Lower Leg, Ankle, and Foot Flashcards
(74 cards)
1
Q
Which malleoli is more inferior?
A
Lateral Malleoli
2
Q
Which lower leg bone bears 90% of the weight?
A
Tibia bears 90%
Fibula bears 10%
3
Q
`The tibia is rotated ____ about a vertical axis proximal to distal
A
laterally
4
Q
The tibia has a prominent ___ malleolus
A
medial
5
Q
The Fibula has a prominent ____ malleolus
A
lateral
6
Q
How does the fibula sit compared to the medial malleolus?
A
more posterior
7
Q
What makes up the hind foot?
A
talus and calcaneus
8
Q
What makes up the midfoot?
A
navicular, cuboid, and the three cuneiforms
9
Q
What makes up the forefoot?
A
metatarsals and phalanges
10
Q
The ___ bone has no muscle attachments
A
talus
11
Q
How much of the talus is covered with articular cartilage?
A
> 50%
12
Q
The superior aspect of the head of the talus is ___ shaped
A
dome
13
Q
What is the mortis?
A
the space between the distal end of the tibia and the head of fibula
14
Q
Inferiorly, the talus articulates with what?
A
the three facets of the calcaneus
15
Q
The anterior aspect of the talus articulates with what?
A
the navicular
16
Q
the medial and lateral aspects of the talar body articulate with what?
A
the medial and lateral malleoli
17
Q
What is the largest and strongest tarsal bone?
A
calcaneus
18
Q
What protects the calcaneus?
A
a thick fat pad
19
Q
The calcaneus attaches to the __ ___ on posterior aspect
A
achilles tendon
20
Q
The calcaneus articulates with the ___ anteriorly
A
cuboid
21
Q
What foot bone does the tibialis posterior insert onto? What side of the foot is this bone on?
A
navicular; medial
22
Q
What is the name of the group of 3 wedge shaped foot bones?
A
cuneiforms
23
Q
Posteriorly, what does the cuboid bone articulate with? Medially? Anteriorly?
A
the calcaneus
the lateral cuneiform
4th and 5th metatarsals
24
Q
How are the heads of the metatarsals shaped?
A
convex
25
What side of the metatarsals are concavely arched? What is good about this?
plantar side; facilitates increased load absorption
26
Which metatarsal has two sesamoids? What is their purpose?
first metatarsal (just posterior to head) - this is where the flexor hallucis brevis inserts (increases mechanical advantage)
27
What tendon runs between the two sesamoids?
FTL
28
How many phalanges does the foot have?
14 (big toe has 2 and the others all have 3)
29
What type of bones are the foot phalanges?
Still considered long bones even though they are so small - this is because of their shape and they fact that they have growth plates
30
What types of joints are the proximal and distal tibiofibular joints?
Proximal: planar/gliding
Distal: amphiarthrotic fibrous syndesmosis
31
Proximal TF joint: What movement occurs during dorsiflexion? Plantarflexion?
Dorsi - head of fibula moves superiorly
| Plantar - head moves inferiorly
32
How are the malleoli held together?
- anterior and posterior ligaments
- interosseous membrane
- interosseous ligament
33
Is there movement at the distal TF joint?
its debated that there is some movement at this syndesmosis
34
joints of the hind foot? (2)
talocrural
| subtalar
35
joints of the mid foot? (6)
```
talonavicular
calcaneocuboid
cubonavicular
cuneonavicular
intercuneiforme
cuneocuboid
```
36
joints of the forefoot?
tarsometatarsal
metatarsophalangeal
interphalangeal
37
Talocrural Joint:
- bones
- classification
- DOF
- movements
- osteokinematics
```
Tibia/Fibula with Talus
Hinge Joint
1 DOF
Plantarflex/Dorsiflex
Swing
```
38
Subtalar Joint:
- bones
- classification
- DOF
- movements
- osteokinematics
- Talus and Calcaneus
- Ant+Post subtalar joints together make modified sellar joint
- 1 DOF
- Eversion, inversion, pronation, supination
- covered later...
39
Subtalar joint - what facets are concave and which are convex?
Anterior and Middle = concave
Posterior = convex
40
Why might you get a hard end feel at the talocrural joint?
if the head of the talus gets shimmied forward
41
Is the trochlea of the talus male or female at the talocrural joint?
male
42
Talocrural joint: The medial and lateral surfaces articulate with what?
the medial and lateral malleoli
43
Talocrural joint: more wide anteriorly or posteriorly?
anteriorly
44
The tibia and fibula forms a strong socket (m or f?) for the trochlea of the wedge-shaped talus bone
female
45
Talocrural joint arthrokinematics: Dorsiflexion? Plantarflexion?
Dorsi - talus glides posteriorly
| Plantar - talus glides anteriorly
46
Talocrural axes of motion? Where does majority occur?
motion in all three planes even though it only has one DOF
majority occurs in sagittal plane with some movement in frontal and transverse planes
47
Plantar flexion: Degrees and End Feel?
50
| firm
48
Dorsiflexion (in sitting - knee flexed): Degrees and End Feel?
20-30
| firm
49
What makes up the anterior subtalar joint and what are their shapes?
- Head of talus (convex)
| - middle and anterior facets of calcaneus (concave)
50
What makes up the posterior subtalar joint and what are their shapes?
- Posterior facet of talus (concave)
| - Posterior facet of calcaneus (convex)
51
Supination of the foot is a combination of what 3 movements?
- inversion
- adduction
- plantar flexion
52
____ and ___ are triplanar movements
supination and pronation
53
Movements at ankle: Supination if open chain includes what movements?
all calcaneal movement - includes inversion, adduction, and plantarflexion
54
Movements at ankle: Supination if closed chain includes what movements?
includes inversion of calcaneus AND talar abduction and dorsiflexion
55
Movements at ankle: Pronation if open chain includes what movements?
all calcaneal movement - includes eversion, abduction, and dorsiflexion
56
Movements at ankle: Pronation if closed chain includes what movements?
includes calcaneal eversion AND talar adduction and plantar flexion
57
Effect of pronation on the kinetic chain?
medial rotation of lower leg and femur
58
Effect of supination on the kinetic chain?
lateral rotation of lower leg and femur
59
Why do we care about the effects of overpronation or oversupination on the kinetic chain?
because injuries that happen in a closed kinetic chain will have effects in different places
60
What ligaments provide lateral stability at the ankle?
The anterior and posterior talofibular ligaments and the calcaneofibular ligaments
61
What lateral ligament is the most commonly torn one?
anterior talofibular ligament
62
How do you test the integrity of the ATFL?
Put the ankle in plantar flexion and inversion - this is the same way it would have been strained, all you need to think about is "how would I stretch this" and then you know how to test the integrity
63
What is the medial ligamentous support for the ankle?
the deltoid ligament
64
What are the collateral ligaments of the ankle?
Deltoid and three lateral ligaments (ATFL, PTFL, and CFL)
65
What shape is the midtarsal joint and what does i split?
S-shaped; splits hind and mid-foot
66
What type of joints are the tarsometatarsal joints?
gliding joints - there is more movement at the 4th and 5th digit, similar to the hand!
67
What movements occur at the tarsometatarsal joints?
flexion/extension
| supination/pronation
68
What movements occur at the metatarsophalangeal joints and what type of joints are they?
Ellipsoid
Flexion/Extension
Abduction/Adduction
69
What movements occur at the Interphalangeal joints and what type of joints are they?
Hinge
| Flexion/Extension
70
What bones do the bases of the 5 metatarsals articulate with?
cuboid and 3 cuneiform bones
71
Which of the tarsometatarsal bones are the most mobile? What do they articulate with?
- 4th and 5th
- average 9 degrees of dorsi/plantar flexion and 11 degrees of inversion/eversion
- articulate with cuboid
72
ROM for MCP joints in flexion and extension compared to MTP joints?
90 degrees of flexion and 0-30 degrees of hyperextension at MCP
flexion is only 30-45 degrees and hyperextension is 90 degrees
73
what do we have so much more hyperextension at our MTP compared to MCP joints?
so that we can walk! when you are in late stance phase you need to have a large range of hyperextension to help with push off and force production = mechanical advantage!
74
How is the ab/adduction movements and muscular control of the toes compared to the hand?
less and less!
