Anatomy > Ankle Foot Study Guide > Flashcards

Ankle Foot Study Guide Flashcards

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1
Q

. What are some unique features for each of the tarsal bones?

A

Talus:
-1st bone we come to if er move distally from leg bones
-Mortise, head, body, trochlea, articular cartilage
- Transfers wight from tibia to calcaneus and forefoot
- No tendon / muscle attachments

Calcaneus:
-Largest, strongest tarsal
-transfers weight from talus to ground
-Sustentaculum tali, calcaneal tuberosity

Navicular
- Navicular Tuberosity

Cuboid:

Cuneiform:
- Medial, intermediate, lateral

Transverse Tarsal Joint:
- Separates hindfoot and midfoot

Tarsometatarsal Joint
- Separates hindfoot and midfoot

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2
Q

Which bones make up Hindfoot

A

-talus
-Calcaneus

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3
Q

Which bones make up midfoot

A

-Navicular
-Cuboid
-1-3 Cuneiforms

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4
Q

Which bones make up the forefoot

A
  • 5 metatarsal bones
  • Phalanges
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5
Q

Primary/contributing muscles of Dorsiflexion

A

-Tibialis Anterior is the strongest Dorsiflexor
-Extensor Hallucis Longus does dorsiflexion and extension of great toe
-Extensor Digitorum Longus dorsiflexes ankle and Extends lateral 4 digits
-Fibularis Tertius Dorsiflexes ankle joint and aids in eversion if subtalar joint

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6
Q

Primary/contributing muscles of Plantarflexion

A
  • Gastrocnemius is the main plantar flexor
    -Soleus is the workhorse of plantarflexion; can plantarflex regardless of knee position because it does not cross the knee
    -Fibularis Longus/brevis both assist in plantarflexion
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7
Q

Primary/contributing muscles of inversion

A

Tibialis Posterior is the best invertor

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8
Q

Primary/contributing muscles of eversion (look up in book)

A
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9
Q

What is the best muscle to maintain longitudinal arch during weight bearing?

A

Tibialis Posterior

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10
Q

Describe the Longitudinal arch of foot ( Medial/Lateral)

A

Medial= calcaneus, talus, navicular, cuneiforms, medial 3 metatarsals

Lateral= Cuboid, cuneiforms, bases of metatarsal

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11
Q

Describe the Transverse arch of the foot

A
  • cuboid, cuneiforms, base of metatarsals
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12
Q

Explain the Passive and Dynamic supports of the foot

A

Passive:
-Noncontractile
-Bone shapes
-Plantar aponeurosis
-Plantar ligaments (Spring, Long, Short)

Dynamic:
- Contractile
- Intrinsic foot muscles
-Extrinsic (Tendons, FHL,FDL, Fibularis Longus, Tibialis Posterior

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13
Q

What happens to the Tibiofibular Syndesmosis during ankle Dorsiflexion?

a. Why does this occur?

b. What ligaments restrain this?
A
  • During ankle dorsiflexion the tibiofibular syndesmosis helps prevent mortis from splaying

A= Stability of ankle joint, keeps lateral malleolus firmly against lateral surface of talus

B= Union of Tibia and Fibula by interosseous membrane (shafts) and anterior, Interosseous and posterior tibiofibular ligaments (making up inferior tibiofibular joint uniting distal ends of bones)

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14
Q

Bones that make up Talocrural Joint

A
  • Mortis/ Talus
  • Hinge type joint
  • Has a capsule
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15
Q

Bones that make up Subtalar Joint

A
  • Talus/Calcaneus
    -Majority inversion/eversion occurs
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16
Q

Bones that make up the Metatarsophalangeal Joint

A

-Connects head of metatarsals with bases of proximal phalanges
-Toe flexion, extension, abduction, adduction

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17
Q

Bones that make up the Transverse Tarsal Joint

A
  • Made up of 2 separate Joints
    1. Talonavicular joint
    2. Calcaneal cuboid joint
    -Plays role in eversion and inversion
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18
Q

Bones that make up Tarsometatarsal Joint

A
  • Connects each tarsal bone to a metatarsal
  • Where forefoot begins
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19
Q

What bones make up the Proximal Interphalangeal Joint

A
  • Connects 1 phalanx to the next
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20
Q

What toe only has 1 IP joint ?

A

Great toe

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21
Q

A: Interphalangeal Joints can only…….
B: Interphalangeal joints can not do …..

A

A= can only do toe flexion/extension
B=Cannot do abduction/adduction

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22
Q

Which bones are connected by Anterior Talofibular ligaments & which motions are restrained

Study These Flashcards
A
  • Flat weak band
    -Extends anteromedially from lateral malleolus to neck of the talus
    -resistant to inversion
23
Q

Which bones are connected by the Posterior Talofibular ligaments & which motions are restrained

Study These Flashcards
A
  • Thick fairly strong band
    -Runs horizontally medially and slightly posteriorly from malleolar fossa of the fibula to the lateral tubercle of the talus
  • Resists ankle joint inversion
24
Q

Which bones are connected by the Calcaneofibular ligament and which motions are restrained

Study These Flashcards
A
  • Round cord
  • Passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
    -Medial ankle: stabilizes the ankle joint during eversion and prevents subluxation
25
Which bones are connected by the deltoid ligaments and which motions are restrained
- Made up of 3 smaller ligaments 1. Tibionavicular 2. Tibiocalcaneal 3. Tibiotalar part (posterior/anterior)
26
Which Bones are connected by the calcaneonavicular (spring) and which motions are restrained
-Calcaneus to navicular -The main ligament responsible for holding up the longitudinal arch of the foot
27
Which bones are connected by the Long Plantar and which motion are restrained
- Calcaneus to cuboid to metatarsal
28
Which bones are connected by the Short Plantar ( Plantar calcaneocuboid ) and which motions are restrained
- Plantar calcaneocuboid ligament -Calcaneus to cuboid
29
Which 3 ligaments maintain longitudinal arch
1. Calcaneonavicular ligament 2. Long plantar 3. Short plantar
30
. Explain the function of the Extensor Expansions of the toes (Look this up in the book)
31
Tom, Dick, ANd Harry Mnemonic
Tom= Tibialis Posterior Dick = flexor Digitorum longus A=tibial Artery N=tibial Nerve Harry= flexor Hallucis longus
32
Plantar fascia
- Continuous with posterolateral deep fascia of leg -Medial and lateral parts - Central part strong = Plantar Aponeurosis - Continuous distally with fibrous digital sheaths - Reinforced at metatarsals heads by superficial transverse metatarsal ligament 5 compartments 1. Medial 2. Central 3. Lateral 4. Interosseous 5.Dorsal
33
Plantar fascia: Medial
Contains : -Adductor hallucis - Flexor Hallucis Brevis -Tendon of FHL - Medial Plantar nerves/vessels
34
Plantar Fascia: Central
- Covered by Plantar aponeurosis Contains: -FDB -Tendons of FHL and FDL - Quadratus planta - Lumbricals -Adductor Hallucis -Lateral Plantar nerve/vessel
35
Plantar Fascia: Lateral
Contains: - Abductor/flexor digiti minimi brevis muscles
36
Plantar Fascia: Interosseous
-Surrounded by plantar/dorsal interossei facias Contains: -Metatarsal bones -Dorsal/ plantar interosseous fascia of mid/forefoot
37
Plantar Fascia: Dorsal
-Lies Between dorsal fascia and tarsal bones and dorsal interosseous of mid/forefoot Contains: - EHB -EDB -Neurovascular structures of the foot
38
Intrinsic Muscles Info
-Has 4 layers - 20 muscles: 14 plantar, 2 dorsal, 4 intermediate -Intrinsic muscles function as a group - Maintains arches of foot, resists collapse during walking
39
Intrinsic Layer 1
- Adductor Hallucis - Flexor Digitorum Brevis -Adductor Digiti Minimi
40
Intrinsic Layer 2
-Quadratus Plantae -Lumbricals: - Medial 2= Medial plantar nerve - Lateral 2= Lateral plantar nerve - Flex MTP'S but extends PIPs and DIPs
41
Does the Hallux and 5th digit need dorsal interossei?
No, because they each have their own abductor muscles
42
Dorsal Extrinsic
-Extensor Digitorum Brevis -Extensor Hallucis Brevis -Both innervated by Deep Fibular Nerve
43
Describe arterial blood flow through the foot
Dorsal Anterior Tibial Artery Dorsalis pedis -1st dorsal metatarsal artery -deep plantar artery - Lateral tarsal branch Plantar Posterior Tibial Artery Medial Plantar Artery - Deep and superficial branches Lateral Plantar Artery -plantar metatarsal arteries -Plantar digit Arteries
44
Veins of the foot
Superficial Dorsal and plantar digital veins --> dorsal metatarsal veins--> Dorsal venous arch --> dorsal venous network--> Plantar venous network-->medial marginal vein (goes to great saphenous vein) Lateral marginal vein (goes to small saphenous vein Deep -Deep plantar arch to posterior tibial veins
45
The 8 Gait Periods
Stance Phase: 1. Initial Contact 2. Loading response 3. midstance 4. Terminal Stance 5. Preswing Swing Phase 6. Initial Swing 7. Midswing 8.Terminal Swing
46
. What is an Os Trigonum?
Secondary ossification center ails to unite during development Causes: - Excessive of forceful plantarflexion early in teen years -non-union fracture Incidence: -14-25% of adults -ballet dancers, soccer players
47
Hallux Valgus
-Causes: - Footwear + DJD - Hallux points laterally -1st metatarsal shifts medially -Sesamoid shifts laterally -Medial longitudinal arch flattens -1st toe may overlap second -Bunions form
48
Hammer Toe
-MTP hyperextension, PIP flexion, DIP hyperextension -2nd toe most affected -Weak lumbricals/interosseous membrane
49
Claw Toes
-MTP hyperextension, PIP and DIP flexion -Lateral 4 toes usually -Callositeies and corns dorsal toe and or plantar metatarsal heads and toe tips
50
Pes Planus
-Flat Feet - Flexible - Flat in WB, Arch present in NWB - No passive support from ligaments -Rigid - Flat regardless of WB or NWB - Aquired Flat foot - Fallen arches - Tibialis posterior dysfunction - No dynamic support from muscles Spring ligament can't hold up talar head then the head falls inferomedially--> medial bulge in foot , loss of arch, lateral deviation of forefoot
51
What is the mechanism of injury for ATFL, CFL, and Trimalleolar Fracture for these ankle sprains Look up more in the book
ATFL= most common injured (inversion) CFL= may sprain with ATFL (inversion) Trimalleolar Fracture= Deltoid ligament sprains are rare from eversion - Pott fracture/dislocation -eversion injury -Deltoid sprained and tears off medial malleolus - Talus breaks lateral malleolus or fibula superior to syndesmosis -Tibia moves anterior shearing off its posterior distal ends on talus
52
What is Tarsal Tunnel Syndrome
Tarsal tunnel= formed by flexor retinaculum -Tibial nerve can be compressed/trapped by: edema or tight synovial sheaths of inverter tendons Symptoms: - Heel pain -Plantar foot parathesis - Motor loss plantar foot muscles
53
Describe the pathology of a Calcaneal Tendon rupture
Causes: - Poor conditioning - History of calcaneal tendinitis Symptoms: - Audible snap -Palpable gap proximal to calcaneal attachment - Excessive dorsiflexion -Pain in the calf/lump in calf -Inability to Plantarflex against resistance Treatment: - Surgical repair -PT for safe progressive rehab
54
Describe the pathology of Plantar Fasciitis
Inflammation of the plantar fascia Causes: - Biomechanical errors -Overuse -Improper footwear Symptoms: -Pain plantar foot and heel - TP medial calcaneus - Worse when trying to walk after periods of rest dissipates with activity -Worse with passive toes extension and dorsiflexion Calcaneal spur may develop from excessive pull of plantar fascia on origin
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