Applied Kinesiology -- Lower leg, Ankle, and Foot

What are the 5 ligaments of the subtalar joint?

- Interosseous ligament - Cervical ligament - Calcaneofibular ligament - Lateral talocalcaneal ligament - Fibulotalocalcaneal ligament

Tarsometatarsal Joints

- Joints between tarsal bones and metatarsals - Between cuneiforms, cuboid, and metatarsals 1-5

What are the 2 ligaments of the inferior tibiofibular joint?

- Anterior inferior tibiofibular (AITF) - Posterior inferior tibiofibular (PITF)

What are the 3 lateral ligaments of the talocrural joint?

- Anterior talofibular (ATF) - Posterior talofibular (PTF) - Calcaneofibular (CF)

What are the 4 components of the deltoid ligament?

- Anterior tibiotalar - Tibionavicular - Tibiocalcaneal - Posterior tibiotalar

What is the job of the interosseous ligament and cervical ligament?

- Keep talus and calcaneus as close as possible - Minimize anterior and posterior displacement - Minimize rotation between talus and calcaneus

What motions occur at the talocrural joint?

- Plantar flexion - Dorsiflexion

What are the 3 types of fractures the styloid process sustains?

- Stress fractures - Avulsion fractures - Normal/plane fractures

What are the 3 joints of the ankle complex?

- Subtalar joint - Talocrural joint - Distal tibiofibular joint

What do the deltoid ligaments do?

- Support the medial/inside aspect of the talocrural joint

Where are the sesamoid bones of the foot located?

- They lie in the tendons of the flexor hallicus brevis - Underneath big toe - Underneath 1st metatarsal

How many phalanges does the big toe have?

2 -- proximal and distal phalanges

The lower leg, ankle, and foot are made up of how many bones?

26 bones

How many cuneiforms are there?

3 (medial, intermediate, lateral)

How many phalanges do toes 2-5 have?

3 phalanges

The lower leg, ankle, and foot are made up of how many joints?

34 joints

What are the interosseous ligament and cervical ligament similar to?

ACL and PCL

What must the calcaneus do?

Absorb and generate force

What site most commonly receives orthopedic injuries?

Ankle

Which lateral ligament of the talocrural joint is the most commonly injured?

Anterior Talofibular (ATF)

What is the navicular bone important for?

Arches of the foot -- it is the attachment point for one of the ligaments that supports the medial longitudinal arch of the foot

Does the base of the 5th metatarsal have a good or bad blood supply?

Bad blood supply

Talocrural Joint

Between talus and tibia

Where is the subtalar joint?

Between the talus and calcaneus

Dorsiflexion

Bringing toes up

What is the lateral malleoli?

Bump on lateral side of the ankle

What is the medial malleoli?

Bump on medial side of the ankle

Heel Bone

Calcaneus

What bone is the sustentaculum tali on?

Calcaneus

What is the first bone you hit when you walk?

Calcaneus

Severe High Ankle Sprain

Damage to the interosseous membrane of the inferior tibiofibular joint

What is another name for the inferior tibiofibular joint?

Distal tibiofibular joint and Syndesmosis joint

If someone sprains/injures the deltoid ligament, what other injury do they also typically have?

Fibular fracture

The calcaneus is the insertion point for what muscles?

Gastrocnemius and soleus

What are the primary muscles for generating force to propel the body forward during walking and during gait mechanics?

Gastrocnemius and soleus

Anterior Inferior Tibiofibular Ligament (AITF)

Goes from tibia to fibula on anterior aspect of the ankle

What is the foot/ankle complex similar to?

Hand/wrist complex

What is the function of the sesamoid bones in the foot?

Increase lever arm and make muscle more efficient

High Ankle Sprain

Injury to inferior tibiofibular joint

Minor High Ankle Sprain

Injury to only one ligament of the inferior tibiofibular joint

Grade 1 Ankle Sprain

Injury to the Anterior Talofibular ligament (ATF)

Grade 2 Ankle Sprain

Injury to the Anterior Talofibular ligament (ATF) and the Calcaneofibular ligament (CF)

Intermetatarsal Joints

Interaction of metatarsals 1&2, 2&3, 3&4, 4&5

What motions occur at the subtalar joint?

Inversion and Eversion

Do you have more eversion or inversion motion at the ankle?

Inversion motion

Where is the styloid process of the 5th metatarsal?

It's the bump on the base of the 5th metatarsal

Metatarsophalangeal Joints

Joints between phalanges and metatarsals (we have 5 of them)

What are the interphalangeal joints?

Joints between the phalanges

What are the metatarsophalangeal joints similar to?

Knuckles

The majority of ankle sprains happen to which ligaments?

Lateral ligaments

What causes you to have less eversion motion at the ankle?

Lateral maleolus

What is more distal, the medial or lateral malleolus?

Lateral maleolus

Is the navicular bone on the medial or lateral side of the foot?

Medial

Eversion

Turning ankle outward

What is another name for the talocrural joint?

Mortise Joint or Tibiotalar Joint

Do high ankle sprains heal quickly?

No, high ankle sprains take a long time to heal

Do you need all of your toes to walk?

No, you can walk without toes 2-5

Is it more common to sprain the inside or outside of the ankle?

Outside of ankle (inside ankle sprains are not very common)

Dome of the Talus

Part that articulates with the tibia

What bone does the cuboid articulate with?

Pinky toe

What toe is the 5th metatarsal?

Pinky toe

Plantar Flexion

Pointing toes down

Is the base of the metatarsals bones proximal or distal to the tarsal bones?

Proximal

Posterior Inferior Tibiofibular Ligament (PITF)

Same as AITF except on the posterior side

Sinus Tarsi

Splits the anterior and posterior portions of the subtalar joint

What joint is the sinus tarsi a part of?

Subtalar joint

What bone is right below the lateral malleolus?

Talus

What bone sits underneath the tibia?

Talus

What is the primary ankle bone?

Talus

What prevents injuries from occurring to the deltoid ligament?

The fibula -- it's long and prevents excess motion

What bone is the medial cuneiform in line with?

The first toe

What is the main difference between the foot and hand?

The foot has to bear weight

Why is it called the deltoid ligament?

The ligaments kind of form a triangle

What do the lateral ligaments of the talocrural joint do?

They help keep the talus underneath the tibia

Where are the interosseous ligament and cervical ligament?

They sits between the talus and calcaneus

Inversion

Turning ankle inward

What is an avulsion fracture?

When a tendon that inserts on a bone, gets pulled off

What are tarsal bones similar to?

Wrist bones

Does the inferior tibiofibular joint have an interosseous membrane?

Yes