Week 1 Flashcards
What are the functions of the foot?
Shock absorption
Adaptation to surfaces
Propulsion
What are the three key joints of the foot?
Talocrural
Subtalor
Midtarsal
What bones articulate in the talocrural joint?
Tibia
Fibula
Talus
What are the actions and degrees of the talocrural joint?
DF- 12-20 degrees
PF- 50-56 degrees
What is the articulation for the subtalor joint?
Calcaneus
Talus
What are the actions of the subtalor joint?
Supination
Pronation
What are the articulations of the midtarsal joint?
Talus and Navicular
Calcaneus and cuboid
What are the actions of the midtarsal joint?
Forefoot PF/DF
Forefoot ADD/ABD
What are the first ray actions?
PF with eversion
DF with inversion
What are the actions of the fifth ray?
Eversion with PF
Inversion with DF
What is it called when the calcaneus is neutral and the forefoot is perpendicular to the calcaneus?
Forefoot Neutral
What is called when the calcaneus is neutral and the forefoot is supinated/inverted?
Forefoot varus
What is it called when the calcaneus is neutral and the forefoot is pronated/everted?
Forefoot valgus
What occurs with a rigid PF 1st ray?
Puts calcaneus in varus
What occurs with forefoot varus and flexible 1st ray?
Puts calcaneus in valgus
What is affected with internal or external rotation?
Lower leg
Rearfoot
Midfoot
Forefoot
What is associated with an internal rotatory deformity?
Tibial internal rotation Calcaneal valgus Midfoot pronation Forefoot abduction Pes planus Medial soles worn out
What is associated with an external rotatory deformity?
Tibial external rotation Calcaneal varus Midfoot supination Forefoot adduction Pes cavus Susceptible to lateral ankle sprains Lateral soles worn out
What does IRD do to the knee?
Valgus moment
Genu Valgum
Medial collateral laxity
Lateral compartment compression
What does ERD do to the knee?
Varus moment at the knee
Genu Varum
Lateral collateral laxity
Medial compartment compression
What can cause rotatory deformities?
Boney anomalies
Joint laxity (lig. and tendons)
Muscle weakness
Muscle imbalance (spasticity, hyper tonicity)
What biomechanical tools can be used to correct and control IRD and ERD?
Three point force systems
Ground reaction force
What occurs with a longer lever arm?
Less force required to correct
Where are the three points of force to counter genu varum?
Proximal medial force directed laterally near mid thigh
Distal medial force directed laterally near ankle
Lateral force directed medially at knee
Where are the three points of force to counter genu valgum?
Proximal lateral force directed medially near mid thigh
Distal lateral force directed medially near ankle
medial force directed laterally at knee
Where are the three points of force to counter genu recurvatum?
Proximal anterior force directed posteriorly at upper thigh
Distal anterior force directed posteriorly near ankle
Posterior force directed anteriorly at knee
Where are the three points of force to counter knee flexion?
Proximal posterior force directed anteriorly at upper thigh
Distal posterior force directed anteriorly at calf
anterior force directed posteriorly at knee
Where are the three points of force to control IRD by an AFO in the coronal plane?
Proximal lateral on calf
Distal lateral on calcaneus
Distal medial on arch, proximal to malleolus and proximal aspect of calcaneus
Where are the three points of force to control ERD by AFO in the coronal plane?
Same as IRD except opposite and have sabolich (carlston) 1in above malleolus and no arch
Where are the three points of force to control IRD by SMO in the coronal plane?
Proximal lateral malleolus
Distal lateral calcaneous
Proximal medial calcaneous
Where are the three points of force to control ERD by SMO in the coronal plane?
Proximal medial malleolus
Distal medial calcaneous
Proximal lateral calcaneous
Can you control ERD with a UCBL?
No
Where are the three points of force to control PF?
Proximal posterior calf
Distal posterior footplate
anterior ankle strap
Where are the three points of force to control DF?
Proximal anterior strap
Distal anterior shoe
Posterior footplate at heel
Can FO control forefoot abduction or adduction?
No
Where are the three points of force to control forefoot adduction for an AFO, SMO, UCBL?
Shaft of 1st Metatarsal
Medial Posterior calcaneous
Lateral Anterior calcaneous
Where are the three points of force to control forefoot abduction for AFO, SMO, UCBL?
Shaft of 5th metatarsal
ST mod
Lateral posterior calcaneous
When dealing with the GRF what control deformities?
Horizontal surfaces
How can you control deformities orthotically when dealing with the GRF?
postings
Locking out the ankle
Stops
What are intrinsic posting?
Change the plaster mold
What are extrinsic postings?
Adding material to the outside of the orthosis
What is an example of a time to use an intrinsic post?
Flexible 1st or 5th Ray
What is an example of a time to use an extrinsic post?
Rigid 1st or 5th ray
When should you use both a extrinsic and intrinsic post?
With correctable calcaneal varus or valgus
When should you lock out the ankle joint?
Block knee flexion with less than 20 degree flexion contracture
Mild knee hyperextension
What are the functional components of the foot?
Rearfoot
Midfoot
Forefoot