2.7 - Smbj - Week 3

Front 1

Do people with flat feet or high arches experience more stress fractures

Back 1

flat feet - b/c the bones are absorbing more of the stress.

Front 2

The consequence of our center of gravity moving during gait

Back 2

- The more it shifts, the more energy we expend.
- Our gait has been finely tuned to minimize COG movement - save energy, smoother gait, decreased impact forces
Note: Synched pelvis and limb motion also aids limb clearance during swing phase.

Front 3

Describe the location and progress of weight bearing on our foot as we take a step during gait

Back 3

Starts at the lateral heel at heel-strike, and moves through the arch, the ball of the foot, and lastly the great toe

Front 4

Muscle activity during swing phase to clear the foot

Back 4

Hip: flexion
Knee: flexion
Ankle: dorsiflexion (tibialis anterior)
Toe: extension (long toe extensors)

Front 5

How much of the gait cycle (walking) do we have both feet touching the ground ("double-limb support")

Back 5

10% of the gait cycle

Note: During running, we NEVER see double-limb support (and we add a "float phase"). The elderly have much more double limb support for stability (sensory feedback).

Front 6

Very strong, very important facial layer on the bottom of the foot, it's origin and insertions.

Back 6

plantar aponeurosis
O: calcaneous
I: heads of metatarsals, proximal phalanxes

Front 7

Explain the windless mechanism

Back 7

when toes are dorsiflexed, it pulls on the tense plantar aponeurosis (aka plantar fascia) and shortens the length of the foot and causing the arch to elevate.

Front 8

medial metatarsals/digits are ______ (more/less) stable than lateral ones.

Back 8

more -- lateral ones are for flexibility, medial ones are for stability.

HINT: Just see how much more wiggle is in your 5th metacarpal versus your 2nd and 3rd. Your feet are the same way.

Front 9

Define: Pes Planus

Back 9

flat foot

NOTE: Foot sort of everted, putting pressure on the tibialis posterior.

Front 10

Define: Pes Cavus

Back 10

high arch

NOTE: Foot sort of inverted putting pressure on the peronius brevis.

Front 11

Describe Charcot Marie Tooth

Back 11

- Scott!
- Hereditary Sensorimotor Neuropathy
- Claw Toes: due to atrophy of intrinsic muscles

Front 12

What could cause a severe case of equinovarus foot deformity

Back 12

Upper motor neuron lesion. Muscles which plantarflex the foot are stronger than dorsiflexors, thus the foot takes on a severe equinovarus deformity.

Front 13

With a rhumatoid/autoimmune syndrome of the synovial joints, what causes deformity of the joints?

Back 13

Erosions of cartilage and bone

Note: This can cause instability, sublaxion, and dislocation

Front 14

***Name the functions of the human foot

Back 14

1 - load bearing, support
2 - leverage, propulsion
3 - shock absorption
4 - balance
5 - protection, sensory information

Front 15

T or F: The foot is very complex, and orthopaedic surgeons are highly trained in treating foot/ankle problems.

Back 15

TRUE

Front 16

Why ventral and dorsal musculature opposite for the muscles of the anterior/posterior compartment above/below the knee

Back 16

Ventral/Dorsal muscle masses grow ventrally/dorsally respectively in the embryo, but the arms and legs rotate opposite directions as a fetus.

Front 17

Compartments innervated by the Tibial nerve

Back 17

Thigh: posterior compartment
Leg: posterior compartment
Foot: intrinsic muscles

Front 18

compartments innervated by the common peroneal nerve

Back 18

Leg: anterior compartment (deep peroneal), lateral compartment (superficial peroneal)

Front 19

Common Peroneal nerve: Sensory and Motor components

Back 19

Sensory: lateral sural nerve
Motor: biceps femoris muscle (short head)

Front 20

Superficial Peroneal nerve: Sensory and Motor components

Back 20

Sensory: lateral leg, dorsum of the foot
Motor: lateral leg compartment (peroneus longus/brevis)

Front 21

Deep Peroneal Nerve: Sensory and Motor components

Back 21

Sensory: Web Space between digits 1 & 2
Motor: anterior leg compartment (e.g. tibialis anterior)

Front 22

Tibial Nerve: Sensory and Motor components

Back 22

Sensory: med. sural nerve
Motor (pior to the split): posterior thigh (piriformis, ST/SM/BF (long head))
Motor ("penis" branch): post. leg compartment (gastroc, soleus, plantarus, etc)

Front 23

Lateral Plantar Nerve: Sensory and Motor components

Back 23

Sensory: lateral plantar foot
Motor: remainder of foot muscles

Front 24

Medial Plantar Nerve: Sensory and Motor components

Back 24

Sensory: medial plantal foot
Motor: "1LAFF" 1st lumbrical, abd. hall., flex hallicus br., flex dig br.

Front 25

Clinical Testing: Myotomes L1-S2

Back 25

L1 - cremastor reflex
L2 - hip flexion
L3 - hip adduction
L4 - knee ext
L5 - dorsiflexion
S1 - plantarflexion
S2 - intrinsic foot muscles (spreading toes)

Front 26

Clinical Testing: Dermatomes L1-S4

Back 26

L1 - inguinal region
L2-L3 - wrap around leg, progressing inferiorly
L4 - medial malleolus
L5 - dorsum of foot (shoelaces)
S1 - lateral foot, calcaneous
S2 - back of thigh
S3 - (follows pattern, closer to anus)
S4 - anus

Front 27

Anterior leg muscles: common action, innervation

Back 27

Common action: dorsiflexion, toe extension
Common innervation: femoral nerve

Front 28

Lateral leg muscles: Common action, attachment, innervation

Back 28

Common action: plantar flexion, eversion
Common attachment: fibula
Common innervation: superficial peroneal

Front 29

Posterior leg muscles: Common action attachment, innervation

Back 29

Common attachment: calcaneus
Common action: plantar flexion
Common innervation: tibial nerve

Front 30

Name the 7 tarsal bones

Back 30

calcaneus, talus, navicular, cuboid, med/int/lat cuneiforms