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272 Cards in this Set
- Front
- Back
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4 functions of the foot
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-acts as a base of support for maintaining upright posture
-provides flexibility to adapt to uneven terrain -shock absorption -acts as lever during pushoff/aids in weight bearing |
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the forefoot is comprised of __ metatarsals and __ phalanges
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5, 14
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waht does MTP stand for ?
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metatarsophalangeal joint
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what does PIP stand for?
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proximal interphalangeal joint
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what does DIP stand for?
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distal interphalangeal joint
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what does TM
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tarsometatarsal joint
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waht does IM stand for?
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intermetatarsal joint
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there are __ total phalanges in the body
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56
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the big toe doesn't have a __, just an __
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PIP, IP
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there are __ total tarsal bones in each foot
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7
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the midfoot is comprised of the __
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navicular, cuboid, and 3 cuneiform bones
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the hindfoot is comprised of the __
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calcaneus and talus
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__ is the largest tarsal bone
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calcaneus
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the __ in the hindfoot bears the weight in the foot
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talus
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runs from the anterior, inferior calcaneus to the metatarsal heads
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medial and lalteral longitudinal arch
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runs across the anterior tarsals and the anterior metatarsals
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transverse arch
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a specialized thick band of fascia that covers the plantar surface of the foot.
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plantar fascia
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extends from the posterior medial calcaneus to the proximal phalanx of each toe.
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plantar fascia
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acts like a spring during gait and may be elongated by stratching the achilles tendon
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plantar fascia
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hammer and claw toes are often __ but can be __ becuase of improperly fitted shoes, contractures of the foot muscles, or malalignment of bony structures
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developed, congenital
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a flexion deformity of the PIP joint
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hammer toe
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a hyperextension of the MTP joint and hyperflexion of the DIP and PIP joints
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claw toe
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found on the plantar aspect of the foot. they have tiny, dark red or black dots within each one. commonly recurs
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plantar warts
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plantar warts __ recurs
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commonly
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plantar warts is also konw as __
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verrucae plantaris
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a common fungal condition characterized by extreme itching on the sole of the foot and between the toes. skin may be scaling, peeling, and cracking
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athletes foot
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what is athletes foot real name
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tinea pedis
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characterized by localized pain primarily in the 2nd and 3rd metatarsal space that often radiates into the other toes. the nerve is compressed between the toes
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plantars neuroma
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what is often used to test for plantars neuroma?
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a pencil eraser
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typically found on the medial ascpect of teh MTP joint of the great toe, but can occur on the lateral aspect of the 5th toe.
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bunions
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when the great toe, (due to several conditions) shifts laterally and overlaps the 2nd toe leading to a rigid non-functional hallux valgus deformity
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bunions
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what are bunions actually called?
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hallux valgus
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discomfort around the metatarsal heads
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matatarsalgia
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what is bursitis commonly called?
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pump bump
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when teh bursa associated with the achillies tendon can become swollen and irritated due to external pressure from a shoe or excessive pronation
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bursitis
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signs and symptoms are pain with palpation just anterior to teh achilles and pain with active push off
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bursitis
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can be quite painful due to getting stepped on or dropping something on teh foot. fractures must be ruled out first. contusions can occur on the plantar aspect from a loos cleat irritating ball of the foot
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midfoot/forefoot contusions
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caused by excessive body weight, age, worn out shoes, and hard surfaces
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hindfoot contusion (heel bruise)
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when the medial or lateral aspect of the nail grows into the nailbed. the ingrown area causes disruption and infection of the skin. appears red and swollen
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ingrown toenail
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another name for ingrown toenail
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onychocryptosis
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occur by tripping or stubing the toe.
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MP and IP sprinas
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varus and valgus forces normally only affect the __
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1rst and 5th toes.
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the heel of teh foot has a __
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fat pad
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when the 1rst toe is shorter than normal
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mortons toe
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caused by jamming the great toe into the end of the shoe, or hyperextending the MTP joint of the great toe. it is related to artificail turf and hyperflexible shoes
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turf toe
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with turf toe, the __ are drawn forward to bear weight under the 1rst metatarsal head
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sesamoid
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the result of severe dorsiflexion, plantar flexion, or pronation
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midfoot sprain
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mostly seen in sports where the foot is unsupported like gymnastics or intrack with less supported flats
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midfoot sprains
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__ have signs and symptoms of pain and swelling deep within the plantar aspect of the foot and pain with weight bearing
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midfoot sprains
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casued by excessive achilles tightnes, excessive pronation, or obesity overloading the plantar fascia at the calcaneus
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plantar fascitis
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plantar fascitis is most common in __
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runners
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S/S of __ are:
pain upon arising in the morning that diminished within 5-10 min, pain with weight bearing, pain with palpation over medical calcaneus and increases with toe extension |
plantar facitis
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seen in running and jumping especially after an increase in work outs, working out on non-yielding surfaces or wearing improper shoes
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stress fractures
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the __ is the most common foot structure to get a stress fracture
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2nd metatarsal
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S/S of __ are:
pain w/WB, swelling and point tender over fracture site |
stress fracture
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occurs normally at the stie of a ligament or tendon attachement.
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avulsion fractures
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when teh peroneusbrevis tendon can avulse the shaft of teh 5th metatarsal
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jones fracture
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what should you look for in bilateral observation of the foot? (3)
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-flat foot
-high arch -pronation/supination |
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what ROM's and strengths should you check with the foot? (6)
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-PF/DF/EV/IV/Toe ext/toe flex
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the tibiofibular joint is a __ or __ type of joint
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fiberous, syndesmosis
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what ligaments support the lateral aspect of the tibiofibular joint? (7)
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-anterior talofibular
-posterior talofibular -calcaneofibular -anterior tibiofibular posterior tibiofibular -retinaculum -interosseous membrane |
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the articulation formed by the distal articular surface of the tibia and its medial malleolus, the fibulas lateral malleolus, and the talus
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ankle mortise
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spans between the talus, tibia, and fibula
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ankle mortise
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a uniaxial modified hinge synovial joint located between the talus, medial malleolus, and lateral malleolus
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talocrural (ankle) joint
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the talocrural (ankle) joint is designed for __ especially in __
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stability, DF
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the major medial ligament of the talocrural joint is the __ ligament
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deltoid
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the deltoid muscle consists of 4 ligaments:
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-tibionavicular
-tibiocalcanean -posterior tibiotalar -anterior tibiotalar |
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if the deltoid ligament ruptures the foot __
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everts
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what is the "spring ligament" of the ankle?
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plantar calcaneonavicular
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a bony structure, protrudes on calcanus, goes inferior on medial malleolus. IS THE ATTACHEMENT SITE FOR CALCANEAL NAVICULAR LIGAMENT
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sustentacululm tali
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stabalizes against excesssive inversion of the talus. most commonly injured by a lateral ankle sprain
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anterior talofibiular ligament
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resists andkle DF and talar AD/medial rotation/medial translation
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posterior talofibular ligament
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'stailizes against maximum IV at the ankle and subtalar joint. second most injured by a lateral ankle sprain
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calcaneofibular ligament
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holds the peroneal tendons in place
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retinaculum
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the subtalar joint is a __ joint
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synovial
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the __ is supported by the lateral and medial talocalcaeanal ligaments
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subtalar joint
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no muscles attach to the __
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talus
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not a specific structure but is an indentation formed on teh talus next to the extensor digitorum brevis. it is concave. after injury to theATF or taler fx, it fills with fluid and loses its indentation in teh foot
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sinus tarsi
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__ and __ are the most unstable ankle positions
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PF and EV
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enclosed by the interosseous membrane lying posteriorly, contains the tivia, fibula on either side and a nonexpansive fascia covering the compartment anteriorly
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anterior compartment
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muscles contained in the anterior compartment (5)
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-tibialis anterior
-extensor digitorum longus -extensor hallucis longus -peroneal nerve -anterior tibial artery |
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the tibialis anterior does __
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DF/IV
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the extensor digitorum does __
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DF/toe extension
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the extensor ahllicus longus does __
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great toe extension
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the peroneus tertius does __
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DF/EV
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structure contained in the lateral compartment (5)
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-peroneus longus
-peroneus breivs -peroneal artery -fibula -peroneal nerve |
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the peroneus longues does __
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PF/EV
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the peroneus brevis does __
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PF/EV
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muscles contained in the posterior deep compartment (5)
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--flexor digitorum .longus
-flexor hallucis longus -tibialis posterior -popliteus -posterior tibial artery |
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the flexor digitorum ongus does __
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PF/toe flexion
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the flexor hallucis longus does __
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PF/great toe flexion
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the tbialis posterior does __
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PF/IV
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the popliteus does __
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knee flexion and flexed leg IR
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what is contained int eh posteiror superficial compartment? (3)
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gastrocnemius
soleus plantaris |
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what makes up the triceps surae?
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gastrocnemius
soleus plantaris |
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the peroneal nerve courses behind the __
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fibular head
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a hard plastic used to treat dropfoot
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ankle foot orthotic (AFO)
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the gastrocnemius does ___
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PF/knee flexion
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the soleus does __
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PF
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what does the plantaris do?
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PF/Knee flexion
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the path of the peroneal nerve courses behind the __
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fibular head
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a hard plastic used to treat dropfoot
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ankle foot orthotic (AFO)
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results in immediate pain, waeakness, and partial loss of motion in the calf. there is a tender/firm mass
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gastrocnemius/calf contusion
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due to direct trauma to the tibia which does not have much subutaneous fat (wear shin gaurds to prevent)
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shin contusio/bruise
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pain down leg to foot. lasts a few seconds, if it worsens, numbness and loss of function occur
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peroneal nerve contusion
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may result from a adirect blow to the lower leg, a fracture, or circulatory oclusion
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compartment syndrom
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the __ compartment is most vulnerable to increases in internal tissue pressure
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anterior
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casued by exploding off a slightly pronated foot or by being kicked from behind near the lateral malleolus
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strains
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caused by vigorous jumbing or excessive endurance running
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achillles tendon strain
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caused by a sudden contraction of the gastroc-soleus complex, pusing off in running or landing form a jump. also can be caused by not stratcing proporly.
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achilles tendon rupture
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caused by a plantarflexed foot being suddenly dorisflexed
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gastrocnemius strain
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casued by tight heel cords, foot malalignment, change in running surfaces, a sudden increase in the workout, or running hills
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achilles tendonopathy
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the peroneal dislocations can be classified into __ different groups
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4
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any pain along the medial border of the tibia usually the distal third, often associated with excessive pronation. other factors are distance, speed, form, stretching, footwear, or surfaces
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medial tibial stress syndrom (MTSS)
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tibial stress fractures are common in __
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running activities
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__ women have a higher incidence rate
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ammenorrheic
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nonunion or stress fracture of steidas process
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traumatic os trigonum
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when teh steidas process separates from the talus
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os trigonum
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blood clot, potentially life threatening
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deep vein thrombosis (DVT)
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deep vein thrombosis can be found by using __
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homans sign
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2 ways of doing vascular assesment for the lower leg
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-posterior tibial artery
-dorsalis pedis artery |
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a test for the achilles tendon
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thomas test
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different stress tests for the leg (4):
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-squeeze test
-tuning fork -tap test -homans sign |
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passively DF the athletes foot with the knee extended. its + if pain
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homans sign
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with walking, one foot is __
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always on the ground
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with running, there is a period of time when __
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neither foot is in the contact with the ground
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higher arch people __
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supinate
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flat arch people __
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pronante
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characterized by ankle PF, subtalar IV and forefoot AD
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supination
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characterized by ankle DF, subtalar EV and forefoot AB
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pronation
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the time interval or sequence of motions occurring between two consecutive initial contacts of teh same foot (heelstrike to heel stike)
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gait cycle
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as the velocity of the cycle __ the cycle length or stide length __
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increases, increases
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jogging is __% of walking cycle and running is __% of the gait cycle
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70, 60
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what 2 parts make up the gait cycle?
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stance phase and swing phase
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with walking, one foot is __
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always on the ground
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with running, there is a period of time when __
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neither foot is in the contact with the ground
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higher arch people __
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supinate
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flat arch people __
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pronante
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characterized by ankle PF, subtalar IV and forefoot AD
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supination
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characterized by ankle DF, subtalar EV and forefoot AB
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pronation
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the time interval or sequence of motions occurring between two consecutive initial contacts of teh same foot (heelstrike to heel stike)
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gait cycle
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as the velocity of the cycle __ the cycle length or stide length __
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increases, increases
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jogging is __% of walking cycle and running is __% of the gait cycle
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70, 60
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what 2 parts make up the gait cycle?
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stance phase and swing phase
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makes up 60-65% of the walking cycle. the foot is on the ground and bearing weight.
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stance phase
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5 subphases of the stance phase:
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-heel strike
-foot flat -midstance -terminal stance -toe off |
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when the foot is in heel strike, its __
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rigid and supinated
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makes up 35-40% of the walking cycle. the foot is not in contact with the ground and is moving forward.
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swing phase
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the swing phase consists of __ subphases
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3
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the 3 subphases of swing phase
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-initial swing
-midswing -terminal swing |
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in the initial swing, the knee is __
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bent
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in teh midswing, the leg is __
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swingning
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the terminal swing is __
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right before the heelstrike
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injuries occur more often in the __ phase due to the hamstrings eccentrically contracting to slow knee extension
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swing
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__ strains happen at terminal swing
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hamstring
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during the swing phase: the hip has __ degrees of extension to __ degress of flexion
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10, 50/55
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during the swing phase: teh knee has __ extension (sprinters) and __ degrees of flexion
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full, 125/40
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during the swing phase: the ankle has __ degrees of plantarflexion to __ degrees of dorsiflexion
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25/20
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sequence of events from a specific point in teh gait on one extemity to the same point in the opposite extremity
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step
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distance traveled between teh initial contacts of the right and left foot
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step legnth
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distance between the points of contact of both feet
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step width
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foot to groiund contact points of teh same foot (two sequential steps). decreases with age and fatigue
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stride length
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side to side movement of the pelvis during walking. it increases if the feet are further apart
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lateral pelvic shift
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hip hike
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vertical pelvic shift
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normally anterior to the 2nd sacral vertebra (belly button) and is higher in men
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center of gravity
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number of steps taken per unit time
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cadence (gait)
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normal cadence is __ steps per minute
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90-120
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women have a __ cadence than men by 10 steps
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faster
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the adult average steps per minute is __
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107+-2.7
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time required to complete a single stride
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stride time
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The distance between your first and last points of contact.
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stride length
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distance covered per unit time
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gait velocity
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contact of the foot with the ground creates force yielding vertical anteroposterior and mediolateral components
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ground reaction force (GRF)
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the characteristics of movement related to time and space (eg range of motion, velocity, and acceleration) the effects of joint action)
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kinematic
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the forces being analyzed; the cases of joint action
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kinetic
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shows the path of the pressure point under the foot during gait
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center of pressure (COP)
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what 3 things make up efficient gait?
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-minimal side to side motion
-maximal forward motion -body rises and falls appox 5 cm |
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differences between running and walking gait cycles (3)
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-flight phase
-no period of double limb support -stance phase time |
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as __ of gait cycle changes, arm swing, stride length, cadence, knee flexion ROM, muscular force, speed of contraction, and less up and down motion change
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speed
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the hip __ during the stance phase and __ during the swing phase
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extends, flexes
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the knee is __ during heel strike, foot flat, and midstnace.
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flexed
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casues less knee flexion and more IR which leads to pronation in stance phase
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patellofemoral pain syndrome
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the foot and ankle should have immediate __ at inintial contact
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PF
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pronation is necessary for __
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shock absorption
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pronation through a range __ has been linked with LE injury
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15.5
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pronation is found in __ during the gait cycle
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midstance or just after push off
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causes tibial rotation and hip rotation
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pronation
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causes stress on lateral soft tissues (peroneus longus)
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toe in
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causes stress on medial and plantar structures
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toe out
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a result of an injury to the plevis, hip, knee, ankle, or foot. the effected leg stance phase is shorter than the other leg (remove weight as quickly as possible). the swing phase on the other leg is decreased as is step lenth
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antalgic (painful) gait
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theis gait results from stiffness, laxity, or deformity (leg length discrepancy). painful or not. the person will lift the entire leg higher than normal to clear the ground
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arthogenic (stiff hip or knee) gait
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if the person was in a cast or brace for a long time. there are several possibilities with this type of gait
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contracture gait
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the contralateral side droops. if bilateral there will be a side-to side- movement
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tredelenbergs gait
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a person with weak or paralyzed dorsiflexors results in drop foot. to compensate, the knee is lifted higher than normal. the foot will slap the ground on contact due to no muscle control
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drop foot gait
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__ counterbalances hips and pelvis
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arm swing
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when running, arms swing is __
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longer
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-absence of initial heel contact
-PF at the ankle is avoided in terminal stance and preswing |
flat foot stance
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there is a fat pad on the knee for __ flexion after that its bone on bone
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20
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normally the knee is near full extension at __ during walking
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contact
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during the swing phase, the knee is normally flexed __ during walking and over __ during running
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30-60, 90
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ways to improve gait: (7)
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-cue words or phrases during gait
-footprints on floor -hand on body segment -orthotics -different shoes -strength training exercises -flexibility or ROM |
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__ is related to genu valgum
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pronation
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pronation causes __
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calcaneal eversion
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calacaneal eversion causes increased pressure on the __
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1rst metatarsal
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causes asymmetrical arm swing (3)
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-UE injury
-leg length discrepancies -spine dysfunction |
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causes of plantarflext ankle at initial contact (4)
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-gastrocnemius spasiticity
-drop foot -hamstring pathology -knee joint pathology |
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causes of flat foot stance (3)
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-ankle sprain
-gastrocnemius strain -soleus strain |
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what causes inadequate ankle plantarflexion angle at pushoff (3)
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-inadequate strength (triceps surae)
-acute ankle sprain -forefoot pathology |
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causes of excessive knee flexion angle at contact (3)
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-pain (hamstring, hip add)
-tight hamstring/spasm -sciatic nerve pathology |
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causes of inadequate knee flexion angle during stance (2)
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-quad pathology
-knee joint pain |
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causes of inadequate knee flexion angle during swing (3)
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-hamsting pathology (stairns, spasms, sciatica
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causes of inadequate hip extension at terminal stance (1)
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-contacture of hip flexors
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what does forward trunk angle indicate? (3)
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-low back pathology
-weak and painful hip flexors -weak ankle plantarflexors |
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what are the purposes of MMT? (5)
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-analyze strength
-analyze muscle tone -give a baseline -evaluate an injury -set up a rehab program |
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when testing for separate or idividual muscle action, sometimes two actions are tested in order to __ a specific muscle
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isolate
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it is important to differentiate between 2 muscles that perform the same __
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action
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when testing 2 muscles, one must be __ and the other one is tested activly
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removed from consideration
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examples of isolation is MMT (2)
|
-hastrings and gluteus maximus (hip extension)
-flex knee first to test for ext. extend hip first to test for flexion |
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when a muscle group attempts to compensate for the lack of function of a weak muscle
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substition
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during MMT, position the athletes in regards to __ and __
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stability and comfort
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assure proper __ by using an exam table, body weight, or the examiner
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proper stabalization
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the examiner places the athlete in the __, or if testing though the whole range the examiner shows the desired __ first
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test position, motion
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always apply resisitance/pressure __ of what is being tested
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opposite
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in MMT always apply pressure __
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gradually
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a factor in testing becuase it is a form of resistance
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gravity
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lifting the body part against gravity (heel raises)
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anti gravity MMT
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working in a plane parallel with the ground (plantar flexion seated on table)
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gravity eliminated MMT
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gravityis used to help assist the movement (wal slides for knee ROM
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gravity assisted MMT
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common errors in MMT (3)
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-not stabalizing
-athlete positioning -incorrect verbal instructions |
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a technique used in the measurement of joint angles, to measure a joints ROM
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goiniometry
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rationale for goiniometry: (3)
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-assess an injury
-checking progress -determines effectiveness of treatment |
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the goniometer consitis of the __ arm and the __ arm
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stationary, moveable
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what stops ROM? (3)
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-bony blocks
-tissue apposition -edema |
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when using the goniometer remember to have the numbers __ you
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facing
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when doing goiniometry, start in the __ position
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anatomical
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maintain at least a __ distance from the body part with the goiniometer
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1 finger
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passive ROM requires __ people
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2
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how well something can be reproduced
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relability
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is the measurement going to be the same between 2 or more separate clinitians
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intertester relability
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deals with the same person doing testing.
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intratester reliability
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the amount of force needed to overcome a body's or body parts present state of rotatory motion
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moment of inertia
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a reflex arc prohibiting the contraction of a specific muslce group
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reflex inhibition
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the crown of an arch that supports the structure on either side of it
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keystone
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a groove or depression within a bone
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sulcus
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the number of cardinal planes in which a joint allows motion
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freedom of movement
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a distinct band of tissue arising form the main portion of a structure
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slip
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the series of bones formed by the metatarsal and phalanges
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ray
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a form of athrisits marked by inflammation and pain in teh distal joints
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gout
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a cancerous tumor that forms in the shaft of long bones or, less frequently, in soft tissue and is most prevalent in children and teenagers
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ewigs sarcoma
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soft and fluid soacked
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macerated
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an oen sore or lesion of the skin or mucous membrane that is accompnied by inflamed and necrotic tissue
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ulceration
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small purplish hemorrhagic spots on the skin
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petechiae
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swirl markings in the skin. fingerpriints are images formed by these
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whorls
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a force that attempts to move a joint beyond its normal ROM
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overpressure
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the noninflammatory degeneration of the fascia
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fasciosis
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a lowering of teh medial foot caused by spasm of the peroneus longus muscle
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peroneal spastic flatfoot
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abnormal movement along the length of a bone caused by a fracture or incomplete fusion
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false joint
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decreased bone density, but less severe than osteoporosis
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osteopenia
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surgical jiont fusion
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arthrodesis
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immobility of a jiont
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ankylosis
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the closed packed position of the ankle is full __
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DF
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a relatively immobile joint in which two bones are bound together by ligaments
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syndesmosis joint
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the union of two bones though the formation of connective tissue
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synostosis
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pain caused by inadequate venous drainage or poor arterial innervation
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claudication
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__ decreses as velocity increases
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stride width
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Distance of feet when side to side.
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stride width
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Walking stride length is (usually) __ than a running stride length.
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shorter
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composed of two steps (stepping forward with one foot and then stepping forward with the other foot).
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stride
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muscles responsible for dorsiflexion (4)
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-ext. digitorum longus
-ext. hallucis longus -peroneus tertius -tibialis anterior |
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muscles responsible for inversion (5)
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-ext. hallucis longus
-flexor digitorum longus -flexor hallucis longsu -tibialis anterior -tibialis posterior |
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muscle responsible for plantarflexion (8)
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-flexor digitorum longus
-flexor hallucis longus -gastrocnemius -peroneus brevis -peroneus longus -plantaris -soleus -tibialis posterior |
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muscles responsible for eversion (4)
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-extensor digitorum longus
-peroneus brevis -peroneus longus -peroneus tertius |
