other joints of the ankle and foot

Question 1

foot is the

Answer 1

terminal joint of the lower kinetic chain

Question 2

lower extremity should distribute and dissipate

Answer 2

compressive

tensile

shearing

rotary forces

Question 3

what can inadequate distribution of forces lead to

Answer 3

abnormal movement

produces excessive stress

results in breakdown of connective tissue and muscles

Question 4

what do the foot and ankle have to be

Answer 4

both mobile and stable

stable –> WB and gait

mobile

Question 5

what do the foot and ankle have to be mobile

Answer 5

allow ground adaptation

shock absorption

compensate for rotation movements

Question 6

allow ground adaptation

Answer 6

foot must adapt to the different surfaces we walk on

Question 7

shock absorption

Answer 7

when the foot hits the ground

Question 8

compensate for rotation movements

Answer 8

that occur proximally at the hip during gait

Question 9

how is the ankle/foot complex divided

Answer 9

3 functional segments

Question 10

3 fxnal segments of the ankle-foot complex

Answer 10

hind foot

mid foot

forefoot

Question 11

hindfoot

Answer 11

posterior segment

Question 12

hindfoot

Answer 12

posterior segment

talus and calcaneus

Question 13

mid foot

Answer 13

middle segment

navicular, cuboid and 3 cuneiforms

Question 14

forefoot

Answer 14

anterior segment

metatarsals and phalanges

Question 15

talocalcaneonavicular joint

Answer 15

functional joint that ties together the talonavicular joint and the subtalar joint

Question 16

talonavicular joint

Answer 16

head of the talus w/ the navicular

Question 17

how does the calcaneus connected to the navicular

Answer 17

by the spring ligament

medial portion of the bifurcate ligament

Question 18

function of the TCN

Answer 18

motion at the WB talus at one articulation will cause motion at the other articulations

Question 19

what does the TCN do

Answer 19

helps what happens in the back of the foot occur in the front of the foot

mechanical link

Question 20

transverse tarsal joint (midtarsal joint)

Answer 20

compound joint

formed by the talonavicular and calcaneocuboid joints

Question 21

what do these two joints of the midtarsal joint form

Answer 21

“S-shape”

divides the hind foot from the midfoot and forefoot

Question 22

midtarsal –> movement of the bones

Answer 22

cuboid and navicular are immobile in WB positions

in WB positions –> movement of the talus and calcaneus on the navicuolocuboid unit

Question 23

calcaneocuboid joint

Answer 23

anterior calcaneus and the posterior aspect of the cuboid

has its own capsule that is reinforced by ligaments

Question 24

ligaments of the midtarsal joint

Answer 24

lateral band of the bifurcate lig

dorsal calcaneocuboid lig

plantar calcaneocuboid (short plantar lig)

long plantar lig

Question 25

long plantar lig --> midtarsal joint

Answer 25

attaches the back of the foot to the front of the foot important for transverse tarsal joint stability support of the longitudinal arch of the foot

Question 26

fxn of the midtarsal joint

Answer 26

mechanically linked with TCN by a shared talonavicular joint subtalar and TCN motion involves the entire transverse tarsal joint

Question 27

when TCN is supinated and locked

Answer 27

transverse tarsal joint is also locked

Question 28

when TCN is pronated and loose-packed

Answer 28

midtarsal joint is also mobile and loose packed

Question 29

what is the transverse tarsal joint to the hind and forefoot

Answer 29

transitional link will add supination and pronation

Question 30

tarsometatarsal joints

Answer 30

plane synovial joints formed by the distal row and the base of the metatarsals

Question 31

1st TMT

Answer 31

base of the first metatarsal w/ the medial cuneiform has its own joint capsule

Question 32

2nd TMT

Answer 32

base of the 2nd metatarsal w/ the middle cuneiform and the sides of the medial and lateral cuneiforms strong and motion is more restricted = more stable

Question 33

3rd TMT

Answer 33

base of 3rd metatarsal w/ the lateral cuneiform shares a joint capsule with the 2nd TMT

Question 34

4th and 5th TMT

Answer 34

bases of the 4th and 5th metatarsals with the cuboid share a joint capsule

Question 35

what reinforce each TMT joint

Answer 35

numerous dorsal, plantar and interosseous ligs

Question 36

fxn of the TMTS

Answer 36

continuation of the transverse tarsal joint will assist in regulating positions of the metatarsals and phalanges relative to the WB surface

Question 37

if the transversetarsal joint motion is adequate

Answer 37

TMT join motion is not required

Question 38

when rear foot motion is extreme

Answer 38

TMT join may rotate to provide further adjustment of forefoot position

Question 39

Ray

Answer 39

fxnal unit formed by a metatarsal and its assocaited cuneiform 3 rays

Question 40

1st ray

Answer 40

1MT w/ medial cuneiform

Question 41

2nd ray

Answer 41

2nd MT w/ middle cuneiform

Question 42

3rd ray

Answer 42

3rd MT w/ lateral cuneiform

Question 43

4th and 5th rays

Answer 43

not associated w/ a cuneiform formed by the metatarsal alone

Question 44

TMT action

Answer 44

contribute to hollowing and flattening the foot help compensate for read foot position if the transverse tarsal joint motion is not adequate

Question 45

metatarsophalangeal joint (MTP)

Answer 45

condyloid synovial joints 2 degrees of freedom allow for flexion/extension and ABD/ADD

Question 46

1st MTP ROM

Answer 46

45 degrees of flexion 70 degrees of extension

Question 47

why is adequate extension of first MTP important

Answer 47

late stand phase of gait

Question 48

2-5th MTP ROM

Answer 48

approx 40 degrees of flexion and extension

Question 49

sesamoid bones --> MTP

Answer 49

first MTP has two sesamoid bones anatomic pulleys for the flexor hallucis brevis protect the flexor hallucis longus from WB trauma also share the WB load with the head of the first MT

Question 50

MTP joint fxn

Answer 50

allow the foot to hinge at the toes

Question 51

2 structural aspects of MTP that enhance hinging at toes

Answer 51

metatarsal break plantar aponeurosis

Question 52

metatarsal break

Answer 52

single oblique axis for MTP flexion/extension that passes through the 2-5 MT heads oblique b/c MT get smaller as we go from 2-5 where the foot hinges when the heel rises

Question 53

plantar aponeurosis

Answer 53

dense fascia that runs from the calcaneus to the toes as the toes are extended @MTP --> the fascia is pulled tight tension will draw the heal towards the toes and contribute to rigidity of the foot (windless mechanism) --> makes it more stable by pulling into supination

Question 54

interphalangeal joint

Answer 54

synovial hinge joints one degree of freedom flexion/extension allowed

Question 55

IP fxn

Answer 55

smooth weight shift to the opposite foot in gait help maintain stability by pressing against the ground