m9: leg, ankle, & foot Flashcards by aespicy buldak

Support of the body’s weight.

Control and stabilization of the leg on the planted foot.

Adjustments to irregular surfaces.

Compensation for more proximal segment malalignment or pathomechanics.

Elevation of the body, as in standing on the toes, climbing, or jumping.

Shock absorption in walking, running, or landing from a jump.

Operation of machine tools.

Substitution for hand functions in persons with upper extremity amputations or muscle paralysis.

FUNCTIONS OF THE ANKLE AND FOOT

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Bones of the Ankle and Foot:

Tibia
Fibula
Tarsals
Metatarsals
Phalanges

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Medial bone of the leg

“Shin bone”

90% weight-bearing

Medial malleolus

TIBIA

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Lateral bone of the leg

Essentially considered as a nonweightbearing bone (Brunnstrom)

10% weight-bearing (Brunnstrom)

It takes no part in the transmission of body weight (Snell)

Carries 17% of the axial load (Magee)

Lateral malleolus

FIBULA

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3 SECTIONS OF THE ANKLE AND FOOT

HINDFOOT (REARFOOT)
MIDFOOT
FOREFOOT

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Calcaneus
Talus

HINDFOOT
(REARFOOT)

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Navicular
Cuboid
Medial, Intermediate and Lateral cuneiform

MIDFOOT

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Metatarsals
Phalanges

FOREFOOT

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The foot assumes a slight toe-out position

This angle is approximately _ to _ from the _ axis of the body, developing from _ in children

FICK ANGLE

12° to 18° ; sagittal ; 5°

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The first metatarsal (1) is longer than the second (2), with the others (3, 4, and 5) of progressively decreasing lengths, so that 1 > 2 > 3 > 4 > 5. This can result in an _ type foot

INDEX PLUS TYPE

Egyptian type foot

69%

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The first metatarsal is equal in length to the second metatarsal, with the others progressively diminishing in length, so that 1 = 2 > 3 > 4 > 5. This results in a _ type foot

INDEX PLUS-MINUS TYPE

squared

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The second metatarsal is longer than the first and third metatarsals. The fourth and fifth metatarsals are progressively shorter than the third, so that 1 < 2 > 3 > 4 > 5. This results in a _ or _ type foot

INDEX MINUS TYPE

Morton’s or Greek

22%

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JOINTS

HINDFOOT (REARFOOT)
MIDFOOT
FOREFOOT

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“Plantar fascia”

It begins _ on the medial tubercle of the calcaneus and continues anteriorly to attach by digitations to the plantar plates and then, via the plates, to the proximal phalanx of each toe.

PLANTAR APONEUROSIS
posteriorly

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Hindfoot joints

Distal tibiofibular joint
Talocrural (ankle) joint
Subtalar or talocalcaneal joint

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Midfoot joints

Talocalcaneonavicular joint
Cuneonavicular joint
Cuboideonavicular joint
Intercuneiform joint

Other:
Chopart joint
Cuneocuboid
Calcaneocuboid

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Forefoot joints

Tarsometatarsal joint
Intermetatarsal joint
Metatarsophalangeal joint
Interphalangeal joint

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Tibiofibular joint

Resting position:
Close packed position:
Capsular pattern:

RP: Plantar flexion
CPP: Maximum dorsiflexion
CP: Pain when joint is stressed

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Talocrural joint

Resting position:
Close packed position:
Capsular pattern:

RP: 10° plantar flexion, midway between inversion and eversion
CPP: Maximum dorsiflexion
CP: Planter flexion, dorsiflexion

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Subtalar joint

Resting position:
Close packed position:
Capsular pattern:

RP: Midway between extension of ROM
CPP: Supination
CP: Limited ROM (valgus, varus)

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Between fibular notch at the lower end of tibia and the lower end of the fibula.

_ joint

No _

Tibiofibular joint

Fibrous joint

No capsule

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Tibiofibular joint ligaments
I
A
P
I

Interosseus ligament
Anterior tibiofibular ligament
Posterior tibiofibular ligament
Inferior ligament

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Talocrural joint

“_ joint” = _ _ and _

Uniaxial

_ _ joint

_ DOF

Motion:

“Ankle joint” = Ankle mortise and talus

Modified hinge joint

1 DOF

Dorsiflexion and plantarflexion

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Talocrural joint ligaments

MCL
LCL

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Subtalar joint _ joint _ DOF Motion:

Synovial 3 DOF Gliding and rotation

Subtalar joint ligaments L M I C

Lateral talocalcaneal ligament Medial talocalcaneal ligament Interosseous talocalcaneal ligament Cervical ligament

Midfoot Resting position: Close packed position: Capsular pattern:

RP: Midway between extremes of ROM CPP: Supination CP: Dorsiflexion, plantar flexion, adduction, medial rotation

“ tarsal joints” “Midtarsal joints” Refers collectively to the midtarsal joints between the: Talus-calcaneus Navicular-cuboid

Chopart joint

Talocalcaneonavicular joint _ joint 3 DOF Motion:

Ball and socket joint 3 DOF Gliding and rotation

Talocalcaneonavicular joint ligament D B P

Dorsal talonavicular ligament Bifurcated ligament Plantarcalcaneonavicular (spring) ligament

Cuneonavicular joint _ joint Motion:

Plane synovial joint Slight gliding and rotation

Cuboideonavicular joint _ joint Motion:

Fibrous joint Slight gliding and rotation

Intercuneiform joint _ joint Motion:

Plane synovial joints Slight gliding and rotation

Cuneocuboid joint _ joint Motion:

Plane synovial joints Slight gliding and rotation

Calcaneocuboid joint _ joint Motion:

Saddle shape joint Gliding with conjuct rotation

Calcaneocuboid joint ligaments B C L

Bifurcated ligaments Calcaneocuboid ligament Long plantar ligaments

Tarsometatarsal joint Resting position: Close packed position: Capsular pattern:

RP: Midway between extremes of ROM CPP: Supination CP: None

Metatarsophalangeal joint Resting position: Close packed position: Capsular pattern:

RP: 10° extension CPP: Full extension CP: Big toe: extension. flexion Second to fifth toe: variable

Interphalangeal joint Resting position: Close packed position: Capsular pattern:

RP: Slight flexion CPP: Full extension CP: Flexion, extension

Taken together, these joints are referred to as “_ joint” _ joint

Tarsometatarsal joint Lisfranc joint Plane synovial joint

Intermetatarsal _ intermetatarsal joints _ joint Allows _

4 Plane synovial gliding

Metatarsophalangeal _ metatarsophangeal joints _ joints _ DOF 4 Motions:

5 Condyloid 2 DOF Flexion, extension, abduction and adduction

Interphalangeal joint _ joint _ DOF 2 Motions:

Synovial hinge joint 1 DOF Flexion and extension

2 Ligaments

MCL LCL

Deltoid MCL _ (resist talar abduction) 3 ligaments: TN TC PTT

Superficial Tibionavicular ligament Tibiocalcaneal ligament Posterior tibiotalar ligament

Deltoid MCL _ Anterior tibiotalar ligament Resists: Lateral _ of the talus Lateral _ of the talus

Deep Lateral translation of the talus Lateral rotation of the talus

3 LCL

Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament

Anterior talofibular ligament Resists _ of _ MC injured (lateral ankle sprain)

Resists inversion of talus

Posterior talofibular ligament Resists ankle _, _ (tilt), _ rotation and _ translation of the _

Resists ankle DF, adduction (tilt), medial rotation and medial translation of the talus

Calcaneofibular ligament Resists maximum _ at the _ and _ joints. _ MC injured (lateral ankle sprain)

Resists maximum inversion at the ankle and subtalar joints. 2nd MC injured (lateral ankle sprain)

5 Anterior muscles

TA EDL PT EHL EDB

2 Lateral muscles

PL PB

3 Posterior muscles (superficial)

GAS PLA SOL

4 Posterior muscles (deep)

POP FDL FHL TP

3 Sole of the foot muscles (1st layer)

ABH FDB ABDM

2 Sole of the foot muscles (2nd layer)

QP L

3 Sole of the foot muscles (3rd layer)

FHB ADH FDMB

2 Sole of the foot muscles (4th layer)

DI PI

Dorsum of the foot

EDB

“Plantar fascia” It begins _ on the medial tubercle of the calcaneus and continues anteriorly to attach by digitations to the plantar plates and then, via the plates, to the proximal phalanx of each toe.

Plantar aponeurosis posteriorly

3 Arches of the foot

Medial longitudinal arch Lateral longitudinal arch Arch

Medial longitudinal arch BONE LIGAMENT TENDON

Talus (keystone) Navicular Calcaneus Cuneiforms 1st, 2nd, 3rd Metatarsals Spring ligament (Plantarcalcaneo navicular ligament) Proximal attachment: Sustentaculum tali Tibialis posterior tendon

Lateral longitudinal arch BONE LIGAMENT TENDON

Calcaneus Cuboid (keystone) 4th and 5th Metatarsals Long plantar ligament Peroneus longus tendon

Arch BONE LIGAMENT

3 cuneiform Intermediate/Middle cuneiform (keystone) Cuboid 1st-5th Metatarsal (bases) Intrinsic muscles of the foot

Arch A. At the level of the _ tarsals. B. At the level of the _ of the metatarsals.

A. anterior B. middle CU, cuboid LC, lateral cuneiform MC, middle cuneiform MeC, medial cuneiform.

FOOT LOADING DURING GAIT Walking Running Jumping (from height of 60 cm [2 feet])

1.2 times the body weight 2 times the body weight 5 times the body weight

A sprained ankle is nearly always an _ injury, involving twisting of the weight-bearing _ foot. The person steps on an uneven surface and the foot is forcibly inverted or lands on an inverted foot from a vertical jump. _ ligament sprains occur in running and jumping sports, particularly basketball (70–80% of players have had at least one sprained ankle). The lateral ligament is injured because it is much weaker than the medial ligament and is the ligament that resists inversion at the talocrural joint. The _ _ ligament—part of the lateral ligament—is most vulnerable and most commonly torn during ankle sprains, either partially or completely, resulting in instability of the ankle joint.

ANKLE SPRAIN inversion injury; plantarflexed foot Lateral ligament sprains anterior talofibular ligament

Inflammation of the _ _ Often caused by an _ mechanism It may result from running and high-impact aerobics, especially when inappropriate footwear is worn. It causes pain on the plantar surface of the foot and heel. The pain is often most severe after sitting and when beginning to walk in the morning.

PLANTAR FASCIITIS plantar fascia overuse mechanism

m9: leg, ankle, & foot Flashcards

(68 cards)