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84 Cards in this Set
- Front
- Back
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Ankle/Foot Palpation: Lateral Malleolus |
Prominent distal end of the fibula on the lateral aspect of the ankle |
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Ankle/Foot Palpation: Medial Malleolus |
Prominent distal end of the tibia on the medial aspect of the ankle. Smaller than the lateral malleolus. |
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Ankle/Foot Palpation: Achilles Tendon |
Prominent ridge on the posterior aspect of the ankle; tendon edges are palpable proximal to the posterior aspect of the calcaneus |
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Ankle/Foot Palpation: Navicular tuberosity |
About 2.5cm inferior and anterior to the medial malleolus |
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Ankle/Foot Palpation: Calcaneus |
Posterior aspect of the heel |
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Ankle/Foot Palpation: Base of 5th metatarsal |
Small bony prominence at the midpoint of the lateral border of the foot |
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Ankle/Foot Palpation: Head of 1st metatarsal |
Round bony prominence at the medial aspect of the ball of the foot, at the base of the great toe |
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Grades for Standing Resisted Plantarflexion |
5=maintaining heel fully off the floor more than 6 reps 4=maintaining heel fully off the floor 3-5 reps 3=maintaining the heel fully off the floor 1-2 reps |
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ROM/MMT Grades for Toes & Fingers |
5=full ROM and maximal resistance 4=full ROM and moderate resistance 3=full ROM and minimal resistance 3=part of ROM 1=none of ROM but palpable/observable muscle action 0=no movement and no muscle action |
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Ankle/Foot Plantarflexion O/I: gastrocnemius |
Origin: medial/lateral femoral condyle Insertion: posterior calcaneus |
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Ankle/Foot Plantarflexion O/I: soleus |
Origin: posterior tibia/fibula Insertion: posterior calcaneus |
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Ankle/Foot Plantarflexion O/I: flexor digitorum longus |
Origin: posterior tibia Insertion: distal phalanx 4 toes |
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Ankle/Foot Plantarflexion O/I: flexor halluces longus |
Origin: fibula, interosseous Insertion: distal phalanx of hallux |
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Ankle/Foot Plantarflexion ROM |
Normal: 50 Position: sitting Goni Axis: lateral malleolus, goni starts at 90 degrees Stat arm: head of fibula Mov arm: sole of the heel/5th metatarsal End Feel: firm/hard (talus hits tibia) Instructions: sit on edge of plinth with knees 90, point your toes toward the ground extending the ankle Hands: one hand around the ankle stabilizing the tibia and fibula and the stat arm, other hand around the top of the foot guiding the movable arm |
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Ankle/Foot Plantarflexion MMT Against Gravity |
Position: standing Test Position: toe raises Instructions: stand while holding onto my hands or edge of plinth, raise the non-affected leg off the floor, keep affected leg straight and foot flat on the floor, go up on your toes and repeat movement until fatigued or instructed to stop Resistance: body weight Gravity eliminated NOT necessary |
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Ankle/Foot Dorsiflexion O/I: anterior tibialis |
Origin: lateral tibia, interosseous Insertion: medial 1st cuneiform & 1st metatarsal |
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Ankle/Foot Dorsiflexion O/I: extensor digitorum |
Origin: fibula, tibia, interosseous Insertion: distal phalanx 4 toes |
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Ankle/Foot Dorsiflexion O/I: extensor hallucis longus |
Origin: fibula, interosseous Instertion: distal phalanx of hallux |
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Ankle/Foot Dorsiflexion ROM |
Normal: 20 Position: sitting Goni Axis: lateral malleolus, goni starts at 90 Stat arm: head of fibula Mov arm: sole of the heel/5th metatarsal End Feel: firm Instructions: sit on edge of plinth with knees 90, point your toes toward your nose flexing the ankle Hands: one hand around the ankle stabilizing the tibia and fibula and the stat arm, other hand around the bottom of the foot guiding the movable arm |
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Ankle/Foot Dorsiflexion MMT Against Gravity |
Position: sitting Test Position: top of foot midway 0 degrees & maximum dorsiflexion Instructions: sit on edge of plinth, start with toes pointed toward floor and slightly turned outward, leg supported by my thigh, keep toes relaxed and point toes toward your nose while moving your foot inward Resistance: dorsomedial aspect of the forefoot |
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Ankle/Foot Dorsiflexion MMT Gravity Eliminated |
Position: side-lying on affected side Instructions: lay on affected side, bend your knee while pointing your toes down and moving your foot outward slightly, flex your toes toward your nose and move your foot inward Palpation: tibialis anterior |
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Ankle/Foot Eversion O/I: peroneus longus |
Origin: fibula, interosseous Insertion: lateral 1st cunieform & 1st metatarsal |
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Ankle/Foot Eversion O/I: peroneus brevis |
Origin: fibula Insertion: 5th metatarsal |
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Ankle/Foot Eversion ROM |
Normal: 15 Position: sitting Goni Axis: mid-malleoli Mov arm: 2nd metatarsal End Feel: firm/hard (talus hits fibula) Instructions: sit on edge of plinth, move toes out to the side Hands: one stabilizing the tibia and fibula and the stat arm, other holding the medial aspect of the foot while guiding the movable arm |
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Ankle/Foot Eversion MMT Against Gravity |
Position: sitting Instructions: sit on edge of plinth, point toe down toward the ground and inward slightly, move the foot outward keeping the toes relaxed Resistance: lateral border of the foot on the plantar surface of the first metatarsal |
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Ankle/Foot Eversion MMT Gravity Eliminated |
Position: supine Instructions: lay on back with heel over edge of the plinth, ankle and toe inward slightly, move foot outward keeping the toes relaxed Palpation: peroneus longus & peroneus brevis |
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Ankle/Foot Inversion O/I: anterior tibialis |
Origin: lateral tibia, interosseous Insertion: medial 1st cuneiform & 1st metatarsal |
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Ankle/Foot Inversion O/I: posterior tibialis |
Origin: tibial fibula I: navicular, tarsals, metatarsals |
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Ankle/Foot Inversion ROM |
Normal: 35 Position: sitting Goni Axis: mid-malleoli Stat arm: tibial tuberosity Mov arm: 2nd metatarsal End Feel: firm Instructions: sitting on edge of plinth, move toes inward Hands: one stabilizing the tibia and fibula and the stat arm, other hand holding lateral aspect of the foot while guiding the movable arm |
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Ankle/Foot Inversion MMT Against Gravity |
Position: sitting Instructions: sit on edge of plinth, foot and ankle in neutral, move foot inward keeping toes relaxed Resistance: medial border of the forefoot |
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Ankle/Foot Inversion MMT Gravity Eliminated |
Position: supine Instructions: lay on back, heel off edge of plinth, foot and ankle in neutral, move foot inward and slightly point toes down Palpation: tibialis posterior |
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Ankle/Foot Toe Flexion O/I: flexor digitorum longus |
Origin: posterior tibia Insertion: distal phalanx 4 toes |
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Ankle/Foot Toe Flexion O/I: flexor hallucis longus |
Origin: fibula, interosseous Insertion: distal phalanx of hallux |
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Ankle/Foot Toe Flexion ROM |
Normal: 0-45 Position: sitting or supine Goni Axis: MTP joint axis medial aspect of great toe Stat arm: parallel to longitudinal axis of 1st metatarsal Mov arm: parallel to longitudinal axis of proximal phalanx of great toe End Feel: firm Instructions: bend toe Hands: one hand stabilizing the first metatarsal and stat arm, other hand moving the movable arm |
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Ankle/Foot Toe Flexion MMT Against Gravity |
Position: sitting or supine Instructions: don't let me straighten your toes Resistance: plantar surface of the proximal phalanges of the great toe Palpation: flexor hallucis brevis |
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Ankle/Foot Toe Extension O/I: extensor digitorum |
Origin: fibula, tibia, interosseous Insertion: distal phalanx 4 toes |
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Ankle/Foot Toe Extension O/I: extensor hallucis longus |
Origin: fibula, interosseous Insertion: distal phalanx of hallux |
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Ankle/Foot Toe Extension ROM |
Normal: 0-70 Position: sitting or supine Goni Axis: MTP joint axis medial aspect of great toe Stat arm: parallel to longitudinal axis of 1st metatarsal Mov arm: parallel to longitudinal axis of proximal phalanx of great toe End Feel: firm Instructions: toes to nose Hands: one hand stabilizing the first metatarsal and stat arm, other hand moving the movable arm |
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Ankle/Foot Toe Extension MMT Against Gravity |
Position: sitting or supine Instructions: don't let me bend your toes Resistance: plantar surface of the distal phalanx of the great toe Palpation: flexor hallucis longus & digitorum longus |
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Tibial Torsion |
twists medially against the shaft of the tibia, mirrors the lateral torsion of the femur back into a straight line, 20-30 degrees |
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Talus: Trochlea |
Rearfoot, very large articular surface of the ankle joint for the tibia and fibula |
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Calcaneal Tuberosity |
Flat, most posterior aspect of the calcaneus, where the Achilles tendon inserts |
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Navicular |
Midfoot, most medial tarsal, cornerstone of the medial arch of the foot |
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Cuneiforms (3) |
Midfoot: lateral, intermediate, & medial. Sit in front of the navicular bone, articulate within the navicular bone and the 1st 3 medial metatarsals respectively |
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Cuboid |
Midfoot: articulates with navicular bone, calcaneus, and metatarsals 4 & 5 |
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Metatarsals |
Forefoot: base-proximal head, shaft; head-distal head |
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Phalanges |
Forefoot: little bones in the toes, lateral toes have 3 phalanges |
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Hallux |
Forefoot: great toe, 2 phalanges |
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Arches of Foot |
like a spring, disperse forces, recoil energy during gait |
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Medial longitudinal arch |
Inside arch-calcaneus to first met head Navicular-cornerstone Transfers compressive forces forward/backward Recoil during gait for pushoff |
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Lateral longitudinal arch |
Flat-in contact with the ground at all times during gait Pushoff |
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Transverse arch |
Between 1st & 5th metatarsals and tarsals-broad 2nd metatarsal-no arch or break metatarsals-foot deformities, decreased power, bones shift, muscles stretch out |
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Spring ligament |
calcaneal-navicular ligament: from calcaneus to navicular bone, thick, supports medial arch. Ankle sprain/inversion can damage this |
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Long plantar ligament |
calcaneus to cuboid & 3rd & 5th met heads: supports lateral arch, gives arch rigidity |
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Plantar aponeurosis |
thick, wide piece of fascia on the sole of the foot, calcaneus to proximal end of phalanges, for cushion and final support of the sole of the foot. Plantar Fasciitis-unable to extend toes, abnormal gait, tight and irritated fascia |
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Deep transverse metatarsal ligament |
binds all of the met heads together, for supporting the transverse arch |
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Tibiofibular Joint: proximal |
By knee, plane synovial-gliding of fibula during plantar and dorsiflexion |
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Tibiofibular Joint: distal |
Fibrous-no synovial lining, gliding of two flat bones during plantar and doriflexion |
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Interosseous membrane |
thick membrane connecting the tibia and fibula along the shaft |
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Talocrural Joint |
Ankle joint. Tibia, fibula, talus-at trochlea of talus, hinge synovial joint, known as malleolar mortise, tibia and fibula sit on the talus and the ligaments of the interosseous membrane grasp the talus, for plantarflexion and dorsiflexion. |
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Medial Collateral Ligament |
(deltoid)-fan-like, limits excessive eversion |
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Lateral Collateral Ligament |
3-4 separate ligaments, lateral malleolus to different tarsals/cuneiforms, weaker than MCL, see in rolling of ankle |
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Anterior Talofibular Ligament |
fibula to talus on anterior aspect, most common ligament injured in ankle sprains, closed pack: extreme dorsiflexion, open pack: slight plantar flexion past neutral |
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Subtalor |
between talus and calcaneus |
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Supination |
inversion, plantarflexion, & adduction between subtalor and talocrural |
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Pronation |
eversion, dorsiflexion, & abduction |
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Transverse Tarsal Joint |
inversion & eversion |
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Pes Planus |
Hyperpronation: more eversion, dorsiflexion, and abduction, foot flat due to weak or overstretched structures that hold up the medial-longitudinal arch, when put weight or during active movements only, can be rigid, bony deformity or muscular imbalance, wear out inside of shes, lateral arch never hits the ground |
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Pes Cavus |
Hypersupination: excessively high arches, almost always very rigid foot and ankle, less common than pes planus, medial arch never hits the ground, wear out outside of shoes |
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Tarsometatersal Joints |
Ray-includes metatarsals and phalanges 1-5 Transfer forces |
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Metatersalphalangeal Joints |
Hyperextension of phalanges |
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Interphalangeal Joints |
little bitty joints in the toes Hallux has 1, others have 2 |
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Anterior compartment |
Tibialis anterior, ext digitorum longus, & ext halluces longus. Shin splints: irritation of the periosteum and interosseous membrane due to excessive pounding |
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Posterior compartment |
Gastrocnemius, soleus, flexor digitorium longus, flexor hallicus longus, & posterior tibialis-inversion |
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Lateral compartment |
peroneus longus & brevis-eversion |
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Stirrup Effect |
For support of the arches of the foot-anterior tibialis and peroneus longus & brevis, attach at the same site |
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Rising from sitting |
28 degrees dorsiflexion |
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Ascending stairs-step over step |
14-27 degrees dorsiflexion 23-30 degrees plantarflexion |
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Descending stairs |
21-36 degrees dorsiflexion 24-31 degrees plantarflexion |
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Walking |
10 degrees dorsiflexion 20 degrees plantarflexion 90 degrees great toe MTP extension |
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Running |
17 degrees dorsiflexion 32 degrees plantarflexion |
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Sitting cross-legged |
26-29 degrees plantarflexion |
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Kneeling with ankles dorsiflexed |
40 degrees dorsiflexion |
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Squatting with heels down |
39 degrees dorsiflexion |
