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Intro to Biomechanics > Functional Joints of the Foot (Part 1) > Flashcards

Functional Joints of the Foot (Part 1) Flashcards

1
Q

Prime directives of foot function

A
  • Must get flat on the ground

- Must become a rigid lever

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2
Q

Foot flat on the ground acts as

A
  • Mobile adaptor
  • Shock absorber
  • Accomplished with pronation
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3
Q

Foot becomes a rigid lever with

A
  • Resupination
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4
Q

Ankle joint characteristics

A
  • One of the most stable joints
  • The Ankle Mortise
  • Hinge joint
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5
Q

Ankle joint axis

A
  • Passes through two points just inferior to malleoli
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6
Q

Ankle as a hinge joint

A
  • “ginglymus”

- Allow flexion and extension in one plane

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7
Q

Ankle joint structures

A
  • Tibial plafond
  • Fibula
  • Talus
  • Ankle joint syndesmosis
  • Collateral ligaments
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8
Q

Ankle joint syndesmosis

A
  • Anterior/posterior tibial-fibular ligament

- Interosseous ligament

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9
Q

Tibial plafond inferior surface

A
  • Smooth articulation with talus
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10
Q

Tibial plafond anterior surface

A
  • Covered with extensor tendons and ankle joint capsule
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11
Q

Tibial plafond posterior surface

A
  • Groove for posterior tibialis muscle
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12
Q

Tibial plafond lateral surface

A
  • Fibular notch

- Attachment for interosseous membrane

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13
Q

Tibial plafond medial surface

A
  • Medial malleolus

- Anterior colliculus

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14
Q

Fibular notch

A
  • Location of tibiofibular joint

- Tibial plafond component

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15
Q

Distal fibula

A
  • Forms the lateral malleolus
  • Provides attachments for collateral ligaments
  • Not a weight bearing bone
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16
Q

Ankle joint mortise

A
  • Strong syndesmosis
  • Distal projection of malleoli
  • Collateral ankle joint ligaments
  • Dynamic approximation
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17
Q

Strong syndesmosis of ankle joint mortise

A
  • Prevents “spreading”

- Extra-articular stability

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18
Q

Distal projection of malleoli on ankle joint mortise

A
  • Intra-articular stability

- Prevent rotation

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19
Q

Dynamic approximation of ankle joint mortise

A
  • Posterior tibialis

- Support at foot strike thru midstance

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20
Q

Ankle mortise ligaments

A
  • Anterior tibial fibular ligament
  • Posterior tibial fibular ligament
  • Transverse ligament
  • Interosseous ligament
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21
Q

Transverse ligament (ankle mortise)

A
  • Some consider it a distal portion of the posterior tib-fib lig
  • Deepens the posterior distal rim of the tibia
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22
Q

Interosseous ligament (ankle mortise)

A
  • Progresses proximally into the syndesmotic membrane
  • Acts as a “spring” allowing slight malleolar separation
  • Continous with the tib-fib ligaments
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23
Q

Talar trochlea

A
  • 3 articular facets
  • Surface convex
  • Slight concavity medially
  • Wider anteriorly
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24
Q

Medial articular surface of talus

A
  • Articulation with tibia

- Tear drop shaped

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25
Lateral articular surface of talus
- Articulation with fibula | - Triangular shaped
26
Lateral collateral ligaments (3 distinct bands)
- Anterior Talofibular - Calcaneofibular - Posterior Talofibular
27
Anterior talofibular ligament attachments
- Anterior inferior border of the lateral malleolus | - Insert onto talar body
28
Anterior talofibular ligament
- Primary collateral when foot is plantarflexed and inverted - Most commonly ruptured - Positive anterior drawer sign
29
Calcaneofibular ligament attachments
- From anterior border of malleolus | - Courses slightly posterior and inferior to insert deep to the peroneal tendon sheaths
30
Calcaneofibular ligament support
- Extracapsular | - Supports both AJ and STJ
31
Calcaneofibular ligament
- Primary collateral when foot is in dorsiflexed position
32
Posterior talofibular ligament
- Very strong ligament - Runs nearly horizontal - Rarely injured
33
Posterior talofibular ligament attachments
- Inserts on lateral tubercle of posterior aspect of talus
34
Ankle sprain types
- Inversion-plantarflexion - Inversion-dorsiflexion - High ankle sprains
35
Inversion-plantarflexion ankle sprain
- Most common | - Anterior talo-fibular ligament
36
Inversion-dorsiflexion ankle sprain
- Calcaneal-fibular ligament | - Evaluate cervical and interosseous ligament of subtalar joint
37
High ankle sprains
- Involve syndesmosis | - Uncommon
38
Angular relationship of lateral collaterals
- In plantarflexion, ATF closely parallels fibula | - CFL- ATFL = 112 +/- 14 degrees on the right
39
Anterior drawer sign
- Assesses stability of the ATF - Must compare to the contralateral limb - May not be reliable with acute injury due to edema
40
Positive clinical findings of anterior drawer test (ruptured ATF)
- Performed with ankle in 10-20 degrees plantarflexion | - Anterior displacement of talus relative to tibial plafond
41
Talar tilt
- Inversion-stress test - Compare to contralateral limb - More than 10 degrees significant Subtalar tilt - Evaluates calcaneofibular ligament
42
Medial collateral ankle ligaments
- Deltoid ligament | - Superficial and deep layers
43
Superficial medial collateral ligaments
- Tibio-navicular (anterior) slip - Calcaneo-tibial (central) slip - Posterior talo-tibial (posterior) slip
44
Deep medial collateral ligaments
- Anterior talo-tibal (anterior deep) slip | - Posterior talo-tibial (posterior deep) slip
45
Ankle ligaments retinaculum
- Superior Extensor - Inferior Extensor - Flexor - Peroneal
46
Ankle joint axis
- 8° from transverse plane | - 15° from frontal plane
47
Ankle joint movement
- Primarily sagittal plane | - Dorsiflexion/Plantarflexion
48
Ankle joint neutral position
- 90° to lower leg
49
Ankle joint range of motion
- 10° dorsiflexion | - 20° plantarflexion
50
Subtalar joint characteristics
- Classically described as a hinge joint - May be some screw-like motion as well - Pronatory/Supinatory axis - Dictates movement of the rearfoot (influences position of forefoot)
51
Subtalar joint anatomy
- Articulation between talus and calcaneus | - 3 articular facets (posterior, middle, anterior)
52
Subtalar joint posterior facet
- Largest facet - Has its own joint capsule - Convex on calcaneal side - Concave on talar side
53
Higher calcaneal inclination angle in relation to posterior facet of subtalar joint
- Higher calcaneal inclination angle = more horizontal posterior facet
54
Average calcaneal inclination angle
- 24.5°
55
Lower calcaneal inclination angle in relation to posterior facet of subtalar joint
- Lower calcaneal inclination angle = more vertical posterior facet
56
Subtalar joint middle facet
- Between sustentaculum tali and inferior talar neck - Concave on calcaneal side - Convex on talar side
57
Subtalar joint anterior facet
- Anterior and lateral to middle facet | - Continuous with middle facet in ~2/3 of population
58
Ligaments of the subtalar joint (cruciate ligaments of the foot)
- Cervical ligament | - Interosseous talocalcaneal ligament
59
Cruciate ligaments of the foot function
- Provide primary stability to the subtalar joint | - Rupture may result in subtalar joint dislocation
60
Cervical ligament
- Strongest ligament connecting the talus and calcaneus | - Roughly parallel to the calcaneofibular ligament
61
Cervical ligament attachments
- Runs from the medial aspect of the sulcus calcanei - Courses obliquely superior, anterior and medial - Inserts onto the talar neck
62
Interosseous talocalcaneal ligament
- Arises from sulcus calcanei close to the capsule of the posterior talocalcaneal joint - Fibers run obliquely upward and medially to insert onto the sulcus tali
63
Subtalar joint axis
- 16° from sagittal plane | - 42° from transverse plane
64
Subtalar joint movement
- Pronation/supination
65
Subtalar joint neutral position
- 2/3 range of motion – inversion - 1/3 range of motion – eversion - Ideally perpendicular to the ground
66
Subtalar joint total range of motion
- 30°
67
Direction of subtalar joint axis
- Runs MAD - From… Lateral, posterior and proximal aspect of the heel - To… Medial, anterior, distal - Exits foot at the dorsal medial aspect of the talar neck
68
Subtalar joint range of motion measurement
- Measurement taken in relation to bisection of the posterior aspect of calcaneus
69
Normal values of subtalar joint range of motion
- 30° total range of motion - 2/3 inversion: 1/3 eversion - Basis of calculation of subtalar joint neutral position
70
Pronation of STJ in OKC
- With reference to the talus: - Dorsiflexion - Eversion - Abduction
71
Supination of STJ in OKC
- With reference to the talus: - Plantarflexion - Inversion - Adduction
72
Open kinetic chain subtalar joint motion
- DorsEvAb (pronation mnemonic) - No axial load - Distal segment free to move upon fixed proximal segment
73
Pronation of STJ in CKC
- Distal segment is fixed - Plantarflexion of talus - Adduction of talus - Eversion of calcaneus
74
Supination of STJ in CKC
- Distal segment is fixed - Dorsiflexion of talus - Abduction of talus - Inversion of calcaneus

Intro to Biomechanics (8 decks)

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