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62 Cards in this Set
- Front
- Back
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Inferior TibFib joint
- Type - DF - Close pack - Open pack - capsular pattern |
- syndesmosis - fibrous
- none - weight bearing dorsiflexion - No weight bearing position - Pain when mortis is splayed |
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Osteokinematics at Inf Tib fib
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dorsiflexion and internal tibial rotaion = supralateral translation
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Arthrokin at Inferior tibfib joint
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- minimal anterior/posterior glide of fibula on tibia
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Talocrural Joint
- Type - DF - Closed pack - Open pack - capsular pattern |
- compound, synovial, modified sellar
- one DF - plantar/dorsi flexion - CP - dorsiflexion - OP - 10 degrees plantar flexion - Greater limitation with plantar flexion before dorsi |
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Osteokin of the Talocrural joint
- Axis/plane - dorsiflexion - plantar flexion |
- oblique transverse axis/ impure sagital plane
- DF - Anterior swing (roll) with conjunct external rotation of Talus PF - posterior swing (roll) with conjunct internal rotation if tibia |
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Arthrokin of Talocrural joint
- Dorsiflexion - Plantarflexion |
DF- posterior glide of talus on talar dome
PF - Anterior glide of talus on talar dome |
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Subtalar joint
- Type |
- Synovial compound
Anterior joint surface = concave Posterior = Convex Anatomically = modified ovoid Functionally = MODIFIED SELLAR |
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Subtalar joint
- Degrees of freedom - Closed pack - OPen pack - Capsular pattern |
DF - 1 (triplanar movement of supination and pronation)
CP = end range supination and pronation OP = Mid position Capsular= more limitation in supination than pronation |
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Osteokin at Subtalar joing
- axis/plane - pronation - supination *during inversion... |
- oblique axis/ frontal plane (impure)
pron - calcaneus = eversion, dorsiflexion, abduction sup - calcaneus = inversion, plantar flexion, adduction - anterior and posterior joint surfaces of calcaneous both roll in a medial direction |
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ARthrokin at subtalar joint
- pronation (hind foot eversion) - ant and post calc - supination (hind foot inversion) - ant and post calc *during inversion.... |
pron - lateral glide of anterior calcaneal facet on the talus
- medial glide of posterior calcaneal facet on talus Sup - medial glide of anterior calcaneal facet on talus - lateral glide of posterior calcaneal facet on talus - anterior joint surface of calc glides medially - posteror joint surface of calc glides laterally |
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Talonavicular joint
- type - Degrees of freedom - close pack - open pack - capsular pattern |
- synovial, modfied ovoid
- 2 (Pf/Df, Inv/Ev) CP- inversion of navic OP - slight plantar flexion Caps - equal limitation |
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Osteokin of the Talonavicular joint
- Dorsiflexion - Plantar flexion |
DF = Dorsal swing (roll) of navic
- conjuct adduction and ER (* talus is abducted = relative adduction of navic) PF = plantar Swing (roll) of navic - conjuct abduction and IR |
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Arthrokin of the Talonavic joint
- Dorsiflexion - Plantar flexion |
DF = Dorsal glide of navic
- conjunct extertnal rotation (inversion) of navic on talus PF = plantar glide of navic - conjuct internal rotation (eversion) of navic on talus |
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Calcanealcuboid joint
- type - degree of freedom - close pack - open pack - capsular pattern |
- simple, synovial - funtionally = modified sellar
DF - 1 - pron/sup Close pack - none Open pack - slight plantar flexion Caps - Equal |
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Calcaneal Cuboid joint Osteokin
- pronation/supination |
- pronates and supinates about an oblique axis
- arcuate swing - roll along an arch |
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Calcaneal cuboid arhtrokin
- Pronation - Supination |
Pron = Dorsal glide of cuboid on calcaneus
- conjunct internal rotation and abduction Sup = Plantar glide of cuboid on calcaneus - jonjunct external rotation and adduction |
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Cubonavicular joint
-Type - Degrees of freedom - Close pack - Open pack Osteo/arthro |
- syndesmosis
- zero CP = supination OP = neutral - no movement |
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Cuneonavicular joint
- type - degrees of freedom - Close pack - open pack - capsular pattern |
- Synovial, compound, modified ovoid
- 2 - DF/PF, Inv/Ev - CP = supination - OP = neutral Caps = Equal |
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Cuneonavicular joint Osteokin
-Dorsifleixon - Plantar flexion |
DF = Dorsal swing (roll) and ext rotation
- conjunct adduction PF = Plantar Swing (roll) and internal rotation - conjunct abduction |
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Cuneonavicular joint Arthrokin
- Dorsi - Plantarl |
DF = Dorsal glide of cuneiforms on navic
- conjunct external rotation (as a group) PF = Plantar glide of cuneiforms on navic - conjunct internal rotation (as a group) |
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Cuneocuboid joint
- type - Degrees of freedom - close pack - Open pack |
- synovial, compound, planar
Df = one - sup/pron CP = supination OP = pronation |
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Cuneocuboid joint osteokin
- pronation - supination |
Pron = dorsal swing (roll) of cuboid on lateral cuneiform
Sup = Plantar swing (roll) of cuboid on lateral cuneiform |
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Cuneocuboid joint arthrokin
- pronation - supination |
Pron = Dorsal glide of cuboid
Sup = Plantar glide of cuboid |
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Intercueiform joints
- type - DF - close pack - open pack |
- synovial, compound, planar
- DF = one - pron/sup - CP = supination - OP = pronation |
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Intercuneiform osteokinematics
- Pronation - Supination |
*swing (roll) moves plantar/dorsal
Pro = medial and lateral cuneiforms slide dorsally on keystone Sup = medial and lateral cuneiforms swing planter direction |
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Intercuneiform Arthrokin (at both lateral and medial cuneiform)
- Pronation - Supination |
Pron =
Medial Cun = slight dorsal glide of medial on middle Lateral Cun = slight dorsal glide of lateral on middle Sup = Medial Cun = slight plantar glide of lateral on middle Lateral Cun - slight plantar glide of medial on middle |
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Tarsometatarsal joint
- Type - Degrees of freedom - Close pack - Open pack |
- simple, synovial, modified ovoid
Df = 2 = DF/ PF, ABD/ Add Close Pack = Full extension Open pack - 10 deg DF |
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Tarsometatarsal joint Osteokin
- 1st ray (with med cuneiform) *axis |
* DF/PF - impure swing about an axis that runs from dorsal posterior medial to plantar anterior lateral
Dorsi - base of 1st swings(rolls) in a dorsal direction |
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Tarsometatarsal joint Osteokin
- 2-4th ray |
DF/PF = impure swing
Dorsi - all roll in a dorsal direction |
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Tarsometatrsal joint Osteokin
- 5th ray |
DF/PF - impure swing about an axis thta runs from plantar posterior lateral to dorsal anterior medial
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Tarsometatarsal joint ARthrokin
- 1st ray DF PF |
Dorsiflexion - Dorsal glide
- conjunct external rotation of 1st MT on medial cun = FANNING Plantarflexion - plantar glide - conjunct internal rotation of 1st MT on medial cun = FOLDING |
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Tarsometatarsal joint ARthro
- 2-4 ray |
- dorsal and plantar glide
*middle 3 rays usually follow the first ray |
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TMT joint ARthro
5th ray DF PF |
DF = dorsal glide
- conjunct internal rotation of 5th MT on cuboid = FANNING PF = Plantar glide - conjunct external rotation of 5th MT on cuboid = FOLDING |
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MTP joint
- type - DF - Close pack - Open pack - Capsular pattern - 1st - 2md - 5th |
- simple, synovial, modified ovoid
Degrees of Freedom = 2 ( DF/PF, Abd/add) CP = full ext OP = 10 deg dorsiflexion Caps = 1st MTP = extension more than flexion - 2-5 = flexion more than extension |
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TMT Osteokin
DF PF ABd/ADD |
DF = phalynx swings (rolls) dorsally
PF = phalynx swings (rolls) plantarlly Ab/Ad = impure swing about a verticle axiz in a coronal plane |
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TMT arthrokin
- Plantar flexion MT 1 - Plantar flexion MT 2-5 - DF - MT 1 - DF - MT 2-5 |
Plantar flexion MT1 = plantar glide of base of phalanx
- conjunct internal external rotation Plantar flexion MT2-5 = plantar glide of bas of phalynx - conjucnt internal rotation Dorsiflexion MT1 - Dorsal glide of base of phalanx - conjunct internal rotation (to maintain ground contact) Dorsiflexion MT 2-5 - Dorsal glide of base of phalanx - conjunct external rotation |
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TMT Arthro ***All in relation to second ray**
- Abduction MT 1 - abduction M3-5 Adduction MT1 Adduction MT 3-5 |
ABd MT 1 - lateral glide of phalanx 1(away from ray 2 - towards medial body)
ABd MT 3-5 - lateral glide away from body Add MT 1 = medial phalanx 1 (toward ray 2 - away from midline) ADD MT 3-5 = medial glide (toward ray 2 so toward midline of body ) |
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Interphalangeal Joints
- type - degree of freedom - close pack - open pack - caps pattern |
- synovial, simple, modified sellar
DF = 1 flex/ext CP = full ext OP = slight flexion Caps = extension loss greater than flexion |
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IP joint Osteokin
- flex - ext |
* arcuate swing about a transverse axis
flexion = plantar swing/roll ext = dorsal swing/roll |
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IP joint Arthrokin
- flex - ext |
flex - plantar glide of distal phangeal base on proximal head
ext = dorsal glide of distal phalangeal base on the proximal phalangeal head |
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What is the Anterior drawer test testing
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- anterior parts of the medial and lateral collateral ligaments and anterior capsule
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What is the posterior drawer testing
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- instability of the inferior tibiofibular joint and the mortise
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3 tests for inflammation
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1. Joint Splaying (syndesmosis and high ankle sprain)
2. Compression of proximal tibfib 3. Squeeze test at mid shaft of tibia |
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2 ligaments limiting Supination
*often injured together |
1. Lateral talocalcaneal
2. Cervical |
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3 ligaments limiting pronation
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1. medial talocalcaneal
2. Interosseous |
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How is the first ray (hallux) stabilized dynamically :
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1- peroneus longus
2. Abductor hallucis 3. Flexor hallucis longus |
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Hallux stability relies on: 9
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1. normal muscle length of peronei
2. minimum 16 deg platar flexion between 1st MT and medial cuneiform 3. minimum 65-75 deg dorsiflexion of 1st MT and medial cuneiform 4. Subtalar supination allows relative plantar flexion of the 1st ray 5. Unrestricted sesamoids allowing 1st MT to glide posteriorly 6. Head of 1st MT gliding on stable base of 1st proximal phalanx 7. plantar fascia extensibility 8. Supination of cuboid allow normal peroneii function 9. Normal Subtalar function |
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2 bones at risk for AVN
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- neck of talus
- base of 5th |
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What is osteochondritis dessicans
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- inflammatory reaction to the detachement of a fragement of cartialge and its underlying bone
- presents with symptoms of a lose body - may be able to palpate the defect along the atnerior joint line of the talocrural joint |
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Where are lose bodies found
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- subtalor and talocrural
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Differential diagnosis for a loose body
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- mortise instabiity
- ruptured calcaneofibular ligament - xrays usually negative |
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Symptoms of osteochondral lesion of talus
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- long history of pain and swelling - 1 yr +
- daily pain with swelling and limited sport - positive anterior drawer - decreased dorsiflexion - decreased subtalar joint |
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Morton's Neuroma
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- entrapment neuropathy on the plantar surface of the intermetatrsal ligament
- pain at 2nd or 3rd intermetatarsal space - transverse compression of toes is painful - tingling in 3rd webspace |
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treatment for Mortons Neuroma
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- footwear modification
- injection - ultrasound - forefoot mobilization - metatarsal pad |
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What is plantar fascitis
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-inflammation of the plantar fascia or perifascial bursae
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Where is plantar fasciitis most commonly located
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- origin of plantar fascia on the medial tubercle of the calcaneus
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Differential diagnosis with plantar fasciitis
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- systemic conditions
- osteoporosis - OA - tarsal tunnel syndrome - bursitis - calcaneal fracture |
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Clinical presentation of plantar fasciitis
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- tenderness on palpation of medial tubercle of calcaneus or length of plantar fascia
- pain with passive dorsiflexion at the big toe - pain with gait - pain with weightbearing (especially after a period of rest) - slow decrease in pain with activity - tight plantar flexors |
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Treatment for plantar fasiitis
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- activity modification
- tape or lift - modalities - stretching - injection - intrinsic strenthening |
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What is equinas foot
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- decreased length of the achilles
- congenital joint restriction - aquired joint disfunction - sublixation |
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Clinical presentation of equinas foot
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- less than 10 degrees of dorsiflexion with knee extended
- compensates with subtalar pronation or dorsiflexion of midtarsal and tarsometatarsal joints - Hallux valgus - Navicular wedging |
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Treatment for Equinas foot
- acute - subacute |
Acute = heel lift
- treat joint dysfunction Subacute - stretch with subtalar in neutral |
