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