-
What is the only true weight bearing bone of the leg?
tibia
-
What are the 3 types of bone in the foot?
- tarsals
- metatarsals
- phalanges
-
How are the metatarsals numbered?
1 thru 5
-
Which of the metatarsals are weight bearing bones?
1 & 5
-
we tend to stand on a ___________
triangle
-
Weight is borne from the base of the _________ to the heads of the ___________
- calcaneus
- 1st & 5th metatarsals
-
What 3 parts can the foot be divided into?
-
What is the hindfoot made up of?
calcaneus
-
In the gait cycle the hindfoot is the part of the foot that does what?
makes contact with the ground influencing the function and movement of the other 2 parts
-
The midfoot is made up of what?
- navicular
- cuboid
- 3 cuneiform bones
-
What does the midfoot do?
provides stability and mobility as it transmits movement from the hindfoot to the forefoot
-
What is the forefoot made up of?
- 5 metatarsals
- all of the phalanges
-
What does the forefoot do?
adapts to the level of the ground
-
Which part of the foot is the last part to make contact with the ground during stance phase?
forefoot
-
What are the 3 main functions performed by the ankle and foot?
- shock absorber as the heel strikes the ground at the beginning of the stance phase
- adapts to the level or unevenness of the ground
- provides a stable base of supprt from which to propel the body forward
-
What is the motion associated with plantar flexion?
- toes go toward ground
- i.e. - putting out a cigarette, putting toes in dirt
-
What is the motion associated with dorsi flexion?
toes come toward the shin
-
In which plane and axis do both plantar flexion and dorsi flexion occur?
- sagittal plane
- frontal axis
-
What is the motion associated with eversion (pronation)?
- raising the lateral border of the foot
- turning the forefoot outward
-
What is the motion associated with inversion (supination)?
- raising the medial border of the foot
- turning forefoot inward
-
Where do adduction and abduction occur?
primarily in the forefoot
-
What does adduction accompany?
inversion
-
What does abduction accompany?
eversion
-
In which plane does the movement in the forefoot occur?
transverse plane
-
What is the valgus position of the foot/ankle?
position where the distal segments is positioned away from the midline
-
What is the varus position of the foot/ankle joint?
position where the distal segment moves toward the midline
-
What is the Calcaneal Valgus position of the foot/ankle joint?
position where the distal part of the calcaneous is angled away from the midline
-
What are the 2 joints with little motion that aren't part of the true ankle joint but play a small role in the proper function of the ankle?
superior/inferior tibiofibular joints
-
What makes up the superior tibiofibular joint?
articulation b/t the head of the fibula and posterior lateral aspec of the proximal tibia
-
What does the plane joint do?
allows small amount of gliding and rotatin of the fibula on the tibia
-
Which joint in the ankle has a joint capsule?
synovial joint
-
What reinforces the capsule in the synovial joint?
ligaments
-
The capsule and synovial joint dissipate what?
torsional stresses applied at the ankle joint
-
What is the inferior tibiofibular?
syndesmosis (fibrous) union b/t the concave distal tibia and convext distal fibula
-
Is the inferior tibiofibular a synovial joint?
no
-
Is the inferior tibiofibular have a joint capsule?
no
-
In the inferior tibiofibular ________ separates bones and __________ hold the joint together
- fibrous tissues
- several ligaments
-
Much of the ankle joint's strength depends upon what?
a strong union at this joint
-
The true ankle joint (talocrural or talotibial) is made up of what?
- distal tibia that sits on the talus with the medial malleolus of the tibia fitting down around the medial asect of the talus
- lateral malleolus of the fibula that fits down around the lateral aspect
-
What makes up the mortise of the tenon & mortise joint?
mlleoli of the tibia/fibula
-
What makes up the tenon of the tenon & mortise joint?
talus
-
Which joint connects the leg and the foot and is responsible for controlling the majority of foot motion relative to the leg?
true ankle joint - talocrural or talotibial
-
The ankle is what kind of joint?
uniaxial hinge joint
-
The ankle consists of articulation between what?
distal end and medial malleoulus of the tibia & the lateral malleolus of the fibula with the talus
-
The ankle joint allows how many degrees of plantar flexion?
30-50
-
The ankle joint allows how many degrees of dorsiflexion?
20
-
What position is the ankle in when in anatomical position?
neutral position
-
At what angle is the axis of rotation of the ankle?
N angle
-
Why is the ankle's axis of rotation considered triplanar?
b/c of motion around an obligquely oriented axis that passes thru all 3 planes
-
At the ankle's axis of rotation, which malleolus extends more distally and lies more posteriorly than the other?
lateral more than medial
-
The axis of the ankle joint tips approximately 8 degrees from which plane?
transverse plane
-
The axis of the ankle joint tips approximtely 82 degrees from which plane?
sagittal plane
-
The axis of the anklejoint tips approximately 20 to 30 degrees from which plane?
frontal plane
-
During dorsiflexion the foot does what?
comes up and out slightly (abduction)
-
During plantar flexion the foot does what?
goes down and slightly in (adduction)
-
What is the open kinetic chain motion at the ankle joint?
- leg fixed and the foot free to move
- angle of the joint causes the foot to abduct during dorsi flexion and adduct during planar flexion
-
Which motion at the ankle joint occurs when the foot is fixed on the ground and the leg moves over it?
closed chain
-
During dorsiflexion the leg does what?
medially rotates on the foot caused by the angle of the joint
-
During ankle plantar flexion the leg does what?
laterally rotates on the foot
-
Why is the leg rotation during ankle plantar flexion allowed?
b/c of the slight movement that is possible at hte tibiofibular joint
-
What does the convex talus do during ankle plantar flexion?
glides posteriorly on the concave tibia
-
What are the end feels for both dorsi and plantar flexion?
firm
-
Why are the end feels for both dorsi and plantar flexon considered soft tissue stretch?
b/c of the tension in the joint capsule, ligaments, and tendons
-
What makes up the subtalar or talocalaneal joint?
bottom of talus on top of the calcaneous
-
What kind of joint is the subtalar or talocalaneal joint?
plane synovial joint with 1 degree of freedom
-
Where does inversion/eversion occur in the subtalar or talocalaneal joint?
at an oblique axis
-
What makes up the transverse tasal joint - midtarsal?
front part of calcaneus and talus articulating with the cuboid and navicular
-
How much movement occurs b/t the nav. and calca. in the transverse tarsal joint - midtarsal?
very little
-
Movement in the transverse tarsal joint links what?
the hindfoot and forefoot in eversion/inversion
-
What motions are involved in inversion at the subtalar and transtarsal joints?
includes a combination of abduction, pronation, and plantar flexion
-
What motions are involved in inversion at the subtalar and transtarsal joints?
includes a combination of adduction, pronation, and dorsiflexion
-
Where do plantar and dorsiflexion primarly occur in the ankle?
at the talocrural joint
-
When the ankle moves in inversion/eversion where do these motions occur?
at the subtalar/transverse tarsal joints
-
The combined motions of all of the joints in the ankle allow the foot to do what?
- assume almost any position in space
- adapt to any irregular surface
-
Point of reference for adduction/abductin in the foot joints is where?
2nd toe which abducts in both directions but adducts only returning from abduction
-
Joints metatarsal heads articulate with what?
proximal phalanges
-
The 5 MTP joints allow what motions?
- flexion
- extension
- hyperextension
- abduction
- adduction
-
Which MTP joint is the most mobile?
1st MTP joint
-
The 1st MTP joints allows approximately 45 degrees of what?
flexion/extension
-
The 1st MTP joint allows approximately 90 degres of what?
hyperextension
-
In what phase of walking is hyperextension extremely important?
toe off phase
-
Each of the lesser toes (2-5) have what kinds of joints?
- Proximal interphalangeals (PIP)
- distal interphalangeals (DIP)
-
Are the PIP and DIP in the foot as important as the ones in the hand?
no
-
How many phalangeal joints are in the thumb and which ones?
1 - IP interphalangeal joint
-
Which joint in the ankle is rather thin anteriorly and posteriorly bu reinforcedby collateral ligaments on both sides?
joint capsule
-
The collateral ligament on the medial side is of the ankle joint is a triangular deltoid ligament whose apex is where?
located along the tip of the medial malleolus
-
The deltoid ligament spreads out and attaches where?
to the talus, navicular, and calcaneus in 4 parts
-
To allow the functions of the feet to occur the bones of the foot are arranged with what?
arches
-
How many arches are located between the calaneus to the heads of the 1st and 5th metatarsals?
2 - medial & lateral longitudinal
-
The medial arch makes up the medial border of the foot running from where and to what?
from the calcaneus anteriorly thru the talus, navicular, and 3 cuneiforms anteriorly to the 1st 3 metatarsals
-
What is at the top of the arch?
talus
-
Why is the talus referred to as the keystone of the arch?
b/c it receives the weight of the body
-
What does the arch do during weight?
depresses somewhat - bearing thn recoils when weight is removed
-
Where does the lateral longitudinal arch run from and to?
from the calcaneus anteriorly thru the cuboid to the 4th, 5th metatarsals
-
Where does the lateral longitudinal arch rest during weight bearing?
on the ground
-
Where does the transverse arch run from and to?
from side to side thru the 3 cuneiforms to the cuboid
-
What is the keystone of the transverse arch?
2nd cuneiform
-
the 3 arches are maintained by what?
- the shape of their bones and relation to each other
- the plantar liaments and fascia
- the mm
-
what are the most important features of the arches?
ligaments ad fascia
-
What does the spring ligament support?
the medial side of the longitudinal arch
-
What is the longest of the tarsal ligaments?
long plantar ligament
-
where does the long plantar ligament attach?
posteriorly to the calcaneus and runs forward to attach on th cuboid and bases of the 3rd, 4th, and 5th metatarsals
-
What is the primary support of the lateral longitudinal arch?
long plantar ligament
-
Which ligament assists the long plantar arch and where does it attach?
- short plantar ligament
- attaches the calcaneus to the cuboid
-
What does the plantar fascia do?
- acts as a tie rod keeping the calcaneus/talus from separating from the anterior tarsals/metatarsals head
- increases the stability of the foot during weight bearing and walking
-
Total muscular support to the arches has been estimated to bear only about what percentage of the total stresses to the arches?
15-20%
-
What makes up the stirrup of the foot?
peroneus longus & tibialis anterior mm
-
Where does the peroneus longus mm attach?
descends the leg latteral before crossing the foot medially to join the tibialis anterior muscle
-
Where does the tibialis anterior mm attach?
descends the leg medially to meet the peroneus longus mm forming a U or stirrup
|
|
