Week 13 Ankle/Foot Anatomy+ Examination

Question 1

What are the major joint of the foot

Answer 1

Talocrural
subtalar
Transverse tarsal

• Talus is involved in all three joints

Question 2

Talocrural Osteokinematics

Answer 2

• one degree of freedom
• diagonal axis
  DF= slight adduction + eversion
  PF= slight adduction + inversion

Question 3

Supination Motion

Answer 3

Plantarflexion + inversion + adduction

Question 4

Pronation Motion

Answer 4

Dorsiflexion+ eversion+ abduction

Question 5

Subtalar Joint

Answer 5

Calcaneus + talus
Ligaments
- talocalcaneal
- calcaneofibular and deltoid
- interosseous and cervical= provides the strongest bond between the calcaneus and the talus

Question 6

Movement of the Subtalar joint is mostly

Answer 6

Inversion and eversion + abd+ add

Question 7

Mid-foot Joints

Answer 7

• transverse tarsal
• distal intertarsal
• medial longitudinal arch

Question 8

Talonavicular Joint

Answer 8

• Concave navicular + calcaneonavicular ligament
• “spring ligament “
• interosseous ligament
• dorsal talonavicular ligament
• bifurcated ligament
• Anterior deltoid ligament

Question 9

Calcaneocuboid joint

Answer 9

• Calcaneus + cuboid
• dorsal calc-cuboid ligament
• bifurcated ligament
• long plantar ligament
• short plantar ligament

Question 10

What does the Transverses Tarsal Joint allow for and what are the kinematics?

Answer 10

• allows for pronation and supination of the midfoot
• associated movement with subtalar joint
• adaptable shape
• pronation supination twist allows you to stand on uneven surfaces

Question 11

What happens to the arch during stance phase and late stance phase

Answer 11

Stance phase = arch lowers

Late Stance= arch rises, STJ supinated–> midfoot ridged

Question 12

Early Stance Phase

Answer 12

• Heel strike: DF Talocrural joint/ supination subtalar joint
• Loading–> footflat= PF and pronation
• Pronated STJ–> pliable midfoot–> better conforms to walking surface

Question 13

Mid to Late Stance phase

Answer 13

Subtalar joint supination
- mid foot and forefoot twist to relative pronation
- rearfoot interna–> external rotation
- late stance: supination subtalar joint + elevation/tensed medial long arch = rigid lever

Question 14

Distal Intertarsal Joints

Answer 14

• Cuneonavicular
• cuboideonavicular
• intercuneiform and cuenocuboid joint complex

All these joints help the foot conform to surfaces better

Question 15

Forefoot

Answer 15

Tarsometatarsal joints
- intermetatarsal joints
- metatarsophalangeal joints
- interphalangeal joints

Question 16

Late Stance Phase

Answer 16

• mid and forefoot rigid for push off
• muscles and med long arch tension
• windlass effect= mech that increases arch tension
  –> body weight moves anterior to MTP’s
  –> heel rises/toes extend
• plantar fascia is stretched
• arch raises and makes fore/mid-foot rigid

Question 17

Nerves:
Anterior compartment
Lateral
Posterior

Answer 17

Anterior= deep branch of peroneal

Lateral = superficial branch of peroneal

Posterior= tibial nerve

All branches of Sciatic L4-S3

Talocrural joint sensory form deep peroneal

Question 18

Muscles of the Anterior Compartment

Answer 18

Tib anterior
Ext Dig Long
Ext Halllicus Longus
Peroneus tertius

DORSIFLEXORS

Question 19

Lateral compartment muscles

Answer 19

Peroneus longus
Peroneus Brevis

EVERTORS

Question 20

Posterior Compartment Muscles

Answer 20

Gastroc
soleus
Plantaris
Tib Post
Flex Dig Long
Flex Hall Long

PLANTAR FLEXORS AND SUPINATORS

Question 21

T/F The plantar flexors can do supination

Answer 21

True

Question 22

Plantarflexors as Knee Extenders

Answer 22

2 joint PF = gastroc
- open chain= knee flexion
- closed chain = knee extension

• foot fixed on ground
• Contraction of PF–> extension moment at knee
• from squat it is the most apparent
• Ankle DF–> neutral
• Knee flexion–> extension

Question 23

Intrinsic Muscles
Layer 1

Answer 23

Flexor digitorum brevis
Abductor Hallucis
Abductor digiti minimi

Question 24

Intrinsic Muscles
Layer 2

Answer 24

Quadratus plantae
Lumbricals

Question 25

Intrinsic Muscles
Layer 3

Answer 25

Adductor Hallucis
Flexor Hallucis Brevis
Flexor Digiti Minimi

Question 26

Intrinsic Muscles
Layer 4

Answer 26

Plantar Interossei
Dorsal Interossei

Question 27

Functionally what do the intrinsic muscles do?

Answer 27

• Standing balance
• Add rigidity to the foot and stabilize the med long arch during push off phase
• maximally active during late stance as the heel is rising off the floor