MSK #9 A&P of Ankle/Foot

Question 1

Joint of the ankle and foot

Answer 1

• distal tibiofibular
• talocrural
• subtalar
• midtarsal also called transverse tarsal
• tarsometatarsal (forefoot)
• metatarsophalangeal (forefoot)
• interphalangeal (forefoot)

Question 2

Articulations of talocrural joint

Answer 2

• formed by distal tibia, distal fibula, and talus
• synovial hinge joint
• 1 degree of freedom
• offers significant stability in dorsiflexion
• become much more mobile in plantarflexion

Question 3

Talocrural joint: osteokinematic motions

Answer 3

dorsiflexion and plantar flexion

Question 4

Talocrural joint: Loose packed position

Answer 4

10 degress PF, midway between max inversion and eversion

Question 5

Talocrural joint: Closed packed position

Answer 5

max dorsifexion

Question 6

Talocrural joint: Capsular Pattern

Answer 6

PF, DF

Question 7

Ankle ROM norms

Answer 7

DF 0-20
PF 0-50
Inversion 0-35
Eversion 0-15

Question 8

Subtalar joint: articulations

Answer 8

• formed by 3 articulations (anterior, posterior, and middle) between talus and calcaneus
• 1 degree of freedom
• anterior and middle are formed by 2 convex facets on talus/2 concave on calcaneus
• posterior formed by concave facet on inferior surface of talus and convex on body of calcaneus

Question 9

Subtalar joint: osteokinematic motions

Answer 9

inversion, eversion

Question 10

Subtalar joint: loose packed position

Answer 10

midway between extremes of ROM

Question 11

Subtalar joint: close packed position

Answer 11

supination

Question 12

Subtalar joint: capsular pattern

Answer 12

limitation of varus ROM

Question 13

Midtarsal joint: All the stuff

Answer 13

• midtarsal (transverse tarsal) joint formed by talocalcaneonavicular joint and calcaneocuboid joint
• joint has 2 axes: longitudinal and oblique
• motions around both axes are triplanar

Question 14

Midtarsal joint: osteokinematic motions

Answer 14

inversion, eversion

Question 15

Midtarsal joint: loose packed position

Answer 15

midway between extremes of ROM

Question 16

Midtarsal joint: close packed position

Answer 16

supination

Question 17

Midtarsal joint: capsular pattern

Answer 17

DF, PF, adduction, medial rotation

Question 18

Joint that make up the forefoot

Answer 18

• tarsometatarsal
• metatarsophalangeal
• interphalangeal

Question 19

Muscles responsible for plantarflexion

Answer 19

• tibialis posterior
• gastroc
• soleus
• peroneus longus and brevis
• plantaris
• flexor hallucis

Question 20

Muscles responsible for dorsiflexion

Answer 20

• tibialis anterior
• extensor hallucis longs
• extensor digitorum longs
• peroneus tertius

Question 21

Muscles responsible for inversion

Answer 21

• tibialis posterior
• tibialis anterior
• flexor digitorum longus

Question 22

Muscles responsible for eversion

Answer 22

• peroneus longus
• peroneus brevis
• peroneus tertius

Question 23

Anterior Talofibular Ligament (ATFL)

Answer 23

• taut during PF
• resists inversion of talus and calcaneus
• resist anterior translation of talus on tibia

Question 24

Calcaneofibular Ligament (CFL)

Answer 24

• extracapsular ligament

- resists inversion of talus w/in midrange of talocrural motion

Question 25

Posterior Talofibular Ligament (PTFL)

Answer 25

• resists posterior displacement of the talus on the tibia

Question 26

Deltoid Ligament

Answer 26

• formed by the anterior tibiotalar ligament, tibiocalcaneal ligament, posterior tibiotalar ligament, and tibionavicular ligament
• provides medial support by resisting eversion of the talus

Question 27

Interosseous Membrane

Answer 27

• consists of a strong fibrous tissue
• serves to fixate fibula to the tibia
• distally, the structure blends into the anterior and posterior tibiofibular ligaments
• provides additional support at the distal tibiofibular syndesmosis joint

Question 28

Distal Tibiofibular joint: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 28

Resting: 0 degrees of PF

Convex/Concave:
Convex- fibula
Concave- tibia

Osteokinematic/Arthrokinematic: opposite direction

Question 29

Talocrural: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 29

Resting: 10 degrees PF, midway between max eversion/inversion

Convex/Concave:
Convex- talus
Concave- tibia and fibula

Osteokinematic/Arthrokinematic: opposite direction

Question 30

Subtalar: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 30

Resting: midway between extremes of ROM

Convex/Concave:
Convex- anterior and middle talus
Concave- anterior and middle calcaneus

Convex- posterior calcaneus
Concave- posterior talus

Osteokinematic/Arthrokinematic: opposite and same depending on intent for manual therapy

Question 31

Intermetatarsal joints: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 31

Resting: midway between extremes of ROM

Convex/Concave:
Convex- more medial metatarsals
Concave- more lateral metatarsals

Osteokinematic/Arthrokinematic: same direction

Question 32

Metatarsophalangeal joints: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 32

Resting: neutral

Convex/Concave:
Convex- metatarsals
Concave- phalanges

Osteokinematic/Arthrokinematic: same direction

Question 33

Interphalangeal joints: resting, convex/concave, osteokinematic/arthrokinematic motions for MT

Answer 33

Resting: slight flexion

Convex/Concave:
Convex- proximal phalanges
Concave- distal phalanges

Osteokinematic/Arthrokinematic: same direction