The Foot Flashcards
Name the tarsal bones of the foot
medial cunneiform
intermediate cunneiform
lateral cunneiform
cuboid bone
navicular bone
talus
calcaneus
what do the arches of the foot provide? (2)
work interdependently to disperse absorption demands of the individual foot bones & assist in propulsion
name the 4 arches of the foot
medial longitudinal arch
lateral longitudinal arch
metatarsal arch
transverse arch
what is the plantar fascia
thickened fascia on the plantar side of the foot. Slips deviate medial and lateral.
functions of the plantar fascia (3)
- contributes to arch stability
- functions as a spring that stores mechanical energy
- protects the plantar aspect of the foot
5 joints of the foot
- Tarsometatarsal joint
- Intermetatarsal joint
- metatarsaophalangeal joint
- Interphalangeal joint
- subtalar joint
name the lower leg extensors (Deep: 4, superficial: 2)
Deep:
- Extensor digitorum longus
-extensor hallucis longus
-extensor hallucis brevis
-extensor digitorum brevis
Superficial:
- extensor digitorum longus
-extensor retinacula
what 2 places can you find pulses on the foot
- Dorsi pedi
- Tibialis posterior
what ‘quality’ words would someone use that typically describe nerve pain?
tingling
burning
shooting/stabbing
electric shock
name the lower leg extensors
flexor digiti minimi brevis
flexor hallucis longus tendon
flexor digitorum longus tendon
adductor hallucis
functional anatomy & biomechanics of the foot to remember (3)
- foot, ankle & leg injuries are segments that are joined together to form a kinetic chain
- each movement of a segment effect the proximal & distal segments
- chronic and over use injuries have a number of biomechanical factors involved (walking/running)
name the 3 main functional demands of the foot
- absorption- dissipate external forces that arise from the body-environment interaction
- propulsion- generate sufficient internal force to overcome the external forces acting on the body
- stability- the ability to provide a stable platform for the transition between absorption & propulsion
describe pronation of the foot & what type of foot is in this position
-combination of eversion & abduction of the foot
-results in lowering of the medial boarder of the foot
-flat feet has this position
describe supination of the foot & what type of foot is in this position
- combination inversion & adduction of the foot
- results in raising of the medial boarder of the foot
-high arched feet are in supinated position
forefoot varus
1st metatarsal is elevated relative to the 5th metatarsal
forefoot valgus
5th metatarsal is elevated relative to the 1st metatarsal
rearfoot varus
calcaneus is inverted relative to the tibia
rearfoot valgus
calcaneus is everted relative to the tibia
how do contusions on the foot happen
result of direct trauma
- dropping a weight on the foot
- being stepped on/kicked
-hit by a speeding ball/implement
rare results of contusion complications (3)
- excessive hemorrhage
- nerve damage
- damage to tendon sheaths leading to tenosynovitis
Heel Contusions: Etiology, S/S, & Management
Etiology: sudden starts/stops, change of direction, irritation of fat pad. Pain often on lateral aspect of heel.
S/S: severe pain in heel & unable to withstand stress of weight bearing. Often warm & redness over the tender area
Management: Reduce weight bearing for 24 hours, RICE & NASAIDs. Resume activity with heel cup/donut pad
Pes Plantus (flatfoot): Etiology, S/S, & Management
etiology: excess pronation, weakening supportive structure:
- wearing tight shoes
-overweight
-excessive exercise placing undo stress on arch.
S/S: pain, weakness/fatigue, calcaneal eversion, buldging navicular, flattening of medial longitudinal arch, dorsiflexion with lateral splaying of first metatarsal.
Management:
-if not causing athlete pain, do nothing
-if painful get orthotics with medial wedge or tape arch
Pes Cavus (High arch foot): Etiology, S/S, & Management
Etiology: higher arch than normal, excessive supination & high medial longitudinal arch
S/S: Poor shock absorption resulting in foot pain. Associated with
- shortening of achellies
-shortening of plantar fascia
-heavy callus development on ball and heel of foot
Management: If no pain, no need for correction.
If pain..
- orthotics can be worn with lateral wedge & stretch achellies and plantar facsia
Mortons toe: Etiology, S/S, & Management
Etiology: abnormally short 1st metatarsal, making the 2nd toe look longer. More weight bearing on 2nd toe & can impact gait= stress fracture could develop
S/S: Stress fracture and pain during/after activity with point tenderness. Positive bone scan. Callus development under 2nd metatarsal head
Management: no symptoms=nothing needs to be done
Symptomatic (forefoot varus)= orthotics with medial wedge
Hallux Valgus deformity (bunion): Etiology, S/S, & Management
Etiology: prolonged pressure against the medial aspect of the first MTP joint. Leads to thickening of the medial capsule and bursa. Caused by..
- foot pronation
-arthritis
-general ligament laxity between 1st/2nd metatarsal
-constant rubbing on the inside of shoe
S/S: Pain over MTP joint, difficulty wearing shoes, 2nd metatarsal bears more weight leading to callus (some people are aysptomatic)
Management:
-wide/soft shoes with broad toe box
-toe strap
surgical correction in severe cases
Sesamoiditis: Etiology, S/S, & Management
Etiology: inflammation of sesamoid bones in the ball of the foot & tendons they are embedded in. Caused by repetitive hyperextension of the great toe resulting in inflammation
S/S: Pain under big toe especially during push off & palpable tenderness under first metatarsal head
Management:
-Treat with orthotics, metatarsal pads, arch supports & metatarsal bars
-Decrease activity to allow inflammation to subside
Sprained toes: Etiology, S/S, & Management
(Metatarophalangeal & Interphalangeal joint sprains)
Etiology: caused by kicking a non-yeilding object. Pushes joint beyond normal ROM or imparting a twisting motion on the toe (disrupting ligaments a joint capsule)
S/S: pain is immediate & intense but short lived, immediate swelling and discolouration within 1-2 days, stiffness and residual pain will last several weeks
Management: RICE, buddy taping to immobilize. Begin weight bearing as tolerable
Overlapping toes: Etiology, S/S, & Management
Etiology: may be congenital or brought upon by improperly fitted shoes (narrow)
S/S: outward projection of big toe articulation. Drop in longitudinal arch
Management: Some cases surgery
- modalities (whirlpool baths for alleviating inflammation)
-Taping to prevent contractual tension in the sports shoe
Subungual Hematoma: Etiology, S/S, & Management
Etiology: Direct pressure, dropping an object on the toe, or kicking another object. Repetitive shear forces on toenail.
S/S: Accumulation of blood underneath toenail. Likely to produce extreme pain and ultimately loss of nail.
Management: RICE immediately to reduce pain & swelling. Relieve pressure within 12-24 hours by lance or nail drill (must be sterile to prevent infection)
Ingrown toenail: Etiology, S/S, & Management
Etiology: Common & preventable with proper hygiene & nail care.
S/S: Nail margin reddens and becomes painful. Soak and apply antiseptic to the area.
name the injuries to the toes
-sprained toes
-overlapping toes
-ingrown toe nail
-subungeal hematoma
name the injuries to the metatarsal region
-pes plantus (flat foot)
-pes cavus (high arch)
-mortons toe
- hallux valgus deformity (bunion)
-sesamoiditis
name the injuries to the heel
heel contusion
