Lower Leg, Ankle, Foot Lecture

Question 1

Hindfoot

Answer 1

Inferior tib fib
Talocrural
Subtalar (talocalcaneal)

Question 2

Midfoot

Answer 2

Talocalcaneonavicular
Cuneonavicular 
Cuboideonavicular
Intercuneiform
Cuneocuboid
Calcaneocuboid

Question 3

Forefoot

Answer 3

Tarsometatarsal
Intermetatarsal
Metatarsophalangeal
Interphalangeal

Question 4

Inferior tib fib

Answer 4

(Hindfoot)
Fibrous syndesmoses
1-2 mm spread w/ DF - superior glide of fibula

Question 5

Tibfib resting

Answer 5

Plantar flexion

Question 6

Tibfib closed pack

Answer 6

Max DF

Question 7

Tibiofibular capsular pattern

Answer 7

Pain on stress

Question 8

Talocrural joint

Answer 8

Uniaxial, modified hinge, synovial

Med and lat malleolus w/ talus
Med doesn’t extend as far down
Branches of tibial and deep fibular nerves

Question 9

The talus is wider

Answer 9

Anteriorly

Question 10

Ankle dorsiflexion and plantar flex ROM

Answer 10

DF 20

PF 50

Question 11

Talocrural open pack

Answer 11

10 deg PF

Midway b/n max inversion and eversion

Question 12

Talocrural closed pack

Answer 12

Full DF

Question 13

Talocrural capsular pattern

Answer 13

PF, DF

Question 14

Talocrural - deltoid / medial collateral ligament

Answer 14

Tibionavicular
Tibiocalcaneal
Posterior tibiotalar
Anterior tibiotalar

Question 15

Talocrural lateral ligaments

Answer 15

ATFL
Posterior talofibular lig
Calcaneofibular lig

Question 16

Subtalar joint

Answer 16

3 seperate planar articulation
Triplanes motion around a single axis
Important for dampening rotational forces imposed by BW
Gliding and rotation are main motions 
May become hypomobile after injury 
No muscles attach to the talus

Question 17

Subtalar joint axis

Answer 17

42 deg upward and anteriorly from transverse plane

Medically included 16 deg

Results in triplanar motion around 1 axis

Question 18

Subtalar primary motions

Answer 18

Supination and pronation - composite motions in three planes that cannot and do not occur independently

Question 19

NWB motion (Subtalar)

Answer 19

Talus stable

Calcaneus and foot move around talus

Question 20

NWB supination

Answer 20

Calcaneal adduction
Inversion
Plantar flexion

Question 21

NWB pronation

Answer 21

Calcaneal abduction
Eversion
Dorsiflexion

Question 22

Closed chain Subtalar

Answer 22

Calcaneous no longer able to accomplish all 3 components of movement

• can still invert and evert
• proximal Tatar segment now moves on fixed calcaneus

Question 23

Closed chain supination

Answer 23

Talus- abducts, dorsiflexion
Calcaneus - inversion or varus

Tibiofibular lateral rotation

Question 24

Closed chain pronation

Answer 24

Talus - adduction, plantar flexion
Calcaneus - eversion or valgus

Tibiofibular medial rotation (10 deg)

Question 25

Talocalcaneonavicular

Answer 25

Convex head of talus and concave navicular -plantar calcaneonavicular ligament depends it Talus acts as ball bearing between mortise, calcaneus, and navicular

Question 26

Talocalcaneonavicular axis

Answer 26

Essentially the same as subtalar

Question 27

Key joint to foot function

Answer 27

TCN

Question 28

Joints forming single elastic unit

Answer 28

Distal to TCN | -moves in response to and compensates for movement of talus and calcaneus

Question 29

Midtarsal joint types

Answer 29

Cuneonavicular - plane synovial Cuboideonavicular - fibrous joint Intercuneiform - plane synovial Cuneocuboid - plane synovial Slight gliding and rotation at these

Question 30

Midtarsal joints resting

Answer 30

Midway b/n extremes of ROM

Question 31

Midtarsal joints closed back

Answer 31

Supination

Question 32

Midtarsal joints capsular

Answer 32

DF, PF, Add, IR

Question 33

TMT joint

Answer 33

Plane synovial | Gliding

Question 34

TMT closed pack

Answer 34

Supination

Question 35

Intermetatarsal joint

Answer 35

Plane synovial | Gliding

Question 36

Intermetatarsal closed pack

Answer 36

Supination

Question 37

MTP joint

Answer 37

Condyloid synovial 2 deg freedom F/E, Ab/Ad

Question 38

Interpalangeal joint

Answer 38

Synovial hinge | 1 deg free

Question 39

Interpalangeal resting

Answer 39

Slight flex

Question 40

Interphalangeal closed pack

Answer 40

Full extension

Question 41

Interphalangeal capsular

Answer 41

Flexion, extension

Question 42

Foot loading

Answer 42

Walking = 1.2xBW Running = 2xBW Jumping (2ft) = 5xBW

Question 43

Ankle sprain grade 1

Answer 43

- ant drawer - Tamar tilt No or little limp Usually ATFL

Question 44

Ankle sprain grade II

Answer 44

- or + ant drawer - Talar tilt Limp w/ walking Unable to toe raise or hop or run Complete tear ATFL, partial calcaneo-fibular

Question 45

Ankle sprain grade III

Answer 45

+ ant drawer and talar tilt Diffuse swelling around Achilles Unable to WB, sig pain inhibition Complete tear ATFL and calcaneofibular

Question 46

Ottawa ankle rules

Answer 46

Bone tenderness at: posterior tip of medial malleolus, posterior tip of lateral malleolus, base of 5th MT, navicular Or Pt cannot WB after injury or during exam (4 steps)