Ankle and foot pt 1 Flashcards
(111 cards)
1
Q
how many bones are in the ankle/foot?
A
28 bones
2
Q
how many joints are in the ankle/foot?
A
25 joints
3
Q
what are some similarities between the ankle/foot and hand/wrist?
A
radius articulates with carpus, tibia with tarsus
7 carpal bones 7 tarsal bones
both have metacarpals/tarsals and phalanges
4
Q
what is an embryological difference with the lower extremities?
A
long bones of the LE IR/MR so the great toe is medial, the top of the foot is the dorsal side, and plantigrade position of foot allows for walking and standing
5
Q
what motion is anterior on the talocrural axis?
A
dorsiflexion
6
Q
what motion is posterior on the talocrural axis?
A
plantarflexion
7
Q
what motion is medial on the subtalar axis?
A
supination
8
Q
what motion is lateral on the subtalar axis?
A
pronation
9
Q
what are the conflicting functions of the ankle-foot?
A
stability vs mobility
10
Q
what are some stability aspects of the ankle and foot?
A
provide stable BOS
act as a rigid lever
11
Q
what are some mobility aspects of the ankle and foot?
A
dampen LE rotation
adapt to varied surface
flexible to absorb shock
12
Q
what are the 3 functional foot segments?
A
forefoot
midfoot
hindfot
13
Q
what makes up the forefoot?
A
metatarsals and phalanges
14
Q
what makes up the midfoot?
A
navicular, cuboid, and 3 cuneiforms
15
Q
what makes up the hindfoot?
A
talus and calcaneus
16
Q
what is the segmental foot function of the hindfoot?
A
coverts LE transverse plane motion into sagittal, frontal and horizontal plane motion
17
Q
what is the segmental foot function of the midfoot?
A
transmits hindfoot motion to forefoot
promotes stability of foot
heavily influenced hind foot
18
Q
what is the segmental foot function of the forefoot?
A
Adapts to terrain
Heavily influenced by hindfoot
19
Q
What action is created with varus?
A
Inversion
20
Q
What action is created with valgus?
A
Eversion
21
Q
If the axes in the ankle and foot with orthogonal what motions occur around the vertical axis?
A
Abduction and adduction
22
Q
If the axes in the ankle and foot with orthogonal what motions occur around the coronal axis?
A
Dorsiflexion and plantarflexion
23
Q
If the axes in the ankle and foot with orthogonal what motions occur around the longitudinal axis?
A
Inversion and eversion
24
Q
When the foot and ankle is pronated what motions occur?
A
dorsiflexion
Eversion
Abduction
25
When the foot and ankle is supinated what motions occur?
Plantarflexion
Inversion
Adduction
26
What makes up the próxima portion of the talocrural joint?
Distal tibia and distal fibula with the talus
27
What is the talocrural structure in the frontal plane?
A mortise
28
What is the asymmetry of the lateral and medial malleloi in the frontal plane?
The lateral malleolus is lower than the medial malleolus
29
What is the asymmetry of the lateral and medial malleloi in the transverse plane?
Lateral malleolus is more posterior and distal
30
What is the asymmetry of the lateral and medial malleloi in the sagittal plane?
The medial malleoli is anterior and superior
31
What is the closed pack position of the distal talocrural joint?
Dorsiflexion
32
What is interesting about the talus in the transverse plane?
Talus body width is greater anterior than posterior up to (25%)
It is wider anterior than posterior which contributes to the closed pack position in DF because wider will push out slightly and promote stability
33
At the distal talocrural joint what object is resembled?
A truncated cone with the apes directed medically
The lateral talar surface area is greater than the medial
34
The greater the surface area the more….
Work/ movement
35
which ligaments are on the medial side of the foot?
medial (deltoid) ligament
plantar calcaneonavicular ligament
posterior talotibial ligament
36
which ligaments are on the lateral side of the foot?
anterior talotibial ligament
anterior talofibular ligament
calcaneofibular ligament
dorsal tarsometatarsal ligament
intermetatarsal ligament
37
what 3 bands make up the medial (deltoid) ligament?
calcaneotibial
anterior talotibia
tibionavicular
38
what is the medial (deltoid) ligament a check rein to?
eversion
39
what is the plantar calcaneonavicular ligament a check rein to?
pronation and eversion
40
what is the plantar calcaneonavicular ligament known as and what does it do?
the spring ligament. Because it is a spring mechanism as the arch rises to lower the support. it is a hammock for the navicular when it is tension loaded when pronated it supports the navicular from dropping
41
what is the posterior talotibial ligament a check rein to?
dorsiflexion and eversion
42
what is the posterior talofibular ligament (PTFL) a check rein to?
dorsiflexion and inversion
43
what is the calcaneofibular (CFL) ligament a check rein to?
inversion
44
what is the anterior talofibular (ATFL) a check rein to?
plantarflexion and inversion
45
what is the most commonly sprained ligament?
the ATFL
46
How are the ATFL and CFL not sprained together?
purely inversion is the CFL
but inversion and plantarflexion is the ATFL and possibly the CFL
47
what are the two motions in the sagittal plane for the talocrural joint?
dorsiflexion and plantarflexion
48
what are the osteokinematic values of dorsiflexion of the talocrural joint?
20º-35º
49
what are the osteokinematic values of plantarflexion of the talocrural joint?
30º-50º
50
what are the two motions in the transverse plane for the talocrural joint?
adduction (medially rotation) and abduction (lateral rotation)
51
what are the osteokinematic values of adduction of the talocrural joint?
7º
52
what are the osteokinematic values of abduction of the talocrural joint?
10º
53
what are the motions in the frontal plane for the talocrural joint?
tilt, inversion (lateral tilt) and eversion (medial tilt)
54
what are the osteokinematic values of inversion or lateral tilt of the talocrural joint?
5º
55
what are the osteokinematic values of eversion or medial tilt of the talocrural joint?
5º
56
what are the talocrural osteokinematic functional requirements for gait?
DF 10º Pf 20º
57
what are the talocrural osteokinematic functional requirements for ascending stairs?
20-25º DF and 10-15º PF
58
what are the talocrural osteokinematic functional requirements for running?
25º DF and 25º PF
59
during gait what is the talocrural compression force?
4.5 x body weight
60
how far is the talocrural joint from the M-L axis?
8-10º
61
how far is the talocrural joint from the longitudinal axis?
80º
62
how far is the talocrural joint from the A-P axis?
70º
63
what is the talocrural joint really good at?
dorsiflexion and plantar flexion
64
what is moving on what in open chain dorsiflexion arthrokinematics of the talocrural joint?
convex talus moving on concave mortise
65
what are the arthrokinematic motions in open chain dorsiflexion at the talocrural joint?
anterior talar roll and posterior slide
66
is the talar facet surface area greater medial or lateral?
greater lateral than medial
67
what does greater surface area allow for?
greater excursion (slide/glide)
68
in posterior talar excursion which is greater medial or lateral?
greater lateral than medial
69
because surface area is greater lateral and there is more excursion on the lateral side of the talar facet what is the result?
abduction (lateral rotation) of talus in mortise
70
what is moving on what in closed chain dorsiflexion arthrokinematics of the talocrural joint?
concave mortise moving on convex talus
71
what are the arthrokinematic motions in closed chain dorsiflexion at the talocrural joint?
anterior mortise roll and slide
72
is the malleolar facet surface area greater medial or lateral?
greater lateral than medial
73
in anterior malleolar excursion which is greater medial or lateral?
greater lateral than medial
74
because surface area is greater lateral and there is more excursion on the lateral side of the malleolar facet what is the result?
adduction (medial rotation) of the mortise on the talus
75
medial rotation of the mortise on the talus equals what?
medial rotation of lower leg on the talus
76
because the radius of curvature of the talus is greater lateral than medial in closed chain kinematics what is the result?
fibular rotation
DF: medial
PF: lateral
77
as the larger portion of talus enters the mortise how does the fibula glide?
superior
78
what are the primary muscle check rein structures to dorsiflexion?
gastrocnemius and gastrocsoleus
79
what are the muscle check rein structures to plantarflexion?
tibialis anterior, extensor hallucis longus, extensor digitorum longus
80
what are the muscle check rein structures on the medial ankle for eversion stress?
Tom Dick and Harry
Tibialis posterior, flexors Digitorum longus, flexor Hallucis longus
81
what are the muscle check rein structures on the lateral ankle for inversion stress?
pronius longus (fibularis longus) and pronius brevis (fibularis brevis)
82
how many talocalcaneal articulations are there?
3
83
what are the 3 talocalcaneal articulations?
anterior, middle and posterior
84
which talocalcaneal articulations are concave and which are convex?
the anterior and middle facets are both concave
the posterior facet is convex
85
what separates the talocalcaneal articulations of the subtalar joint?
the tarsal canal creating 2 separate joint cavities
86
what is the job of the subtalar joint?
dampens LE rotary forces
87
what is the goal of the subtalar joint?
maintains foot contact with the ground
88
where can the sinus tarsi "bullet hole" be seen?
between the talus and calcaneus
89
what are the 4 subtalar joint ligaments?
interossesous talocalcaneal
lateral talocalcaneal
ligamentum cervicis
posterior talocalcaneal
90
what is the interossesous talocalcaneal ligament a check rein to?
limits eversion
91
what is the lateral talocalcaneal ligament a check rein to?
limits inversion
92
what is the ligamentum cervicis ligament a check rein to?
limits inversion
93
what is the posterior talocalcaneal ligament a check rein to?
dorsiflexion
94
the subtalar joint is a ___________ axis, ________________ motion
single axis triplanar motion
95
what is moving on what in subtalar open chain osteokinematics?
calcaneus moving on talus
96
in open chain subtalar supination what motions are occurring?
calcaneal inversion, adduction and plantarflexion
97
in open chain subtalar pronation what motions are occurring?
calcaneal eversion, abduction and dorsiflexion
98
body weight prevents the calcaneus from what motions on the talus?
abduction/adduction and DF/PF so the talus has to move instead
99
in closed chain subtalar supination what motions are occurring?
calcaneal inversion, talar abduction and dorsiflexion
100
in closed chain subtalar pronation what motions are occurring?
calcaneal eversion, talar adduction and plantarflexion
101
what is the closed pack position for the subtalar joint?
supination
102
what is the ROM for subtalar inversion and eversion?
inversion 20º eversion 10º
103
how much talar abduction/adduction is required for gait?
10º
104
how much talar supination/pronation is required for gait?
4-6º
105
at the subtalar joint in closed chain at the posterior articulation what is moving on what?
concave talus moves on convex calcaneus
106
at the subtalar joint in closed chain at the anterior and middle articulations what is moving on what?
convex talus moving on concave calcaneus
107
how far is the subtalar joint from the longitudinal axis?
approx 45º
108
how far is the subtalar joint from the vertical axis?
approx 45º
109
how far is the subtalar joint from the M-L axis?
approx 75º
110
what is the subtalar joint good at?
equally good at inversion/eversion and abd/add
111
what is the ROM ratio at the subtalar joint?
4:4:1
inv/ev, abd/add, df/pf
