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