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Kin test 3
Kin test 3
50
Science
Professional
03/31/2012

Additional Science Flashcards

 


 

Cards

Term

the hindfoot is made of what bones?

 

Definition
talus and calcaneus
Term
the bones of the midfoot are?
Definition
navicular, cuneiforms(3) and cuboid
Term
the bones of the forefoot?
Definition
metatarsals and tarsals
Term
what are the general functions and characteristics of the FOOT?
Definition

provide stability- act as a platform, and a lever for movement. also a B.O.S.

 

Provide mobility- accounts for torsion of proximal segments (share load with knee, even in close chain)... also acommodate for uneven surfaces.

Term
General functions and characteristics of the talocrural joint (Ankle)?  in means of motion...
Definition
Primary motion- plantar and dorsal flexion
Term
how much congruency is ther in the talocrural joint (ankle)?
Definition
Most congruency of any joint in the entire body...
Term
what is the close packed position of the talocural joint?
Definition
dorsiflexion is the closed packed position.
Term
is osteoarthritis prevelant in the talocrural joint?
Definition
the talocrual is not prone to osteoarthritis... almost restistant and is able to handle 4 to 5x the BW of an individual before issues...
Term
proximal segment- proximal tibiofibular joint
Definition

is a classic synovial joint- (capsule, synovial, articular cartilage...)

 

allows for superior/ inferior glide

 

also allows some rotation of the fibula with respect to the tibia

 

has anterior and posterior ligmanets that are part of the capsule

Term
Tibiofibular interosseus membrane
Definition

binds the two muscles together and provides attachment for muscles...

 

has 2 layers to displace the forces, but the majority of the forces are not run into the fibula and back into to the tibia

 

stabolizes the distal T/Fib joint...

Term

distal tibiofibular joint.

 

function?

type of joint?

motions?

Bony landmarks?

Definition

it stabolizes the crura...

 

allows little to no motion because of all the CT. (anterior, posterior, and interossei ligaments)

 

it is a synarthrosis joint (fibrosis tissue, no synovial cavity)

 

go to lateral malleolus, go proximal, then go medial to find

 

to increase ROM focus on the proximal tibular/ fibular ligament.

Term
stuff about the distal tibia
Definition

it is flattened bow shapped (plafond)- plafond means shelf and is seen on the AP x-ray

 

bony landmark is the medial malleolus (at the same level as the junction of talus/ tibia)

Term
weight distribution through the the Tibia and fibula
Definition
90% through the tibia, 10% through the fibula
Term
distal segment of the talocural joint is?
Definition
the talus
Term
talus with a DOME... discribe the DOME
Definition

the Dome has 3 facets (superior, medial and lateral)

 

the superior has a groove in it and is wedge shaped (making the joint a mortise joint) it is also the convex overall (minus the groove)

 

the lateral facet is larger than the medial facet.

 

the fibula articulates with the lateral facet, and the tibia with the medial facet.

 

the dome is covered in articular cartilage

 

 

Term

capsule and ligaments of the talocrural joint.

 

is it a shower?

 

discribe the anterior and posterior capsule?

Definition

is like a shoer curtain all the way around.

 

the anterior and posterior capsule is actually very thin and weack

Term
discribe the lateral collateral ligaments of the talocrural joint.
Definition

anterior talofibular ligaments (ATFL) which runs near anterior surface of lateral M, to neck and head of the talus (also this is the most commonly injured of the lateral collateral ligaments)

 

calcaneofibular- shars function of the ATFL, this one jumps over the talus (hense the name) ... limits inversion... and is placed on stretch during dorsiflexion... (combined with ATFL they help limit anterolateral rotation) thus its not a good assumtion to see that ATFL was damaged when the lateral bump protrudes) but is the 2nd most commonly injured of the 3...

 

posterior talofibular is the deepest of the 3... posterior part of the talus to the fibula. cant really palpate. not commonly injured unless a really severe injury. its ether stronger or out of the line of fire...

 

all three can be stressed during dorsal and plantar flexion (ATFL- plantar flexion) (PTFL and calcaneofibular - dorsiflexion)

Term
discribe the medial collateral (deltoid) ligament.
Definition

Function- control/ limit eversion (valgus) stress... this is helped by the 5 ligament and the lateral malleolus.

 

5 segments- anterior tibiotalar, tibio vanicular, tibio spring, calcanotibial, posterior tibiotalar... (anterior tibiotalar, calcanotibial, and posterior tibiotalar- run from the medial malleolus to adjacent bones) ...

 

 

Term
high ankle sprain is what?
Definition

lateral collateral damage-

distal tibularfibular joing

the crura are separated, by the talus

 

this is done through internal roation of the tibia, but the foot goes lateral (normally in closed chain with a force to the lateral knee)--- needs a screw to sometimes fix this, but it can have issues if people are too FAT.

Term
what type of joint is the ankle?
Definition
mortise joint- one of the partners is wedge shapped
Term
what is the axis of rotation for the ankle?
Definition

it goes through the malleoluseseses... lateral and medial...

 

the medial malleolus is proximal to the lateral

the lateral malleolus is posterior to the medial

 

there is tibial torsion of 20 to 40 degrees

 

because of all of this there will be toe out, and more toe out during dorsiflexion and less toe out during plantarflexion.

 

open chain is ER of the foot

close chain is IR of the tibia

 

when we measure with a goni we know that we are measuring wrong.

 

 

Term
is there more ROM in the lateral or medial facet?
Definition
there is more ROM during the lateral facet.
Term
ROM of the dorsiflexion/ plantarflexion is blocked by?
Definition

it is blocked by bone if hypermobile, but soft tissue if normal...

 

flex the knee to put the stress on the posterior ligaments...

 

dont look at the forefoot...

Term
dorsiflexion of the ankle - is how many degrees? checked by?
Definition

20 degrees, normally blocked by gastrosoleus (2 muscles)..

 

flex the knee to take the stress off of the muscles..

Term
Plantarflexion- how many degrees? checked by?
Definition

30-50 degress of motion...

 

checked by anterior portion of the collaterals and the dorsiflexor muscels

Term
component motions of the ankle?
Definition

shift and tilt...

 

5 degrees of tilt, 1-3 mm of shift...

 

there is more tilt toward the medial, not toward the lateral like shown in pictures...

 

thus there is more motion allowed on the lateral aspect, and less motion on the medial aspect...

 

 

 

 

Term
what is the structure of the talar dome?
Definition
the lateral is larger than the medial... thus a cone
Term
is the deltoid ligament commonly injured?
Definition
no the medial collateral ligaments are not commonly injured unless there is a fracture.
Term
the subtalar joint is what?
Definition
the key to foot motion...
Term
where is the subtalar joint?
Definition
bottom of the talus
Term
what is the difference between the subtalar proper and subtalar complex?
Definition

the subtalar complex involves 3 facets... the proper is just the posterior portion of the talus (inferior body) to the superior (body) of the calcaneous.

 

the other 2 articular surfaces are the anterior surfaces from the inferior head of the talus...

Term
what is between the subtalar proper and the anterior surfaces of the subtalar complex?
Definition

an interosseus talocalcanela ligament, which is palpable through the sinus tarsi... (whole on the lateral aspect of the foot)... over this is part of the ATFL and the rest of the whole is filled with the interosseus ligament. difficult to diagnose...

 

it is a dense band holding the 2 together.

Term
medial and lateral talocalcaneal ligaments?
Definition
are part of the interosseous ligament...
Term
does the calcaneal-fibular ligament support the subtalar joint proper?
Definition

yes it jumps the joint (acts as a LAD)

 

 

Term
is the subtalar proper joint a seperate joint space?
Definition
yes
Term
discribe the anterior segments of the subtalar complex?
Definition
the inferior articular facets from the talus articulate with the calcaneus by the sutentacular tali, while the portion anterior to those articulation is articulating with the navicular (not part of the subtalar complex) but does share synovial fluid.
Term
capsule and ligament of the anterior segmens of the subtalar complex?
Definition
they are thin, they are a different joint space than the subtalar proper
Term
the head of the talus lays on what, beside the calcaneus and the navicular?
Definition

a dense piece of fibrocartilage (the spring ligament)...

 

the thick fibrocartilage is the articular surface of the head of the talus, makes a hamic... bathed in synovial fluid, but not a synocial membraine.

Term
Deltoid ligament (MCL of the talocrural joint) with respects to the subtalar joint?
Definition
it comes down on the medial aspect of the anterior subtalar joint were is attaches to the spring ligament... and becomes a capsular ligament of the joint... (anterior portion of tibiocalcaneal, tibeonavicular) are also involved besides the spring ligament..
Term
the bifurcate ligament (specifially the calcaneocuboid of the bifurcate lig) with respects the subtalar joint?
Definition
makes up the lateral portion of the anterior subtalar complex. raps around the anterior inferior portion of the talar head and attaches the spring ligament.... helping support the lateral portion of the subtalar complex...
Term

when is the spring ligament dmged?

 

Definition

during crush injuries...

 

you can palpate the edge of it on the medial aspect.... find the sustantaculi tali and find the end of the navicular...

 

this lig supports the anterior portion of the subtalar complex... the head of the talus...

Term
axis of motion for the subtalar joint? and which partners are moving during open chain and closed chain?
Definition

it is 42-45 degrees from the horizontal, and 16-23 degrees towar midline...

 

this AOR goes through the neck of the talus and through the body.. and exit through the calcaneal (lateral heal)...

 

close chaing the talus moves, open chain the calcaneous moves...

Term
what type of joint is the subtalar joint complex?
Definition

complex plain joint.

 

complex because of the 3 surfaces and the navicular is also limiting the ROM.

Term

ROM of the talus and calcaneous are responsible for supination and pronation of the hindfoot... discribe open chain (S/P) and closed chain (S/P)

 

Definition

first supination and pronation sould only be used to discribe the hindfoot and not the midfoot.

 

open chain supination- calcaneal inversion (varus), adduction, and plantarflexion

 

open chain pronation- calcaneal eversion (valgus), abduction, dorsiflexion

 

closed chain (everything changes) supination- calcaneal inversion (varus), talar abduction (lateral rotation), talar dorsiflexion, tibial lateral rotation

 

closed chain (everything changes) pronation- calcaneal eversion (valgus), talar adduction (medial rotation), talar plantarflexion; tibial medial rotation

 

in closed chain the talus has to move and the tibia gets involved because it is tied to the talus........

Term
what is the closed packed position of the subtalar joint? and what is the least packed position?
Definition

supination = closed

 

mid pronation= least packed...

Term
what type of motin occurs in closed chain betwen the hindfoot and the tibia?
Definition
concurrent rotaion...
Term

ROM of the hindfoot?

 

supination/ pronation?

calcaneal eversion?

calcaneal inversion?

Definition

supination and pronation cant be measured

 

calcaneal eversion (valgus)= 10 degrees

calcaneal inversion (varus)= 20 degrees

Term
mechanical definition of subtalar neutral?
Definition
position from which calcaneal inversion ROM is 2x that of enversion
Term
clinical definitions of subtalar neutral? (2)
Definition

position at which the anteromedial and anterolateral edges of the dome of the talsus protrude equally with respect to the anterior lip of the distal tibia.

 

postiion at which the talar head articulates symmetrically with the navicular

Term
functions of the subtalar joint?
Definition
allows for the calcaneus to adjust to uneven surfaces while keeping the tibia vertical and allows the tibia and talus to undergo torsion while on the ground.
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