The Foot- Palastanga

Question 1

Where is the subtalar joint

Answer 1

Between the talus and the calcaneus

Question 2

What is the function of the subtalar joint

Answer 2

Allows side to side movement (inversion and eversion) and participates in retsraint and propulsion of the foot

Question 3

What is the role of the midtarsal joint

Answer 3

Puts the spring into the propulsive phase of gait by allowing the anterior part of the foot to adjust itself against the posterior part

Question 4

What is the difference between the 2 longitudinal arches

Answer 4

Medial is higher and more elastic allowing propulsion and spring
Longitudinal is flatter to provide a solid base of support

Question 5

List the intertarsal joints

Answer 5

Subtalar, talocalcaneonavicular, calcaneocuboid, mid tarsal, cuneonavicular, intercuneiform, cuneocuboid

Question 6

What makes up the mid tarsal joint

Answer 6

Talocalcaneonavicular and calcaneocuboid joints

Question 7

Classification of the subtalar joint

Answer 7

Synovial plane

Question 8

Which ligament is mainly responsible for stability at the subtalar joint

Answer 8

The interosseous ligament

Question 9

Classification of the talocalcaneonavicular joint

Answer 9

Synovial ball and socket

Question 10

Name some important ligaments associated with the talocalcaneonavicular joint

Answer 10

Plantar calcaneonavicular ligament aka spring ligament

Question 11

Is movement possible at the TCN joint

Answer 11

Yes, inversion and eversion are augmented at this joint

Question 12

Classification of the calcaneocuboid joint

Answer 12

Synovial plane joint

Question 13

What movements are possible at the calcaneocuboid joint

Answer 13

Pronation and supination of the forefoot

Question 14

Describe supination and pronation of the foot

Answer 14

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

Question 15

What are ROMs of supination and pronation

Answer 15

Supination= 50degrees
Pronation= 25-30degrees

Question 16

What is significant about movement at the mid tarsal joint

Answer 16

It is always accompanied by movement at the subtalar joint

Question 17

How is inversion of the foot achieved

Answer 17

Adduction at the subtalar joint and supination of the forefoot at the midtarsal joint
Increased with plantarflexion

Question 18

How is eversion of the foot achieved

Answer 18

Abduction at the subtalar joint and pronation of the forefoot at the midtarsal joint
Increased with dorsiflexion

Question 19

What is the classification of the rest of the intertarsal joints (cuneonavicular, intercuneiform and cuneocuboid)

Answer 19

Synovial plane

Question 20

Classification of the tarsometatarsal joints

Answer 20

Synovial plane

Question 21

Classification of the metatarsophalangeal joints

Answer 21

Synovial conyloid

Question 22

Movements possible at the metatarsophalangeal joint

Answer 22

Dorsi and plantarflexion, abduction and adduction and circumduction

Question 23

Classification of the interphalangeal joints

Answer 23

Synovial hinge

Question 24

Movements at the interphalangeal joints

Answer 24

Plantar and dorsiflexion of the toes

Question 25

What are the divisions of the foot and what do they consist of

Answer 25

Forefoot- metatarsals and phalanges Midfoot- cuneiforms, cuboid and navicular Hindfoot- talus and calcaneus

Question 26

How many intermetatarsal joints are there

Answer 26

Only 3, between the lateral 4 metatarsal bones, the 1st and 2nd metatarsals are held together by interosseous fibres only

Question 27

What is the significance of the tarsometatarsal and intermetatarsal joints

Answer 27

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

Question 28

Plantarflexion of the 1st metatarsal is accompanied by

Answer 28

Adduction and a slight degree of rotation | Due to the line of obliquity of the 1st metatarsal jt

Question 29

What provides support to the medial longitudinal arch

Answer 29

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

Question 30

What makes up the medial longitudinal arch

Answer 30

Calcaneus, Talus, Navicular, 3 Cuneiforms, Metatarsals 1-3

Question 31

What makes up the lateral longitudinal arch

Answer 31

Calcaneus, Cuboid, Metatarsals 4 and 5

Question 32

What supports the lateral longitudinal arch

Answer 32

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

Question 33

What maintains the transverse arch

Answer 33

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

Question 34

Why is beneficial to have a flexible foot

Answer 34

Enhances the propulsive mechanism of contraction of gastrocnemius and soleus causing plantarflexion at the ankle

Question 35

Explain how the flexibility of the foot enhances the propulsive mechanism during walking

Answer 35

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

Question 36

What happens at the foot when landing from a jump

Answer 36

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.

Question 37

Upon weight bearing how are forces transmitted throughout the foot

Answer 37

In 3 directions towards the supports of the plantar vault, resulting in each of the arches of the foot becoming flattened and lengthened

Question 38

Muscles inverting the foot

Answer 38

Tibialis posterior and anterior

Question 39

Muscles everting the foot

Answer 39

Peroneus (fibularis) longus, brevis and tertius

Question 40

Muscles extending the toes (dorsiflexion)

Answer 40

Extensor hallucis longus Extensor digitorum longus Extensor digitorum brevis Lumbricals

Question 41

Muscles flexing the toes (plantarflexion)

Answer 41

``` Flexor digitorum longus and brevis Flexor hallucis longus and brevis Quadratus plantae Flexor digiti minimi brevis Interossei and Lumbricals ```

Question 42

What is the central digit of the foot when regarding abduction and adduction

Answer 42

The 2nd toe

Question 43

Muscles abducting the toes

Answer 43

Abductor hallucis Abductor digiti minimi Dorsal interossei

Question 44

Muscles adducting the toes

Answer 44

Adductor hallucis | Plantar interossei