the ankle and foot complex Flashcards
(163 cards)
1
Q
stability is require to allow for rigid foot during __ __
A
push off
2
Q
___ is required for shock absorption and uneven terrain
A
mobility
3
Q
what is considered the rearfoot (hind foot) , mid foot , and fore foot
A
rearfoot: talus and calcaneus
mid foot: navicular, cuboid and 3 cuneiform bones
forefoot: metatarsals and phalanges
4
Q
what are the 3 motions of the foot and ankle complex
A
DF/PF (talocural)
INV/ EV ( subtalar)
ABD/ADD (subtalar, forefoot)
5
Q
what movement of the food is pronation
A
DF/EV/ABD
6
Q
what movement of the foot and ankle is supination
A
PF/INV/ADD
7
Q
what is considered calcaneovalgus
A
pronation >180°
8
Q
what is considered calcaneovarus
A
supination < 180°
9
Q
what is considered the proximal tib-fib joint
A
head of fibula and posterolateral aspect of tibia
10
Q
in the proximal proximal tib fib there is a ___ tibial facet and ___ fibular facet
A
convex and concave
11
Q
the proximal tib-fib is anatomically belongs to the ___ but functionally to the ___
A
knee
ankle/foot
12
Q
the distal tib-fib is a ___ union
A
syndesmosis (ligament in between 2 bones)
13
Q
is there a join capsule in the distal tib fib
A
no just ligaments
14
Q
what are the 2 ligaments of the distal tib fib
A
anterior and postioer tib fib lig
interosseous lig
15
Q
the function of what joint is dependent on the stability of the tibiofibular joint
A
talocural joint
16
Q
____ trauma could lock prox tibfib joint
A
inversion
17
Q
hypermobility of proximal tibfib joint could leave to what nerve injury
A
common fibular
18
Q
injury of the syndesmosis of the distal tibfib can lead to what
A
widening of the “mortise” which will lead to instability at talocrural joint
19
Q
what type of joint is the talocrural joint
A
synovial hinge joint
20
Q
what is the talocrural joint
A
distal tibtfib on body of talus
21
Q
what makes up the mortise of the ankle
A
concave tibial plafond + malleoli
22
Q
what is the distal articulating surface of the talocrural joint
A
body of talus with 3 facets and trochlear surface (convex)
23
Q
is the capsule for the talocrural joint thin or thick and weak or strong
A
thin and weak
24
Q
wh are the ligaments of the talocrural joint
A
medial collateral lig (deltoid)
lateral collateral lig
25
where does the medial collateral lig insert
navicular , talus and calcaneus
26
what is medial collateral lig or lateral collateral lig stronger
medial collateral lig
27
what are the 3 ligament names of the lateral collateral lig
anterior and posterior talofibualr lig
calcaneofibular lig
28
what was the lateral collateral lig of the talocrural joint help limit
inversion or supination
29
which axis of the talocrural allows the foot to move across 3 planes
oblique
30
how does the talocrural axis go thru the foot
goes thru fibular malleolus thru talus to tibial mall distally and posteriorly
31
how is the talocrural axis aligned
inclined down laterally 14° and posteriorly 23°
32
what is the typical amount of toe out ?
20°
33
during dorsiflexion what is the motion of the talocrural motion
head of talus rolls dorsally while the body of the talus glides plantarly
34
normal ROM of DF
20°
35
when is DF limited ? and why
in closed packed position by the acitive or passive tension in gastroc/soleus
36
during plantarflexion what is the motion of the talocrural joint
the head of the talus rolls plantarly and the body of the talus rolls dorsally
37
what is the normal ROM of PF
50°
38
during PF small amount of what 2 motions may happen
talar rotation (abd/add) or talar tilt (inv/ev)
39
when is only the posterior body of the talus is in contact
loose pack PF
40
during loose pack PF there is a higher incidence of what
ankle sprains
41
loose pack PF is limited by tension in what 3 muscles
anterior tibialis , EHL and EDL
42
the medial ankle is protected by what 3 mm
posterior tib, FHL , FDL
43
what lateral ankle is protected by what 2 mm
fibular longus and brevis
44
where is the shape of the talus wider distally or proximally
distally
45
in WB , as the mortise rotators over the __- the tib fib joint adjusts to widen around the ___ talus
talus
distal
46
DF causes what rotation of the tib fib
medial
47
plantarflexion causes what rotation of the tib fib
lateral
48
is the lateral facet or medial facet larger on the talocrural joint
lateral
49
what is the subtalar joint made up of
talus and calcaneus
50
how many articulations does the subtalar joint have
3 seperate
51
what is the proximal articulation of the subtalar joint
concave talus on convex calcaneus (largest facet )
52
what is the distal and medial articulations of the subtalar joint
convex facet of inferior body and neck of talus on 2 concave facets on calcaneus
53
the tarsal canal is formed by ___ in both bones of the subtalar joint and runs from what to what
sulcus
runs from sinus tarsi (lateral) to sustentaculum tail (medial)
54
what are the 5 ligaments of the subtalar ligaments
• Calcaneofibular ligament
• Anterior and posterior talofibular
ligaments
• Lateral and interosseous talocalaneal ligament
• Cervical ligament (strongest component)
• Deltoid ligament
55
the alternating convex and concave facets of the subtalar joint limits what
mobility
56
the axis of the subtalar joint is inclined ___ dorsally and distally and ____ medially
42° dorsally and distally (superior and anteriorly) and medially 16°
57
NWB coupled motions for supination is what
calcaneal ADD, INV, and PF
58
NWB coupled motions for pronation is what
calcaneal ABD, EV, DF
59
EV is sometimes referred to as ___ and INV as ___
valgus
varus
60
when the calcaneus is fixed on the ground the subtalar joint is only able to move in what plane
EV/INV
61
what is the subtalar motion of WB pronation
calcaneal EV , talar ADD and PF , the tib fib medial rotation
62
what is the subtalar motion during WB supination
calcaneal INV , talar ABD and DF
tib fib lateral rotation
63
what is normal INV ROM
20-30
64
what is normal ROM for EV
5-10
65
in bilateral stance there is a ___ degree of EV
3.5
66
gait range requires how much INV at heel strike
3 °
67
gait range requires how many degrees of INV during push off
5.5 °
68
what is the closed pack position of the subtalar joint
supination , stable foot position
69
what is the open packed position for the subtalar joint
pronation , flexible foot position
70
Talonavicular and calcaneocuboid form S shaped …
transverse tarsal joint line
71
___ and____ are immobile in weight bearing
navicular and cuboid
72
the talus in WB can be soldiered to act as a ball bearing between what 3 joints
the tibfib mortise superiorly
the calcaneus plantarly (the subtalar joint)
the navicular bone distally (the talonavicular joint)
73
what makes up the talonavicular joint
distal convex head of the talus with concave proximal aspect of navicular
74
what ligaments runs from the sustentaculum tail of the calcaneus to plantar aspect navicular bone
plantar calcaneonavicular ligament (spring)
75
what does the medial segments of the spring ligaments act as
a sling to hold the head do the talus
76
what does the lateral segments of the spring ligaments resist
tensile forces
77
the talonavicular joint is reinforced by what medially and laterally
medially - deltoid ligaments
laterally - bifurcate ligaments
78
the talonavicular joint has additional suppport from what other 3 ligaments
dorsal talonavicular ligament, talocrural ligaments, and subtalar ligaments
79
When talus adjusts over calcaneus at subtalar, motion also occurs at ___ joint
talonavicular
80
what makes up the calcaneocuboid joint
distal calcaneus with proximal cuboid
81
the calcaneocuboid joint is linked to ___ in WB
subtalar
82
INV/ EV of the calcaneus causes the calcaneocuboid joint to also move on a fixed ____ in a twisting motion
cuboid
83
the calcaneocuboid joint has its own capsule with what 4 things
lateral band of bifurcate, dorsal CC ligament, plantar CC ligament, and long plantar ligament
84
the longer planatar ligaments runs from ___ across ___ to base of ___ MT
calcaneus across cuboid to bases of 2-4 MT
85
the transfer tarsal axis is a longitudinal axis that inclines up to how many degrees from the transverse plane
15°
86
the transverse tarsal axis angles ___ medially from the sagittal plane aloowing triplanar motion for ____ and ____
9°
sup and pro
87
in the tarsal axis the talus and calcaneus moves on the ___ and ____ mostly in INV/EV
nav and cuboid
88
the oblique axis of the tarsal axis is ____ medial to the sagittal plane and ___ supinated to the transverse plane which allows sup/pro of talus and calcaneus
57°
52°
89
what motion is mostly in the oblique axis for the calcaneocuboid joint
DF/PF and ADD?ABD
90
the transverse tarsal joint is mechanically linking to the subtalus in WB of ___ and___
pro and sup
91
As subtalar supinates, ___ and ____ also supinate until all joints are locked in ___ packed position
talonavicular
calcanealcuboid
closed
92
as the subtalar pronates the ____ and ___ also _____ until all the joints are in a ___ packed position
talonavicular and calcanealcuboid
loose `
93
how do you assess the mid foot motion
put the hind foot into pronation to “unlock” the transverse tarsal joint
94
what is the transitional link between the hind foot and forefoot
transverse tarsal joint
95
what joint aids in the ability of the forfeoot to remain flat on the ground while the rearfoot SUP/PRO in response to terrain or the rotations of the leg
transverse tarsal joint
96
in WB supination there is ___ rotation of the tibia which will impose ____ supination with relative pronation of the ____
lateral
hind foot
forefoot
97
what ligaments can be sprains easily in excessive supination
lateral ligaments
98
what rotation of the tibia imposes subtalar pronation in WB
medial rotation
99
what kind of joint is the tarsometatarsal joint
plane synovial joint
100
what makes up the tarsomatatarsal joint
distal tarsal and base of MT
101
what is the 1st TMT joint formed by
base of 1st MT and medial cuneiform (has own capsule)
102
what is the 2nd and 3rd MT share a capsule with
2nd and 3rd cuneiforms
103
the 4th and 5th TMT joint are formed with what
cuboid and share a capsule
104
which TMT joint is the strongest and more restricted in motion
2nd and 3rd
105
which rat for the TMT have the most motion
1st and 5th ray with oblique axis and triplanar motion
106
what motion does the 1st ray do during pronation and supination
pro: DF, INN, ADD
SUP: PF, EV and ABD
107
what motion does the 5th ray of the TMT joint do during pronationa and supination
pro:DF, EV, ABD
sup:PF, INV, ADD
108
what is the function of the TMT joint
contribute to arching/ flattening of foot
109
When hindfoot motion is near end ranges but can’t fully compensate, ____ can rotate for further compensation of forefoot
TMT
110
When hindfoot pronates a lot in WB, transverse tarsal joint will supinate to counter rotate the forefoot and keep the plantar aspect of foot on the ground… If more adjustment is needed, 1st and 2nd rays are pushed into ____ by GRF and 4th and 5th rays will ___ to maintain ground contact
DF
PF
111
what is associated at the forefoot with excessive pronation of hind foot
forefoot varus
112
when in WB , someone with forefoot varus will present with an ___ subtalar joint
everted
113
how many DOF does the Metatarsaphalangeal Joints have
2 (flex/ext and abd/add)
114
in the late stance phase of walking ____ of the Metatarsaphalangeal Joints is key so foot can pass over toes
extension
115
Metatarsal heads and toes help ____ ___
balance bodyweight
116
concave/convex metatarsal heads with convex/concave proximal phalanx
convex
concave
117
which MT is typically the longest
2nd
118
___ ____ bear weight in stance
metatarsal heads
119
there are seasamoid bones on the plants aspect of which MTP and they act as anatomical pulley for what muscle and protects what tendon in WB
1st
FHB
FHL
120
what is the normal ROM of flex/ext of the 1st MTP
ext- 82
flex- 17
121
how many degress of MTP ext is used during walking
42°
122
what is stiff 1st MTP called
hallux rigidus
123
excessive extension at MTP can results in what toe deformity
hammer toe
124
how much does the 1st MTP adduct during gait
15°
125
if the MTP adducts past 15° then what toe deformity is that
hallux valgus deformity
126
how many DOF does the Interphalangeal Joints have
1 (flex/ext)
127
how many Interphalangeal Joints does each toe have
2-5 have 2
GT has 1
128
what is it called if someone has an extra toe
Polydactyly
129
what is it called if someone is missing toes
Ectrodactyly
130
what are the 3 arches in our foot
medial and lateral longitudinal arches
transverse arch
131
where does the longitudinal arches (medial and lateral ) attach to posteiorly and anteriorly
posteriorly to the calcaneus and anteriorly to the MET heads
132
which longitudinal arch is higher
medial
133
what is the keystone of the longitudinal arches
talus
134
what is the key stone of the transverse arch
medial cuneiform
135
where is it easiest to see the transverse arch
TMT joint
136
what are the 4 ligaments that support the arches
spring lig
interosseous talocalcaneal lig
plantar aponeruosis
cervical lig
137
which ligament is the most static stabilize for the arches ? and what is it a sling for
spring lig and sling for talar head
138
which ligament of the arches support is within the subtalar joint
interosseous talocalcaneal lig
139
where does the plantar aponeurosis connect to
calcaneus (medial tub) to MT heads
140
what does the cervical lig support
posterior longitudinal arch
141
what ligaments i the strongest of talocalcaneal structures
cervical lig
142
where does the cervical lig attach to
lateral calcaneus to talus
143
what is the mobility function of the arches
accept weigh during early stand and adapt to surfaces
144
the arches of the foot requires flexibility to do what 3 things
damien impact of WB forces ‘
dampen rotational motion
adapt to changes in support surface
145
the stability function of the arches require stiffness for what 2 things
distribution of weight thru the foot
covert flexible foot to ridge lever for gait
146
where does the plantar fasciitis run
calcaneus to plantar plates and prox phalanx
147
when is the plantar aponeurosis subject to tension forces
during toe ext
148
what mechanism explains that Tension of the plantar aponeurosis contributes to foot supination and increasing longitudinal arch and rigid lever function
– Windlass mechanism
149
how much weight does the talus receive in bilateral stance
50% on each
150
how much weight does the talus receive in unilateral stance
100%
151
during unilateral stance WB the talus receives 100% if the body weight and then distributes it where
50% to the calcaneus and 50% to the talonavicular and calcaneocuboid
152
when is plantar pressure greater than, during walking or standing
walking
153
where is there the highest pressure under the MET head during gait
during push off
154
when is hell pressure that greatest during gait
greatest at heel strike
155
a supinated foot is also called what
pes cavus
156
an excessive pronated foot is called what
pes planus
157
someone with a supinated foot will present with what
inverted calcaneus
high medial longitudinal arch
lateral talonavicular bulge
forefoot valgus
158
what is common with supinated foot (pes cavus)
ankle sprains
159
someone with pes cavus will have a ___ shock absorption
decreased
160
someone with excessive pronated foot (pes plantus) will present how
flat medial longitudinal arch
hallus valgus
tired feet
161
someone with excessive pronated feet will have a ___ ridge lever
decreased
162
club foot has mid foot ___ deformity , metatarsals ___ deformity , hind foot __ deformity , and hind foot ___ deformity
• Midfoot cavus deformity
• Metatarsus adductus deformity
• Hindfoot varus deformity
• Hindfoot equinus deformity
163
Congenital Talipes Equinovarus (club foot) happens how often
1 per 1000 births
