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Musculo-Skeletal System > The Lower Limb 3- Foot and ankle, disorders of foot and ankle > Flashcards

The Lower Limb 3- Foot and ankle, disorders of foot and ankle Flashcards

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1
Q

tarsal bones

A

a set of seven irregularly-shaped bones, situated proximally in the foot

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2
Q

metatarsals

A

five metatarsals connect the phalanges to the tarsal bones

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3
Q

phalanges

A

the bones of the toes each toe has 3 except the big to which has 2

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4
Q

the foot can be divided into

A

hindfoot- talus and calcaneus
midfoot- navicular, cuboid and cuneforms
forefoot- metatarsals and phalanges

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5
Q

articulations of the tarsal bone

A

superiorly- ankle joint, between the talus, tibua and fubula

inferiorly- subtalar joint between talus and calcaneus

anteriorly- talonaviclar joint, between the talus and the navicular

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6
Q

what movements can the ankle joint do

A

dorsiflexion

plantarflexion

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7
Q

what muscles allow plantarflexion

A

gastroceminus
soleus
plantaris
tibialis posterior

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8
Q

what muscles allow dorsiflexion

A

tibialis anterior
extensor hallucis longus
extensor digitorium longus
peroneus tertius

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9
Q

what ligaments are lateral and what do they resist

A

anterior talofibular ligament between lateral malleolus and neck of talus

posterior talofibular ligament beween malleolar fossa and the lateral tubercle of the talus

calcaneofibular ligament between the tip of the lateral malleolus and the lateral surface of the calcenus

INVERSION

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10
Q

what prevents exessive eversion

A

the medial ligament

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11
Q

where does eversion and inversion occur

A

at the subta;ar, calcaneocuboid and the talocalcaneonavicular joints of the midfoot

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12
Q

subtalar joint

A

articulation between the talus and calcaneus

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13
Q

what 4 muscles make up the anterior compartment of the leg

A

tibialis anterior
extensor digitorum longus
extensor hallucis longus
peronues/ fibularis tertius

allow dorsiflexion and invertion

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14
Q

what innervates the anterior compartment and what is the blood supply

A

deep peroneal nerve L4/5

anterior tibial artery

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15
Q

what innervates the posterior compartment of the leg

A

tibial nerve- branch of sciatic

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16
Q

superficial posterior compartment

A 
gastroceminus
plantaris 
soleus
popliteus 
tibialis posterior 
flexor digitorium lomgus 
flexor hallucis longus
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17
Q

structures behind the medial malleolus medial to lateral

A 
tibialis posterior
flexor digitorium longus tendon
posterior tibial artery
posterior tibial vein
tibial nerve
flexor hallucis longus
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18
Q

femoral pulse

A

can be palpated as it enters the femoral triangle midway between the anterior superior illiac spine of the pelvis and the pubic symphysis - MIPA- mid inguinal point

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19
Q

popliteal artery pulse

A

hardest place to palpate. lies deep in popliteal fossa

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20
Q

dosalis pedis pulse

A

located palpating the dorsum of the foot, immediately lateral to extensor hallucis tendon

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21
Q

posterior tibial pulse

A

palpated in the tarsal tunnel just below and behind the medial malleolus

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22
Q

what makes up the popliteal fossa

A

superomedial border- semimembranous
superolateral border- biceps femoris
inferomedial border- medial head of gastrocemeninus
inferolateral border- lateral head of the gastroceminus and plantaris

floor- popliteal surface of the femur, popliteal surface of the knee joint capsule and the oblique popliteal ligament and the popliteus muscle

roof- politeal fascia and skin

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23
Q

ankle joint an associated ligaments as ring

A

the proximal part of the ring is formed by the articular surfaces of the tibia and fibula, united at the inferior tibiofibular joint by syndesmotic ligaments

medial side of the ring is formed by the medial deltoid ligaments

inferior part of the ring is formed by the subtalar joint

lateral side formed by the lateral ligament complex of the ankle

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24
Q

talar shift

A

when there is disruption of any 2 out of the syndesmosis, medial or lateral ligaments, the ankle mortise becomes unstable and widens so that the talus can shift medially or laterally within the joint

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25
what is an ankle sprain
partial or complete tear in one of the ligaments of the ankle joint heal with time and rest usually occur through excessive strain on the ligaments of the ankle. Excessive external rotation, inversion or eversion of the foot due to an external force.
26
what contributes to an increased risk in ankle sprain
weak muscles/tendons that cross the ankle the ankle joint. especially the peroneal muscles weak or lax ankle ligaments inadequate joint proprioception slow neuromuscular response to an off-balance position running on uneven surfaces
27
what is the most common mechanism of injury to the ankle
inversion injury affecting a plantar-flexed and weight-bearing foot anterior talofibular ligament is most at risk of sprain
28
mechanism of achilles tendon rupture
making a forceful push-off with an extended knee a fall with the foot outstretched in front snd the ankle dorsiflexed falling from a height or off a kerb
29
signs and symptoms of a achilles tear in the tendon
a sudden and severe pain at the back of the ankle or in the calf the sound of a loud pop or snap a palpable gap or depression in the tendon initial pain and swelling followed by bruising inability to stand on tip toe or push off
30
hallux valgus
varus deviation of the first metatarsal valgus deviation and/or lateral rotation of the hallux prominence of the first metatarsal head, with or without an overlying callus
31
hallux rigidus
osteoarthritis of 1st metarsophalangeal joint resulting in stiffness of this joint range of dorsiflexion becomes severely restricted due to the arthritis. A dorsal bunion (osteophyte) may develop on top and rub on shoes
32
arthroplasty
joint replacement
33
arthrodesis
joint fusion
34
excision arthroplasty
surgical removal of the joint with interposition of soft tissue
35
osteotomy
surgical cutting of bone to allow realignment
36
claw toe
affect all 4 toes at the same time toes hyperextended at the MTPJ and flexed at the PIP joint a result of muscle imbalance which causes the ligaments and tendons to become tight due to neurological damage
37
hammer toe
a deformity in which the toe is flexed at the PIPJ, whereas a mallet toe is flexed at the DIPJ. Most common second toe
38
curly toe
congenital and usually involve 3rd and 4th digits bilateral thought to occur due to tendons of flexor digitorium longus or digitorium brevis are too tight
39
achilles tendinopathy
degernative process in which the tendon becomes thickened and degernative follows many years of over-use or inactive
40
signs and symptoms of achilles tendinopathy
pain and stiffness along the achilles tendon in the morning pain in the tendon or at the back of the heel that worsens with activity severe pain 24 hours after exercising thickening of the tendon swelling that is present all of the time but worsens with activity palpable bone spur
41
pes planovalgus
flat foot valgus refers to the valgus angulation of the hindfoot medial arch of the foot has collapsed so medial border touches the ground
42
charcot arthropathy
which involves progressive destruction of the bones joints and soft tissues
43
gait
the mechanism by which the body is transported using co-ordinated movements of the major lower limb joints
44
what is needed for normal gait 5 things
``` stability foot clearance during swing pre-positioning for inital contact adequate step length energy conservation ```
45
double support
2 periods of time when both feet are in contact with the ground decreases as you walk faster, leading to jogging, running and eventually sprinting
46
double float
time in the gait cycle when neither foot is in contact with the ground
47
initial contact
first part of foot to strike the ground which is the heel- heel strike
48
loading response
period of deceleration where the shock of the impact is absorbed by the knee and ankle
49
mid stance
the foot is flat on the ground and the centre of gravity of the body is shifted from behind the foot to in front of the foot ready for forward propulsion
50
terminal stance
the ankle is plantarflexed and the heel of the supporting leg raises from the ground
51
pre-swing
the metatarsopharangel joints flex to give a push off by toes
52
initial swing
the kne flexes to enable the foot to clear the ground
53
mid swing
the hip flexs and the pelbis swings forwards to enable forward progression. There is dorsiflexion of the ankle to the neutral position
54
terminal swing
the knee extends and the foot is brought close to the ground in preparation for the inital contact - heel strike
55
stride
the distance from initial contact with one leg to the next initial contact with the same leg
56
step
the distance from inital contact with ine le t initial contact with opposite leg
57
cadence
the number of steps per minute
58
gait analysis
kinematics- the motions themselves | kinetics- the forces and moments that cause motion
59
antalgic gait
patients walk in a manner that reduces pain- walk on a limp. Shortening the stance phase of the painful limb. Shortened swing phase of unaffected limb. uneven gait walking stick used in opposite limb
60
hemiplegic gait
due to paralysis on one side results from stroke can occur as a consequence of cerebral palsy or trauma to CNS patients have spasticity of affected side typically have a flexed upper limb and extended long limb in order to take a step they have to lean towards the unaffected side of the body then circumduct the paralysed leg
61
diplegic gait
spasticity affects both lower limbs most commonly develops in cerebral palsy walks with a very narrow-based gait, dragging both legs and scraping toes on the ground forefoot that makes initial contact with the ground
62
high steppage gait
when the foot is raised from the ground in the swing phase the abscence of dorsiflexion means that the foot under gravity assumes plantarflexion patient has to flex the hip much more than usual to lift their foot high off the ground and stop their toes dragging
63
arrangement of tendon instertions in pes anserinus
say grace before tea sartorius gracilis Tendinosus
64
peroneal nerve- action
PED common Peroneal Everts and Dorsiflexes ] injury- foor drop
65
tibial nerve
TIP Tibial Inverts and Plantar flexes injury cant walk on tip toes

Musculo-Skeletal System (16 decks)

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