Kines 202 Exam 2

Label the bones of the feet

A. Talus

B. Calcaneus

C.Cuboid

D. Navicular

E.Lateral cuneiform

F. Intermediate cuneiform

G. Medial cuneiform

H. Metatarsals (1-5)

I. Proximal Phalange (1-5)

J. Middle Phalange (2-5)

K. Distal Phalange (1-5)

Label the parts of each of these short bones

Base= proximal

Head=distal

Middle= Shaft

True or False all 14 phalanges have a base, shaft, and head?

True; all 14 phalanges have a base, head, and shaft

What 2 sesamoid bones are in the foot?

2 sesamoid bones are found under the tendon of the flexor hallucis brevis, used to disperse motion for running

What is the purpose of the arch of the foot?

for shock absorption

What 3 arches do we have in our foot?

medial longitudinal arch-determines foot type

lateral longitudinal arch

transverse arch

What are the 3 different types of arches that are determined by the medial longitudinal arch?

Pes rectus- normal arch

Pes cavus- high arch

Pes planus- flat arch

Label these joints A-F

A. Metatarsophalangeal joint

B. Proximal Interphalangeal Joint

C. Distal Interphalangeal Joint

D. Interphalangeal Joint

E. Tarsometatarsal Joint

F. Intermetatarsal Joint

Label the two joints A and B, and what movements they do.

A. Talocrural Joint, Plantar Flexion and Dorsiflexion

B. Subtalar Joint, Ankle Eversion and Inversion

What is the function of the subtalar joint?

tri-planar motion- supination, pronation

Label the ligaments from A-D

A. Anterior Tibiofibular Ligament

B. Anterior Talofibular Ligament

C. Calcaneofibular Ligament

D. Posterior Tibiofibular Ligament

Label each ligament from A-D

A. Plantar Calcaneonavicular (Spring) Ligament (makes up arch)

B.Tibiocalcaneal Ligament

C. Posterior Tibiotalar Ligament

D. Anterior Tibiotalar Ligament

E. Tibionavicular Ligament

What ligament is on the bottom of the foot?

Long Plantar ligament, from the Calcaneus to the 2nd-5th Metatarsals

What other 3 ligaments make up the plantar fascia?

helps maintain longitudinal arch, includes medial band, central band, and lateral band

What is the difference between intrinsic and extrinsic muscles of the foot?

intrinsic= bone origin and insertion are in the foot

extrinsic= bone origin is out of the foot and insertion is in the foot

What are the plantar layers and muscles are included in them?

1st Layer- flexor digitorum brevis, abductor hallucis, abductor digiti minimi

2nd Layer- lumbricals and quadratus plantae

3rd LAYER- flexor hallucis brevis, adductor hallucis (2), flexor digiti minimi brevis

4th Layer- plantar interossei, and dorsal interossei

What muscle, layer, action and innervation is this?

muscle= flexor digitorum brevis

layer= 1st layer

action= flexes digits

innervation=medial plantar nerve

What muscle, layer, action and innervation is this?

muscle= abductor hallucis

layer= 1st layer

action= abducts 1st digit

innervation= medial plantar nerve

What muscle, layer, action and innervation is this?

muscle= abductor digiti minimi

layer= 1st layer

action= abducts and flexes the 5th metatarsal

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= quadratus plantae

layer= 2nd layer

action= assists in flexor digitorum longus, flexes digits

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= lumbricals

layer= 2nd layer

action= flexes and extends digits 2-5 b/c they attach extrinsically and inserts in foot

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= flexor hallucis brevis

layer= 3rd layer

action= flexes 1st digit

innervation= medial plantar nerve

What muscle, layer, action and innervation is this?

muscle= adductor hallucis (oblique head)

layer= 3rd layer

action= adducts the metatarsophalangeal joint of great toe

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscles= adductor hallucis (transverse head)

layer= 3rd layer

action= adducts metatarsophalangeal joint of great toe

innervation=lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= flexor digiti brevis

layer= 3rd layer

action= flexes 5th phalange

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= plantar interossei (3)

layer= 4th layer

action= adducts and flexes 3rd, 4th, and 5th toe

innervation= lateral plantar nerve

What muscle, layer, action and innervation is this?

muscle= dorsal interossei (D.A.B)

layer= 4th layer

action= abduction of 2nd, 3rd, and 4th toes

innervation= lateral plantar nerve

What muscles are dorsal intrinsic muscles?

1. extensor digitorum brevis

2. extensor hallucis brevis

What muscle, action and innervation is this?

muscle= extensor digitorum brevis

action= helps extensor digitorum longus, extends toes 2-4

innervation= deep peroneal nerve

What muscle, layer, action and innervation is this?

muscle= extensor hallucis brevis

action= helps extensor hallucis longus, extends great toe

innervation= deep peroneal nerve

What two vascular arteries supply the foot?

1. Anterior tibial artery

2. Posterior tibial artery

Label the menisci and ligaments

A.Medial Menisci

B.Lateral Menisci

C.Infrapatellar tendon

D. Anterior Cruciate Ligament

Label this ligament

A. Posterior Cruciate Ligament

Label this ligament

A. Medial Collateral Ligament

Label this Ligament

A. Lateral Collateral Ligament

What type of joint in the tibiofibular joint?

amphiarthrodial (syndesmosis)

What is membrane is in between the Tibia and Fibula

Interosseous Membrane

Action of Subtalar Joint

eversion and inversion on the frontal plane

Action of Talocrural Joint

plantar flexion and dorsiflexion on the sagittal plane

Action of Tibiofibular Joint

Gliding

Difference between Open and Closed Kinetic Chain

Open Kinetic Chain= both feet off the ground/ in the air

Close Kinestic Chain= some [art of the foot is on the floor, usually leads to sprains

CKC Pronation joints

Subtalar: eversion

Forefront: abduction

Talocrural: plantar flexion

OKC Supination joints

Subtalar: inversion

Forefront: adduction

Talocrural: dorsiflexion

What muscles in the anterior compartment of the lower leg, what nerve innervates them, and what action do they all have in common?

Muscles- Anterior Tibialis, Extensor Digitorum Longus, Extensor Hallucis Longus, and Peroneus Tertius

Nerve- deep peroneal

Action-dorsiflexion

Label this muscle from A-C

A. Tibialis Anterior

B. Extensor Hallucis Longus

C. Extensor Digitorum Longus

Label this muscle

Peroneus Tertius

What kind of joint is the proximal and distal Tibiofibular Joint?

Amphiatrhrodial-syndesmosis

OIF of Anterior Tibialis

O: Lateral Tibial condyle

I: Medial Cuneiform and 1st Metatarsal

F:Dorsiflexion

OIF of Extensor Digitorum Longus and innervation

O: Lateral Tibia and head of Fibula

I: Dorsal (bottom side) of 2-5 Phalanges

F: Dorsiflexion of 4 digits

innervation: deep peroneal nerve

OIF of Extensor Hallucis Longus and innervation

O: Anterior surface of Fibula

I: Dorsal side (bottom side) of 1st Phalange

F: Dorsiflexion of big toes (1st metatarsal)

innervation: deep peroneal nerve

OIF of Peroneus Tertius

O: distal third of fibula

I: base of 5th metatarsal

F: small contribution to ankle dorsiflexion

What muscles are in the deep posterior compartment?

Muscles: Tibialis Posterior_,Flexor Digitorum Longus, Flexor Hallucis Longus

Nerve: Tibial Nerve

Action: Plantar Flexion

Label the muscles from A-D

A. Popliteus

B. Tibialis Posterior

C. Flexor Digitorum Longus

D. Flexor Hallucis Longus

OIF of Posterior Tibialis

O: Posterior Surface of Upper Intake interosseous membrane

I: Lower surface of navicular and cuneiform

F: Plantar Flexion

OIF of Flexor Digitorum Longus and innervation

O: Middle 1/3rd of Posterior Tibia

I:Base of distal phalanges

F: 4 digit plantar flexion

innervated- tibial nerve

OIF of Flexor Hallucis Longus

O: Posterior Fibula

I: Base of the distal phalanx of the big toe

F: plantar flexion of big toe

3 types of ankle sprains and which one is the most likely to be injured?

1. Medial Sprain; MOI- ankle rolls with eversion, damage to medial ligaments

2. Lateral Sprain: MOI- #1 musculoskeletal injury ankle rolls with inversion, damage to the lateral ligaments

3. High ankle sprains: MOI- external or dorsiflexion with rotation with damage to tibiofibular joint

What is the medical term for “shin splints”? What is the MOI and predisposing factors that can lead to shin splints?

Medical term is Medial Tibial Stress Syndrome, due to any muscles attached to Tibia pulling on periosteum from Tibia, is a precursor of tibial stress fractures

MOI: repetitive stress like running and jumping

Predisposing factors: overtraining, flat feet, poor footwear

What is compartment syndrome? MOI for acute and chronic? The 6 P’s

The pressure that can build up in a muscle compartment

MOI: acute: trauma, crush injuries, severe swelling chronic: repetitive exercise

Treatment: Fasciotomy

Most common in order is Anterior, Lateral, Posterior, but never Superficial Posterior

6 P’s

1. Pain

2. Pressure

3. Pallor

4. Pulse

5. Paresthesia

6. Passive ROM

What is Tarsal tunnel syndrome? How can we treat it and what muscles are affected?

compression of tibial nerve within tarsal tunnel

muscles: gastrocnemius, tibialis posterior, flexor hallucis longus, flexor digitorum longus, and soleus

treatment: rest, ice, anti-inflammatory meds

What is “turf toe”? MOI?

a sprain on the 1st phalange (big toe) from pushing of ground/turf

MOI: hyperextension of big toe

What is “hallux valgus”? MOI?

a deformity where big toe deviates medially than the other phalanges

MOI: genetics, tight shoes, overuse

What is a bunion? MOI?

Excess bony enlargement of the base of big toe

MOI: chronic pressure from tight shoes, genetics

more common in women and passed down by women

What is plantar fasciitis? Symptoms and signs?

inflammation of the plantar fascia

symptoms and signs- heel pain, pain in first steps, tenderness under foot

What is bursitis? List the kinds of bursa happen in the lower leg and ankle?

inflammation in a bursa

1. Achilles Tendon

2. Posterior Tibial Tendonitis

3. Peroneal Tendonitis

4. Plantar Fasciitis

5. Sesamoiditis

6. Bursitis

What is tendonitis? Which tendons would be involved in each compartment?

inflammation in tendons

Anterior Compartment- AT, EDLT, EHLT, Peroneus tertius

Deep Posterior Compartment- PT, FDLT, FHLT

Superficial Posterior Compartment- Gastrocnemius, Soleus

Lateral- Peroneus longus and brevis

OIF of Gastrocnemius and innervation

O: just above superior to the medial and lateral condyles of femur

I: Calcaneal tuberosity via Achilles Tendon

F: two joint muscle, knee flexion and plantar flexion

Innervation: Tibial nerve

OIF of Soleus and innervation

O: proximal tibia and fibular head

I: inserts into calcaneal tuberosity via Achilles Tendon

F: plantar flexion

Nerve: Tibial nerve

OIF of Plantaris and innervation

O: superior lateral condyle of femur

I: calcaneal tuberosity via Achilles Tendon

F: weak plantar flexion

Nerve: Tibial nerve

OIF of Popliteus and innervation

O: lateral surface of femoral condyle

I: posterior proximal surface of tibia

F: knee flexion; screw-home method

Nerve: Tibial nerve

OIF of Peroneus Longus and innervation

O: proximal fibular shaft/head

I: plantar aspect of 1st metatarsal

F: ankle eversion

Nerve: superficial peroneal nerve

OIF of Peroneus Brevis and innervation

O: Distal fibular shaft

I: plantar aspect of 5th metatarsal

F: ankle eversion

Nerve: Superficial peroneal nerve

Label these muscles

A. Peroneus Longus

B. Peroneus Brevis

Label this muscle

Peroneus tertius

Label this muscle

Plantaris

Label these muscles

A. Medial head of gastrocnemius

B. Lateral head of gastrocnemius

C. Achilles Tendon

Label this muscle

Soleus

What is Retinaculum, Synovial Sheaths, and Bursa?

Medial and Lateral Retinacula- connective tissue that are non-contractile used to hold tendons in place

Synovial Sheaths-reduce friction and allow smooth movements of tendons

Bursa- fluid filled sacs to reduce friction of tissues

Label these retinaculum? medial or lateral?

Lateral Retinaculums:

A. Inferior Peroneal Retinaculum

B. Superior Peroneal Retinaculum

C. Inferior Extensor Retinaculum

D. Superior Extensor Retinaculum

Label these retinaculum? medial or lateral?

Medial Retinaculum:

A. Flexor Retinaculum

B Inferior Extensor Retinaculum

C. Superior Extensor Retinaculum

Label the bursa, medial or lateral?

Lateral Bursa

A. subcutaneous calcaneal bursa

B. subtendinous calcaneal bursa

C. lateral malleolus and subcutaneous bursa

Label this bursa, medial or lateral?

Medial bursa

A. medial malleolus and subcutaneous bursa

What is the flow of vascular supply for the lower leg started at the iliac hip?

1. Iliac Artery

2. Femoral Artery

3. Popliteal Artery

4. Anterior Tibial Artery-splits into 4 anterior and dorsal arteries in foot

5. Posterior Tibial Artery-splits into 2 posterior arteries, caudal, in foot

6. Peroneal Artery

7. Medial and Lateral Plantar Artery

After the Anterior Artery is split off from the Popliteal Artery what 4 main arteries does it goe into?

On the dorsal side of the foot it goes into

1. Dorsi pedis artery

2. Lateral Tarsal Artery

3. Dorsal metatarsal artery

4. Digital artery

After the Posterior Artery is split off from the Popliteal Artery what 2 main arteries does it goe into?

On the caudal side of the foot

1. medial plantar artery

2. lateral plantar artery

What 3 joints are important in the knee? What type of joint is the knee joint?

1. Patellofemoral joint

2. Proximal Tibiofibular joint

3. Tibiofemoral joint

Biaxial diarthrodial joint for flexion and extension and internal and external rotation

What kinds of bone is the Patella?

Sesamoid bone and increases moment arm (leverage) of knee extension

What is the screw-home method?

The popliteus muscle origin is lateral femoral condyle to insert into medial posterior side of Tibia that helps lock the knee for extension and flexion stability

Label this bone

Patella bone

1. Base

2. Lateral Facet

3. Medial Facet

4. Apex of Patella

What is the terrible triad?

a sprain ACL, MCL, and medial meniscus tear all at the same time

Where are most injuries to menisci in the knee if they tear?

On the Posterior horns because the hamstrings and popliteus are attached posteriorly

OIF of MCL (medial collateral ligament)

O: Medial condyle of Femur

I: Medial condyle of Tibia

F: prevents valgus deformity

OIF of LCL (lateral collateral ligament)

O: Lateral condyle of Femur

I: Lateral head of Fibula

F: prevents varus deformity

What are static restraints of the Patellofemoral joint

Static restraint provides joint stability without actively contracting

1. Medial Retinaculum

2. Lateral Retinaculum

3. Patellotibial Ligaments

4. Patellofemoral Ligaments

5. Iliotibial Tract (easy to tear)

What are dynamic restraints of the Patellofemoral Joint

muscular structures that help stabilize joints through active contraction

1. Vastus Lateralis

2. Vastus Medialis

3. Vastus Intermedius

4. Rectus Femoris

5. Tensor Vastus Intermedius

6. Suprapatellar tendon

7. Infrapatellar tendon

What type of joint is the proximal Anterior and Posterior Tibiofibular joint and Interosseous membrane?

Both anterior and posterior proximal tibfib joints are diarthrodial more specifically synovial

The interosseous membrane is syndesmosis

Label the Femur

inside head of Femur is Fovea Capitis

A.Head of Femur

B. Greater Trochanter

C. Medial Condyle (above is epicondyle)

D. Lateral Condyle ( above is epicondyle)

E. (Not labeled) lesser Trochanter

Label A

A. Linea Aspera

Label the quad muscles

A. Vastus Intermedius ( Rectus Femoris taken out)

B. Vastus Medialis

C. Vastus Lateralis

Label this muscle

Gracilis