Kinesiology Exam 4 DTQs

Which muscles attach to the talus?

None

Pronation at Talocrural joint consists of what (emphasis on dorsiflexion)

pronation = dorsiflexion, abduction, eversion (Pro DABE)

Supination at Talocrural joint consists of what (emphasis on plantarflexion)

supination = plantarflexion, adduction, inversion (Super PADDI)

Deltoid ligament taut with what

eversion, anterior ligaments taut with plantarflexion (tibionavicular), posterior ligaments taut with dorsiflexion (tibiotalar)

AOR of talocrural plantar/dorsiflexion

from malleolus to malleolus (oblique)

Pt broke their ankle and is casted in 0 degrees of dorsiflexion, what tissues will be shortened?

anterior joint capsule, anterior talofibular ligament, tibionavicular ligament

What stops dorsiflexion at talocrural joint

wide anterior talus creates a wedge

Closed pack position of talocrural joint

dorsiflexion

Talocrural position during gait cycle

Heel contact -> plantarflex for foot flat -> dorsiflex for stance phase -> plantarflex for push off -> dorsiflex for foot clearance during swing phase

What ligaments stabilize the subtalar joint

any ligaments that go down to the calcaneus (tibiocalcaneal, calcaneofibular, interosseous, cervical)

DTQ: 4 ligaments of subtalar joint and what motion they limit

calcaneofibular = inversion, tibiocalcaneal = eversion, interosseous & cervical = limits extremes of all motions (especially inversion)

DTQ: AOR of subtalar joint

posterior lateral calcaneus and travels medial, superior, and anterior

Non weight bearing (NWB) vs Weight bearing (WB) motion on subtalar joint

NWB = calcaneus swings into pronation/supination ; WB = calcaneus will move and drag talus + rest of leg with it (why we can have knee valgus with pronated subtalar)

If you pronate or supinate the subtalar joint while weight bearing, what happens to the shank

pronate = shank IR ; supinate = shank ER

motions at subtalar joint

pronation = eversion + abduction, supination = inversion + adduction (no dorsi/plantarflexion)

TT joint mobility lateral vs medial

lateral side is more rigid (calcaneocuboid = flat), medial side is more mobile (talonavicular = concave navicular on convex talus)

motions at TT joint

pronation = eversion + abduction + dorsiflexion, supination = inversion + adduction + plantarflexion

to keep foot flat on floor, how does the TT joint need to interact with the subtalar joint

should do opposite motion, so pronated subtalar needs supinated TT

AOR of TT joint (longitudinal, oblique we don't worry abt)

from lateral heel and travels medial and superior and anterior (same as subtalar but a lil less superior)

pronated subtalar vs supinated subtalar creates for what type of foot

pronated = pliable foot (loose packed), supinated = stable foot (closed packed)

what stabilizes the longitudinal arch of the foot?

plantar fascia and intrinsics, want them to be toned to support arch at rest, also windlass mechanism

Subtalar position during gait cycle

supinated during heel contact (stable) -> pronated for stance (pliable for shock absorption) -> supinated for push off (stable)

DTQ: why does the subtalar joint pronate during early in the gait cycle (initial stance)

bc GRF (ground reaction force) tells it to and bc the shank IRs

DTQ: what position would you want to be in to fully inspect the bottom of your foot (@ hip, knee, subtalar, TT)

Hip = flexion + ER, Knee = flexion, Subtalar = supinated, TT = supinated

which metatarsals have the most mobility

1st, 4th, and 5th ; 2 & 3 are most stable

if you supinate your subtalar joint, and then pronate your TT joint to keep your foot flat, what movement happens at the 1st metatarsal

plantarflexion and eversion (keeps big toe on ground)

movement at 1st metatarsal with a pronated subtalar and supinated TT joint

dorsiflexion and inversion

windlass mechanism

extension of big toe tightens up the plantar fascia which provides stability to the longitudinal arch

hallux valgus is caused by what muscles

tibialis posterior pulls it medially, fibularis longus pulls it laterally so a weak one could create bunion

3 compartments of shank and their associated nerves

anterior = deep fibular, lateral = superficial fibular, posterior = tibial

muscles of the anterior compartment

tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius

muscles of the lateral compartment

fibularis longus, fibularis brevis

muscles of the posterior compartment

gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus

DTQ: what muscle is a complete antagonist to anterior tibialis

fibularis longus + brevis bc they plantarflex and evert

dorsiflexor muscles action during gait cycle

eccentric during foot flat (slows plantarflexion), concentric during swing phase for toes to not drag

fibularis longus + brevis actions during push off

plantarflexes talocrural, counteracts inversion forces of other plantar flexors, holds 1st met head on ground (by helping TT joint pronate)

what goes through the tarsal tunnel

flexor digitorum longus, tibialis longus (NOT flexor hallucis)

DTQ: compare and contrast actions of tib anterior and tib posterior

antagonists at talocrural joint (posterior = plantarflex, anterior = dorsiflex), agonists at subtalar joint (both invert)

plantar flexors action during the gait cycle

eccentric stance phase to slow down dorsiflexion, concentric for pushoff

can the soleus act on the knee

kinda, it can extend the knee if the foot is fixed via plantarflexion

what is dropfoot

paralysis of deep fibular nerve, no dorsiflexion

what is pes varus deformity

paralysis of superficial fibular nerve, no eversion with plantarflexion, going to bear weight on 5th met

what is pes equinovarus deformity

paralysis of common fibular nerve, lost everything except plantarflexion + inversion

what is pes calcaneo-valgus deformity

paralysis of tibial nerve, no plantarflexion + inversion, may walk with knees bent bc stuck in dorsiflexion

what happens when the intrinsic foot muscles activate

they raise the arch and stiffen the foot

what happens if the intrinsic foot muscles don't activate

if not puts too much pressure on plantar fascia and posterior tib (shin splints/plantar fascitis)

when are the intrinsics active during the gait cycle

during late stance phase for push off so the foot is stiff

Step vs stride

Step is from R foot to L foot, stride is from R heel strike to next R heel strike

What can decrease step length

tight hip flexor, leg length discrepancy, poor balance, pain

what percent of the gait cycle is stance and what percent is swing

60% stance, 40% swing

@ midstance on R foot, where is your center of mass?

high and to the right

How many degrees of HIP flexion and extension do you need for normal gait

hip flexion = 30 degrees, hip extension = 15 degrees (most often limited)

How many degrees of KNEE flexion and extension do you need for normal gait

knee flexion = 60 degrees, knee extension = full extension (most often limited)

How many degrees of ANKLE dorsiflexion and plantarflexion do you need for normal gait

dorsiflexion = 10 degrees (most often limited), plantarflexion = 20 degrees

If 0% of gait cycle is R heel strike, what is 50% and what is 100%

50% = L heel strike, 100% = 2nd R heel strike