits into:
      • calcaneocuboid portion: attaching to the medial surface of the cuboid
      • calcaneonavicular portion: attaching to the dorsal-lateral surface of the navicular
  • extracapsular
36
Q

cuboideonavicular joint:

bones and articulation

A
  • cuboid:
    • posterior-medial
    • just proximal to the facet for the lateral cuneiform
  • navicular:
    • anterior-lateral
37
Q

cuboideonavicular joint:

type of joint and movement

A
  • either synovial w/ articular facets and hyaline cartilage; sometimes syndesmotic
  • essentially no mvmt
    • joint is designed to move as unit w/ calcaneus
    • helps connect medial and lateral columns
38
Q

3 ligaments holding the cuboideonavicular joint

A
  • dorsal cuboideonavicular ligament
  • plantar cuboideonavicular ligament
  • interosseous cuboideonavicular ligament
39
Q

dorsal cuboideonavicular ligament:

course and characteristics

A
  • connects the DORSAL surfaces of cuboid and navicular
  • sometimes overlaps the lateral cuneiform
40
Q

plantar cuboideonavicular ligament:

course and characteristics

A
  • connects the plantar surfaces of the cuboid and navicular
41
Q

interosseous cuboideonavicular ligament:

course and characteristics

A

short, strong ligament connecting two bones

42
Q

other names for talonavicular joint

A

talocalcaneonavicular joint

or talo-calcaneonavicular joint

43
Q

which two bones form a “socket” for the head of the talus to fit into?

A
  • calcaneus and navicular form “socket” conceptually
  • and talus is part of the leg, while calcaneus/navicular/cuboid move as a unit w/ the foot
44
Q

talonavicular joint:

key parts and structures forming “socket”

A
  • bone:
    • anterior/middle facets of the calcanceus
    • posterior surface of the navicular
      • concave and ovid
  • soft tissue:
    • “Triangular gap” closed by the plantar calcaneonavicular ligament (fibrocartilaginous spring ligament)
45
Q

talonavicular joint:

supporting structures of “socket”

A
  1. bifurcate ligament laterally
  2. tibionavicular ligament medially
  3. posterior tibial tendon on outside of plantar calcaneonavicular ligament
  4. flexor hallucis longus underneath sus tali
46
Q

talonavicular joint:

talar components

A
  • talar head and neck
    • talar head is convex in all directions, w/ long axis superior-lateral –> inferomedial, and short axis dorsal-to-plantar
  • several facets/articular area:
    • large ovoid one for the navicular
    • 1-2 for the anterior/middle articular facets
    • triangular facet for the plantar calcaneonavicular ligament
    • sometimes a lateral one for the bifurcate ligament
47
Q

talonavicular joint:

type of joint and motion

A
  • compound, synovial joint; similar to condyle or ball & socket
  • multiplanar motion incl. inversion/eversion adn adduction/abduction
48
Q

talonavicular joint:

ligaments holding joint together

A
  1. plantar calcaneonavicular ligament/ spring ligament
  2. talonavicular ligament
  3. bifurcate ligament
49
Q

plantar calcaneonavicular ligament/ spring ligament:

course/portions, and characteristics

A
  • course
    • lateral portion runs b/w calcaneus (an area b/w the sustentaculum tali and the anterior tubercle) to the navicular tuberosity
    • central portion b/w anteior border and entire edge of sustentaculum tali to the navicular (plantar surface, tuberosity and dorsal surface)
    • medial portion running b/w the sustentaculum tali and the navicular (tuberosity and dorsal surface)
  • characteristics
    • tough fibrocartilage (not elastic tissue) forms the floor fo the TCN joint socket and medially along the course of the posterior tibial tendon
    • capsular ligament
50
Q

describe the fusion of the medial portion of the plantar calcaneonavicular ligament:

A

medial portion running b/w the sustentaculum tali and the navicular (tuberosity and dorsal surface)

  • fuses w/ the tibiocalcaneal ligament medially and proximally
  • fuses w/ the tibionavicular ligament medially and distally
51
Q

talonavicular ligament:

course and characteristics

A
  • broad and “weak” ligament running b/w the superior surfaces of the talar head/neck and the navicular
  • more broad LATERALLY than medially
  • capsuar ligament
52
Q

bifurcate ligament:

course and characteristics

A
  • attaches the calcaneus to both the cuboid and the navicular
  • begins at the lateral end of the sulcus calcanei and splits into:
    • calcaneocuboid portion (attaching to medial surface fo the cuboid)
    • calcaneonavicular portion (atttaching to dorsal-lateral surface of the navicular)
  • extracapsular
53
Q

transverse tarsal joint:

which other joints does it include?

A

combination of :

  • calcaneonavicular joint and,
  • calcaneocuboid joint
54
Q

describe actions involved in foot pronation?

A
  1. talus plantarflexes and ADducts (primarily @ ankle and talonavicular joints)
  2. cuboid and calcaneus relatively dorsiflex and ABducts
  3. calcaneus also everts at the subtalar joint
55
Q

how does the foot supinate?

A
  • talus dorsiflexes and ABducts (@ ankle and talonavicular joints)
  • cuboid and calcaneus relatively plantarflex and adduct
  • calcaneus also inverts at subtalar joint
56
Q

peritalar subluxation

A
  • pronation and supination of talar head
  • Talus and navicular are very well-covered (good, forward efficient direction)
57
Q

transverse tarsal joint:

actions in pronation

A
  1. talus ADducts and plantarflexes
  2. navicular-cuboid-calcaneus relatively abducts and dorsiflexes
  3. calcaneus everts and carries the rest of the foot along w/ it
58
Q

transverse tarsal joint:

pronation actions

A
  1. talus ADducts and plantarflexes
  2. navicular-cuboid-calcaneus relatively ABduct and dorsiflex
  3. calcaneus everts and carries the rest of the foot along w/ it
59
Q

Evans calcaneal osteotomy

A
  • lateral column lengthening; a cut has been made in the bond and a wedge of tissue has been inserted –> which moves the navicular back into place on top of talar head (judge based on talonavicular joint)
  • to correct a pronated foot
  • transverse tarsal joint
60
Q

triple arthrodesis:

procedure

A
  • fusion of the TN, CC, and STJ joints
  • at the transverse tarsal joint
  • *If a foot is too pronated and a lot of arthritis results; you can remove the cartilage and move the foot w/ wedges building it back into the proper/desirable position (refers to fusion of 3 joints); and building it in desirable set.
61
Q

Fusion of which joint in the rearfoot complex (STJ, CC, TN) has the MOST effect on the other two joints?

A

arthrodesis w/ talonavicular joint severely limited the motion of the remaining joints to about 2 degrees and limited the excursion of the posterior tibial tendon to 25% of preop value.

62
Q

Fusion of which joint in the rearfoot complex (STJ, CC, TN) has the least effect on the other two joints?

A

Simulated arthrodesis w/ calcaneocuboid joint had little effect on ROM of subtalar joint, & it reduced the ROM of the talonavicular joint to a mean of 67% of preop

Y1 - LEA- Quiz 7/8 (9 decks)

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