Ankle Test Prep
heel-strike
(initial contact) landing on the heel with the foot in supination and the leg (tibia) in external rotation
how many bones are in the foot?
26
swing phase
40% of gait cycle; occurs when foot leaves the ground and the leg moves forward to another point of contact
stance phase
60% of gait cycle, divided into heel-strike, midstance, and toe-off
True or False: The cuboid bone is located medially with respect to the navicular bone
False (cuboid bone is lateral, navicular is medial)
What do the Tom Dick and Harry muscles stand for?
Tibialis posterior, Flexor digitorum longus, Flexor hallucis longus
True or False: The distal malleoli of the tibia and fibula serve as pulleys for the posterior tendons to increase the mechanical advantage of the respective muscles in performing inversion and eversion actions.
True
True or False: flexor hallucis longus is innervated by the tibial nerve (L5, S1, S2)
True
True or False: heel-strike normally occurs by landing on the heel with the foot in supination and the leg in external rotation
True
pronation of the foot
a combination of ankle dorsiflexion, subtalar eversion, and forefoot abduction (toe-out)
supination of the foot
a combination of ankle plantar flexion, subtalar inversion, and forefoot adduction (toe-in)
ankle joint range of motion
allows 50 degrees of plantar flexion and 15 to 20 degrees of dorsiflexion (greater with flexed knee 35 degrees dorsiflexion)
talocrural joint
ankle joint, hinge joint made up of the talus, distal tibia, and distal fibula
very common injury; involves stretching or tearing one or more ligament; most common type results from excessive inversion that damages lateral ligamentous structures (anterior talofibular ligament, calcaneofibular ligament)
ankle sprain
transverse arch
assists in adapting the foot to the ground; extends across foot from 1st metatarsal to the 5th metatarsal
Is the ankle more stable in dorsiflexion or in plantar flexion?
dorsiflexion
tibialis anterior muscle action
dorsiflexion of ankle, inversion of foot
Base of 5th metatarsal
enlarged & prominent to serve as insertion for peroneus brevis & tertius
Peroneus (fibularis) longus and brevis muscle action
eversion of foot, plantar flexion of ankle
less common ankle sprain
excessive eversion injures deltoid ligament (medially)
extensor digitorum longus muscle action
extends four lesser toes, dorsiflexion of ankle, eversion of foot
fibula movement during ankle dorsiflexion and plantarflexion
fibula rotates 3 to 5 degrees externally with dorsiflexion; 3-5 degrees internally during plantarflexion
which muscle performs great toe flexion, transverse tarsal and subtalar inversion, and ankle plantar flexion?
flexor hallucis longus
deep posterior compartment muscles starting from most posterior aspect of distal lower leg/ankle and moving medially
flexor hallucis longus, flexor digitorum longus, tibialis posterior (Tom, Dick, and Harry muscles)
toe-off
follows midstance; foot returns to supination and external rotation of the leg prior to and during
When do problems arise in the ankle joint when walking?
foot is too rigid and doesn't pronate adequately, foot remains in pronation past midstance
evertor muscles
found in lateral compartment; peroneus (fibularis) longus, peroneus (fibularis) brevis, peroneus (fibularis) tertius, extensor digitorum longus
Which of the following muscles performs knee flexion when concentrically contracting? gastrocnemius, soleus, tibialis anterior, flexor digitorum longus
gastrocnemius
superficial posterior compartment muscles
gastrocnemius (medial and lateral heads), soleus
Where do the peroneus brevis and peroneus longus tendons attach?
immediately behind the lateral malleolus (of the fibula)
Where do the "Tom, Dick, and Harry" muscles attach?
immediately posterior to the medial malleolus (of the tibia)
medial longitudinal arch
important for shock absorption, extends from calcaneus bone to talus, navicular, 3 cuneiforms, and proximal ends of 3 medial metatarsals; supported dynamically by tibialis posterior and tibialis anterior muscles
lateral longitudinal arch
important in balance; extends from calcaneus to cuboid and proximal ends of 4th and 5th metatarsals, long arches may be high, medium, or low
gastrocnemius muscle action
knee flexion, ankle plantar flexion
What are the arches of the foot?
medial longitudinal arch, lateral longitudinal arch, transverse arch
midstance
middle portion of walking, immediately follows heel-strike; characterized by pronation and internal rotation of the foot and leg
plantar flexion (extension)
movement of the ankle and foot away from the anterior tibia (pointed toe)
dorsiflexion
movement of the top of the ankle and foot toward the anterior tibia
Which of the following muscles does not perform plantar flexion? flexor hallucis longus, peroneus longus, peroneus brevis, peroneus tertius
peroneus tertius
Tibiofibular joint
pertaining to the proximal and distal joints between the tibia and fibula, ligaments and interosseus membrane between shafts provide support
What is the purpose of the distal malleoli of tibia and fibula?
serve as pulley for posterior tendons to increase the mechanical advantage of muscles in performing inversion and eversion actions
common term describing painful leg condition often associated with running activities; most often involves tibialis posterior, medial soleus or anterior tibialis; partially prevented by stretching plantar flexors and strengthening dorsiflexors
shin splints
What does SCASC stand for when discussing prerequisites of proper gait?
stability in stance, foot clearance during swing, appropriate prepositioning during swing, adequate step length, energy conservation
Walking can be divided into which two phases?
stance phase and swing phase
inversion and eversion occur at which joint? What degrees of motion do they have?
subtalar and transverse tarsal joints; classified as gliding; 20-30 degrees of inversion, 5-15 degrees of eversion
high ankle sprain
syndesmotic sprain, primarily involves anterior inferior tibiofibular ligament; more severe injuries can involve posterior tibiofibular ligament, interosseus ligament, and interosseus membrane
inversion
turning the ankle and foot inward; adduction, toward the midline; weight is on the lateral edge of the foot
eversion
turning the ankle and foot outward; abduction, away from the midline; weight is on medial edge of foot