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Musculo-Skeletal System > The Lower Limb 3- Foot and ankle, disorders of foot and ankle > Flashcards

The Lower Limb 3- Foot and ankle, disorders of foot and ankle Flashcards

1
Q

tarsal bones

A

a set of seven irregularly-shaped bones, situated proximally in the foot

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2
Q

metatarsals

A

five metatarsals connect the phalanges to the tarsal bones

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3
Q

phalanges

A

the bones of the toes each toe has 3 except the big to which has 2

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4
Q

the foot can be divided into

A

hindfoot- talus and calcaneus
midfoot- navicular, cuboid and cuneforms
forefoot- metatarsals and phalanges

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5
Q

articulations of the tarsal bone

A

superiorly- ankle joint, between the talus, tibua and fubula

inferiorly- subtalar joint between talus and calcaneus

anteriorly- talonaviclar joint, between the talus and the navicular

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6
Q

what movements can the ankle joint do

A

dorsiflexion

plantarflexion

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7
Q

what muscles allow plantarflexion

A

gastroceminus
soleus
plantaris
tibialis posterior

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8
Q

what muscles allow dorsiflexion

A

tibialis anterior
extensor hallucis longus
extensor digitorium longus
peroneus tertius

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9
Q

what ligaments are lateral and what do they resist

A

anterior talofibular ligament between lateral malleolus and neck of talus

posterior talofibular ligament beween malleolar fossa and the lateral tubercle of the talus

calcaneofibular ligament between the tip of the lateral malleolus and the lateral surface of the calcenus

INVERSION

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10
Q

what prevents exessive eversion

A

the medial ligament

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11
Q

where does eversion and inversion occur

A

at the subta;ar, calcaneocuboid and the talocalcaneonavicular joints of the midfoot

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12
Q

subtalar joint

A

articulation between the talus and calcaneus

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13
Q

what 4 muscles make up the anterior compartment of the leg

A

tibialis anterior
extensor digitorum longus
extensor hallucis longus
peronues/ fibularis tertius

allow dorsiflexion and invertion

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14
Q

what innervates the anterior compartment and what is the blood supply

A

deep peroneal nerve L4/5

anterior tibial artery

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15
Q

what innervates the posterior compartment of the leg

A

tibial nerve- branch of sciatic

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16
Q

superficial posterior compartment

A 
gastroceminus
plantaris 
soleus
popliteus 
tibialis posterior 
flexor digitorium lomgus 
flexor hallucis longus
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17
Q

structures behind the medial malleolus medial to lateral

A 
tibialis posterior
flexor digitorium longus tendon
posterior tibial artery
posterior tibial vein
tibial nerve
flexor hallucis longus
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18
Q

femoral pulse

A

can be palpated as it enters the femoral triangle midway between the anterior superior illiac spine of the pelvis and the pubic symphysis - MIPA- mid inguinal point

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19
Q

popliteal artery pulse

A

hardest place to palpate. lies deep in popliteal fossa

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20
Q

dosalis pedis pulse

A

located palpating the dorsum of the foot, immediately lateral to extensor hallucis tendon

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21
Q

posterior tibial pulse

A

palpated in the tarsal tunnel just below and behind the medial malleolus

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22
Q

what makes up the popliteal fossa

A

superomedial border- semimembranous
superolateral border- biceps femoris
inferomedial border- medial head of gastrocemeninus
inferolateral border- lateral head of the gastroceminus and plantaris

floor- popliteal surface of the femur, popliteal surface of the knee joint capsule and the oblique popliteal ligament and the popliteus muscle

roof- politeal fascia and skin

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23
Q

ankle joint an associated ligaments as ring

A

the proximal part of the ring is formed by the articular surfaces of the tibia and fibula, united at the inferior tibiofibular joint by syndesmotic ligaments

medial side of the ring is formed by the medial deltoid ligaments

inferior part of the ring is formed by the subtalar joint

lateral side formed by the lateral ligament complex of the ankle

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24
Q

talar shift

A

when there is disruption of any 2 out of the syndesmosis, medial or lateral ligaments, the ankle mortise becomes unstable and widens so that the talus can shift medially or laterally within the joint

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25
Q

what is an ankle sprain

A

partial or complete tear in one of the ligaments of the ankle joint

heal with time and rest

usually occur through excessive strain on the ligaments of the ankle. Excessive external rotation, inversion or eversion of the foot due to an external force.

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26
Q

what contributes to an increased risk in ankle sprain

A

weak muscles/tendons that cross the ankle the ankle joint. especially the peroneal muscles

weak or lax ankle ligaments

inadequate joint proprioception

slow neuromuscular response to an off-balance position

running on uneven surfaces

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27
Q

what is the most common mechanism of injury to the ankle

A

inversion injury affecting a plantar-flexed and weight-bearing foot

anterior talofibular ligament is most at risk of sprain

28
Q

mechanism of achilles tendon rupture

A

making a forceful push-off with an extended knee

a fall with the foot outstretched in front snd the ankle dorsiflexed

falling from a height or off a kerb

29
Q

signs and symptoms of a achilles tear in the tendon

A

a sudden and severe pain at the back of the ankle or in the calf

the sound of a loud pop or snap

a palpable gap or depression in the tendon

initial pain and swelling followed by bruising

inability to stand on tip toe or push off

30
Q

hallux valgus

A

varus deviation of the first metatarsal
valgus deviation and/or lateral rotation of the hallux
prominence of the first metatarsal head, with or without an overlying callus

31
Q

hallux rigidus

A

osteoarthritis of 1st metarsophalangeal joint resulting in stiffness of this joint

range of dorsiflexion becomes severely restricted due to the arthritis. A dorsal bunion (osteophyte) may develop on top and rub on shoes

32
Q

arthroplasty

A

joint replacement

33
Q

arthrodesis

A

joint fusion

34
Q

excision arthroplasty

A

surgical removal of the joint with interposition of soft tissue

35
Q

osteotomy

A

surgical cutting of bone to allow realignment

36
Q

claw toe

A

affect all 4 toes at the same time
toes hyperextended at the MTPJ and flexed at the PIP joint

a result of muscle imbalance which causes the ligaments and tendons to become tight due to neurological damage

37
Q

hammer toe

A

a deformity in which the toe is flexed at the PIPJ, whereas a mallet toe is flexed at the DIPJ. Most common second toe

38
Q

curly toe

A

congenital and usually involve 3rd and 4th digits
bilateral
thought to occur due to tendons of flexor digitorium longus or digitorium brevis are too tight

39
Q

achilles tendinopathy

A

degernative process in which the tendon becomes thickened and degernative

follows many years of over-use or inactive

40
Q

signs and symptoms of achilles tendinopathy

A

pain and stiffness along the achilles tendon in the morning
pain in the tendon or at the back of the heel that worsens with activity
severe pain 24 hours after exercising
thickening of the tendon
swelling that is present all of the time but worsens with activity
palpable bone spur

41
Q

pes planovalgus

A

flat foot
valgus refers to the valgus angulation of the hindfoot
medial arch of the foot has collapsed so medial border touches the ground

42
Q

charcot arthropathy

A

which involves progressive destruction of the bones joints and soft tissues

43
Q

gait

A

the mechanism by which the body is transported using co-ordinated movements of the major lower limb joints

44
Q

what is needed for normal gait 5 things

A 
stability 
foot clearance during swing 
pre-positioning for inital contact 
adequate step length 
energy conservation
45
Q

double support

A

2 periods of time when both feet are in contact with the ground
decreases as you walk faster, leading to jogging, running and eventually sprinting

46
Q

double float

A

time in the gait cycle when neither foot is in contact with the ground

47
Q

initial contact

A

first part of foot to strike the ground which is the heel- heel strike

48
Q

loading response

A

period of deceleration where the shock of the impact is absorbed by the knee and ankle

49
Q

mid stance

A

the foot is flat on the ground and the centre of gravity of the body is shifted from behind the foot to in front of the foot ready for forward propulsion

50
Q

terminal stance

A

the ankle is plantarflexed and the heel of the supporting leg raises from the ground

51
Q

pre-swing

A

the metatarsopharangel joints flex to give a push off by toes

52
Q

initial swing

A

the kne flexes to enable the foot to clear the ground

53
Q

mid swing

A

the hip flexs and the pelbis swings forwards to enable forward progression. There is dorsiflexion of the ankle to the neutral position

54
Q

terminal swing

A

the knee extends and the foot is brought close to the ground in preparation for the inital contact - heel strike

55
Q

stride

A

the distance from initial contact with one leg to the next initial contact with the same leg

56
Q

step

A

the distance from inital contact with ine le t initial contact with opposite leg

57
Q

cadence

A

the number of steps per minute

58
Q

gait analysis

A

kinematics- the motions themselves

kinetics- the forces and moments that cause motion

59
Q

antalgic gait

A

patients walk in a manner that reduces pain- walk on a limp. Shortening the stance phase of the painful limb. Shortened swing phase of unaffected limb.

uneven gait

walking stick used in opposite limb

60
Q

hemiplegic gait

A

due to paralysis on one side
results from stroke
can occur as a consequence of cerebral palsy or trauma to CNS
patients have spasticity of affected side

typically have a flexed upper limb and extended long limb
in order to take a step they have to lean towards the unaffected side of the body then circumduct the paralysed leg

61
Q

diplegic gait

A

spasticity affects both lower limbs
most commonly develops in cerebral palsy

walks with a very narrow-based gait, dragging both legs and scraping toes on the ground

forefoot that makes initial contact with the ground

62
Q

high steppage gait

A

when the foot is raised from the ground in the swing phase the abscence of dorsiflexion means that the foot under gravity assumes plantarflexion

patient has to flex the hip much more than usual to lift their foot high off the ground and stop their toes dragging

63
Q

arrangement of tendon instertions in pes anserinus

A

say grace before tea

sartorius
gracilis
Tendinosus

64
Q

peroneal nerve- action

A

PED
common Peroneal Everts and Dorsiflexes ]
injury- foor drop

65
Q

tibial nerve

A

TIP
Tibial Inverts and Plantar flexes
injury cant walk on tip toes

Musculo-Skeletal System (16 decks)

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