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Chapter 11 The Ankle and Foot Joints. Bones of the Foot Tarsals Head Shaft Base Metatarsals Distal Middle ProximalPhalanges Calcaneus Talus Navicular.

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Presentation on theme: "Chapter 11 The Ankle and Foot Joints. Bones of the Foot Tarsals Head Shaft Base Metatarsals Distal Middle ProximalPhalanges Calcaneus Talus Navicular."— Presentation transcript:

1 Chapter 11 The Ankle and Foot Joints

2 Bones of the Foot Tarsals Head Shaft Base Metatarsals Distal Middle ProximalPhalanges Calcaneus Talus Navicular Cuboid 3 rd Cuniform 2 nd Cuniform 1 st Cuniform Calcaneus Talus Navicular 1 st Cuniform Label

3 Joints Note: There is significant variation from joint to joint and from person to person Tibiofibular (amphiarthrodial – syndesmotic)  Anterior Inferior Tibiofibular Ligament  Posterior Inferior Tibiofibular Ligament 1.Tibiofibular 2.Tibiotarsal 3.Subtalar 4.Metatarsophalangeal 5.Interphylangeal Tibiotarsal (talocrural joint) (ginglymus) ROM: Dorsiflexion: 20° greater ROM with knee flexed Plantarflexion: 50° Subtalar (arthrodial) & Transverse Tarsal Combined ROM: Inversion: 20° to 30° Eversion: 10° to 15° Metatarsophalangeal (condylodial) Big Toe ROM: Flexion: 45° Extension: 70° (Slight abduction & adduction) Four Lesser Toes ROM: Flexion: 40° Extension: 40° (Slight abduction & adduction) Interphylangeal (ginglymus) Big Toe ROM: Flexion: 90° Four Lesser Toes ROM: Proximal Interphylangeal Joints: Flexion: 35° Distal Interphylangeal Joints: Flexion: 60°

4 Ligaments (*= true ankle ligament) 1.* Deltoid Ligament (internal stabilizers) Tibiocalcaneal ligament  Attaches from medial malleolus to calcaneous Tibionavicular ligament  Attaches from medial malleolus to navicular Anterior Talotibial ligament  Attaches anterior medial malleolus to anterior talus Posterior Talotibial ligament  Attaches posterior medial malleolus to posterior talus

5 Ligaments (*= true ankle ligament) 2.* Anterior Talofibular ligament Horizontal attachment from lateral malleolus to anterior talus 3.* Calcaneofibular ligament Vertical attachment from lateral malleolus calcaneous 4.* Posterior Talofibular ligament Horizontal attachment from lateral malleolus to posterior talus 5.Lateral Talocalcaneal ligament Attaches lateral talus to calcaneous 6.Posterior Talocalcaneal ligament Attaches posterior talus to posterior calcaneous 7.Dorsal Talonavicular ligament Attaches dorsal anterior talus to navicular

6

7 Retinaculum Transverse Crural (Superior Extensor Retinaculum) Attaches lateral distal fibula and medial distal tibia Cruciate Crural (Inferior Extensor Retinaculum) “Y” shaped band that connects to the lateral calcaneous and medial malleolus and plantar aponeurosis Peroneal Retinaculum Superior: Attaches posterior lateral malleolus to calcaneous Inferior: Attaches lateral superior calcaneous to lateral inferior calcaneous Attaches medial malleolus to medial tarsal bones Flexor Retinaculum

8 Movements Dorsiflexion Plantarflexion Inversion Eversion

9 Muscles: Anterior Compartment

10 Muscles: Lateral Compartment

11 Muscles: Posterior Superficial Compartment

12 Muscles: Posterior Deep Compartment

13 Superficial Posterior Compartment Gastrocnemius Strengthen Stretch

14 Superficial Posterior Compartment Soleus Strengthen Stretch

15 Superficial Posterior Compartment Plantaris Strengthen Stretch

16 Lateral Compartment Peroneus Longus Strengthen Stretch

17 Lateral Compartment Peroneus Brevis Strengthen Stretch

18 Anterior Compartment Peroneus Tertius Strengthen Stretch

19 Extensor Digitorum Longus Anterior Compartment Strengthen Stretch

20 Extensor Hallucis Longus Anterior Compartment Strengthen Stretch

21 Tibialis anterior Anterior Compartment Strengthen Stretch

22 Deep Posterior Compartment Tibialis Posterior Strengthen Stretch

23 Flexor Digitorum Longus Strengthen Stretch

24 Flexor Hallucis Longus Strengthen Stretch

25 Line of Pull of Muscles Working on the Tibiotarsal & Subtalar Joints

26 Flexor Digitorium Brevis

27 Abductor Digiti Minimi

28 Flexor Hallucis Brevis

29 Abductor Hallucis

30 Flexor Digiti Minimi

31 Quadratus Plantae

32 Lumbricales

33 Adductor Hallucis

34 Plantar Interossei

35 Dorsal Interossei

36 Extensor Digitorium Brevis

37 Bunions are commonly hereditary but may also be caused or aggravated by shoe wear. The condition is far more common in women than in men and rarely occurs in individuals who do not wear shoes. Once a bunion is present the deformity of hallux valgus worsens slowly over time. Hallux Valgus Hallux Varus

38 Claw Foot

39 Pes Cavus Pes Planus

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41 Pronation and Supination Achilles Tendon Ant. Line of Gravity Navicular Tuberosity Arch Wedge PronationSupination

42 Heel Wedges Used to correct imbalances Rule: The wedge is placed on the opposite side than the problem Medial Wedge Heel Valgus (Pronated foot) Genu Valgum External Tibial Torsion External Hip Rotation Lateral Wedge Heel Varus (Supinated foot) Genu Varum Internal Tibial Torsion Internal Hip Rotation

43 Walking Gait Pattern Stance Phase 1.Heel-Strike a.Foot in supination b.Leg in external rotation 2.Midstance (immediately foot pronates and leg internally rotates) a.Loading Response b.Midstance c.Terminal Stance 3.Toe-Off (Immediately prior to and during toe-off) a.Foot returns to supination b.Leg returns to external rotation Swing Phase (When the foot leaves the ground & the leg moves forward) 1.Initial Swing 2.Midswing 3.Terminal Swing Click picture for animation Click Picture for photographs Click picture for animation

44 Abnormal Gait Patterns Tibialis Anterior Gait Gastrocnemius Gait


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