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43 Cards in this Set
- Front
- Back
talocrural joint
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Talocrural joint
Articulations between distal tibia, fibula and talus Hinge, diarthrotic joint |
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Bones in Ankle Joint
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Bones
Tibia – the weight bearing Inferior articular surface Medial malleolus articular surface Fibula – non-weight bearing Articular surface lateral malleolus – talus Articular surface of these bones forms mortise Bones Talus Supports body weight, transfers to calcaneous Trochlea is articular surface Widest part is anterior |
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ankle joint movements
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Movements
Dorsiflexion most stable position (“dig heels in”) Wider anterior part of trochlea is wedged within ankle mortise Limited by stretching posterior leg muscles Plantarflexion less stable Narrow part of trochlea in mortise Time of most injury Limited by stretching anterior muscles |
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dorsiflexion
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Dorsiflexion most stable position (“dig heels in”)
Wider anterior part of trochlea is wedged within ankle mortise Limited by stretching posterior leg muscles |
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plantar flexion
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Plantarflexion less stable
Narrow part of trochlea in mortise Time of most injury Limited by stretching anterior muscles |
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ankle joint ligaments
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Joint capsule supported by strong lateral and medial ligaments
Deltoid ligament (medial or tibial collateral ligament of ankle) Anterior tibiotalar Tibionavicular Tibiocalcaneal Posterior tibiotalar Resists eversion |
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lateral collateral ligament of ankle
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Lateral collateral ligament of ankle
Anterior talofibular Posterior talofibular Calcaneofibular Support foot during inversion |
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most common sprain in ankle
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Ankle sprains common injuries
Inversion sprains most common Involves anterior talofibular and sometimes calcaneofibular ligaments |
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pott's fracture
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Pott’s fracture – ankle dislocation
Forced eversion causes stretching of strong deltoid ligament, often fracturing medial malleolus Talus and tibia move laterally causing fracture in fibula usually above posterior tibulofibular ligament |
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movements of foot
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Movements of the foot
Dorsiflexion and plantarflexion occur at talocrural joint Inversion and eversion occur at subtalar and transverse tarsal joints Flexion and extension occur at metatarsophalangeal and interphalangeal joints Abduction and adduction occur at metatarsophalangeal joints Other tarsal joints joined tightly by ligaments – limited movement Inversion and eversion occur at subtalar and transverse tarsal joints Subtalar (talocalcaneal) joint– plane synovial joint Inferior surface of body of talus with superior surface of calcaneous |
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Talocalcaneonavicular joint
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Talocalcaneonavicular joint
Head of talus articulates with navicular – talonavicular joint (ball and socket) Talus has 2 articulations with calcaneous Inferior surface of body (subtalar joint) Inferior surface of head with anterior calcaneous – talocalcaneal joint From functional standpoint many consider subtalar joint to be both anatomical subtalar joint and the talocalcaneal part of talocalcaneonavicular joint |
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transverse tarsal joint
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Transverse tarsal joint (anatomic)
Talonavicular (of talocalcaneonavicular joint) Ball and socket joint Calcaneocuboid Plane joint **These two joints together form the transverse tarsal joint |
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arches of the foot
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Function to absorb and distribute weight, allow balance on uneven surfaces
Longitudinal arch Medial longitudinal arch Lateral longitudinal arch Transverse arch Arches maintained by shape of bones, ligaments, plantar aponeurosis, and muscle tension |
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medial longitudinal arch
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Medial longitudinal arch
Comprised of calcaneus, talus, navicular, 3 cuneiform, 3 metatarsals Talus is keystone bone Also supported by tendons of tibialis anterior, flexor hallucis longus, spring ligament, plantar aponeurosis |
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lateral longitudinal arch
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Lateral longitudinal arch
Comprised of calcaneous, cuboid, and lateral 2 metatarsals Keystone is cuboid Supported by long and short plantar ligaments, tendon fibularis longus, plantar aponeurosis |
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transverse arch
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Transverse arch
Comprised of cuneiforms, cuboid and base of metatarsals Supported by tendons of fibularis longus and tibialis posterior |
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major ligaments of foot
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Support the arches:
Long plantar ligament From calcaneous to cuboid and metatarsals 3,4 Tunnel for tendon fibularis longus Supports lateral longitudinal arch Short plantar ligament Aka calcaneocuboid Maintain lateral longitudinal ach Spring ligament Aka plantar calcaneonavicular Maintains medial longitudinal arch |
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long plantar ligament
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Long plantar ligament
From calcaneous to cuboid and metatarsals 3,4 Tunnel for tendon fibularis longus Supports lateral longitudinal arch |
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short plantar ligament
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Short plantar ligament
Aka calcaneocuboid Maintain lateral longitudinal ach |
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spring ligament
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Spring ligament
Aka plantar calcaneonavicular Maintains medial longitudinal arch |
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fascia of foot
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Plantar aponeurosis
Thickening of the plantar (deep) fascia Supports longitudinal arches From calcaneous to digital fibrous sheaths Inflammation causes plantar fasciitis |
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muscles of foot
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Although specific actions, most work together to stabilize foot, maintain arches, redistribute weight
2 dorsal muscles 16 (9) plantar muscles Abductor layer Lumbrical/tendon layer Flexor layer Interossei layer |
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innervation of dorsal foot nerve
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Deep fibular nerve (S1,2)
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blood supply to dorsal foot muscles
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Dorsal pedis artery off anterior tibial artery
Name change at level of ankle joint Lateral tarsal artery becomes arcuate artery (dorsal arch) |
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extensor hallicus brevis
and extensor digitorum brevis |
Extensor hallucis brevis
Calcaneous to base proximal phalanx of hallux Extensor digitorum brevis Calcaneous to base middle phalanges of digits 2-4 Both also weakly assist with dorsiflexion |
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innervation of plantar foot muscles
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Medial and lateral plantar nerves (S2,3) from tibial nerve
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blood supply to plantar foot muscles
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Medial and lateral plantar arteries from posterior tibial artery
Lateral plantar artery forms deep plantar arch Medial and lateral plantar nerves and arteries between abductor and lumbrical/tendon layers of muscles |
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plantar foot mucles- abductor layer- superficial
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Abductor layer – superficial
Abductor hallucis Flexor digitorum brevis Abductor digit minimi |
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abductor hallicus
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Abductor layer
Abductor hallucis From calcaneous, plantar aponeurosis to medial base proximal phalanx hallux Abducts and flexes hallux (MTP joint) Medial plantar nerve and artery |
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flexor digitorum brevis
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Abductor layer
Flexor digitorum brevis From calcaneous and plantar aponeurosis to middle phalanx of 2,3,4,5 digits Flexes digits at MTP and PIP joints Medial plantar nerve and medial and lateral plantar arteries |
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abductor digiti minimi
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Abductor layer
Abductor digiti minimi From calcaneous and plantar aponeurosis to lateral base proximal phalanx 5th digit Abducts, flexes 5th digit (MTP joint) Lateral plantar nerve and artery |
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lumbrical/tendon layer of foot
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Lumbrical/tendon layer
Quadratus plantae From calcaneous to tendon flexor digitorum longus Assists FDL in flexing lateral 4 digits Lateral plantar nerve Medial/lateral plantar arteries Lumbricals From tendons FDL to extensor expansion of lateral 4 digits Flex proximal phalanges; extend middle, distal phalanges Medial one; medial plantar nerve Lateral 3: lateral plantar nerve Lateral plantar artery, deep plantar arch |
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plantar foot muscles- flexor layer
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Flexor layer
Flexor hallucis brevis Adductor hallucis Flexor digiti minimi |
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flexor hallicus brevis
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Flexor layer
Flexor hallucis brevis From cuboid and cuneiforms to both sides proximal phalanx hallux Flex proximal phalanx of hallux Medial plantar nerve Medial and lateral plantar arteries |
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adductor hallicus
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Flexor layer
Adductor hallucis Oblique head: base metatarsals 2-4 Transverse head: plantar ligaments MTP joint Adduct hallux Lateral plantar nerve Medial and lateral plantar arteries |
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flexor digiti minimi
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Flexor layer
Flexor digiti minimi From 5th metatarsal to proximal phalanx digit 5 Flex proximal phalanx 5th digit Lateral plantar nerve and artery |
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interossei layer
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Interossei layer
3 plantar interossei Medial side metatarsals to medial side proximal phalanges 3,4,5 Adduct (PAD), flex MTP Lateral plantar nerve Deep plantar arch 4 dorsal interossei Adjacent metatarsals 1-5 1st to medial side proximal phalanx 2nd digit 2-4 to lateral sides 2-4 digits Abduct digits 2-4 (DAB), flex MTP Lateral plantar nerve Dorsal pedis and arcuate artery |
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big picture-plantar foot innervation
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Medial plantar nerve
Abductor hallucis Flexor hallucis brevis Flexor digitorum brevis 1st lumbrical Lateral plantar nerve Abductor digiti minimi Quadratus plantae 2nd, 3rd, 4th lumbricals Adductor hallucis Flexor digiti minimi Dorsal and plantar interossei |
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MUSCLES PRODUCING MOVEMENT AT KNEE JOINT
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Flexion
Primary -- semimembranosus, semitendinosus, biceps femoris Secondary -- gracilis, sartorius, gastrocnemius popliteus Extension Quadriceps femoris Medial rotation Primary -- semitendinosus, semimembranosis when knee flexed Secondary -- gracilis, sartorius Lateral rotation Biceps femoris when knee flexed |
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MUSCLES PRODUCING MOVEMENT AT ANKLE JOINT
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Dorsiflexion
Primary – muscles anterior compartment leg Plantarflexion Primary – triceps surae, plantaris, flexor digitorum longus, tibialis posterior Secondary – flexor hallucis longus, fibularis longus and brevis |
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MUSCLES PRODUCING MOVEMENT AT SUBTALAR AND TRANSVERSE TALAR JOINTS
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Eversion
Fibularis longus/brevis/tertius Inversion Tibialis anterior/posterior |
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MUSCLES PRODUCING MOVEMENT AT MTP JOINTS
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Flexion
Flexor digitorum longus*/brevis* Flexor hallucis longus*/brevis Lumbricals and interossei Extension Extensor digitorum longus*/brevis* Extensor hallcuis longus* Adduction Adductor hallucis Plantar interossei Abduction Abductor hallucis Abductor digiti minimi Dorsal interossei **these muscles also perform same movement at IP joints |
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***Anatomical subtalar vs functional subtalar joint
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***Anatomical subtalar vs functional subtalar joint
Anatomical subtalar joint- Inferior surface of body of talus with superior surface of calcaneous Functional subtalar joint- functionally includes the head of talus and anteriorarticular part of calcaneus or talocalcanial joint- referred to as the functional subtalar joint |