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movement science final!!!!! > the ankle and foot complex > Flashcards

the ankle and foot complex Flashcards

1
Q

stability is require to allow for rigid foot during __ __

A

push off

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2
Q

___ is required for shock absorption and uneven terrain

A

mobility

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3
Q

what is considered the rearfoot (hind foot) , mid foot , and fore foot

A

rearfoot: talus and calcaneus

mid foot: navicular, cuboid and 3 cuneiform bones

forefoot: metatarsals and phalanges

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4
Q

what are the 3 motions of the foot and ankle complex

A

DF/PF (talocural)
INV/ EV ( subtalar)
ABD/ADD (subtalar, forefoot)

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5
Q

what movement of the food is pronation

A

DF/EV/ABD

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6
Q

what movement of the foot and ankle is supination

A

PF/INV/ADD

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7
Q

what is considered calcaneovalgus

A

pronation >180°

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8
Q

what is considered calcaneovarus

A

supination < 180°

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9
Q

what is considered the proximal tib-fib joint

A

head of fibula and posterolateral aspect of tibia

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10
Q

in the proximal proximal tib fib there is a ___ tibial facet and ___ fibular facet

A

convex and concave

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11
Q

the proximal tib-fib is anatomically belongs to the ___ but functionally to the ___

A

knee
ankle/foot

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12
Q

the distal tib-fib is a ___ union

A

syndesmosis (ligament in between 2 bones)

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13
Q

is there a join capsule in the distal tib fib

A

no just ligaments

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14
Q

what are the 2 ligaments of the distal tib fib

A

anterior and postioer tib fib lig
interosseous lig

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15
Q

the function of what joint is dependent on the stability of the tibiofibular joint

A

talocural joint

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16
Q

____ trauma could lock prox tibfib joint

A

inversion

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17
Q

hypermobility of proximal tibfib joint could leave to what nerve injury

A

common fibular

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18
Q

injury of the syndesmosis of the distal tibfib can lead to what

A

widening of the “mortise” which will lead to instability at talocrural joint

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19
Q

what type of joint is the talocrural joint

A

synovial hinge joint

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20
Q

what is the talocrural joint

A

distal tibtfib on body of talus

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21
Q

what makes up the mortise of the ankle

A

concave tibial plafond + malleoli

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22
Q

what is the distal articulating surface of the talocrural joint

A

body of talus with 3 facets and trochlear surface (convex)

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23
Q

is the capsule for the talocrural joint thin or thick and weak or strong

A

thin and weak

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24
Q

wh are the ligaments of the talocrural joint

A

medial collateral lig (deltoid)
lateral collateral lig

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25
Q

where does the medial collateral lig insert

A

navicular , talus and calcaneus

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26
Q

what is medial collateral lig or lateral collateral lig stronger

A

medial collateral lig

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27
Q

what are the 3 ligament names of the lateral collateral lig

A

anterior and posterior talofibualr lig
calcaneofibular lig

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28
Q

what was the lateral collateral lig of the talocrural joint help limit

A

inversion or supination

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29
Q

which axis of the talocrural allows the foot to move across 3 planes

A

oblique

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30
Q

how does the talocrural axis go thru the foot

A

goes thru fibular malleolus thru talus to tibial mall distally and posteriorly

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31
Q

how is the talocrural axis aligned

A

inclined down laterally 14° and posteriorly 23°

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32
Q

what is the typical amount of toe out ?

A

20°

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33
Q

during dorsiflexion what is the motion of the talocrural motion

A

head of talus rolls dorsally while the body of the talus glides plantarly

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34
Q

normal ROM of DF

A

20°

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35
Q

when is DF limited ? and why

A

in closed packed position by the acitive or passive tension in gastroc/soleus

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36
Q

during plantarflexion what is the motion of the talocrural joint

A

the head of the talus rolls plantarly and the body of the talus rolls dorsally

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37
Q

what is the normal ROM of PF

A

50°

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38
Q

during PF small amount of what 2 motions may happen

A

talar rotation (abd/add) or talar tilt (inv/ev)

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39
Q

when is only the posterior body of the talus is in contact

A

loose pack PF

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40
Q

during loose pack PF there is a higher incidence of what

A

ankle sprains

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41
Q

loose pack PF is limited by tension in what 3 muscles

A

anterior tibialis , EHL and EDL

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42
Q

the medial ankle is protected by what 3 mm

A

posterior tib, FHL , FDL

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43
Q

what lateral ankle is protected by what 2 mm

A

fibular longus and brevis

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44
Q

where is the shape of the talus wider distally or proximally

A

distally

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45
Q

in WB , as the mortise rotators over the __- the tib fib joint adjusts to widen around the ___ talus

A

talus
distal

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46
Q

DF causes what rotation of the tib fib

A

medial

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47
Q

plantarflexion causes what rotation of the tib fib

A

lateral

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48
Q

is the lateral facet or medial facet larger on the talocrural joint

A

lateral

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49
Q

what is the subtalar joint made up of

A

talus and calcaneus

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50
Q

how many articulations does the subtalar joint have

A

3 seperate

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51
Q

what is the proximal articulation of the subtalar joint

A

concave talus on convex calcaneus (largest facet )

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52
Q

what is the distal and medial articulations of the subtalar joint

A

convex facet of inferior body and neck of talus on 2 concave facets on calcaneus

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53
Q

the tarsal canal is formed by ___ in both bones of the subtalar joint and runs from what to what

A

sulcus
runs from sinus tarsi (lateral) to sustentaculum tail (medial)

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54
Q

what are the 5 ligaments of the subtalar ligaments

A

• Calcaneofibular ligament
• Anterior and posterior talofibular
ligaments
• Lateral and interosseous talocalaneal ligament
• Cervical ligament (strongest component)
• Deltoid ligament

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55
Q

the alternating convex and concave facets of the subtalar joint limits what

A

mobility

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56
Q

the axis of the subtalar joint is inclined ___ dorsally and distally and ____ medially

A

42° dorsally and distally (superior and anteriorly) and medially 16°

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57
Q

NWB coupled motions for supination is what

A

calcaneal ADD, INV, and PF

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58
Q

NWB coupled motions for pronation is what

A

calcaneal ABD, EV, DF

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59
Q

EV is sometimes referred to as ___ and INV as ___

A

valgus
varus

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60
Q

when the calcaneus is fixed on the ground the subtalar joint is only able to move in what plane

A

EV/INV

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61
Q

what is the subtalar motion of WB pronation

A

calcaneal EV , talar ADD and PF , the tib fib medial rotation

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62
Q

what is the subtalar motion during WB supination

A

calcaneal INV , talar ABD and DF
tib fib lateral rotation

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63
Q

what is normal INV ROM

A

20-30

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64
Q

what is normal ROM for EV

A

5-10

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65
Q

in bilateral stance there is a ___ degree of EV

A

3.5

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66
Q

gait range requires how much INV at heel strike

A

3 °

67
Q

gait range requires how many degrees of INV during push off

A

5.5 °

68
Q

what is the closed pack position of the subtalar joint

A

supination , stable foot position

69
Q

what is the open packed position for the subtalar joint

A

pronation , flexible foot position

70
Q

Talonavicular and calcaneocuboid form S shaped …

A

transverse tarsal joint line

71
Q

___ and____ are immobile in weight bearing

A

navicular and cuboid

72
Q

the talus in WB can be soldiered to act as a ball bearing between what 3 joints

A

the tibfib mortise superiorly
the calcaneus plantarly (the subtalar joint)
the navicular bone distally (the talonavicular joint)

73
Q

what makes up the talonavicular joint

A

distal convex head of the talus with concave proximal aspect of navicular

74
Q

what ligaments runs from the sustentaculum tail of the calcaneus to plantar aspect navicular bone

A

plantar calcaneonavicular ligament (spring)

75
Q

what does the medial segments of the spring ligaments act as

A

a sling to hold the head do the talus

76
Q

what does the lateral segments of the spring ligaments resist

A

tensile forces

77
Q

the talonavicular joint is reinforced by what medially and laterally

A

medially - deltoid ligaments
laterally - bifurcate ligaments

78
Q

the talonavicular joint has additional suppport from what other 3 ligaments

A

dorsal talonavicular ligament, talocrural ligaments, and subtalar ligaments

79
Q

When talus adjusts over calcaneus at subtalar, motion also occurs at ___ joint

A

talonavicular

80
Q

what makes up the calcaneocuboid joint

A

distal calcaneus with proximal cuboid

81
Q

the calcaneocuboid joint is linked to ___ in WB

A

subtalar

82
Q

INV/ EV of the calcaneus causes the calcaneocuboid joint to also move on a fixed ____ in a twisting motion

A

cuboid

83
Q

the calcaneocuboid joint has its own capsule with what 4 things

A

lateral band of bifurcate, dorsal CC ligament, plantar CC ligament, and long plantar ligament

84
Q

the longer planatar ligaments runs from ___ across ___ to base of ___ MT

A

calcaneus across cuboid to bases of 2-4 MT

85
Q

the transfer tarsal axis is a longitudinal axis that inclines up to how many degrees from the transverse plane

A

15°

86
Q

the transverse tarsal axis angles ___ medially from the sagittal plane aloowing triplanar motion for ____ and ____

A

9°
sup and pro

87
Q

in the tarsal axis the talus and calcaneus moves on the ___ and ____ mostly in INV/EV

A

nav and cuboid

88
Q

the oblique axis of the tarsal axis is ____ medial to the sagittal plane and ___ supinated to the transverse plane which allows sup/pro of talus and calcaneus

A

57°
52°

89
Q

what motion is mostly in the oblique axis for the calcaneocuboid joint

A

DF/PF and ADD?ABD

90
Q

the transverse tarsal joint is mechanically linking to the subtalus in WB of ___ and___

A

pro and sup

91
Q

As subtalar supinates, ___ and ____ also supinate until all joints are locked in ___ packed position

A

talonavicular

calcanealcuboid
closed

92
Q

as the subtalar pronates the ____ and ___ also _____ until all the joints are in a ___ packed position

A

talonavicular and calcanealcuboid
loose `

93
Q

how do you assess the mid foot motion

A

put the hind foot into pronation to “unlock” the transverse tarsal joint

94
Q

what is the transitional link between the hind foot and forefoot

A

transverse tarsal joint

95
Q

what joint aids in the ability of the forfeoot to remain flat on the ground while the rearfoot SUP/PRO in response to terrain or the rotations of the leg

A

transverse tarsal joint

96
Q

in WB supination there is ___ rotation of the tibia which will impose ____ supination with relative pronation of the ____

A

lateral
hind foot
forefoot

97
Q

what ligaments can be sprains easily in excessive supination

A

lateral ligaments

98
Q

what rotation of the tibia imposes subtalar pronation in WB

A

medial rotation

99
Q

what kind of joint is the tarsometatarsal joint

A

plane synovial joint

100
Q

what makes up the tarsomatatarsal joint

A

distal tarsal and base of MT

101
Q

what is the 1st TMT joint formed by

A

base of 1st MT and medial cuneiform (has own capsule)

102
Q

what is the 2nd and 3rd MT share a capsule with

A

2nd and 3rd cuneiforms

103
Q

the 4th and 5th TMT joint are formed with what

A

cuboid and share a capsule

104
Q

which TMT joint is the strongest and more restricted in motion

A

2nd and 3rd

105
Q

which rat for the TMT have the most motion

A

1st and 5th ray with oblique axis and triplanar motion

106
Q

what motion does the 1st ray do during pronation and supination

A

pro: DF, INN, ADD
SUP: PF, EV and ABD

107
Q

what motion does the 5th ray of the TMT joint do during pronationa and supination

A

pro:DF, EV, ABD
sup:PF, INV, ADD

108
Q

what is the function of the TMT joint

A

contribute to arching/ flattening of foot

109
Q

When hindfoot motion is near end ranges but can’t fully compensate, ____ can rotate for further compensation of forefoot

A

TMT

110
Q

When hindfoot pronates a lot in WB, transverse tarsal joint will supinate to counter rotate the forefoot and keep the plantar aspect of foot on the ground… If more adjustment is needed, 1st and 2nd rays are pushed into ____ by GRF and 4th and 5th rays will ___ to maintain ground contact

A

DF

PF

111
Q

what is associated at the forefoot with excessive pronation of hind foot

A

forefoot varus

112
Q

when in WB , someone with forefoot varus will present with an ___ subtalar joint

A

everted

113
Q

how many DOF does the Metatarsaphalangeal Joints have

A

2 (flex/ext and abd/add)

114
Q

in the late stance phase of walking ____ of the Metatarsaphalangeal Joints is key so foot can pass over toes

A

extension

115
Q

Metatarsal heads and toes help ____ ___

A

balance bodyweight

116
Q

concave/convex metatarsal heads with convex/concave proximal phalanx

A

convex
concave

117
Q

which MT is typically the longest

A

2nd

118
Q

___ ____ bear weight in stance

A

metatarsal heads

119
Q

there are seasamoid bones on the plants aspect of which MTP and they act as anatomical pulley for what muscle and protects what tendon in WB

A

1st
FHB
FHL

120
Q

what is the normal ROM of flex/ext of the 1st MTP

A

ext- 82
flex- 17

121
Q

how many degress of MTP ext is used during walking

A

42°

122
Q

what is stiff 1st MTP called

A

hallux rigidus

123
Q

excessive extension at MTP can results in what toe deformity

A

hammer toe

124
Q

how much does the 1st MTP adduct during gait

A

15°

125
Q

if the MTP adducts past 15° then what toe deformity is that

A

hallux valgus deformity

126
Q

how many DOF does the Interphalangeal Joints have

A

1 (flex/ext)

127
Q

how many Interphalangeal Joints does each toe have

A

2-5 have 2
GT has 1

128
Q

what is it called if someone has an extra toe

A

Polydactyly

129
Q

what is it called if someone is missing toes

A

Ectrodactyly

130
Q

what are the 3 arches in our foot

A

medial and lateral longitudinal arches
transverse arch

131
Q

where does the longitudinal arches (medial and lateral ) attach to posteiorly and anteriorly

A

posteriorly to the calcaneus and anteriorly to the MET heads

132
Q

which longitudinal arch is higher

A

medial

133
Q

what is the keystone of the longitudinal arches

A

talus

134
Q

what is the key stone of the transverse arch

A

medial cuneiform

135
Q

where is it easiest to see the transverse arch

A

TMT joint

136
Q

what are the 4 ligaments that support the arches

A

spring lig
interosseous talocalcaneal lig
plantar aponeruosis
cervical lig

137
Q

which ligament is the most static stabilize for the arches ? and what is it a sling for

A

spring lig and sling for talar head

138
Q

which ligament of the arches support is within the subtalar joint

A

interosseous talocalcaneal lig

139
Q

where does the plantar aponeurosis connect to

A

calcaneus (medial tub) to MT heads

140
Q

what does the cervical lig support

A

posterior longitudinal arch

141
Q

what ligaments i the strongest of talocalcaneal structures

A

cervical lig

142
Q

where does the cervical lig attach to

A

lateral calcaneus to talus

143
Q

what is the mobility function of the arches

A

accept weigh during early stand and adapt to surfaces

144
Q

the arches of the foot requires flexibility to do what 3 things

A

damien impact of WB forces ‘
dampen rotational motion
adapt to changes in support surface

145
Q

the stability function of the arches require stiffness for what 2 things

A

distribution of weight thru the foot
covert flexible foot to ridge lever for gait

146
Q

where does the plantar fasciitis run

A

calcaneus to plantar plates and prox phalanx

147
Q

when is the plantar aponeurosis subject to tension forces

A

during toe ext

148
Q

what mechanism explains that Tension of the plantar aponeurosis contributes to foot supination and increasing longitudinal arch and rigid lever function

A

– Windlass mechanism

149
Q

how much weight does the talus receive in bilateral stance

A

50% on each

150
Q

how much weight does the talus receive in unilateral stance

A

100%

151
Q

during unilateral stance WB the talus receives 100% if the body weight and then distributes it where

A

50% to the calcaneus and 50% to the talonavicular and calcaneocuboid

152
Q

when is plantar pressure greater than, during walking or standing

A

walking

153
Q

where is there the highest pressure under the MET head during gait

A

during push off

154
Q

when is hell pressure that greatest during gait

A

greatest at heel strike

155
Q

a supinated foot is also called what

A

pes cavus

156
Q

an excessive pronated foot is called what

A

pes planus

157
Q

someone with a supinated foot will present with what

A

inverted calcaneus
high medial longitudinal arch
lateral talonavicular bulge
forefoot valgus

158
Q

what is common with supinated foot (pes cavus)

A

ankle sprains

159
Q

someone with pes cavus will have a ___ shock absorption

A

decreased

160
Q

someone with excessive pronated foot (pes plantus) will present how

A

flat medial longitudinal arch
hallus valgus
tired feet

161
Q

someone with excessive pronated feet will have a ___ ridge lever

A

decreased

162
Q

club foot has mid foot ___ deformity , metatarsals ___ deformity , hind foot __ deformity , and hind foot ___ deformity

A

• Midfoot cavus deformity
• Metatarsus adductus deformity
• Hindfoot varus deformity
• Hindfoot equinus deformity

163
Q

Congenital Talipes Equinovarus (club foot) happens how often

A

1 per 1000 births

movement science final!!!!! (9 decks)

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