Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
84 Cards in this Set
- Front
- Back
|
Pronation is the combination of what 3 actions? |
Dorsiflexion, eversion, abduction |
|
|
Supination is the combination of what 3 actions? |
Plantarflexion, inversion, adduction |
|
|
How many tibiofibular joints are there? |
2: Superior and inferior tibiofibular joints |
|
|
What joins the tibia and fibula? |
The interosseous membrane |
|
|
What makes up the hindfoot? |
talus and calcaneous |
|
|
What makes up the midfoot? |
The navicular, cuboid, and three cuneiforms |
|
|
What makes up the forefoot? |
Metatarsals, phalanges |
|
|
What do the tibiofibular joints do for the ankle? |
Provide accessory motion that allow greater movement at the ankle |
|
|
What bones make up the talocrural joint? |
The tibia, fibula, and talus |
|
|
What part of the talocrural joint is the concave/convex? |
Concave: The mortise (distal end of tibia, and tibial and fibular malleoli) Convex: the talus |
|
|
What is the axis of motion of the talocrural joint? |
20-30 degrees laterally and 10 downward |
|
|
What is the close-packed/open-packed position of the talocrural joint? |
Closed-packed: dorsiflexion Open-packed: plantarflexion |
|
|
How many articulations does the subtalar joint have? |
3: posterior articulation, anterior articulation, and middle articulation |
|
|
For the posterior articulation of the subtalar joint, what part is concave/convex? |
Concave: Talus Convex: Calcaneus |
|
|
For the anterior articulation of the subtalar joint, what part is concave/convex? |
Concave: Calcaneus Convex: talus |
|
|
What motion does the subtalar joint do? |
supination and pronation |
|
|
Talonavicular joint |
articulation between the talus and navicular, and the anterior articular of the subtalar joint |
|
|
In a closed chain postion resulting in pronation, what are the movements of the calcaneus and talus? |
Calcaneus: everts Talus: PF/adducts |
|
|
In a closed chain position resulting in supination, what are the movements of the calcaneus and talus? |
Calcaneus: inverts Talus: DF/abducts |
|
|
In an open chain position resulting in supination, what are the movements of the calcaneus and talus? |
Calcaneus: inversion, adduction, plantarflexion Talus: stable |
|
|
In a closed chain position resulting in pronation, what are the movements of the calcaneus and talus? |
Calcaneus: eversion, abduction, dorsiflexion |
|
|
What makes up the transverse tarsal joint? |
Talonavicular and calcaneocuboid joints |
|
|
What is the function of the transverse tarsal joint? |
Assists in supination/pronation and compensatory movements to adjust surfaces |
|
|
What are the functions of the intertarsal and tarsometatarsal joints? |
compensatory movements |
|
|
What is the main function of the metatarsophalangeal and interphalangeal joints of the foot? |
Extension ROM |
|
|
If the ankle pronates and supinates, does the leg move? |
Yes! Subtalar motion and tibial rotation are interdependent |
|
|
During supination of the subtalar joint, how does the tibia move? |
ER (femur moves same) |
|
|
During pronation of the subtalar joint, how does the tibia move? |
IR (femur moves same) |
|
|
Windlass effect |
When toes extend, arch shortens. During WB: flattened, lengthened arch During NWB: short arch |
|
|
Pes planus |
pronated, flat/low arch. Results in: IR leg, knee valgus, and shorter LE |
|
|
Pes cavus |
Supinated, high arch Results in: ER leg, |
|
|
What are secondary plantarflexors? |
tibialis posterior Flexors Peroneals |
|
|
Dorsiflexors |
tibialis anterior Extensors |
|
|
What is the function of the intrinsic muscles of the foot? |
Arch support Marble game increases support |
|
|
Absence of ankle dorsiflexors results in? |
Foot drop |
|
|
Absence of ankle plantarflexors results in? |
No force push off |
|
|
What do the ankle evertors do during gait? |
Transfer weight to medial side of foot Provide stability |
|
|
What do the ankle invertors do during gait? |
control pronation force on arch |
|
|
What nerves in the foot are subject to pressure and trauma? |
Common fibular nerve Posterior tibial nerve Plantar and calcaneal nerves |
|
|
What spinal segments terminate in the foot? |
L4, L5, S1 |
|
|
What are some nonoperative conditions with joint hypomobility? |
RA, DJD, OA, Gout Post-immobilization stiffness |
|
|
RA usually affects which joints in the foot? |
MTP and forefoot |
|
|
Degenerative joint disease occurs to which joints of the foot? |
Joints that are repetitively traumatized (ankle sprains, chronic instability, fracture) |
|
|
OA occurs in which joints of the foot? |
OA does not naturally occur in the foot but can form because of DJD |
|
|
What is gout? |
arthritic condition of the big toe |
|
|
Hallux valgus |
Deformity of the great toe in which the proximal phalanx shifts laterally toward the second toe. Bursa may become inflamed. |
|
|
Hallux limitus/hallux rigidus |
Narrowing and eventual obliteration of the first MTP joint space occur with progresssive loss of extension |
|
|
Dorsal subluxation/dislocation of the proximal phalanges on the metatarsal heads |
The fat pad migrates dorsally with the phalanges and the protective cushion during weight bearing is lost. |
|
|
Claw toe |
MTP hyperextension and IP flexion |
|
|
Hammer toe |
MTP hyperextension, PIP flexion, and DIP hyperextension |
|
|
Common impairments from joint hypomobility |
1. limited ROM 2. Muscle weakness 3. Impaired balance 4. Fall risk 5. Painful WB 6. Gait deviation |
|
|
Joint Hypomobility Management: Acute phase |
1. educate the patient 2. Decrease pain 3. Maintain joint, soft tissue mobility, and muscle integrity 4. provide joint protection |
|
|
Joint Hypomobility Management: Subacute and Chronic Phases |
1. Increase joint play and accessory motions 2. Improve joint track of Talocrural jt 3. Increase mobility of soft tissues 4. Progressive strengthening 5. Improve balance and proprioception 6. Develop cardiopulmonary fitness |
|
|
When is surgical intervention necessary for arthritic joints? |
When nonoperative management no longer alleviates symptoms |
|
|
What are indications for a total ankle arthroplasty? |
Advanced Arthritis Deformation Severe trauma
|
|
|
A total ankle arthroplasty is performed on which joint? |
The talocrural joint |
|
|
After a total ankle arthroplasty, what do doctors order patients to do? |
Be immobilized and have WB precautions Varies from pt and doctor |
|
|
How long does a total ankle arthroplasty implant last? |
10-15 years |
|
|
What things are to be avoided forever post total ankle arthroplasty |
High-impact activities Quick stop-and-go motions |
|
|
What are some indications for an ankle arthrodesis? |
severe arthritis debilitating pain instability failed surgery severe trauma |
|
|
An ankle arthrodesis is the procedure of choice for which individuals? |
Young, active patients with posttraumatic arthritis and gross instability |
|
|
What is an arthrodesis? |
Fusion of the two bones using screws to hold them together |
|
|
Where are arthrodesis typically performed? |
1. ankle 2. hindfoot 3. 1st MTP 4. IP joints |
|
|
What are some complications of arthrodesis? |
Non-union Infection Neurological effects Stress fracture |
|
|
What is something you never want to do with a ankle arthrodesis patient? |
PROM or joint mobs! |
|
|
Post op exercises of ankle arthrodesis |
ROM of the nonoperated joints Return strength, balance, and function |
|
|
Causes of heel pain |
Plantar fasciitis, heel spurs, achilles tendinopathy, and bursitis |
|
|
What are the two types of shin splints? |
Anterior and posterior |
|
|
Leg, heel, and foot pain management: acute phase |
Cross-friction massage Modalities to control pain Taping or orthotic device AROM within pain-free range |
|
|
Leg, heel, and foot pain management: subacute and chronic phase |
Pt. education Stretch range-limiting structures Improve muscle performance |
|
|
What is the most common type of sprain? |
Inversion |
|
|
What are the ligaments involved in inversion sprains? |
1. Anterior talofibular ligament (number 1) 2. Calcaneofibular ligament 3. Posterior talofibular ligament |
|
|
During eversion sprains, what ligament is affected and how? |
The deltoid ligament usually has an avulsion fracture |
|
|
What are indications for a lateral ligament repair? |
Grade 3 sprain that has persistent instability and unsuccessful non-op management |
|
|
Direct repair surgery of torn lateral ligament |
ligaments are tied back together. |
|
|
Reconstruction of torn lateral ligament |
Creating new ligament by tendon graft and transposition of the peroneus brevis tendon |
|
|
Thermally assisted capsular shift |
a laser shrinks and tightens the lateral ligaments and joint capsule |
|
|
Activity-related precautions to reduce the risk of re-injury after lateral ligament reconstruction of the ankle |
Low-impact sports Wear orthotic device Tape ankle or insert lift participate in pre-season injury prevention
|
|
|
An achilles tendon rupture is most common in what individuals? |
Men ages 30-50 who engage in athletic activities |
|
|
When does an achilles tendon rupture occur? |
During sudden acceleration, abrupt deceleration, and jumping or landing |
|
|
What is the motion of the "True" Subtalar joint? |
Inversion/eversion. Occurs at the posterior articulation |
|
|
What is the closed packed position of the subtalar joint? |
Supination |
|
|
What is the main complication of an ankle arthroplasty? |
Premature implant wear/loosening |
|
|
What is the main complication of achilles tendon repair? |
Tendon re-rupture |
