Flashcards in Ankle and Foot Deck (72)
What joint sustains the greatest load per surface area of any joint in the body?
the ankle joint
The ____ foot absorbs the majority of the load followed by what?
What are the 5 functions of the foot?
- Acts as a support base that provides the necessary stability for upright posture with minimal muscle effort
- Provides a mechanism for rotation of the tibia and fibula during stance
- Provides flexibility to adapt to uneven terrain
- Provides flexibility for absorption of shock
- Acts as a lever during push-off
What are the 3 joints of the rearfoot?
- tibiofibular joint
- talocrural joint
- subtalar joint
What is the resting position of the tibiofibular joint?
What is the closed-packed position of the tibiofibular joint?
What is the capsular pattern for the tibiofibular joint?
there is pain on stress
What are the 3 supporting ligaments of the tibiofibular joint?
- Anterior tibiofibular ligament
- Posterior tibiofibular ligament
- Interosseous ligament
What is the talocrural joint designed for?
What is the resting position of the talocrural joint?
10 degrees of plantarflexion
What is the closed-packed position of the talocrural joint?
What is the capsular pattern for the talocrural joint?
plantarflexion > dorsiflexion
What are the 2 supporting ligaments of the talocrural joint?
- Deltoid ligament (Medial Collateral)
- Lateral Collateral
What 4 ligaments make up the deltoid ligament?
- Tibionavicular ligament
- Tibiocalcaneal ligament
- Posterior tibiotalar ligament
- Anterior tibiotalar ligament
What 3 ligaments make up the lateral collateral ligament?
- Anterior talofibular ligament
- Posterior talofibular ligament
- Cancaneofibular ligament
How many degrees of freedom does the subtalar joint have?
What is the resting position of the subtalar joint?
Midway between extremes of ROM
What is the closed-packed position of the subtalar joint?
What is the capsular pattern for the subtalar joint?
Varus of the rearfoot > Valgus at Rearfoot
What are the 4 supporting ligaments of the subtalar joint?
- Lateral (anterior) talocalcaneal ligament
- Medial (posterior) talocalcaneal ligament
- Cervical ligament
- Interosseous ligament
What aspect of the subtalar joint is stable in open chain exercises?
What 3 movements result in supination in open chain exercises?
PF, Inversion, and Adduction
What 3 movements result in pronation in open chain exercises?
DF, Eversion, and Abduction
What aspect of the subtalar joint is stable in closed chain exercises?
What 3 movements result in supination in closed chain exercises?
Talus Abduction, DF, and Cancaneal Inversion
What 3 movements result in pronation in closed chain exercises?
Talus Adduction, PF, and Cancaneal Eversion
What are the 5 joints of the midfoot?
- Transverse tarsal joint (aka Midtarsal)
- Cuneonavicular joint
- Cuboidenavicular joint
- Intercuneiform joints
- Cuneocuboid joint
What is the resting position of all joints of the midfoot?
midway between the extremes of ROM
What is the closed-packed position of all joints of the midfoot?
What is the capsular pattern for the midtarsal and cuneonavicular joints?
DF > PF > Adduction > Medial Rotation
What are the 4 joints of the forefoot?
- Tarsometatarsal joints
- Intermetatarsal joints
- Metatarsophalangeal joints (MTP)
- Interphalangeal joints (IP)
What is the closed packed position for the tarsometatarsal and intermetatarsal joints?
What is the resting position for the MTP joints?
10 degrees of extension
What is the closed-packed position for the MTP joints?
What is the capsular pattern for the MTP joints?
flexion > extension
How many degrees of extension are required at the 1st MTP joint during gait?
How many degrees of extension are required at the 1st MTP joint during running and squattin?
What is the resting position for the IP joints?
What is the closed-packed position for the IP joints?
Where does the plantar fascia originate and insert?
Originates from the calcaneus
Inserts to the plantar forefoot
What are the functions of the plantar fascia?
Serves a supportive and protective role and is intricately involved with the weight-bearing function of the foot
What are the functions of the 4 retinaculum of the ankle and foot?
To tether the tendons as they cross the ankle to enter the foot
What are the 4 retinaculum of the ankle and foot?
- Superior Extensor retinaculum
- Inferior Extensor retinaculum
- Superiofibular retinacula
- Flexor retinaculum
What tendons does the superior extensor retinaculum contain?
- extensor digitorum longus
- extensor halluces longus
- tibialis anterior
- fibularis tertius
The inferior extensor retinaculum contains the tendons of the ____ foot.
What tendons does the superiofibular retinaculum contain?
Fibularis longus and brevis tendons
What tendons does the flexor retinaculum contain? What structure does it also contain?
- flexor digitorum longus
- flexor hallucis longus
- tibialis posterior
- the neurovascular bundle
What are the 3 main arches of the foot?
- Medial longitudinal
- Lateral longitudinal
- Transverse arch
The arches support the foot by what 3 mechanisms?
- Osseous relationship of the tarsal and metatarsal bones
- Ligamentous support from the plantar aponeurosis and plantar ligaments
- Muscle support
An anterior glide of the talus assess the talocrural joint's ability to move into ___flexion
A posterior glide of the talus assess the talocrural joint's ability to move into ___flexion
Calcaneal eversion usually measures between __ and __ degrees
Calcaneal inversion usually measures between __ and __ degrees
Describe the process of assessing ankle girth
Figure-8 Tape Method:
1) midway between the tibialis anterior tendon and lateral malleolus
2) drawn medially and is placed just distal to the navicular tuberosity
3) across the arch and just proximal to the fifth metatarsal
4) across the tibialis anterior tendon and around the ankle to just distal to the medial malleolus
5) across the Achilles tendon and placed just distal to the lateral malleolus and across the start of the tape
What does the Cotton test asses?
the lateral ankle ligaments
What does a positive cotton test indicate?
significant mortise widening
What is Kleiger Test used for?
Used to determine if pain is due to the tibiofibular ligaments/interosseous membrane or the medial (deltoid) ligament of the ankle
What 3 tests asses the lateral collateral ligament?
- calcaneus tilt
- talar tilt
- anterior drawer test
The talar tilt test used to determine whether what ligament is torn?
What ligament is the anterior drawer test used to asses?
Anterior Talofibular ligament (ATFL)
What 2 tests test for an Achilles tendon rupture?
- Thompson's test
- Matles test
What is the navicular drop test used to assess?
the degree to which the talus plantarflexes on a stabilized calcaneus, during subtalar joint pronation
A navicular drop greater than __ mm is considered abnormal
What is Feiss line test used to assess?
the height of the medial arch, using the navicular position
Describe the concepts of 1st, 2nd, and 3rd flatfoot
When performing the feiss line test...
- If the navicular falls 1/3rd of the distance to the floor, it represents a 1st flatfoot
- If the navicular falls 2/3rds of the distance to the floor, it represents a 2nd flatfoot
- If the navicular rests on the floor, it represents a 3rd flatfoot
What is Homan's sign used to detect?
What is Buerger's Test used to assess?
arterial circulation in the LE
Where can the dorsal pedis pulse be felt?
Just lateral to the tendon of the extensor hallucis longus over the posterior aspect of the foot
A positive Morton's test is indicative of what?
the presence of a neuroma or a stress fracture of the metatarsal heads
When performing Tinel's sign tapping anterior to the medial malleolus will percuss which nerve?
Tapping posterior to the medial malleolus will percuss which nerve?
Anterior tibial branch of the deep peroneal nerve
Posterior tibial nerve
What are 2 subjective ankle functional tests?
- The Ankle Joint Functional Assessment Tool
- The Foot Function Index