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Ankle & Foot

Lippert - Ch.20 Ankle Joint & Foot - p. 301-324

QuestionAnswer
What structure keeps the tibia & the fibula together while providing a greater surface area for muscle attachment? the interosseous membrane
What bone is the only true weight-bearing bone of the leg? tibia
where is the tibial crest? anterior
How many tarsal bones are in each foot? seven
Which tarsal bone sits on the calcaneus & is the 2nd largest tarsal bone? talus
Which tarsal bone is on the lateral side of the foot, proximal to the 4th & 5th metatarsals, & distal to the calcaneus? cuboid
Which tarsal bone is on the medial side of the foot, distal to the talus, & proximal to the cuneiforms? navicular
How many cuneiform bones are there? 3
Where are the cuneiform bones located? distal to the navicular, proximal to the 1st 3 metatarsals
How are the cuneiform bones numbered? And which is the largest? numbered 1,2,3 from medial to lateral; the 1st is the largest
Which tarsal bone is the largest and most posterior? calcaneus
Where is the calcaneal tuberosity? projection on posterior inferior surface
Where is the sustenaculum tali? it is the medial superior projection of the calcaneus that supports the medial side of the talus
Where is the navicular tuberosity? projection on medial side of navicular
Where are the metatarsals located? distal to the cuneiforms & cuboid, proxiaml to phalanges
How are the metatarsals numbered? 1 - 5, starting medially going laterally
What is the 1st digit of the foot also called? great toe (or hallux)
What are the 2nd through 5th digits of the foot referred to as? lesser toes
hindfoot talus & calcaneus
midfoot naviculat, cuboid, & 3 cuneiforms
forefoot 5 metatarsals & all phalanges
Which part of the foot provide stability & mobility as it transmits movement? the midfoot
Which part of the foot can adapt to the level of the ground? the forefoot
Which part of the foot influences function & movement of the rest of the foot? the hindfoot (because it hits the ground 1st)
What are the 3 main functions of the ankle joint & foot? 1. shock absorber, 2. adapts to uneven ground, 3. provides stable to BOS (base of support) to propel body forward
Which motions of the foot & ankle occur in the SAGITTAL plane around the FRONTAL axis? plantar flexion & dorsiflexion
Which motions of the foot & ankle occur in the FRONTAL plane around the SAGITTAL axis? inversion & eversion
Which motions of the foot & ankle occur in the TRANSVERSE plane,and occurs primarily in the forefoot ? abduction & adduction
What motion involves raising the medial boarder of the foot and turning the forefoot inward? inversion
What motion involves raising the lateral boarder of the foot and turning the forefoot outward? eversion
Supination of the foot is a combination of what 3 motions? plantar flexion, inversion, adduction
Pronation of the foot is a combination of what 3 motions? dorsiflexion, eversion, abduction
valgus abnormal position where distal segment is AWAY from midline
varus abnormal position where distal segment is TOWARD the midline
superior tibiofibular joint between head of fibula & posterior lateral aspect of proximal tibia; functions to dissipate torsional stresses at ankle; synovial joint
inferior tibiofibular joint between concave distal tibia & convex distal fibula; accomodates motion of talus; major contributor to ankle joint strength; no joint capsul; synovial joint
Name 2 other names for the ankle joint talocrural joint or talotibial joint
between the tibia, fibula, & talus
inversion is a combination of what motions? adduction, supination, & plantar flexion
eversion is a combination of what motions? abduction, pronation, & dorsiflexion
motion around an obliquely oriented axis that passes through all 3 planes
How will the foot move during ankle dorsiflexion in an open kinetic chain (leg is fixed)? abduction
How will the foot move during ankle plantar flexion in an open kinetic chain (leg is fixed)? adduction
How will the leg move during ankle dorsiflexion in an closed kinetic chain (foot is fixed)? leg medially rotates
How will the leg move during ankle dorsiflexion in an closed kinetic chain (foot is fixed)? leg laterally rotates
another name for subtalar joint talocalcaneal joint
What type of joint is the suptalar joint? plane synovial with 1 degree of freedom
Where is the subtalar joint? between talus & calcaneus
What motions occur at the subtalar joint? inversion & eversion around oblique axis
another name for transverse tarsal joint midtarsal joint
motions of transverse tarsal joint inversion & eversion around oblique axis
Where is the transverse tarsal joint? where calcaneus & talus articulate with navicular & cuboid
inversion is a combination of what motions? adduction, supination, & plantar flexion
eversion is a combination of what motions? abduction, pronation, & dorsiflexion
metatarsalphalangeal (MTP) joints between metatarsals and proxiamal phalanges
1st MTP flexion 45 degrees
1st MTP hyperextension 90 degrees
2nd – 5th MTP flexion 40 degress
2nd – 5th MTP hyperextension 45 degrees
What joints does the foot have in common with the hand? PIP, DIP, IP joints
The capsule of the ankle joint is reinforced by what? collateral ligaments
deltoid ligament triangular in shape; strengthens the medial ankle, holds the calcaneus & navicular against the talus, and maintains medial longitudinal arch
lateral ligament actually 3 ligaments; connect lateral malleolus to talus & calcaneus
Which 3 bones create a triangle to bear weight when standing? 1st & 5th metatarsal & calcaneus
medial longitudinal arch medial boarder of foot from calcaneus to 1st 3 metatarsals; depresses and recoils, but should not flatten to ground
keystone of medial longitudinal arch talus
lateral longitudinal arch lateral boarder of foot from calcaneus to 4th & 5th metatarsals, rests on ground during weight-bearing
transverse arch through 3 cuneiforms to cuboid
keystone of transverse arch 2nd cuneiform
what maintains the 3 arches of the foot 1. Shape of bones & relation to each other; 2. Plantar ligaments & fascia; 3. Muscles
spring ligament aka: plantar calcaneonavicular lig.: from calcaneus to navicular
long plantar ligament calcaneus to cuboid, 3rd, 4th, & 5th metatarsals
short plantar ligament calcaneus to cuboid
plantar fascia calcaneus to proximal phalanges, increases stability and keeps anterior & posterior segments from separating
4 groups of extrinsic muscles superficial posterior, deep posterior, anterior, & lateral (table 20-2)
intrinsic muscle of the foot are located where? mostly the plantar surface (table 20-5)
What nerve innervates the posterior leg & plantar surface of the foot? tibial nerve
What nerve innervates the lateral leg? superficial peroneal nerve, except the peroneus tertius
What nerve innervates peroneus tertius, extensors, & tibialis anterior deep peroneal nerve
shin splints exercise induced pain to medial tibia (usually from running & jumping)
medial tibial stress syndrome anterior leg pain without stress fracture
plantigrade normal foot with sole at right angles to leg when standing
equinus foot aka: horse’s foot; hindfoot fixed in plantar flexion
calcaneus foot fixed in dorsiflexion
pes cavus abnormally high arch
pes planus aka: flat foot; loss of medial longitudinal arch
hallux valgus great toe points laterally
hallux rigidus degenerative condition, 1st MTP joint pain & limited ROM
hammer toe PIP flexed, DIP extended
mallet toe PIP extended, DIP flexed
claw toe PIP & DIP flexed
metatarsalgia bruise-like pain in metatarsal heads
Morton’s neuroma enlarged nerve between 3rd & 4th toes (p. 72 & 322)
turf toe caused by forced hyperextension of great toe at MTP joint (common to football, soccer, baseball)
ankle sprains lateral or inversion sprain is most common
ankle fracture usually involves twisting component to ankle involving lateral malleolus
bimalleolar fracture both malleoli break
trimalleolar fracture both mallieli & posterior lip of tibia break
plantar fasciitis from overuse; pain in heal
Achilles tendonitis inflammation of gastrocnemius-soleus tendon
What happens if the achillies tendon is completely ruptured? unable to plantarflex {squeeze the muscle belly in prone to test}
triple arthrodesis surgical procedure fusing the talocalcaneal, calcaneocuboid, & talonavicular joints [provides medial-lateral stability to foot]
Created by: jteich