Exam 1 - Foot & Ankle Complex Flashcards
(54 cards)
1
Q
What are the 2 main functions of the foot/ankle complex?
A
- Stable base of support
- Shock absorption
2
Q
Bones of the ankle
A
- distal tibia
- distal fibula
- talus
3
Q
What 2 bones make a mortise?
A
Fibula and tibia, held together by interosseous membrane
- allow talus to pass through
4
Q
What forms a malleoli?
A
Ends of tibia & fibula
- L. little hammer
5
Q
Hindfoot
A
Talus and calcaneus
6
Q
Mid-foot
A
3 cuneiforms, navicular, cuboid
7
Q
Forefoot
A
Metatarsals & phalanges
8
Q
Tarsals
A
7 bones
- Gr. tarsos, any flat surface
9
Q
Metatarsals
A
Gr. Meta, after
10
Q
Phalanges
A
- Gr. phalanx, line of battle
11
Q
Joints
A
4 mains
- ankle
- subtalor
- tarsometatarsal
- metatarsalphalangeal
12
Q
2 motion of the ankle
A
Plantarflexion (point) - 50 degrees
Dorsiflexion - 30 degrees
13
Q
Talus
A
- wider anteriorly
- narrower posteriorly
- often fractured in dislocations of the ankle
- upward arterial supply
- prone to necrosis with severe injury
- avascular necrosid
“Snowboarder’s Fracture”
14
Q
Subtalar Joint
A
“Below the ankle”
- between talus and calcaneus
- calcaneum = L. Heel
- inversion: 30 degrees
- eversion: 10 degrees
15
Q
Subtalar Neutral
A
- in the middle
- “optimally aligned foot”
- best stress distribution
16
Q
Tarsometatarsal Joint
A
3 cuneiforms and cuboid with metatarsals
- helps regulate positions of the foot
17
Q
Metatarsopharangeal Joint
A
“MTP”
- 5 joints
- primarily flexion and extension
- hinge to allow heel to rise while toes stabilize
- gait
18
Q
6 main movements
A
- plantarflexion
- dorsiflexion
- inversion
- eversion
- pronation
- supination
19
Q
Pronation
A
Foot rolls inwards
- eversion
- dorsiflexion
P. E. D.
20
Q
Supination
A
- Foot rolls outward
- inversion
- plantarflexion
S.I.P.
21
Q
Ligaments
A
~60 Main ligaments 1. Interosseous membrane 2. Deltoid ligament 3. Anterior Talofibular Ligament 4. Plantar Calcaneonavicular Ligament
22
Q
Interosseous membrane
A
Tibia to fibula
Force distribution
Shock attenuation
High ankle sprain
23
Q
Deltoid Ligament
A
Connects tibia to talus, calcaneus, and navicular bone
- strong
- bone often fails before ligament ruptures
24
Q
Anterior talofibular ligament
A
ATF or ATFL
- fibula to talus
- most often sprained
- plantarflexion and inversion injury
25
Plantar calcaneonavicular ligament
Aka spring Ligament
Helps support medial longitudinal arch
- helps prevent overpronation
26
Arches
- Longitudinal
Medial
Lateral
- Transverse
- Function: add stability & shock absorption
- supported by ligaments, shapes of bones, tendons, and muscles
27
Muscles
--
28
Plantarflexors
5 main muscles
- gastrocnemius
- plantaris
- soleus
- flexor hallucinating longus
- flexor digitorum longus
GPSFF
29
Gastrocnemius
PA: posterior condyles of femur
DA: common insertion via Achilles
A: plantarflexes foot
30
Soleus
PA: proximal posterior tibia along soleal line
DA: Achilles
A: plantarflexes foot
31
Plantaris
PA: distal posterior femur
DA: posterior calcaneus
A: plantarflexes foot
32
Flexor hallucis longus
PA: distal 2/3 of posterior fibula
DA: base of distal phalanx of the great toe, plantar surface
A:plantarflexes foot and big toe
33
Flexor digitorum longus
PA: distal 1/2 of posterior tibia
DA: base of distal phalanges of digits 2-5
A: plantarflexes foot & toes 2-5
34
Dorsiflexors
3 main:
- tibialis anterior
- extensor digitorum longus
- extensor hallucis longus
35
Everters
- peroneus longus
- peroneus brevis
- peroneus tertius
EVERTERS= PERONEUS
36
Peroneus longus
PA: head and proximal 1/2 of fibula, lateral side
DA: cross plantar surface of foot to attach 1st cuneiform & 1st metatarsals
A: everts foot
37
Peroneus brevis
PA: distal 1/2 of lateral side of fibula
DA: tuberosity of lateral side of 5th metatarsal
A: everts foot
38
Peroneus tertius
PA: distal 1/3 of anterior surface of fibula
DA: dorsal surface of base of 5th metatarsal
A: everts foot
39
Inverters
- tibialis anterior
| - tibialis posterior
40
Tibialis Anterior
PA: superior 2/3 of anterolateral tibia
DA: base of 1st metatarsal of 1st digit & cuneiform
A: dorsiflexes & inverts foot
41
Tibialis Posterior
PA: lateral side of posterior tibia proximally
DA: navicular tuberosity, 3 cuneiforms, cuboid, metatarsals 2-4
A: inverts foot
42
Injuries
--
43
Ankle Sprain
- most common orthopedic injury
44
Ankle Sprain - inversion with plantarflexion
- tear ATF
| - severe inversion may fracture distal fibula
45
Ankle Sprain - eversion
- tear delt ligament
| - rare
46
Plantar fasciitis
Inflammation of plantar fascia
- fascia tears usually near its calcaneus attachment
"Pain worst with 1st few steps in the morning"
- microtearing
- slow to heal
- restriction in dorsiflexion ROM
47
Plantar fasciotomy
- can cause collapsed foot
48
Fibular fracture
- caused by excessive inversion
- ambulation is often still possible
15% of BW on fibula
85% on tibia
- surgical options
Open reduction and internal fixation
49
Achilles tendinitis
- 1-2" above attachment to calcaneus
- critical zone of avascularity
- pronation increases length on Achilles
- rupture
- violent start or stop
- over 30 yrs old
- audible snap
50
Shin splints
- anterior tibialis tension
- repetitive micro trauma to tibia and it's muscular attachments
- microtears to tibialis posterior
muscle or soleus (medial tibial pain)
- microtears to peroneal muscles (lateral tibial pain)
51
Causes of shin splints
```
Excess probation
Poor shock absorption
Poor foot alignment
Sudden increase in activity
Muscle imbalances
Poor warm up
Poor conditioning
Tight Achilles
Toe running
Tension on tibia
```
52
Sever's Disease
Pull on Achilles' tendon on calcaneal insertion
- growing children
- pain in heel
53
Posterior tibial tendinitis
- increased pronation
| - wringing effect of post tibial tension
54
Talus fracture
Talus avascular necrosis
- following fracture or dislocation
- inverted arterial supply
- no muscular attachments
