Anatomical Kinesiology - EXAM 2

What are the functions of the Foot and Ankle Complex?

Provides a stable base of support for the body in different weight

How is the Foot and Ankle Complex structurally described?

A highly complex system of joints

What are the three functional segments of the foot?

Hindfoot (Talus and Calcaneus); Midfoot (Navicular, Cuboid, and Cuneiforms); Forefoot (Metatarsals and Phalanges)

What bones make up the Foot and Ankle Complex?

Tibia, Fibula, Tarsals, Metatarsals, Phalanges

What are the characteristics of the tibia?

Larger bone (shin bone); medial of the two lower leg bones; primary weight

What are the characteristics of the fibula?

Slender bone; smaller than tibia; minimal role in weight

What joints make up the Foot and Ankle Complex?

Proximal tibiofibular joint; distal tibiofibular joint; talocrural joint; subtalar joint; transverse tarsal joint; intertarsal joints; tarsometatarsal joints; metatarsophalangeal joints; phalangeal joints

What type of joint is the proximal tibiofibular joint?

Synovial plane joint

What type of joint is the distal tibiofibular joint?

Fibrous syndesmosis joint

How many degrees of freedom do the tibiofibular joints have?

Zero degrees of freedom (movement allows slight change in mortise width)

What ligaments stabilize the tibiofibular mortise?

Anterior tibiofibular ligament; posterior tibiofibular ligament; inferior tibiofibular ligament; tibiofibular interosseous membrane

What is the talocrural joint?

The ankle joint formed by the tibia, fibula, and talus

What type of joint is the talocrural joint?

Synovial hinge joint

How many degrees of freedom does the talocrural joint have?

One degree of freedom

What movements occur at the talocrural joint?

Dorsiflexion and plantarflexion

Why is the talocrural joint considered highly stable?

It is the most congruent joint in the human body due to the mortise formed by the distal tibia and fibula around the talus What is the subtalar joint also called?

What type of joint is the subtalar joint?

Synovial plane joint

What bones articulate at the subtalar joint?

Talus and calcaneus

How many degrees of freedom does the subtalar joint have?

One degree of freedom

What movement occurs at the subtalar joint?

Inversion and eversion

What is another name for the transverse tarsal joint?

Midtarsal joint

What joints make up the transverse tarsal joint?

Talonavicular joint and calcaneocuboid joint

What type of joints are the talonavicular and calcaneocuboid joints?

Saddle joints that function together

What is the function of the transverse tarsal joint?

Assists inversion and eversion of the subtalar joint

What are the intertarsal joints?

Talocalcaneonavicular; calcaneocuboid; cuneonavicular; cuboidonavicular; intercuneiform joints

What type of joint are the tarsometatarsal joints?

Plane synovial joints

What articulates at the tarsometatarsal joints?

Tarsal bones with the metatarsals

What is the function of the tarsometatarsal joints?

Connect the midfoot to the forefoot; support the arches; transfer weight

How many metatarsophalangeal (MTP) joints are there?

Five

How are the MTP joints numbered?

Starting at the great toe (big toe) as number one

What is the function of the MTP joints?

Facilitate toe extension during walking; contribute to balance and stability on different surfaces

What are the phalangeal joints?

Proximal interphalangeal (PIP) joints and distal interphalangeal (DIP) joints

What movements occur at the phalangeal joints?

Flexion and extension of the toes

How is naming different in the great toe?

The great toe has only one interphalangeal (IP) joint

What are the three arches of the foot?

Medial longitudinal arch; lateral longitudinal arch; transverse arch

How are the arches of the foot maintained?

Shape of the tarsal and metatarsal bones; ligaments; intrinsic and extrinsic muscles

How are feet classified based on arch height?

Normal arch; high arch (pes cavus); low arch (pes planus)

What is pes cavus?

A high

What causes pes cavus?

Congenital deformity or neurological disorder

What are symptoms of pes cavus?

General foot pain; rigid tarsal motion; callus formation due to faulty weight distribution

What is pes planus?

A flat foot with low medial longitudinal arch

What causes pes planus?

Weak supportive tissues; obesity; postural abnormalities

What are symptoms of pes planus?

Tired and tender feeling in the arch and heel

What are the functions of the plantar arches?

Load absorption; adapt to changes in support surface; distribute weight; shock absorption

What is calcaneovalgus?

Eversion of the calcaneus

What is calcaneovarus?

Inversion of the calcaneus

What are the three types of ankle sprains?

Lateral ankle sprains; medial ankle sprains; high (syndesmotic) ankle sprains

What is the most common type of ankle sprain?

Lateral ankle sprain

Approximately how many lateral ankle sprains occur annually in the U.S.?

About 2 million

What is the mechanism of a lateral ankle sprain?

Combination of plantarflexion and inversion

Why are lateral ankle sprains most common?

The lateral ligaments are weaker and the lateral malleolus is longer, making inversion injuries more likely

What is another name for a high ankle sprain?

Syndesmotic ankle sprain

What is the mechanism of a high ankle sprain?

Forced dorsiflexion

What structures are injured in a high ankle sprain?

Anterior tibiofibular ligament and/or interosseous membrane

Why are high ankle sprains difficult to treat?

They involve the syndesmosis and are slow to heal

Why are medial ankle sprains uncommon?

Due to the strong deltoid ligament and structural stability of the ankle

Why are medial ankle sprains more serious?

Higher risk of associated injuries such as fractures and more complex healing process What muscles are in the anterior compartment of the leg?

What nerve and blood supply serve the anterior compartment?

Deep peroneal nerve; anterior tibial artery and vein

What is anterior compartment syndrome?

Increased pressure within the anterior compartment

What causes anterior compartment syndrome?

Direct blow to the anterolateral tibia; prolonged activity

What are symptoms of anterior compartment syndrome?

Pain; pressure; paresthesia; pallor; passive stretch pain

What muscles are in the lateral compartment of the leg?

Peroneus (fibularis) longus; Peroneus (fibularis) brevis

What nerve and blood supply serve the lateral compartment?

Peroneal nerve; peroneal artery and vein

What muscles are in the superficial posterior compartment?

Gastrocnemius; Soleus; Plantaris

What muscles are in the deep posterior compartment?

Tibialis posterior; Flexor hallucis longus; Flexor digitorum longus

What nerve and blood supply serve the posterior compartment?

Tibial nerve; posterior tibial artery and vein

What are the origins, insertion, and innervation of the gastrocnemius?

Medial head originates from posterior medial femoral condyle; lateral head from posterior lateral femoral condyle; inserts on posterior calcaneus via Achilles tendon; innervated by tibial nerve (S1, S2)

What are the origin, insertion, and innervation of the soleus?

Originates from posterior fibula and tibia; inserts on posterior calcaneus via Achilles tendon; innervated by tibial nerve (S1, S2)

What are the origin, insertion, and innervation of the plantaris?

Originates from lateral supracondylar line of femur and oblique popliteal ligament; inserts on calcaneus via Achilles tendon; innervated by tibial nerve (S1, S2)

What are the origin, insertion, and innervation of tibialis anterior?

Originates from upper 2/3 lateral tibia; inserts on medial cuneiform and base of 1st metatarsal; innervated by deep peroneal nerve (L4, L5, S1)

What are the origin, insertion, and innervation of tibialis posterior?

Originates from posterior interosseous membrane and posterior tibia and fibula; inserts on navicular, cuneiforms, and bases of 2nd–5th metatarsals; innervated by tibial nerve (L5, S1)

What are the origin, insertion, and innervation of peroneus longus?

Originates from head and upper 2/3 lateral fibula; inserts under 1st cuneiform and 1st metatarsal; innervated by superficial peroneal nerve (L4, L5, S1)

What are the origin, insertion, and innervation of peroneus brevis?

Originates from lower 2/3 lateral fibula; inserts on tuberosity of 5th metatarsal; innervated by superficial peroneal nerve (L4, L5, S1)

What are the origin, insertion, and innervation of peroneus tertius?

Originates from distal 1/3 anterior fibula; inserts on base of 5th metatarsal; innervated by deep peroneal nerve (L4, L5, S1)

What are the origin, insertion, and innervation of flexor digitorum longus?

Originates from middle 1/3 posterior tibia; inserts on distal phalanges of toes 2–5; innervated by tibial nerve (L5, S1)

What are the origin, insertion, and innervation of flexor hallucis longus?

Originates from middle 2/3 posterior fibula; inserts on distal phalanx of great toe; innervated by tibial nerve (L5, S1)

What are the origin, insertion, and innervation of extensor digitorum longus?

Originates from lateral tibial condyle and upper anterior fibula; inserts on middle and distal phalanges of toes 2–5; innervated by deep peroneal nerve (L4, L5, S1)

What are the origin, insertion, and innervation of extensor hallucis longus?

Originates from middle anterior fibula; inserts on distal phalanx of great toe; innervated by deep peroneal nerve (L4, L5, S1)

What are the steps in analyzing cross sectional anatomy of the leg?

Slice taken at joint center; divide into 4 quadrants; assign muscle groups to quadrants; position muscles; determine muscle

What is tendinopathy?

Any condition affecting a tendon

What is Achilles tendinitis?

Acute inflammatory condition with swelling and inflammation of the Achilles tendon

What causes Achilles tendinitis?

Overuse (especially distance runners); acute trauma

What are symptoms of Achilles tendinitis?

Swelling along tendon; stiffness with dorsiflexion

What is Achilles tendinosis?

Chronic non

What are symptoms of Achilles tendinosis?

Microtearing; localized pain at tendon insertion

What causes an Achilles tendon rupture?

Hyperdorsiflexion or sudden forceful calf contraction

What are symptoms of Achilles tendon rupture?

Sudden sharp pain; swelling; bruising; difficulty walking

What is retrocalcaneal bursitis also called?

Pump bump bursitis

What causes retrocalcaneal bursitis?

Repeated pressure and rubbing from tight shoes

What is hallux valgus?

Medial splay of 1st metatarsal with lateral deviation of great toe

What causes hallux valgus?

Poorly fitted shoes; chronic irritation and pressure

What is a common result of hallux valgus?

Bunion formation

What causes bunions?

Chronic irritation and pressure from poorly fitted shoes; structural anomalies

What is plantar fasciitis?

Inflammatory reaction at insertion of plantar fascia into calcaneus

What causes plantar fasciitis?

Windlass mechanism (forced dorsiflexion with toe extension); activity changes

What is sesamoiditis caused by?

Repetitive hyperextension of the great toe

What is turf toe?

Hyperextension injury of the great toe causing sprain of the MTP joint

What are Lisfranc injuries?

Fractures, dislocations, or sprains of the tarsometatarsal joints

What causes Lisfranc injuries?

Hyperplantarflexion of forefoot; high or low energy trauma

What are symptoms of Lisfranc injuries?

Pain; inability to bear weight; swelling on dorsal aspect of foot