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sup tib/fib jnt articultes w what?
inf tib/fib jnt articulates w what?
- sup - nada - doesn't articulate w knee
- inf - forms top of ankle jnt
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unlike elbow/wrist, the tib/fib jnts don't...?
add degrees of freedom to ankle, but may change its ROM if fused
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interosseous ligament
small, runs inferomedially at distal end of tib/fib joint
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texture of interosseous membrane
virtually woven - this allows the tib/fib joint to move
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sup tib/fib jnt - resting pos, closed packed pos, capsular pattern
- resting pos - 25 degrees knee flex and 10 degrees PF
- closed packed and capsular pattern - none known
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classification of sup tib/fib jnt
plane synovial jnt - bc the bones are flattish and slide against each other
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the articular surfaces the sup tib/fib jnt
- tibia: convex, faces lateral, dorsal, caudal (lat, post, inf)
- fibula: concave, faces med, vent, cephal (med, ant, sup)
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nerve supply to the sup tib/fib jnt
common peroneal nerve (aka fibular nerve) (leads to lat compartment of foot)
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fib glide when foot does inversion
inf/caudal
so for eversion it does sup/cephal/cranial
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tib/fib joints - how they move in dorsiflex
- inf - seperate/expand
- sup - fib does IR
so, for PF it's the opposite (and ER/IR can be considered post/ant glide of fib)
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talocrural jnt consists of what bones? how about the hindfoot?
- talocrural: tib, fib, talus
- hindfoot: talocrural + calcaneus
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how does the tibial styloid process compare to the fibular styloid?
result of this?
- tib: higher, more anterior
- fib: lower, more posterior
the axis is skewed, on an angle, which is brilliant bc it helps us w shock absorption and accomodating to all sorts of terrain
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syndesmosis joint
- a slightly movable articulation where the contiguous bony surfaces are united by an interosseous ligament
- ex: inferior tib/fib jnt
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clasification fo the inf tib/fib jnt
- syndesmosis - fibrocartilaginous junction
- this allows the jnt some rigidity despite its mobility
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articular surfaces of the inf tib/fib jnt
- tib: concave, faces lat
- fib: convex, faces med
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nerve supply for inf tib/fib jnt
deep peroneal and tibial nerve
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in the top of the ankle, which jont is synovial, which isn't?
- syndesmosis btwn tib and fib
- synovial btwn tib and talus
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crural tibiofibular interosseous ligament
- runs inferolat - oblique fibers
- serves as the axis of motion for the fibula
- allows for small amounts of distal tib/fib mvmnt and large amounts of prox mvmnt
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ant and post tib/fib ligaments
how they run
inferolat from lat tib to fib
very strong - fib will fracture before these tear
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inferior transverse tib/fib lig is where
inf joint, posterior
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why are the post tib/fib and inferior transverse ligs oblique?
to let fib move
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ways to mobilize fibula
- ant, post, cephal caudal
- can be done at prox or distal tib/fib jnt
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how to do fib mobs proximally
- post: pt is supine w cushion under thigh so knee will be in resting pos
- stabilize tib w meat of inner hand, other hand's thenar eminence presses on fib
- ant: pt is prone w pillow under calf
- stabilize med tib shaft and press on fibula, being careful to avoid the nerve
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how to do fib mobs distally
position the pt and then manipulate the lat malleoli
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how to do cranal and caudal mobs for the fibula
sidelying or supine, press on lat malleolis
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ant glide of fib done at sup tib/fib joint cause what in distal tib/fib ad ankle?
- distal fib goes post
- dorsiflection
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from the prox tib/fib joint, how to trigger PF?
push fib post
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