calcaneocuboid joint is classified as= NB= what is the other joint in the body classified as this?

- simple, synovial modified SELLAR joint - thumb

Lecture: The Leg, Foot & Ankle Flashcards by Sonny D

the ankle &amp; foot is a complex structure composed of \_\_ bones.
2 \_\_ bones (inflamed=?).
55 \_\_ (including 30 \_\_ joints interconnected by?)
sustains \_\_ forces &amp; converts the \_\_ movements that occur w/ weight bearing activities into \_\_, \_\_ &amp; \_\_ movements.

28
sesamoid; sesamoiditis
articulations; synovial; ligs. & muscles
substantial; rotational; sagittal, frontal & transverse

How well did you know this?

Not at all

Perfectly

foot is subdivided:
rear-foot/hind-foot=
mid-foot=
fore-foot=

talus & calcaneus
navicular, cuboid & 3 cuneiforms
phalanges (14 bones), 5 metatarsals & med./lat. sesamoids

How well did you know this?

Not at all

Perfectly

distal tibiofibular joint:
classified as a?
consists of __ tibial surface & a __ or __ surface on the medial, distal end of the fibula.
common area of diastasis (define=?)

syndesmosis
concave; convex or plane
separating ankle bones due to injury

How well did you know this?

Not at all

Perfectly

talocrural joint;
formed b/w __-shaped __ & distal __.
classified as a __ hinge or a __ seller joint.
primary motion are __ & __ w/ a total range of __deg.
closed-packed position?
open-packed position?

saddle; talus; tibia
synovial; modified
dorsiflexion & plantar flexion; 70-80degrees
weight-bearing & dorsiflexion
midway b/w supination & pronation

How well did you know this?

Not at all

Perfectly

subtalar (talocalcaneal) joint:
=a synovial, __ compound joint.
consisting of 2 separate __ __ surfaces w/ their own joint cavities.
this relationship ensures ant/post aspects can move in opp. directions during functional movements: ant. aspect moves medial, post. aspect moves?

bicondylar
modified ovoid
laterally

How well did you know this?

Not at all

Perfectly

subtalar joint __ & __ are measured clinically by the amount of calcaneal inversion & eversion.
normal individuals inv/ev. ratio=
which is approximately __deg. of inversion & __deg. of __.

supination & pronation
2:3 to 1:3
20deg. inv. & 10deg. of eversion

How well did you know this?

Not at all

Perfectly

reason for increased limitation of inversion?
reason for increased limitation of eversion?
close-packed position for subtalar joint?
open-packed position for subtalar joint?

chronic arthritic conditions
traumatic arthritis
full inversion
inversion/plantarflexion

How well did you know this?

Not at all

Perfectly

talocalcaneal joint ligaments:
2 superficial ligs. are=
deep ligs.=

lateral & posterior talocalcaneal ligaments

- interosseous, cervical & axial ligaments (interosseous ligs)

How well did you know this?

Not at all

Perfectly

most medial aspect of the foot=

-sustentaculum tali

How well did you know this?

Not at all

Perfectly

midtarsal joint complex consists of __ & __ articulations.

-talonavicular & calcaneocuboid

How well did you know this?

Not at all

Perfectly

the talonavicular joint is classified as a=

formed by the components of the=

synovial compound, modified ovoid joint

- talus, navicular, calcaneus & spring ligament

How well did you know this?

Not at all

Perfectly

spring ligament aka?

-plantar calcaneonavicular ligament

How well did you know this?

Not at all

Perfectly

calcaneocuboid joint is classified as=

* NB= what is the other joint in the body classified as this?

simple, synovial modified SELLAR joint

- thumb

How well did you know this?

Not at all

Perfectly

the spring ligament connects the __ bone to the __ __ on the calcaneus.

navicular

- sustentaculum tali

How well did you know this?

Not at all

Perfectly

4 more joints classified as Compound, Synovial Modified Ovoid Joints=

cuneonavicular joint
intercuneiform joint
cuneocuboid joint
cubometatarsal joint (when considered alone)

How well did you know this?

Not at all

Perfectly

cubonavicular joint classified as a __ or __ surfaced joint.

-syndesmosis; plane

How well did you know this?

Not at all

Perfectly

intermetatarsal joints: 1st=
& 2nd-4th are=
the metatarsophalangeal joints=
*interphalangeal joints=

simple, synovial modified ovoid joint
compound, synovial modified ovoid joints
simple, synovial modified ovoid joints
simple, synovial modified sellar joints

How well did you know this?

Not at all

Perfectly

Claw toe=

-hyperextension of the MTP joint & flexion of DIP & PIP joints

How well did you know this?

Not at all

Perfectly

Hammer toe=

-hyperextension of the MTP & DIP with flexion of the PIP

How well did you know this?

Not at all

Perfectly

Mallet toe=

-hyperflexion of the DIP w/ callus formations

How well did you know this?

Not at all

Perfectly

1st MTP joint- Hallux/Valgus=
overlapping toes are a result of the __ to the __.
if at the 5th toe=

lateral deviation of proximal phalanx of 1st toe, w/ pain on medial side of the 1st MTP; can result in ext. rot. of 1st.
adaptation; bunion
Tailors Bunion or a Bunionette

How well did you know this?

Not at all

Perfectly

the Plantar Fascia/aponeurosis is the __ layer on the __ aspect of the foot.
originates from the __ __ and inserts thru a __ network to the plantar __.
a tough, __ layer composed histologically of both __ & __ fibers.
__ portions.

fascial; plantar
os calcis; complex; forefoot
fibrous; collagen & elastic
3

How well did you know this?

Not at all

Perfectly

with standing & weight bearing, the plantar fascia plays a major role in the __ of the __ of the body by virtue of its __ across the __ __ arch.
abnormally high arch=
(*NB) absent arch=

support; weight; attachments; medial longitudinal
pes cavus
pes planus

the ankle retinacula fxn to=

-tether the leg tendons as they cross the ankle to enter the foot

extrinsic muscles of the foot are divided into=

- anterior & posterior superficial - posterior deep - & lateral compartments

the anterior compartment contains which muscles?

- the dorsiflexors (extensors) - tibialis anterior - extensor digitorum longus - extensor hallucis longus - & peroneus tertius

``` tibialis anterior tendon: strongest __ & __ of the foot. loss of the muscle strength can lead to __-__ or __ gait. tested in which nerve root? innervation? ```

- dorsiflexor & invertor - drop-foot or steppage gait - L4 - deep peroneal nerve

``` posterior superficial compartment includes= located where? action? tested in which nerve root? innervation? ```

- (calf m.'s) gastrocnemius, soleus & plantaris muscles - posterior to the interosseous membrane - plantarflex the foot - S1 - tibial nerve

the posterior deep compartment includes= action? lateral compartment includes= action? nerve root? & innervation?

- posterior tibialis, flexor digitorum longus & flexor hallucis longus - flexors of the foot - peroneus longus & brevis - plantarflex & eversion; S1; superficial peroneal nerve.

(intrinsic muscles of the foot: subdivided into 4 layers) | 1st layer=

- abductor hallucis - abductor digit minimis - flexor digitorum brevis

(intrinsic muscles of the foot: subdivided into 4 layers) | 2nd layer=

- flexor digitorum accessorius (quadratus plantae) | - lumbricals

(intrinsic muscles of the foot: subdivided into 4 layers) | 3rd layer=

- flexor hallucis brevis - flexor digit minimis - adductor hallucis

(intrinsic muscles of the foot: subdivided into 4 layers) | 4th layer=

- dorsal interossei | - plantar interossei

dorsal intrinsic muscles of the foot=

- extensor hallucis brevis | - & extensor digitorum brevis muscles

3 main arches of the foot=

- medial longitudinal - lateral longitudinal - transverse

the medial longitudinal arch is made up of=

- talus - navicular - 3 cuneiforms - 1st 3 digits & their metatarsals

the lateral longitudinal arch is made up of=

- calcaneus - cuboid - digits 4 &5 & their metatarsals

transverse arch is primarily formed by=

-5 metatarsal bones

a __ transverse arch leads to excessive __ b/w the metatarsal __. 1st most common place to have this pain? 2nd most common place to have this pain? (*NB) __ apparent injury. leads to __ __.

- dropped; pressure; heads - b/w 3rd & 4th toes - b/w 2nd & 3rd toes - no - morton's neuroma

the __ nerve, the __ cutaneous branch of the __ nerve, provides cutaneous distribution to the __ aspect of the foot.

- saphenous - largest - femoral - medial

Sciatic nerve provides= it divides into the common peroneal & tibial nerves: common peroneal nerve divides into= tibial nerve divides into=

- sensory & motor innervation to the foot & leg - superficial peroneal & deep peroneal nerves. - sural, medial calcaneal, medial plantar & lateral plantar N.'s

Tarsal Tunnel Syndrome: __ of the Posterior Tibial Nerve (PTN) in tarsal __ due to compression or __. repetitive __ or __ motion resulting in __ with resulting constriction of the PTN.

- neuropathy; - tunnel - stretching - hyperflexion - hyperextention - tenosynovitis

what forms the main blood supply to the foot?

- 2 branches of the popliteal artery: - the anterior tibial artery - & the posterior tibial artery

unilateral swelling of the foot may indicate=

-residual edema secondary to trauma

bilateral swelling of the foot may indicate=

-cardiac or lymphatic problems or a pelvic obstruction to venous return

single plane motions of the foot: frontal plane= sagittal plane= horizontal plane=

- inversion & eversion - dorsiflexion & plantarflexion - adduction & abduction

triplanar motion describes a movement about an __ oriented axis, thru all 3 body planes. triplanar motions occur at what joints? __ & __ are considered triplanar motions.

- obliquely - talocrural, subtalar, midtarsal & at 1st & 5th rays - pronation & supination

``` pronation of the foot: __ in the transverse plane. __ in the sagittal plane. __ in the frontal plane. which toe on ground, which toe up? ```

- abduction - dorsiflexion - eversion - big toe down; little toe up

``` supination of the foot: __ in the transverse plane. __ in the sagittal plane. __ in the frontal plane. which toe on ground, which toe up? ```

- adduction - plantarflexion - inversion - little toe down; big toe up

the fxn of the big toe is to provide __ to the __ aspect of the foot & to provide for normal __ during gait. normal alignment varies b/w _deg. varus & _deg. valgus. has remarkable discrepancy b/w __ & __ motion. approx. __deg. of active plantar flexion & __deg. of active extension; possibly increasing to __-__degrees during passive motion.

- stability; medial; propulsion - 5; 15 - passive & active - 30; 50 - 70-90

systemic problems that may involve the leg, foot & ankle include: (8)

- diabetes mellitus - osteomyelitis - gout - pseudogout - sickle cell disease - complex regional pain syndrome - peripheral vascular disease - rheumatoid arthritis

``` Gout= male _:_ predominance. ages _-_. __ evoke a strong inflammatory arthritis. common site? las tests show elevated: ESR= Leukocytosis= hyperuricemia= diet high in __ __ &/or red __. ```

- disorder of the purine metabolism where hyperuricemia leads to deposition of sodium monourate crystals into cartilage synovium & subcutaneous tissues - 20:1 - 40-60 - crystals (tophi) - 1st MTP jt. (big toe) - erythrocyte sedimentation rate - an abnormal increase in the # of circulating WBC's - an abnormal increase of uric acid levels in the blood - organ meats; wine

weakness on isometric testing needs to be analyzed for the type: __ weakness with __ contractions of the same resistance indicates __. consistent weakness with __ contractions which could suggest a __ muscle, or a significant __ tear, & the pattern of weakness (spinal __ root, nerve __ or __ nerve).

- increasing; repeated; palsy - reapeated; reconditioned; muscle - nerve; trunk; peripheral

passive articular __ tests assess the __ motions available b/w the joint surfaces. these include tests of the: (3) as w/ any other joint complex, the __ & __ of the joint motion must be assessed to determine the level of joint involvement.

- mobility; accessory - joint glides, joint compression & joint distraction tests - quality & quantity

important neurological structures that pass thru the ankle & terminate in the foot are: (6)

- saphenous n. - superficial peroneal n. - deep peroneal n. - posterior tibial n. - anterior tibial n. - sural n.

common reflexes in this area are: (2) sometimes this reflex is tested at L5 level: pathological reflexes tested when an upper __ neuron __ is suspected.

- achilles reflex (S1) - patellar reflex (L4) - posterior tibial nerve - motor; lesion

*NB: Tibialis posterior M. sometimes provides reflex for __. __/__ of foot, tap the tendon before it inserts on the __ tubercle. *NB: __ nerve is sometimes tested at level of L5.

- L5 - dorsiflexion/eversion; navicular - Tibial