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Kinesiology > The Lower Extremity: The Ankle and Foot [2] > Flashcards

The Lower Extremity: The Ankle and Foot [2] Flashcards

1
Q

How many bones in the foot, and how many of each type?

A

26 bones in the foot
- 7 tarsals
- 5 metatarsals
- 14 phalanges

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2
Q

Review the diagram of the bones

A

..

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3
Q

What are the major movements of the foot and ankle (TC, ST, MTP, & IP)?

A
  • Talocrural (TC): dorsiflexion and plantarflexion
  • Subtalar (ST): inversion and eversion
  • Ankle pronation: EV + AB + DF
  • Ankle supination: IN + AD + PF
  • MTP & IP: toe flexion and toe extension
  • MTP: toe abduction and toe adduction
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4
Q

Describe the talocrural joint?

A

It includes the distal tibia + the distal fibula + the talus dome (which all equate to make the ankle mortise which is the “house of the ankle”)
* it is a hinge joint
* so it does plantar flexion (45-50 degrees)
* it dorsiflexes (20 degrees)

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5
Q

Describe the Subtalar (ST) Joint and its movements?

A

It is between the talus and calcaneus. It’s movements include:
* inversion (20-30 degrees)
* Eversion (5-10 degrees), the lateral malleolus extends so far down that it crosses the subtalar joint and restricts furtherh motion in eversion

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6
Q

Describe the toe joints and their motions

A
  • Metatarsophalangeal joints (MTP) do flexion, extension, abduction, and adduction
  • Interphalangeal joints (IP) do flexion, extension, include proximal interpahalngeal and distal interphalangeal
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7
Q

What is the OIA of the plantar fascia?

A
  • O: (plantar medial) calcaneal tuberosity
  • I: base of proximal phalanx of toes 1-5
  • A: supports the foot against downward forces

Bonus: it is non-contractile, there are no muscle fibers, just inert muscle tissue

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8
Q

What is the OIA of the Plantar Calcaneonavicular (spring ligament)?

A
  • O: sustentaculum tali of calcaneous
  • I: medial plantar surface of navicular
  • A: supports medial plantar surface of longitudinal arch
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9
Q

What are the 3 lateral ankle ligaments?

A
  1. Anterior talofibular ligament (more commonly sprained)
  2. Calcaneofibular ligament
  3. Posterior talofibular ligament
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10
Q

What are the 4 medial ankle ligaments?

A

Deltoid complex: much broader, more closely packed and stronger
1. Tibionavicular
2. Tibiocalcaneal
3. Anterior Tibiotalar
4. Posterior Tibiotalar

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11
Q

What are the 4 compartments of the lower leg and what muscles are in each of them?

A

Anterior:
1. tibialis anterior
2. Extensor Digitorum longus
3. extensor hallucis longus
4. peroneus tertius

Lateral:
1. peroneus brevis
2. peroneus longus

Posterior superficial:
1. gastrocnemius
2. soleus
3. plantaris

Posterior deep:
1. flexor digitorum longus
2. flexor hallicus longus
3. tibialis posterior

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12
Q

What is the OIA of the Anterior Compartment

A

Extensor Hallicus Longus
* O: midshaft of the fibula
* I: distal phange of big toe
* A: extends the big toe and helps dorsiflex

Anterior Tibialis:
* O: lateral crest of the tibia and fibular head
* I: plantar asprct of the 1st metatarsal
* A: crosses medially so it inverts

Extensor Digitorum Longus:
* O: fibular head
* I: distal phalanges of toes 2-5
* A: toe extension & dorsiflexion

Fibularis Tertius:
* O: midshaft fibula
* I: styloid process on 5th metatarsal
* A: dorsiflex & eversion

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13
Q

What is IOA for the lateral compartement?

A

Peroneus Brevis:
* O: midshaft of the fibula
* I: styloid process of the 5th metatarsal
* A: eversion, & plantar flexion

Peroneus Longus:
* O: fibular head
* I: base of the 1st metatarsal
* A: eversion & plantar flexion

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14
Q

What is the OIA of the posterior deep compartment?

A

Posterior Tibialis:
* O: proximal tibia and fibula
* I: base of 1st metatarsal, navicular, cuboid, medial cuneiform (just pick 1)
* A: plantar flexion & inversion

Flexor Hallicus longus:
* O: fibular mid-shaft
* I: distal phalanx of 1st digit
* A: flex the big toe, plantar flexion, eversion

Flexor digitorum longus:
* O: mid-shaft of tibia
* I: distal phalanges 2-5
* A: plantarfelxion & inversion & toe flexion

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15
Q

What is OIA for posterior superfical compartment?

A

Soleus:
* O: posterior tibia and fibula (proximally)
* I: calcaneous
* A: plantarflexion

Plantaris:
* O: lateral femoral epicondyle
* I: calcaneous
* A: plantarflexion, and knee flexion (useless tho and used in tommy john surgery)

Gastrocnemius:
* O: medial head at the medial femoral epicondyle & lateral head at the lateral femoral epicondyle
* I: calcaneus
* A: plantarflexion and knee flexion

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16
Q

What muscle dorsiflexes and inverts?

A
  • Tibialis anterior
17
Q

What 2 muscles dorsiflex and evert?

A
  • peroneus tertius
  • extensor digitorum longus
18
Q

What 6 muscles plantarflex and invert? And why are there so many more muscles used for this?

A

We use these all the time to run, jump, walk, ect..
* gastrocnemius
* soleus
* plantaris
* posterior tibialis
* Flexor digitorum longus
* Flexor hallicus longus

19
Q

What 2 muscles plantarflex and evert?

A
  • peroneus brevis
  • peroneus longus
20
Q

What is the role of the retinacula?

A
  • it is connective tissue that holds tendons into place
  • our musles are curved so they want to be straight, the retinaculum holds them down
  • example “bloody sock”
21
Q

What are the names of the intrinsic Flexor muscles of the foot?

A
  • flexor digitorum brevis
  • flexor hallicus brevis
  • flexor digiti minimi brevis
  • quadratus plantae
22
Q

What are the names of the intrinsic extensor muscles of the foot?

A
  • Extensor digitorum brevis
  • extensor hallicus brevis
23
Q

What are the other just general intrinsic muscles of the foot?

A
  • Abductor hallicus
  • adductor hallicus
  • abductor digit minimi
  • plantar interossei
  • Dorsal interossei
  • Lumbricals
24
Q

What is the purspose and function of the foot?

A

Purpose:
* support and propulsion
Function:
* adapt to terrain
* absorb ground reaction forces (mid-stance)
* rigid lever (toe-off)
* it can be pliable in sand, but also ridgid to move us off the ground

25
Q

What is a toe splay and what type of muscle controls this?

A

A splay creates a stable, controlled foot gait
- instrinsics control it
Narrow shoes can lead to hallux valgus, bunions, nad hallux limitus

26
Q

What is the ROM for Normal, hallux limitus, and hallux rigidus?

A

Normal: 70-90 degrees
Hallux Limitus: less than 45-60 degrees (limits the windlass effect)
Hallux rigidus: less than 30 degres

27
Q

Describe what a foot can do when it is rigid?

A

Motion:
* supinate (IN, ADD, PF)
NWB:
* calcaneal inversion, adduction, plantarflexion

28
Q

Describe what a foot can do when it is pliable?

A

Motion:
* pronation (EV, ABD, DF)

NWB:
* calcaneal eversion
* abduction
* dorsiflexion

29
Q

What 2 things do you need for walking?

A
  • pronation and supination
30
Q

What are the different arches of the foot?

A
  1. the longitudinal medial arch (big arch on inside of foot)
  2. The longitudinal lateral arch
  3. The transverese metatarsal arch
31
Q

Explain how the medial longitudinal arch is maintained and what it interacts with?

A

Maintained by passive and active forces
* passive= articulations of the bone & plantar ligaments + spring ligamements
* Active: muscles like the instrinsics and post/anterior tibialis

32
Q

What are the 2 types of pes planus?

A
  1. Rigid: congenital, bony or joint malformations (the foot is always flat)
  2. Flexible: dropped arch when WB
33
Q

What are the signs of Pes Planus?

A
  1. Too many toes
  2. rearfoot valgus (arch collapses and caves inwards)
  3. compensated foot varus (non WB the big toe is higher than the pinky)
  4. Navicular drop test (more than 1cm)
34
Q

What are the effects of pes planus?

A
  • unstable foot
  • arch collapses with each step
  • excessive motion with each step
  • BUT good adaptation to terrain
35
Q

What are the pathomechnaics of the pes planus and wear pattern?

A
  • overstretched plantar fascia
  • muscles must be hyperactive
  • related injuries (shin splints and plantar fasciitis)

Wear pattern: lateral heel strike and medial toe off
(you can use orthotics to help)

36
Q

What is pes cavus?

A
  • high arches
  • related injuries like lateral ankle sprains and stress fractires
  • we get a valgus stress here (ankle goes outwards)
  • not good at absorbing forces
  • we dont see any toes bc the foot is so supinated

Wear pattern: plantar pressure stays latreal on both superior and inferior parts of the shoes

37
Q

What diagnoses falls under valgus and which under varus stress on the rearfoot?

A

Valgus = pes plantar
Varus= pes cavernus

38
Q

How does the plantar fascia affect gait?

A
  • Distal attachment of plantar fascia onto the flexor muscles
  • Activates the intrinisc muscles
39
Q

Describe the windlass effect?

A

The plantar fascia bows the foot’s longitudinal arch
* tested in a flat position and have them go up on their toes in Non-WB.
* then the plantar fascia bows and mechanically raises the arch up a little bit
* this helps create a rigid structure

Kinesiology (16 decks)

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