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Flashcards in joints of lower extremities Deck (56)
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Acetabulofemoral joint classification

Structure: synovial
subtype ball and socket
Multiaxial
Function: diarthrotic

1

AF joint ROM

Flexion 120
Extension 30
Abduction 45
Adduction 30
Medial rotation 35 (limited by ishofemoral lig)
Lateral rotation 45 (limited by pubofemoral and iliofemoral ligaments0

2

AF joint resting, closed pack and capsular pattern

Resting: 30 flexion, 30 abduction and slight lateral rotation
Closed pack: full extension, abduction and medial rotation
Capsular pattern: internal rotation and abduction > flexion and extension> external rotation

3

AF joint articular surfaces

Femoral head (convex)
Acetabulum (concave)
Strong

4

AF joint ligaments (6)

1. Ligamentum capitis femoris
2. Iliofemoral ligament
3. Pubofemoral ligament
4. Ishiofemoral ligament
5. Transverse acetabular ligament
6. Zona Orbicularis
Strong because of zona orbicularis (circular fibers of the articular capsule)

5

AF joint bursae (2)

iliopectineal and trochanteric
(Acetabular labrum)

6

AF joint mob

Distraction
Long-axis traction/inferior glide -increase abduction
Posterior glide - increase flexion /medial rotation
Anterior glide - increase extension/lateral rotation
Postero-lateral glide of femur on pelvis -increase medial rotation
Lateral glide - increase adduction/medial rotation

7

Tibiofemoral joint classification

Structure: synovial, hinge, uniaxial
Function: diarthrotic

8

Tibiofemoral joint ROM

Flexion 130
Extension up to 10 (hyperextension is called genu recurvatum)
Rotation: +/- 10

9

Tibiofemoral joint resting position, closed pack, capsular pattern

Resting: 25 of knee flexion
Closed-pack position: full extension with lateral rotation
Capsular pattern: flexion > extension

10

Articular surfaces of Tibiofemoral joint

Femoral condyles (convex)
Tibial condyles (concave)
with menisci in between

11

Tibiofemoral joint ligaments (7)

1. Tibial (medial) collateral ligament
2. Fibular (lateral) collateral ligament
3. Popliteal ligament (Oblique, arcuate)
4. Cruciate ligaments
-Anterior for extension
-Posterior for flexion
5. Coronary ligament

12

Tibiofemoral joint bursae and additional structures

suprapatellar and semimembranosus bursae
Medial and lateral (more circular in shape) menisci

13

Joint mobs of Tibiofemoral joint

Distraction
Posterior glide - increase flexion 2 techniques
Anterior glide - increase extension - 3 techniques
medial glide - increase flex/ext
Lateral glide - increase flex/ext
Medial gap - increase flex/ext and to treat genu varum
Lateral gap - increase flex/ext and to treat genu valgum

14

Patellofemoral joint classification

Structure: synovial, planar nonaxial
Function: diarthrotic

15

Patellofemoral ROM

Superior/inferior glide (s-shaped)

16

Patellofemoral joint resting position, closed pack position, capsular pattern

25-40 of flexion
Closed pack position full flexion
Capsular pattern : flexion>extension

17

Patellofemoral joint articular surfaces

Patellar surface of femur (concave)
Medial/lateral surfaces of patella (convex)

18

Patellofemoral joint ligaments (2)

Patellar ligament
Patellar retinaculam

19

Patellofemoral joint mob

Superior glide
Inferior glide - to increase flexion
Medial glide
Lateral glide care taken because this motion may be hypermobile
Medial/lateral tilts

20

Proximal tibiofibular joint classification and ROM

structure: synovial, planar, nonaxial
Function: diarthrotic
ROM: slight gliding

21

Proximal Tibiofibular joint resting, closed-pack, capsular pattern

0 of plantar flexion
full dorsiflexion
Capsular pattern: none

22

Proximal tibiofibular joint articular surfaces

Facet on the lateral condyle of the tibia (convex)
Facet on the head of the fibula (concave)

23

Proximal tibiofibular joint ligaments (2)

Anterior ligament of the head of the fibula
Posterior ligament of the head of the fibula
Capsular strength : moderate reinforced by strong ligaments

24

Proximal tibiofibular joint mob

Posterior glide (caution - possible Hypermobility, can help correct positional fault)
Anterior glide (as with previous mob)

25

distal tibiofibular joint classification and range of motion

Structure: syndesmosis, non axial
Function: amphiathrosis
ROM: slight gliding

26

Articular surface of Distal tibiofibular joint

Post-lat aspect of distal tibia (concave)
Ant-med aspect of distal fibula (convex)

27

Resting, closed pack, capsular pattern of restriction of distal tibiofibular

resting: not described
closed pack: not described
capsular pattern n/a

28

Capsular strength of distal tibiofibular

moderate, reinforced by strong ligament (Interosseus membrane)

29

Ligaments around tibiofibular

1. Ant. Tibiofibular ligament
2. post. Tibiofibular ligament
3. inferior transverse ligament
4. interosseous membrane

30

Joint mob of distal tibiofibular

posterior glide - positional fault/general ROM
anterior glide - positional fault/general ROM
Superior glide - increased dorsiflexion
Inferior glide - general ROM

31

Tarocrural joint classification

Structure: synovial, hinge, uniaxial
Function: diarthrotic

32

Tarocrural joint ROM

Dorsiflexion 20 degree
Plantar flexion: 50 degree

33

Resting, closed pack, capsular pattern of restriction of Talocrural joint

Resting position: plantar flexion 10 degree
Closed pack position: full dorsiflexion
Capsular pattern of restriction: plantarflexion slightly > dorsiflexion (plantar flexion is slightly more limited than Dorsiflexion)

34

Articular surfaces of talocrural

Talus: trochlea (convex)
Tibia: Malleolar and inferior articular surfaces (concave)
Fibula: Malleolar articular surface (concave)

35

Capsular strength of Talocrural

weak

36

Ligaments of Talocrural

Lateral collateral ligs (3)
posterior talofibular lig
Calcaneofibular lig
Anterior talofibular lig (most frequently sprained ligament)

Medial (Deltoid) Collateral lig (4)
posterior tibiotalar part
Tibiocalcaneal part
Tibionavicular part
anterior tibiotalar part

37

Joint mobs of Tatocrural joint

Distraction
Posterior glide (increasing dorsiflexion)
Anterior glide (increasing plantar flexion)

38

Subtalar (Talocalcaneal)joint classification

Structure: synovial, planar, non axial
Function diarthrotic

39

Range of motion of Subtalar

inversion 5 degree
eversion 5 degree

40

Resting position, closed pack, capsular pattern of restriction of subtalar

Resting position 10 degree plantarflexion with neutral inversion/eversion
closed pack position: full inversion
capsular pattern of restriction: inversion>eversion, which is relatively free (there is a limitation in inversion)

41

articular surfaces of subtalar

anterior, middle and posterior articular facets of talus and calcaneus
posterior part: talus with calcaneus
anterior part: talus with navicular (inversion/eversion)
capsular strength: weak

42

Subtalar ligaments

medial talocalcaneal lig
lateral talocalcaneal lig
posteior talocalcaneal lig
interosseous talocalcaneal lig
(tibiocalcaneal and calcaneofibular)

43

joint mob of subtalar

Distraction
medial glide
lateral glide
medial gap (increasing subtalar eversion)
lateral gap (increasing subtalar inversion)

44

Foot is comprised of 4 sets of joints

Midtarsal joints
intermetatarsal joints
Metatarsophalangeal joints
Interphalangeal joints

the midtarsal joint is composed of the talonavicular and calcaneocuboid joint

45

Talocalcanealnavicular joint classification and range of motion

stracture: synovial, gliding nonaxial
functional: diarthrotic
ROM: inversion 20 degree
Eversion 10 degree

46

Resting, closed pack and capsular pattern of restriction of talocalcanealnavicular joint

Resting 10 degree plantar flexion, with neutral supination/pronation
closed pack position: full supination
capsular pattern of restriction: supination> pronation (supination is more limited than pronation)

47

articular surfaces of talocalcanealnavicular joint

Talus: anterior and middle facets and facet for navicular
Calcaneus: anterior and middle talar facets
Navicular: posterior facet for talus

48

Ligaments of talocalcaneal navicular joint

dorsal talonavicular lig
dorsal calcaneaonavicular lig
plantar calcaneonavicular lig

49

Distal intertarsal joints (3)

Cuneonavicular joint
Intercuneiform joint
Cuneocuboid joit

50

Classification of distal intertarsal joints

structure: synovial planar, nonaxial
Function: diarthrotic
Slight gliding

51

Tarsometatarsal joint classification, range of motion

Structure: synovial, planar, nonaxial
Function: diarthrotic
Range of Motion: slight flexion/extension, abduction/adduction and rotation at the 1st tarsometatarsal jt. (to facilitate pronation/supination)

52

Resting, closed pack, capsular pattern of restriction

Resting position: midway between supination and pronation
Closed-pack position full supination
Capsular pattern of restriction: not described

53

Articular surfaces of tarsometatarsal joint

medial cuneiform to metatarsals 1 and 2
Intermediate cuneiform to 2nd metatarsal
Lateral cuneiform to metatarsals 2,3 and 4
Cuboid to metatarsals 4 and 5

54

Intermetatarsal joint classification and range of motion

structre: synovial, planar, nonaxial
Function: diarthrotic
Range of motion slight gliding

55

articular surfaces of intermetatarsal joint

adjacent surfaces of the lateral four metatarsals