exsc 322 - ankle & foot part 1(1)

7/25/2019 EXSC 322 - Ankle & Foot Part 1(1)

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Ankle and FootChapter 6, pp. 223-238

Oatis, Ch 44 & 45

Floyd, Ch 11


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The nee Co!ple"

#e$ie%

atis, Ch 41 & 42

loyd, Ch


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'(s)les

Anterior !(s)les

*"tend knee

+(adri)eps

rectus femoris

vastus lateralis

vastus intermediusvastus medialis


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#e)t(s Fe!oris '(s)le

hip flexion

knee extensionhip abduction

anterior pelvic tilt


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ast(s ateralis '(s)le

knee extension


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ast(s nter!edi(s '(s)le

knee extension


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ast(s 'edialis '(s)le

knee extension


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+(adri)eps '(s)les

/tren0th & end(ran)e is essential or!aintenan)e o patelloe!oralstaility oten a prole! (ads are parti)(larly prone to atrophy

%hen in(ries o))(r

!ay e de$eloped y resisted kneee"tension a)ti$ities ro! a seatedposition

(n)tional %ei0ht earin0 a)ti$ities s()has step-(ps or s(ats are parti)(larly(se(l or stren0thenin0 & end(ran)e


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'(s)les

osterior !(s)lesFle" the knee

a!strin0s

semitendinosus

semimembranosus

biceps femoris

Other knee 7e"ors

PopliteusTensor fascia latae

Sartorius

Gracilis

Gastrocnemius


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/e!itendinos(s '(s)le

hip extension

knee flexion

hip internal rotation

knee internal rotation

posterior pelvic tilt


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/e!i!e!ranos(s '(s)le

hip extension

knee flexion





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i)eps Fe!oris '(s)le

hip extension

knee flexion

hip external rotation

knee external rotation



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a!strin0 '(s)les

a!strin0 !(s)le strains $ery )o!!on

9#(nnin0 !(s)les: (n)tion in a))eleration

Anta0onists to (adri)eps !(s)les at knee

;a!ed or )ordlike atta)h!ents at knee All ori0inate on is)hial t(erosity o pel$is

/e!itendinos(s inserts on antero!edialtiia

/e!i!e!ranos(s inserts onpostero!edial tiia

i)eps e!oris inserts on lateral tiial)ondyle & head o


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oplite(s '(s)le


knee flexion

Key to the knee


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/artori(s '(s)le

hip flexion

hip abduction

hip external rotation

knee flexion

anterior pelvic tilt


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=ra)ilis '(s)le

hip adduction


weak knee flexion


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=astro)ne!i(s '(s)le

ankle plantarflexion

knee flexion


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nee *"tension

Agonists

Rectus femoris

Vastus lateralis

Vastus intermedius

Vastus medialis


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nee Fle"ion

Agonists

Biceps femoris

(long & short heads)

Semitendinosus

Semimembranosus


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nee nternal #otation

Agonists

Semitendinosus

Semimembranosus

Popliteus


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nee *"ternal #otation

Agonists

Biceps femoris

(long & short heads)


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Ankle and FootChapter 6, pp. 223-238

Oatis, Ch 44 & 45Floyd, Ch 11


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The Ankle and Foot

26 ones 1 lar0e !(s)les

'any s!all >intrinsi)? !(s)les

'ore than 1@@ li0a!ents /(pport & prop(lsion

Foot tro(le - )o!!on ail!ent

oor oot !e)hani)s leads to oot dis)o!ort

;o s(stit(te or ade(ate !(s)(larde$elop!ent, stren0th, & proper oot!e)hani)s


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istal tiia

Arti)(lar s(ra)e

Plafond

/addle shaped

Concavein an Adire)tion

Convexin a ' dire)tion

ears 90%o ankle load

ateral aspe)t arti)(lates

%ith the


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istal tiia

'edial !alleol(s ro!inent proe)tion on inerior

and !edial aspe)t o tiia

ateral s(ra)e arti)(lates %ith

!edial aspe)t o the talus

irt(ally no %ei0ht earin0

(lley or posterior tendons9To!, i)k & arry: !(s)les

Tibialis posterior

Flexor digitorum longus

Flexorh

allucis longus


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Tiial ali0n!entistal end o the tiia is laterallyrotated in

the trans$erse plane wrtpro"i!al end o thetiia

ateral >e"ternal? tiial torsion

;or!al ran0es ro! 2@o

-4@o


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istal


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Tarsal ones

Foot is oined to le0y )o!ple"or0aniBation o ones. tarsal ones

5 !etatarsals 14 phalan0es

Allo% or )onsiderale!oility

'aintains staility or%ei0ht earin0 anda!(lation


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Tarsal ones

Tal(sDoins the oot to the le0

Tro)hlea >aka talar do!e?

Convexin A dire)tion

Concavein ' dire)tion

Anterior aspe)t is slightlywider than posterior aspe)t

ateral rid0e is slightly widerthan !edial rid0e

Asy!!etry e"plains !otion o

the ankle


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Tarsal ones

Cal)ane(s 9heel one:

ar0est o the tarsal ones

/(stains lar0e i!pa)tor)es at heel )onta)t

d(rin0 0ait

ro$ides lon0 momentarm or the A)hilles

tendon


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Tarsal ones;a$i)(lar

Cres)ent-shaped one osterior s(ra)e

arti)(lates %ith head othe tal(s

3 anterior a)ets

C(oid osterior s(ra)e

arti)(lates %ith )al)ane(s

2 anterior a)ets

3 )(neior! ones elp or! trans$erse ar)h


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ones o the di0its

'etatarsal ones 'iniat(re lon0 ones

'etatarsal o the 0reat toe /hortest and thi)kest /esa!oid ones at head

pro$ide !e)hani)alad$anta0e or !(s)les

5th!etatarsal proe)tsineriorly ro$ides atta)h!ent or the

perone(s re$is tendon


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ones o the di0its

halan0es /horter, (t si!ilar to

phalan0es o the


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Tiio


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/yndes!oti)

i0h Ankle/prain


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Talo)r(ral >Ankle? oint

Arti)(lations et%een the tal(s and

the tiia and


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eltoid i0a!ent


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Talo)r(ral oint

Oli(e oint a"is #(ns !edial to lateral

et%een !alleoli

Oriented posteriorandinferior

ri!ary !o$e!ents Foot !o$es to%ards le0 H

Dorsiexion Foot !o$es a%ay ro! le0

H Plantarexion


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'o$e!ents o the oot

Dorsiflexion (flexion)

movement of foot toward anteriortibia

Plantarflexion (extension)

movement of foot away fromtibia


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/(talar oint

Arti)(lation o the talusandcalcaneus

A)ts to translate !otion o the

tiia to the oot>or $ise $ersa?

Allo%s h(!ans to %alk s!oothlyo$er (ne$en s(ra)es?

Oli(e a"is Allo%s triplanar !otion

Foot rotates (p%ard -pronation

Foot rotates do%n%ard -supination


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'o$e!ents o the oot

Pronationcombination of:

anle dorsiflexionsubtalar eversion

forefoot abduction(toe!out)

Supinationcombination of:anleplantarflexionsubtalar inversionforefoot adduction (toe!in)


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'o$e!ents o the oot

"versionturning foot outward#eight is on medialedge of foot

$nversionturning foot inward#eight is on lateraledge of foot


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/(talar oint

/TD a"is lies )loser to lon0 a"is othe foot!ostly inversion andeversion

/TD a"is lies )loser to lon0 a"is othe leg!ostly abduction andadduction

'idtarsalTrans$erse Tarsal


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'idtarsalTrans$erse TarsalDoint

Talona$i)(lar oint

Arti)(lation o tal(s %ith na$i)(lar /(pported yE

/yno$ial oint )aps(le

Talona$i)(lar li0a!ent

orsal )al)aneona$i)(lar li0a!ent

lantar )al)aneona$i)(lar >sprin0?li0a!ent

Cal)aneo)(oid oint Arti)(lation o )al)ane(s %ith

)(oid

/addle oint

/(pported yE

/yno$ial oint )aps(le

i(r)ate li0a!ent

/hort and lon0 plantar li0a!ents

h i h id


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Other oints o the !idoot

istal intertarsal oints Arti)(lation et%eenE

na$i)(lar and )(neior! ones

)(oid and lateral )(neior!

)(neior! ones the!sel$es

ery li!ited !o$e!ent

Tarso!etatarsal >T'T? oints

1stT'T oint is !ost !oile

ri!arily sa0ittal plane !otion ery li!ited rontal and trans$erse

plane !otion

2ndT'T !ost li!ited

'oility in)reases ro! 3rd-5th

T'T oints

O h i h


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Other oints o the oot

'etatarsophalan0eal oints

Condyloid joints bi!axial"

/(pported yE syno$ial oint )aps(le

)ollateral li0a!ents

plantar plates

9T(r toe:

nterphalan0eal oints

#inge joints uni!axial"

/(pported yE syno$ial oint )aps(le

)ollateral li0a!ents

plantar plates

O h i h


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Other oints o the oot Plantar Plates$-


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'o$e!ents o the oot

%oe flexion

movement of toes toward

plantar surface of foot

%oe extension

movement of toes away from

plantar surface of foot

A h th t


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Ar)hes o the oot

ateral lon0it(dinal ar)hn)l(des )al)ane(s,

)(oid, and 5th!etatarsal

'edial lon0it(dinal ar)hn)l(des )al)ane(s,

tal(s, na$i)(lar, !edial)(neior!, and 1st

!etatarsalTrans$erse ar)h

For!ed y the )(oidand )(neior!s

A h th t


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Ar)hes o the oot

rote)t ner$es, lood $essels, and!(s)les on plantar surface ro!)o!pression d(rin0 %ei0ht earin0

bsorbs shoc& d(rin0 i!pa)t

'tores and releases !e)hani)alener0y to i!pro$e eJ)ien)y

es plan(s

i!inished medial longitudinal ar)hFlat oot

es )a$(sAnor!ally hi0h medial longitudinal

ar)h


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eor!ities o Foot

Pes Planus Pes Cavus

exsc 322 - ankle & foot part 1(1)

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