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Biomechanics > Ankle & Foot > Flashcards

Ankle & Foot Flashcards

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1
Q

static & dynamic functions of foot and ankle

A
  • support base for upright posture w/ minimal effort
  • transition of mobile adaptor (absorb shock) to rigid lever (impart thrust)
  • sensory / proprioceptive function
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2
Q

Ankle Contents (bones & joints)

A

Bone: tibia, fibula, talus

Joint: talocrural, proximal and distal tibiofibular

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3
Q

Rearfoot contents (bone and joints)

A

bone: calcaneus & talus
joint: subtalar (talocalcaneal)

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4
Q

Midfoot contents (bone & joints)

A

Bone: navicular, cuboid, cuneiforms

Joint: transverse tarsal, distal intertarsal

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5
Q

Forefoot (bone & joints)

A

Bone: metatarsal and phalangeal
Joint: TMT, InterMT, MTP, IP

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6
Q

fibula osteology

A

(proximal fibular & lateral malleolus)

  • comprises lateral ankle
  • attachment side for ligament
  • implicated in fractures .
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7
Q

tibia osteology

A

expanded size distally to accommodate load

  • medial malleolus
  • fibular notch
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8
Q

Ankle Mortis of Talus

A

when you DF, the talus moves back into this joint & causes the tib & fib to seperate

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9
Q

Open Kinetic Chain Motions of Ankle & Foot

A

PF & DF

Inversion & Eversion

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10
Q

Closed Kinetic Chain motions of ankle & foot

A

squatting = DF

walking downhill/stepping/heel raises = PF

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11
Q

PF & DF axis and plane of motion

A

medial - lateral axis

sagittal plane

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12
Q

Inversion & Eversion axis and plane of motion

A

anterior-posterior axis

frontal plane

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13
Q

abduction and adduction axis and plane of motion

A

vertical axis

horizontal plane

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14
Q

oblique axis of rotation

A

triplanar motion

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15
Q

supination axis and plane of motion

A

oblique axis

plane: inversion, ADD, PF

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16
Q

pronation axis & plane of motion

A

oblique axis

plane: eversion, ABD, DF

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17
Q

DF ROM

A

10-20 degree

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18
Q

PF ROM

A

30-50 degree

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19
Q

Eversion/Inversion ROM

A

approx 40 degree

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20
Q

what is inversion limited by

A

subtalar interosseous ligament (stabilized supinated foot)

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21
Q

what is eversion limited by

A

eversion limited by bony obstruction on both side

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22
Q

Proximal Tib-Fib Ankle joint

A
  • synovial joint
  • articulation b/w head of fibula and posterolateral lateral condyle of tibia
  • stabilization of anterior and posterior ligaments
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23
Q

Distal Tib-Fib Ankle Joint

A
  • syndesmotic joint
  • articulation b/w convex medial fibula and concave fibular notch on tibia
  • stabilization of interosseous membrane, anterior and posterior tibiofibular ligaments
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24
Q

anterior and posterior tibiofibular notch

A
  • stabilizer to splaying of ankle mortise during DF
  • limits ER
  • limits fibular mobility on tibia
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25
interosseous membrane
- force dissipation | - stabilizer of splaying of ankle mortise
26
Talocrural Joint
- synovial hinge joint | - capable of sustaining weight bearing forces
27
Anterior Talofibular ligament
- reisist PF, Inversion, ADD - anterior translation of talus on mortise (lateral ankle sprain)
28
Calcaneofibular ligament
-resist inversion, DF -resist subtalar inversion (2nd most common inversion ankle sprain)
29
Posterior talofibular ligament
- resist DF, ABD, Inversion | - posterior translation of talus on mortise
30
deltoid ligament
-resist eversion
31
Special medial ligaments and what they resist | tibiotalar, tibionavicular, tibiocalcaneal
-tibiotalar: EV, DF -tibionavicular: TCJ - EV & PF TNJ - EV & AB -tibiocalcaneal STJ EV
32
Talocrural Joint Arthrokinematics PlantarFlexion | "Fixed Shank"
``` convex = talus concave = tib/fib complex ``` convex on concave - roll & slide in opposite direction
33
Talocrural Arthrokinematics Dorsiflexion "Fixed Shank"
roll: counter-clockwise from lateral view slide: posterior slide of taluss
34
DF & ankle mortise
talus fill mortise and spread malleoli apart - creates tight grip on talus - strong ligament & tendon support
35
PF & ankle mortise
talus leaves mortise and malleoli come together -loose grip w/o ligamentous support = unstable
36
non-weight bearing DF/PF
dorsiflexion accomponied by external rotation (25/2.5) plantar flexion includes IR (35/1)
37
weight bearing DF/PF
DF - includes eversion/ IT | PF - includes Inversion & ER of tibia
38
ATF Test
anterior drawer | -put pt in PF / anterior displacement of talus
39
Talar Tilt
positive finding = pain -talus tilts or gaps excessively compared to uninjured side stabilize tib/fib while other hand on heel - rounding foot into inversion
40
Major articulations within the foot
``` subtalar joint transverse tarsal joint tarsometatarsal MTP IP ```
41
subtalar joint is stabilized by
-interosseous ligament: EV -deltoid: EV -cervical: INV CFL: INV
42
Open Chain of subtalar
- Supination: calcaneal inversion, PF, ADD | - Pronation: calcaneal eversion, DF, ABD
43
Closed Chain of subtalar
Supination: calcaneal inversion, talar DF & ABD - MLA elevation - role up the chain Pronation: calcaneal eversion, talar PF, and ADD - MLA depression - role up the chain
44
function of subtalar joint
main interconnection between mobility of foot mechanism & stability of ankle/leg -allows for adaptive positioning
45
Midfoot is stabilized by
medial longitudinal arch, specialized ligaments, joint capsule and muscle heavily reliant on STJ
46
Talonavicular
- convex head of talus - concave navicular bone ball and socket like inferior support by spring ligament greater degree of joint play/mobility
47
calcaneocuboid
articulation of anterior calcaneus and proximal cuboid - support by long and short plantar ligaments - little movement
48
plantar calcaneonavicular ligament
shock absorbing = spring ligament - main supporter of medial longitudinal arch of support - excessive prolonged pressure leads to permanent stretch - lowered longitudinal arch (fallen arch)
49
Medial Foot & Ankle Ligaments
- plantar aponeurosis - long plantar ligament - short plantar ligament
50
Mutli-axis functional mobility
``` parallel = mobile adapter divergent = rigid lever ``` longitudinal and oblique axis contribute to pronation & supination
51
middle functional segment
transverse tarsal arch held together by interosseous ligament ; flattens on weight bearing foot elasticity: accommodate uneven surfaces
52
what muscle eccentrically impacts arch?
tibialis posterior
53
Foot locomotion supination
subtalar inversion, forefoot ADDuction and PF
54
foot locomotion pronation
subtalar eversion, forefoot ABD, DF
55
foot locomotion: running
heel strike: rearfoot inversion foot rolls forward: forefoot contact; supination (Inversion, PF, ADD) Mid-stance: eversion, abduction and beginning of d-flex (pronation - prolongs foot contact with ground)
56
tarsometatarsal joint
permit gliding and sliding
57
medial tarsometatarsal
most ROM | no ligamentous restriction
58
intermed. tarsometatarsal
2nd cuneiform shorter in length 2nd MT is longest & wedged strongest joint; little ROM
59
lateral tarsometatarsal
intermediate ROM
60
MTP joint (forefoot)
largest ROM of any joints (flexion/extension) - important in propulsion - knuckle like joint
61
IP joint
- greater mobility - hinge (big toe can hyperextend) - reinforced with plantar and collateral ligaments
62
1st MTP
integral to static and dynamic mobility task - force generation; efficiency (heel lift / propulsion)
63
Windlass Mechanism
tension from plantar fasciae when digits are extended - extension of MTP creates tension in plantar fascia - role of overpronation
64
intrinsic muscles
plantar surface of foot strong in central portion supports arch
65
extrinsic support muscles
helps maintain arch, stabilize joints, shock absorption (quiets landing) control toes
66
where do major muscles pass malleoli?
PF: gastroc & soleus DF: tibialis anterior, EHL, & EDL Inver/Sup: TA, TP, FHL, FDL Ever/Pron: peroneus brevis and peroneus longus
67
MOVERS malleoli
act as pulley - alter angle of pull for muscles
68
force plate gait sensors
initial peak = heel hits | second peak = pushing off
69
posterior tibialis dysfunction
- role in maintaining supination & MLA - elevated arch in supination - going into PF,carried ADD & inversion if person is pronated, there will be a change in the ability to maintain arch
70
orthotics
support surrounding arch structures and limit pronation moment at foot/ankle complex
71
pes planus
low arch flexible lever = push off progressive loading of supporting ligaments of MLA
72
Pes Cavus
``` high arch shortens foot length pressure of metatarsal head toes claw bear more weight on heel ```
73
Heel height effect on MT heads
3/4 inch heel - 22% increase 2 inch heel - 57% increase 3 1/4 inch - 76% increase
74
Hallux Valgus
- distal end outward (proximal inward) - 2nd most frequent forefoot surgery - 94% of cases are women
75
bunion
medial side of foot at 1st MP joint sesamoid shift and thicken MT head
76
March fracture
"Stress fracture" hairline fracture across 2nd MT occurs because 2nd metatarsal joint has little movement and not accustomed to stress level or repetition. (runners)

Biomechanics (7 decks)

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