Term
| functions of foot and ankle complex |
|
Definition
| stable base of support, rigid lever for push off and propulsion, absorb and distribute forces, adapt to surfaces and accommodate superior segmental adjustments |
|
|
Term
| what axis provides pronation/supination? |
|
Definition
|
|
Term
| what does it mean that the foot/ankle is triplanar? |
|
Definition
| moves through all 3 planes. Get relative motion in all 3 planes |
|
|
Term
| what motions produce pronation in open chain? |
|
Definition
| eversion, abduction, dorsiflexion |
|
|
Term
| what motions produce supination in open chain? |
|
Definition
| inversion, adduction, plantarflexion |
|
|
Term
| what motions produce pronation in closed chain? |
|
Definition
| dorsiflexion, eversion, internal rotation |
|
|
Term
| what motions produce supination in closed chain? |
|
Definition
| plantarflexion, inversion, external rotation |
|
|
Term
| what movements occur at talocrural joint? |
|
Definition
| dorsiflexion, plantarflexion |
|
|
Term
| what movements occur at subtalar joint? |
|
Definition
| abduction/adduction, inversion/eversion |
|
|
Term
| how much WB does the fibula do? |
|
Definition
|
|
Term
| what type of joints are the distal and proxial talofibular joints? |
|
Definition
| plane joints that are mostly fixed |
|
|
Term
| what are the ligamentous supports to the distal talofibular joint? |
|
Definition
| anterior and posterior tibiofibular ligaments; interosseous membrane |
|
|
Term
| what kind of sprain occurs at distal tibiofibular joint? |
|
Definition
|
|
Term
| what is the most congruent joint in the human body? |
|
Definition
|
|
Term
| what are the shapes of the talocrural joit? |
|
Definition
|
|
Term
| what are the 3 articulations of the talocrural joint |
|
Definition
| trochlear surface with distal tibia; medial malleolus and medial talar facet; lateral malleolus and lateral talar facet |
|
|
Term
| describe convexity/concavity of trochlea and tibia |
|
Definition
| tibia is concave, talus trochlea is convex |
|
|
Term
|
Definition
| wedge shaped: wider anteriorly than posteriorly AND wider laterally than medially |
|
|
Term
| closed chain arthrokinematics of tibia/talus |
|
Definition
| concave tibia moving on convex talus |
|
|
Term
| open chain arthrokinematics of tibia/talus |
|
Definition
| convex talus moving on concave tibia |
|
|
Term
| what is close packed position of talocrural joint? |
|
Definition
|
|
Term
| why is dorsiflexion close packed position for talocrural joint? |
|
Definition
| wedge shaped talus is wider anteriorly; in dorsiflexion, wide anterior portion is jammed into mortise shape of tibia, providing stable joint |
|
|
Term
| what causes a high ankle sprain? |
|
Definition
|
|
Term
|
Definition
| tibia is externally rotated: medial malleolus is more anterior and more proximal than lateral malleolus |
|
|
Term
| what bone makes the lateral malleolus? |
|
Definition
|
|
Term
| what provides medial ligamentous support to talocrural joint? |
|
Definition
|
|
Term
| what is likely to happen in excessive eversion? |
|
Definition
| medial malleolus may fracture before deltoid ligament ruptures |
|
|
Term
| what provides lateral ligamentous support to talocruraljoint? |
|
Definition
| anterior talofibular, posterior talofibular, calcaneofibular ligaments |
|
|
Term
| are the lateral ligaments stronger or weaker than medial ligaments at talocrural joint? |
|
Definition
| lateral ligaments are weaker |
|
|
Term
| what type of ankle sprain is more common? |
|
Definition
| 85% of ankle injuries are inversion, usually of anterior talofibular ligament |
|
|
Term
| what is the motion that causes a lateral ankle sprain? |
|
Definition
| inversion with plantarflexion |
|
|
Term
| what ligaments are sprained in lateral ankle sprains? |
|
Definition
| anterior talofibular ligament, calcaneofibular ligament, posterior talofibular ligament (rarely) |
|
|
Term
| what does a lateral ankle sprain result in? |
|
Definition
| laxity of the joints of the ankle; instability |
|
|
Term
| what should you strengthen after a lateral ankle sprain? |
|
Definition
| fibularis longus and brevis so they can resist inversion by everting |
|
|
Term
| where is the talocrural joint axis? |
|
Definition
| through medial/lateral malleoli |
|
|
Term
| what are the movements of the talocrural joint? |
|
Definition
| plantarflexion, dorsiflexion |
|
|
Term
| what slight movements occur with dorsiflexion? |
|
Definition
|
|
Term
| what slight movements occur with plantarflexion? |
|
Definition
|
|
Term
| what are the arthrokinematics of closed chain dorsiflexion? |
|
Definition
| concave tibia rolls and slides anteriorly on talus |
|
|
Term
| what are the arthrokinematics of closed chain plantar flexion? |
|
Definition
| concave tibia rolls and slides posteriorly on talus |
|
|
Term
| what are the arthrokinematics of open chain dorsiflexion? |
|
Definition
| convex talus rolls anteriorly and slides posteriorly on concave tibia |
|
|
Term
| what are the arthrokinematics of open chain plantar flexion? |
|
Definition
| convex talus rolls posteriorly and slides anteriorly on concave tibia |
|
|
Term
| which side of the talus is larger, lateral or medial? |
|
Definition
| lateral surface is larger |
|
|
Term
| describe anterior translation of lateral malleolus across talus in closed chain dorsiflexion |
|
Definition
| dorsiflexion produces greater anterior translation of the lateral malleolus across the talus in the closed chain |
|
|
Term
| how does dorsiflexion affect lower limb in closed chain? |
|
Definition
| DF results in internal rotation of lower limb |
|
|
Term
| how does plantar flexion affect lower limb in closed chain? |
|
Definition
| PF results in external rotation of lower limb |
|
|
Term
| what bones make up the subtalar joint? |
|
Definition
|
|
Term
| what are the 3 articulations of the subtalar joint? |
|
Definition
| anterior talus and calcaneus; middle talus and calcaneus; posterior talus and calcaneus |
|
|
Term
| what is the shape of the middle and anterior talus? |
|
Definition
|
|
Term
| what is the shape of the middle and anterior calcaneus? |
|
Definition
|
|
Term
| what is the shape of the posterior talus? |
|
Definition
|
|
Term
| what is the shape of the posterior calcaneus? |
|
Definition
|
|
Term
| where is the talus convex? |
|
Definition
|
|
Term
| where is the talus concave? |
|
Definition
|
|
Term
| what are the motions of the subtalar joint? |
|
Definition
| inversion/eversion, abduction/adduction, slight plantar flexion/dorsiflexion |
|
|
Term
| what is the ROM ration of inversion to eversion? |
|
Definition
| 2:1 = 20 deg inversion: 10 deg eversion |
|
|
Term
| what is the total amount of abduction/adduction |
|
Definition
|
|
Term
| how does the STJ joint axis change if you have a high arch? |
|
Definition
| high arch = more vertical STJ axis = more abduction/adduction |
|
|
Term
| how does low arch affect STJ joint axis? |
|
Definition
| low arch = more horizontal STJ axis = more inversion/eversion |
|
|
Term
|
Definition
|
|
Term
| what are the implications of pes cavus? |
|
Definition
| rigid foot: less ability of foot and ankle to absorb force/shock |
|
|
Term
|
Definition
|
|
Term
| what are the implications of pes planus? |
|
Definition
| more pronation, floppier/less rigid foot |
|
|
Term
| what is the loose packed position of ankle? |
|
Definition
|
|
Term
| what is the close packed position of ankle? |
|
Definition
|
|
Term
| what is the close packed position of talocrural joint? |
|
Definition
|
|
Term
| does someone with pes planus have more pronation or supination? |
|
Definition
|
|
Term
| does someone with pes cavus have a more vertical or more horizontal STJ joint axis? |
|
Definition
|
|
Term
| does a person with pes cavus have more abd/add or more inv/eversion? |
|
Definition
| more abd/add, less inversion/eversion |
|
|
Term
| what is the shape of the anterior calcaneus? |
|
Definition
|
|
Term
| what is the shape of the posterior calcaneus? |
|
Definition
|
|
Term
| how is the STJ like a screw? |
|
Definition
| because of convex and concave calcaneal surfaces, the talus rotates as we invert and evert |
|
|
Term
| arthrokinematics of anterior portion of STJ in closed chain |
|
Definition
| convex talus on concave calcaneus |
|
|
Term
| arthrokinematics of posterior portion of STJ in closed chain |
|
Definition
| concave talus on convex calcaneus |
|
|
Term
| how do we get inversion at STJ? |
|
Definition
| roll talus medially. Slide the convex anterior portion laterally. Slide the concave posterior portion medially |
|
|
Term
| how do we get eversion at STJ? |
|
Definition
| roll talus laterally. Slide convex anterior portion medially. Slide concave posterior portion laterally |
|
|
Term
| what is the function of the STJ? |
|
Definition
| transmits rotational motion of shin to foot |
|
|
Term
| if at 45 deg flexion, how does tibial internal rotation transfer to eversion? |
|
Definition
| for every 1 deg of tibial internal rotation, you get 1 degree of eversion |
|
|
Term
| does tibial external rotation give you supination or pronatoin? |
|
Definition
|
|
Term
| does tibial internal rotation give you supination or pronation? |
|
Definition
|
|
Term
| what motions produce pronation in open chain? |
|
Definition
| eversion, abduction, dorsiflexion |
|
|
Term
| what motions produce supination in open chain? |
|
Definition
| inversion, adduction, plantarflexion |
|
|
Term
| what motions produce pronation in closed chain? |
|
Definition
| dorsiflexion, eversion, internal rotation |
|
|
Term
| what motions produce supination in closed chain? |
|
Definition
| plantarflexion, inversion, external rotation |
|
|
Term
| what are the motions of open chain pronation? |
|
Definition
| eversion, abduction, dorsiflexion |
|
|
Term
| what are the movements of open chain supination? |
|
Definition
| inversion, adduction, plantarflexion |
|
|
Term
| what are the movements of closed chain pronation? |
|
Definition
| eversion, internal rotation, dorsiflexion |
|
|
Term
| what are the motinos of closed chain supination? |
|
Definition
| plantarflexion, inversion, external rotation |
|
|
Term
| in open chain movements at STJ, which bone is fixed and which is moving? |
|
Definition
| talus is fixed, calcaneus is moving |
|
|
Term
| what movements occur at STJ in open chain pronation? |
|
Definition
|
|
Term
| what movements occur at STJ in open chain supination? |
|
Definition
|
|
Term
| in closed chain movements at STJ, which bone is moving and which bone is fixed? |
|
Definition
| calcaneus is fixed, talus is moving |
|
|
Term
| what movement of tibia results in pronation at STJ in closed chain? |
|
Definition
|
|
Term
| what movement of tibia results in supination? at STJ in closed chain? |
|
Definition
|
|
Term
| is supination or pronation functional shortening of the limb? |
|
Definition
|
|
Term
| is supination or pronation functional lengthening? of the limb? |
|
Definition
|
|
Term
| what is the closed pack position for the rearfoot/midfoot except talocrural joint? |
|
Definition
|
|
Term
| is pronation or supination more rigid? |
|
Definition
|
|
Term
|
Definition
| land in supination, go to pronation, push off in supination |
|
|
Term
| why do we touch down in supination in gait? |
|
Definition
| typically land on outside of heel. Looks like inversion = supination |
|
|
Term
| why do we go to pronation after our foot is on the ground in gait |
|
Definition
| pronation allows mobility at midfoot to absorb force of body weight |
|
|
Term
| why do we supinate during push-off in gait? |
|
Definition
| supination allows for rigidity/stability at midfoot for strong pushoff |
|
|
Term
| what are pathomechanics of STJ in gait? |
|
Definition
| inadequate pronation, pronate too early, pronate too late, pronate too long |
|
|
Term
| what is the joint that connects rearfoot to forefoot (it has 3 different names) |
|
Definition
| midtarsal, transverse tarsal, talocalcanealnavicular |
|
|
Term
| what are the 2 articulations that occur at the midtarsal joint? |
|
Definition
| talonavicular, claclaneocuboid |
|
|
Term
| is the talus convex or concave at the talonavicular part of the midtarsal joint? |
|
Definition
|
|
Term
| is the navicular convex or concave at the talonavicular part of the midtarsal joint? |
|
Definition
|
|
Term
| describe the shapes of the bones at the calcaneocuboid joint of the midtarsal joint |
|
Definition
| both surfaces are slightly concave and convex, making an interlocking wedge for stability |
|
|
Term
| what is the function of the midtarsal = talocalcanealnavicular = transverse tarsal joint? |
|
Definition
| allows compensation of midfoot/forefoot to changes at the hindfoot; keeps foot in good alignment with the floor |
|
|
Term
| describe the joint axis of the midtarsal joint |
|
Definition
| functionally has TWO joint axes: longitudinal and oblique |
|
|
Term
| where is the longitudinal axis of the midtarsal joint? |
|
Definition
| 15 deg up from horizontal and 10 deg medial to horizontal |
|
|
Term
| where is the oblique axis of the midtarsal joint? |
|
Definition
| 50 deg up from horizontal and 69 deg medial to horizontal |
|
|
Term
| what movements occur at the longitudinal axis of the midtarsal joint? |
|
Definition
|
|
Term
| what movements occur at the oblique axis of the midtarsal joint? |
|
Definition
|
|
Term
| how does STJ pronation affect the midtarsal joint? |
|
Definition
| causes oblique axes of talonavicular and calcaneocuboid to assume parallel alignment, providing relatively free movement |
|
|
Term
| how does STJ supination affect the midtarsal joint? |
|
Definition
| causes oblique axes of talonavicular and calcaneocuboid to move perpendicular to each other, locking the midtarsal joint more rigidly |
|
|
Term
| how do open packed/close packed positions compare for STJ and midtarsal joints? |
|
Definition
| they are the same: open = pronation; closed = supination |
|
|
Term
| what movements occur at talocrural joint? |
|
Definition
| dorsiflexion/plantarflexion |
|
|
Term
| what movements occur at STJ? |
|
Definition
| inversion/eversion, abduction/adduction |
|
|
Term
| what movements occur at the midtarsal joint? |
|
Definition
| dorsiflexion/plantarflexion, inversion/eversion, abduction/adduction |
|
|
Term
|
Definition
| a functional segment of the foot from a toe to the heel |
|
|
Term
| how many rays do we have? |
|
Definition
|
|
Term
| which rays have the most motion |
|
Definition
|
|
Term
| how many planes of motion do the rays have? |
|
Definition
|
|
Term
| which ray has the most motion? |
|
Definition
|
|
Term
| what motion accompanies plantarflexion of the 1st ray? |
|
Definition
|
|
Term
| what motion accompanies dorsiflexion of the 1st ray? |
|
Definition
|
|
Term
| how does supination of the ankle affect 1st ray? |
|
Definition
| decreased mobility, increased stability |
|
|
Term
| how does dorsiflexion affect 1st ray? |
|
Definition
| increased mobility, decreased stability |
|
|
Term
| what is the only place our movement rules don't work? |
|
Definition
| 1st ray: eversion and plantarflexion are together and inversion and dorsiflexion are together |
|
|
Term
| how much motion occurs in 5th ray? |
|
Definition
|
|
Term
| how do joint axes compare of 1st and 5th rays? |
|
Definition
| opposite; they cross in the middle |
|
|
Term
| what motion accompanies dorsiflexion in the 5th ray? |
|
Definition
|
|
Term
| what motion accompanies plantarflexion in the 5th ray? |
|
Definition
|
|
Term
| what does a varus ankle look like? |
|
Definition
|
|
Term
| what does a valgus ankle look like? |
|
Definition
|
|
Term
| what bones do you look at in determining rearfoot varus/valgus? |
|
Definition
|
|
Term
| how does rearfoot look in forefoot varus? |
|
Definition
|
|
Term
| how does rearfoot look in forefoot valgus? |
|
Definition
|
|
Term
| how does forefoot look in varus? |
|
Definition
|
|
Term
| how does forefoot look in valgus? |
|
Definition
|
|
Term
| how does a person with forefoot varus compensate? |
|
Definition
| rearfoot eversion (subtalar pronation) |
|
|
Term
| how does someone with forefoot valgus compensate? |
|
Definition
| rearfoot inversion (subtalar supination) |
|
|
Term
| if the rearfoot pronates, how will the forefoot compensate? |
|
Definition
|
|
Term
| about what ray does the forefoot supinate to compensate for rearfoot pronation? |
|
Definition
| 2nd ray AND at midtarsal joint |
|
|
Term
| why would we pronate in one area of the foot and supinate in another? |
|
Definition
| keep stress low and help distribute weight evenly in the foot |
|
|
Term
| what type of joints are MTP joints? |
|
Definition
|
|
Term
| how many DOF in MTP joints? |
|
Definition
|
|
Term
| what are the movements of the MTP joints? |
|
Definition
|
|
Term
| how much dorsiflexion occurs at 1st MTP? |
|
Definition
|
|
Term
| how much plantarflexion occurs at 1st MTP? |
|
Definition
|
|
Term
| how much DF/PF occurs at other MTP joints? |
|
Definition
|
|
Term
| arthrokinematics of MTP joint |
|
Definition
| concave phalanx moving on convex metatarsal head |
|
|
Term
| what is the functional importance of the MTP joint? |
|
Definition
| the weightbearing force travels through this joint during the final stages of push off |
|
|
Term
| what is the metatarsal break? |
|
Definition
| axis in which the toes extend at the MTP joints, helping to distribute weight across all metatarsal heads |
|
|
Term
|
Definition
| limitation in DF/PF of hallux |
|
|
Term
| implications of hallux rigidus |
|
Definition
| can't go into full extension, limits movement of steps |
|
|
Term
| what is the long arch of the foot? |
|
Definition
|
|
Term
| what is the sideways arch of the foot? |
|
Definition
|
|
Term
| functions of the arches of the foot |
|
Definition
| absorb stress, distribute forces, adapt to surfaces, enhance force for forward propulsion in gait |
|
|
Term
| what ligaments support medial longitudinal arch |
|
Definition
| spring ligament, short and long plantar ligaments, plantar aponeurosis |
|
|
Term
| what does the plantar fascia travel to and from |
|
Definition
| calcaneus to proximal phalanges |
|
|
Term
| does plantar fascia adapt well to changes to length? |
|
Definition
|
|
Term
| what happens to plantar fascia as triceps surae are passively stretched in gait? |
|
Definition
| fascia undergoes additional stress |
|
|
Term
| how can you stretch plantar fascia |
|
Definition
| dorsiflex ankle or extend toes |
|
|
Term
| describe windlass mechanism |
|
Definition
| as we push off, foot plantaflexes and toes dorsiflex, tightening plantar fascia and making foot more rigid for push-off |
|
|
Term
| where is the apex of the proximal transverse arch? |
|
Definition
|
|
Term
| where is the apex of the distal transverse arch? |
|
Definition
|
|
Term
| if you have a dropped metatarsal head, what will you see on the bottom of the foot? |
|
Definition
|
|
Term
| what does hallux valgus look like? |
|
Definition
| big toe points out towards other toes |
|
|
Term
| what do you get on your big toe if you have hallux valgus? |
|
Definition
|
|
Term
| when you have hallux valgus, what is the deformity of the 1st ray? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| congenital or acquired from wearing short, narrow shoes |
|
|
Term
|
Definition
| foot pain, callus on sole of foot, corn on top of affected toe |
|
|
Term
| how is hammer toe treated? |
|
Definition
|
|
Term
|
Definition
| people who have had strokes |
|
|
Term
| motions/lack of motions in equinus foot |
|
Definition
| inadequate dorsiflexion; excessive plantarflexion and inversion |
|
|
Term
| limitations of equinus foot |
|
Definition
| reduces propulsion/push-off |
|
|
Term
| compensation for equinus foot |
|
Definition
| subtalar joint pronation to unlock midtarsal joint; toe walking |
|
|
Term
| what joint is the anterior/posterior cut off for dorsiflexors/plantarflexors? |
|
Definition
|
|
Term
| what joint is the medial/lateral cutoff for muscles that invert and evert the foot? |
|
Definition
|
|
Term
| which mucles dorsiflex the foot? |
|
Definition
| tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius |
|
|
Term
| which muscles plantarflex the foot? |
|
Definition
| gastroc soleus, tibialis posterior, flexor hallucis longus, flexor digitorum longus, fibularis longus, fibularis brevis |
|
|
Term
| which muscles inver the foot? |
|
Definition
| tibialis anterior, tibialis posterior, flexor digitorum longus, flexor hallucis longus |
|
|
Term
| which muscles evert the foot? |
|
Definition
| fibularis longus, fibularis brevis, extensor digitorum longus, fibularis tertius |
|
|
Term
| what muscles restrain forefoot during rearfoot supination? |
|
Definition
| fibularis longus and brevis |
|
|
Term
| what muscles provide lateral stability to ankle? |
|
Definition
| fibularis longus and brevis |
|
|
Term
| what does the tendon of fibularis longus do? |
|
Definition
| works as muscular sling to support longitudinal arch |
|
|
Term
| how does fibularis longus/brevis help transfer weight along foot in gait? |
|
Definition
| late stance: we want to go into supination to have a rigid foot. Fibularis longus/brevis helps transfer weight by lifting up lateral side of foot transfer weight from lateral to medial foot |
|
|
Term
| actions of tibialis posterior |
|
Definition
| inversion, weak plantarflexion |
|
|
Term
| action of posterior tibialis at STJ |
|
Definition
| supination; eccentric control of STJ pronation during early stance; supports medial longitudinal arch |
|
|
Term
| how does tibialis posterior help as our foot goes from supination to pronation in gait? |
|
Definition
| eccentric control to keep foot from falling quickly into pronation |
|
|
Term
| actions of tibialis anterior |
|
Definition
|
|
Term
| how does tibialis anterior help in walking? |
|
Definition
| eccentric control helps slowly lower foot during landing to minimize foot slap; eccentric control of pronation; concentric dorsiflexion during swing to keep from tripping on toes |
|
|
Term
| functions of gastroc/soleus in walking |
|
Definition
| plantarflexion of talocrural joint; eccentric control of dorsiflexion during stance |
|
|
Term
| describe subtalar joint neutral position |
|
Definition
| creates optimal bony contact and stability. Allows for optimal foot mechanics |
|
|
Term
| what are compensations for forefoot valgus (5th ray higher = eversion) |
|
Definition
| rearfoot inversion or plantarflexing 1st ray |
|
|
Term
| what alignment issues of lower extremity will foot compensate for? |
|
Definition
| tibial torsion, femoral anterversion, genu varum or valgus, increaseddecreased hip inclination, SI positional fault |
|
|
Term
|
Definition
|
|
Term
| compensation for tibial torsion |
|
Definition
| abduct foot for better alignment with tibia |
|
|
Term
| compensation for femoral anteversion |
|
Definition
|
|
Term
| compensation for SI problems |
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Definition
| supinate to increase leg length on "shorter" side |
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