The Foot- Palastanga Flashcards
Where is the subtalar joint
Between the talus and the calcaneus
What is the function of the subtalar joint
Allows side to side movement (inversion and eversion) and participates in retsraint and propulsion of the foot
What is the role of the midtarsal joint
Puts the spring into the propulsive phase of gait by allowing the anterior part of the foot to adjust itself against the posterior part
What is the difference between the 2 longitudinal arches
Medial is higher and more elastic allowing propulsion and spring
Longitudinal is flatter to provide a solid base of support
List the intertarsal joints
Subtalar, talocalcaneonavicular, calcaneocuboid, mid tarsal, cuneonavicular, intercuneiform, cuneocuboid
What makes up the mid tarsal joint
Talocalcaneonavicular and calcaneocuboid joints
Classification of the subtalar joint
Synovial plane
Which ligament is mainly responsible for stability at the subtalar joint
The interosseous ligament
Classification of the talocalcaneonavicular joint
Synovial ball and socket
Name some important ligaments associated with the talocalcaneonavicular joint
Plantar calcaneonavicular ligament aka spring ligament
Is movement possible at the TCN joint
Yes, inversion and eversion are augmented at this joint
Classification of the calcaneocuboid joint
Synovial plane joint
What movements are possible at the calcaneocuboid joint
Pronation and supination of the forefoot
Describe supination and pronation of the foot
Occurs about the foots own longitudinal axis
Sole facing medially= supination
Sole facing laterally= pronation
Cannot occur as a pure movement and is always accompanied with adduction or abduction
What are ROMs of supination and pronation
Supination= 50degrees Pronation= 25-30degrees
What is significant about movement at the mid tarsal joint
It is always accompanied by movement at the subtalar joint
How is inversion of the foot achieved
Adduction at the subtalar joint and supination of the forefoot at the midtarsal joint
Increased with plantarflexion
How is eversion of the foot achieved
Abduction at the subtalar joint and pronation of the forefoot at the midtarsal joint
Increased with dorsiflexion
What is the classification of the rest of the intertarsal joints (cuneonavicular, intercuneiform and cuneocuboid)
Synovial plane
Classification of the tarsometatarsal joints
Synovial plane
Classification of the metatarsophalangeal joints
Synovial conyloid
Movements possible at the metatarsophalangeal joint
Dorsi and plantarflexion, abduction and adduction and circumduction
Classification of the interphalangeal joints
Synovial hinge
Movements at the interphalangeal joints
Plantar and dorsiflexion of the toes
What are the divisions of the foot and what do they consist of
Forefoot- metatarsals and phalanges
Midfoot- cuneiforms, cuboid and navicular
Hindfoot- talus and calcaneus
How many intermetatarsal joints are there
Only 3, between the lateral 4 metatarsal bones, the 1st and 2nd metatarsals are held together by interosseous fibres only
What is the significance of the tarsometatarsal and intermetatarsal joints
The joint surfaces interlock and are held together by strong ligaments so allow very little movement, however they contribute to the flexibility of the foot, particularly inversion and eversion
Plantarflexion of the 1st metatarsal is accompanied by
Adduction and a slight degree of rotation
Due to the line of obliquity of the 1st metatarsal jt
What provides support to the medial longitudinal arch
Plantar aponeurosis is most important and strongest ligament
Plantar calcaneonavicular ligament (spring)
Interosseous ligaments
Ligaments alone are no good and muscles must function to support it, flexor hallucis longus most important
What makes up the medial longitudinal arch
Calcaneus, Talus, Navicular, 3 Cuneiforms, Metatarsals 1-3
What makes up the lateral longitudinal arch
Calcaneus, Cuboid, Metatarsals 4 and 5
What supports the lateral longitudinal arch
Ligaments are relatively more important here than medially
Lateral part of the plantar aponeurosis, short and long plantar ligaments etc
Fibularis longus pulls upwards on the arch as it passes under the foot and is the single most important maintaining factor
What maintains the transverse arch
Bony factors only play a small part (due to shape of medial cuneiform)
Mainly: deep transverse ligament of the metatarsals, tendons of tibialis posterior, peroneus longus and the adductor hallucis muscle
Why is beneficial to have a flexible foot
Enhances the propulsive mechanism of contraction of gastrocnemius and soleus causing plantarflexion at the ankle
Explain how the flexibility of the foot enhances the propulsive mechanism during walking
As the heel leaves the ground the toes are extended. Extension of the great toe increases the height of the medial longitudinal arch. Flexors hallucis and digitorum longus are also stretched increasing the force of their contraction.
Contraction of long and short toe flexors increases the force of toe off
What happens at the foot when landing from a jump
The toes and then the forefoot take the potentially damaging strain (and high energy) before the heel touches the ground. Muscles and ligaments are put under tension and may absorb as much as 50% of the energy.
Upon weight bearing how are forces transmitted throughout the foot
In 3 directions towards the supports of the plantar vault, resulting in each of the arches of the foot becoming flattened and lengthened
Muscles inverting the foot
Tibialis posterior and anterior
Muscles everting the foot
Peroneus (fibularis) longus, brevis and tertius
Muscles extending the toes (dorsiflexion)
Extensor hallucis longus
Extensor digitorum longus
Extensor digitorum brevis
Lumbricals
Muscles flexing the toes (plantarflexion)
Flexor digitorum longus and brevis Flexor hallucis longus and brevis Quadratus plantae Flexor digiti minimi brevis Interossei and Lumbricals
What is the central digit of the foot when regarding abduction and adduction
The 2nd toe
Muscles abducting the toes
Abductor hallucis
Abductor digiti minimi
Dorsal interossei
Muscles adducting the toes
Adductor hallucis
Plantar interossei
