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(1) Kinesiology > S3_L3: Kinesiology of the Ankle and Foot > Flashcards

S3_L3: Kinesiology of the Ankle and Foot Flashcards

1
Q

Determine the corresponding descriptions of the motions of the foot

  1. Varus movement of calcaneus
  2. Distal aspect of a segment moves towards the midline of the foot
  3. May also be referred to as extension
  4. Valgus movement of calcaneus
  5. Distal aspect of a segment moves away from the midline of the foot
  6. May also be referred to as flexion

A. Dorsiflexion
B. Plantarflexion
C. Inversion
D. Eversion
E. Abduction
F. Adduction

A
  1. C
  2. F
  3. A
  4. D
  5. E
  6. B
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2
Q

Determine the corresponding descriptions of the tibiofibular joints

  1. Syndesmosis type of joint
  2. Forgotten Joint
  3. Ankle is dependent of the stability of this joint
  4. Plane, Synovial joint
  5. Ankle is not dependent on the stability of this joint

A. Superior tibiofibular joint
B. Inferior tibiofibular joint

A
  1. B
  2. A
  3. B
  4. A
  5. A
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3
Q

Determine the corresponding motions occurring in NWB supination and pronation

  1. Calcaneal Eversion
  2. Calcaneal Plantarflexion
  3. Calcaneal Adduction
  4. Calcaneal Dorsiflexion
  5. Calcaneal Abduction
  6. Calcaneal Inversion

A. NWB Supination
B. NWB Pronation

A
  1. B
  2. A
  3. A
  4. B
  5. B
  6. A
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4
Q

Determine the corresponding motions occurring in WB supination and pronation

  1. Talar Adduction (IR)
  2. Talar Plantarflexion
  3. Talar Abduction (ER)
  4. Tibiofibular medial rotation (IR)
  5. Talar Dorsiflexion
  6. Tibiofibular lateral rotation (ER)

A. WB Supination
B. WB Pronation

A
  1. B
  2. B
  3. A
  4. B
  5. A
  6. A
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5
Q

Determine the corresponding descriptions of supination and pronation twists

  1. 4th & 5th ray: plantarflex
  2. Tarsometatarsal joint: eversion rotation of entire foot
  3. Hindfoot pronation
  4. Medial forefoot: lift
  5. 1st & 2nd ray: dorsiflex
  6. Lateral forefoot: press into ground

A. Supination twist
B. Pronation twist

A
  1. A
  2. B
  3. A
  4. B
  5. A
  6. B
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6
Q

Determine the corresponding descriptions of the talocrural ligaments: Lateral collateral ligament

  1. Stressed when the ankle is dorsiflexed and externally rotated
  2. Common MOI: excessive inversion with foot in neutral position or sometimes, minimal dorsiflexion
  3. Orientation of fibers are more spread out (anteriorly and horizontally)
  4. Can be tested using the anterior drawer test

A. Anterior Talofibular Ligament
B. Posterior Talofibular Ligament
C. Calcaneofibular ligament

A
  1. B
  2. C
  3. A
  4. A
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7
Q

Determine the corresponding descriptions of the talocrural collateral ligaments

  1. Also known as Deltoid Ligament
  2. Helps control inversion and/or supination of the ankle and talus
  3. Ligaments are thick and clumped together
  4. Helps control eversion and/or pronation of the ankle and talus
  5. More commonly injured
    because it is thin and spread apart
  6. Stronger and has a low frequency of injury

A. Lateral collateral ligament / LCL
B. Medial collateral ligament / MCL

A
  1. B
  2. A
  3. B
  4. B
  5. A
  6. B
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8
Q

Determine the corresponding descriptions of the lateral supports of the subtalar joint

  1. Strongest among the 4
  2. Part of the LCL
  3. Found between talus and calcaneus
  4. Provide lateral stabilization
  5. Lies medially and follows an oblique path

A. Interosseous talocalcaneal ligament
B. Lateral talocalcaneal ligament
C. Calcaneofibular ligament
D. Cervical ligament

A
  1. D
  2. C
  3. A
  4. B
  5. A
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9
Q

Determine the corresponding descriptions of the ligaments supporting the calcaneocuboid joint

  1. Dorsal support
  2. Plantar support, supports lateral longitudinal arch
  3. Lateral support
  4. Plantar support inferiorly

A. Plantar calcaneocuboid / short plantar ligament
B. Bifurcate / Calcaneocuboid ligament
C. Long plantar ligaments
D. Dorsal calcaneocuboid ligament

A
  1. D
  2. C
  3. B
  4. A
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10
Q

Determine the corresponding descriptions / keystones of the arches of the foot

  1. Keystone: middle / intermediate cuneiform
  2. Largest arch
  3. Keystone: cuboid
  4. Keystone: talus (navicular / scaphoid)

A. Medial longitudinal arch
B. Lateral longitudinal arch
C. Transverse arch

A
  1. C
  2. A
  3. B
  4. A
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11
Q

Determine the corresponding passive supports of the arches of the foot

  1. Long and short plantar ligaments
  2. Plantar aponeurosis
  3. Deep transverse metatarsal ligaments
  4. Spring ligament, deltoid ligament
  5. Interosseous talocalcaneal ligament

A. Medial longitudinal arch
B. Lateral longitudinal arch
C. Transverse arch

A
  1. B
  2. A
  3. C
  4. A
  5. A
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12
Q

Determine the corresponding descriptions of the talocrural ligaments: Lateral collateral ligament

  1. Rarely torn and runs horizontally
  2. Can be tested using talar tilt test
  3. Weakest among the 3
  4. Runs vertically, located more laterally
  5. Stressed when the ankle is moved into greater degrees of plantar flexion, medial rotation, and inversion

A. Anterior Talofibular Ligament
B. Posterior Talofibular Ligament
C. Calcaneofibular ligament

A
  1. B
  2. C
  3. A
  4. C
  5. A
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13
Q

Determine the corresponding plane / axis of the motions of the foot

  1. Plane where Dorsiflexion occurs
  2. Axis for Plantarflexion
  3. Plane where Inversion occurs
  4. Axis for Eversion
  5. Plane where Abduction occurs
  6. Axis for Adduction

A. Vertical axis
B. Coronal axis
C. Anteroposterior axis
D. Sagittal plane
E. Frontal plane
F. Transverse plane

A
  1. D
  2. B
  3. E
  4. C
  5. F
  6. A
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14
Q

It is supports the head of the talus and talonavicular joint and acts as the main / most important passive stabilizer of the medial longitudinal arch. A triangular sheet of ligamentous connective tissue arising from the sustentaculum tali of the calcaneus and inserting on the inferior navicular bone.

A

Spring Ligament / Plantar Calcaneonavicular Ligament

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15
Q

An increase in normal valgus angulation of the first metatarsophalangeal joint is referred to as ___.

A

Hallux valgus

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16
Q

Hallux valgus may be associated with a varus angulation of the first metatarsal at the tarsometatarsal joint, known as ___.

A

Metatarsus varus

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17
Q

It is aka Invertor Par Excellence, the deepest muscle of the posterior compartment.

A

Tibialis posterior

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18
Q

The tendons of the peroneus longus and peroneus brevis are ___ to the axis of ankle plantarflexion and dorsiflexion.

A

Posterior

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19
Q

The tibialis posterior contracts (1)___ to control subtalar and transverse tarsal pronation and works (2)___ as the foot moves toward supination and plantarflexion.

A
  1. eccentrically
  2. concentrically
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20
Q

The tibialis posterior, flexor hallucis longus, and flexor digitorum longus all help protect the ___ aspect of the ankle.

A

Medial

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21
Q

The extensor digitorum brevis sends fibers to the medial four toes to aid in extension of toes. Its most medial fiber is also referred to as ___.

A

Extensor hallucis brevis

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21
Q

The dorsiflexor that also everts the foot

A

Peroneus tertius

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22
Q

TRUE OR FALSE: Flatfootedness can cause genu varum.

A

False, genu valgum

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23
Q

Determine the corresponding descriptions of these joints

  1. S shaped type of compound joint; transects the foot horizontally, dividing the hindfoot from the midfoot and forefoot
  2. Composite joint formed by three separate plane articulations
  3. Houses the proprioceptive center
  4. Generally considered to have a single oblique axis with one degree of freedom around which the motions of dorsiflexion / plantarflexion occur
  5. Motion of the talus and of the calcaneus on the relatively fixed naviculocuboid unit
  6. Has 2 DOF (dorsiflexion / plantarflexion & abduction / adduction)

A. Talocrural joint
B. Subtalar joint / Talocalcaneal joint
C. Transverse Tarsal / Midtarsal / Chopart’s / Surgeon’s joint
D. Tarsometatarsal Joint / Lisfranc’s joint
E. Metatarsophalangeal Joint (MTP)

A
  1. C
  2. B
  3. B
  4. A
  5. C
  6. E
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24
Q

The mobility role of the ankle mortise belongs primarily to the ___.

A

fibula

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24
Q

Limited extension ROM at the first metatarsophalangeal joint that interferes with the metatarsal break

A

Hallux rigidus

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25
Q

Characterized by excessive extension at MTP and flexion of both distal and proximal IP joints. It doesn’t influence the metatarsal break, however, it poses too much pressure on the metatarsal heads, resulting to skin breakdown.

A

Hammer toe

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26
Q

What are the Open- and Close-packed positions of the talocrural joint?

A

OPP: 10° plantarflexion, midway between inversion and eversion
CPP: Full dorsiflexion

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27
Q

Determine the corresponding descriptions of the anatomic configurations of the MTP joints

  1. Characterized by the first and second metatarsals being the same length, with the other remaining three progressively decreasing in length
  2. First metatarsal being longer than the second with the other remaining three progressively decreasing in length
  3. Second metatarsal is the longest then followed progressively by the first, third, fourth, and fifth
  4. Increased force through the second metatarsal, predisposing it to injury such as a stress fracture

A. Index plus/Egyptian Foot
B. Index minus/Morton’s Foot/Greek Foot
C. Index plus minus/Roman Foot

A
  1. C
  2. A
  3. B
  4. B
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28
Q

Determine the corresponding descriptions of the superficial plantarflexors

  1. Type 1 muscle fibers
  2. Double Jointed
  3. Weak plantarflexor of ankle
  4. Type 2 muscle fibers
  5. Influenced by knee position

A. Gastrocnemius
B. Soleus
C. Plantaris

A
  1. B
  2. A
  3. C
  4. A
  5. A
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28
Q

Enumerate the 4 ligaments that are part of the Deltoid ligament

A
  1. Anterior tibiotalar ligament
  2. Posterior tibiotalar ligament
  3. Calcaneotibular ligament
  4. Tibionavicular ligament
29
Q

It is defined as a functional unit formed by a metatarsal and its associated cuneiform bone (for the first through third)

30
Q

Most critical function of the foot complex

A

Weight-bearing

31
Q

Regarding the component / coupled motions of the foot, (1)___ of the foot is for mobility, whereas (2)___ of the foot is for stability.

A
  1. Pronation
  2. Supination
32
Q

The (1)___ makes the posterior strut and the (2)___ makes the anterior strut of the ankle and foot complex.

A
  1. Calcaneus
  2. 5 metatarsals
33
Q

The bones of the ankle and foot complex form how many joints on 1 extremity?

A

25 joints

  • proximal and distal tibiofibular joints
  • talocrural (ankle) joint
  • talocalcaneal (subtalar) joint
  • talonavicular and calcaneocuboid joints (transverse tarsal joints)
  • 5 tarsometatarsal joints
  • 5 metatarsophalangeal joints
  • 9 interphalangeal joints
34
Q

TRUE OR FALSE: The subtalar joint relies more on the configuration of the bones rather than the ligaments for its stability.

35
Q

TRUE OR FALSE: Stability of the ankle depends on an intact ligamentous structure as the capsule of the ankle joint is fairly thin and is especially weak anteriorly and posteriorly.

36
Q

It acts interdependently with the joints of the hindfoot to contribute to increasing the longitudinal arch as the heel rises during the metatarsal break, thus contributing to converting the foot to a rigid lever for effective push-off. It spans from the medial tubercle of calcaneus to plantar plates to the proximal phalanx of each toe.

A

Plantar aponeurosis / Plantar fascia

37
Q

In standing, 100% of the BW will be received by the ___. From this structure, 50% is distributed posteriorly to the hindfoot, then the remaining 50% is distributed anteriorly to the midfoot and forefoot.

38
Q

It occurs due to the tension brought about by the MTP hyperextension that approximates the hindfoot and metatarsals, produces tension on the plantar fascia, and raises the longitudinal arches. This is especially important in push-off.

A

Windlass effect

39
Q

It is aka Fishermen’s Nerve because it appears similar to a nerve when dissected.

A

Plantaris muscle

40
Q

TRUE OR FALSE: The plantar arches are flat for children below 5 years old.

A

True

The arches are usually not present at birth but evolve with the progression of weight bearing

41
Q

The tension in the tibialis anterior, extensor hallucis longus, and extensor digitorum longus muscles is the primary limit to what movement?

A

plantarflexion

42
Q

The primary limitation to dorsiflexion, whether active or passive tension.

A

Triceps surae (Gastrocnemius & soleus)

Additional: Strongest plantar flexors of the ankle

43
Q

TRUE OR FALSE: The function of the ankle (talocrural) joint is dependent on stability of the tibiofibular mortise.

44
Q

TRUE OR FALSE: Plantar fasciitis is common in flat footed individuals and a common area of pain is just in front of calcaneus or sometimes, medial longitudinal arch.

45
Q

A foot that appears to be pronated in a fixed position

A

Pes planus / flat foot

46
Q

A foot that appears to be supinated in a fixed position

A

Pes cavus

Additional: A high-arched foot is relatively more rigid and can be more susceptible to impact-type injuries, especially on the lateral side of the foot.

47
Q

If adaptive tissue changes result in a sustained tarsometatarsal supination twist, the deformity is known as a ___.

A

forefoot varus

48
Q

TRUE OR FALSE: Hyperpronated foot / pes planus / flat footedness is often associated with tibialis anterior dysfunction.

A

False, it’s tibialis posterior

49
Q

TRUE OR FALSE: In hyperpronated foot / pes planus / flat footedness, MTP extension is limited, the plantar aponeurosis is lengthened, and the windlass effect decreases.

50
Q

Differentiate fixed and mobile flatfootedness.

A

Fixed: Navicular bone is fixed, no arch whether WB or NWB
Mobile: Navicular bone can be moved back to its original position with arch support

51
Q

Refers to MTP extension as the heel rises during gait. It helps in pushing the foot on the ground to propel forward.

A

Metatarsal break

52
Q

TRUE OR FALSE: Any weight-bearing subtalar motion causes the talonavicular and calcaneocuboid joint to move simultaneously.

53
Q

In the posterior view during PA, the PT should be able to see only the 3 lateral toes. If the PT saw more than 3, the patient has an excessive ___ of the tibia.

A

External rotation

54
Q

The only tarsometatarsal joint with its own articular capsule

A

1st / medial tarsometatarsal joint

55
Q

The third tarsometatarsal joint, formed by the third metatarsal and the ___, shares a capsule with the second tarsometatarsal joint.

A

lateral cuneiform

56
Q

The bases of the fourth and fifth metatarsals, with the distal surface of the ___, form the fourth and fifth tarsometatarsal joints.

A

cuboid bone

57
Q

___ of ankle dorsiflexion is considered the minimal amount needed to ambulate without deviation.

58
Q

TRUE OR FALSE: The talocrural axis (from edge of medial and lateral malleoli) is not completely horizontal.

59
Q

The large end of the sinus tarsi is anterior to the (1)___ malleolus and the small end lies below the (2)___ malleolus.

A
  1. lateral
  2. medial / tibial
60
Q

The sustentaculum tali is a bony prominence palpable close to the ___ end of the sinus tarsi.

61
Q

TRUE OR FALSE: The amount of outward tibial torsion increases from birth until 10 years or age. As tibial torsion increases, the axis of the ankle joint is positioned more laterally in the transverse plane.

62
Q

Normal values of the Toe Out Angle of the foot / Fick’s Angle in adults and children

A

Adults: 12-18°
Children: 5°

63
Q

What are the movements done by the Transverse Tarsal / Midtarsal / Chopart’s / Surgeon’s joint?

A

Abduction & adduction of the forefoot

64
Q

In the composite motions in WB (supination / pronation), the only movements the calcaneus can do are?

A

inversion and eversion

65
Q

TRUE OR FALSE: Flattening of the triangle (pronation of the foot) in weight-bearing will increase tension in the plantar aponeurosis (the tie-rod) and limit metatarsophalangeal joint extension.

66
Q

TRUE OR FALSE: Dorsiflexion of the foot around a typically inclined ankle axis will not only bring the foot up but will also simultaneously bring it slightly lateral to the leg and appear to turn the foot longitudinally away from the midline.

67
Q

The transitional link between the hindfoot and the forefoot, serving to add to the supination / pronation range of the subtalar joint.

A

Transverse Tarsal / Midtarsal / Chopart’s / Surgeon’s joint
/ Calcaneocuboid and Talonavicular joint (Talocalcaneonavicular joint)

68
Q

TRUE OR FALSE: The subtalar joint has 2 articulations. Its posterior articulation is between the concave talus superiorly and convex calcaneus inferiorly. Its smaller anterior articulation is by the 2 convex facets of talus and calcaneus.

A

True

Additional: When the talus moves on the posterior facet of the calcaneus, the articular slides in the same direction as the bone moves. At the medial and anterior joints, the talar surfaces glide in opposite direction.

69
Q

TRUE OR FALSE: The normal values for subtalar inversion and eversion are 0-5° for both.

A

True, as more than that would mean other motions are occurring (supination/pronation)

70
Q

TRUE OR FALSE: The more distally protruded and situated more posteriorly lateral malleolus results in external tibial torsion / tibiofibular torsion. This position of the lateral malleolus is due to the normal torsion or twist that exists in the distal tibia in relation to the tibia’s proximal plateau.

71
Q

Location of a lot of mechanoreceptors (Deep sensory receptors) which provides proprioception information on movement of ankle and foot.

A

Sinus tarsi

72
Q

TRUE OR FALSE: Recurring ankle inversion sprains / eversion sprains leads to injury of the proprioceptors in the sinus tarsi. Thus, the
proprioceptive ability to detect the position of the foot is diminished.

(1) Kinesiology (13 decks)

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