FOOT AND ANKLE

J O I N T S , P A L P A T I O N S , & R O M

BELL RINGER

• What bones make up the foot?

• What bones make up the ankle?

• What bones make up the lower leg?

• What is the main ligament on the medial aspect of the ankle?

• What is the ligament most commonly sprained on the lateral side?

ANSWERS

• • • • • 5 phalynx (great toe, digits 2-5, w/ DP, PP, DP, MP, PP), Metatarsals 1-5, 3 cuneiforms, Cuboid, Navicular, Talus, Calcaneous Talus, Tibia, Fibula Tibia, Fibula Deltoid Ligament ATFL (Anterior Talofibular Ligament)

JOINTS:

• • • A synovial joint, also known as a diarthrosis , is the most common and most movable type of joint in the body Other types: Fibruous and Cartlaginous Main structural differences between synovial and fibrous joints are capsules surrounding the articulating surfaces of a synovial joint and the

presence of lubricating synovial fluid within those

capsules (synovial cavities).

JOINTS

• Toes and Metatarsals: • Interphalangeal joints: These joints connect the phalanges. They’re synovial joints strengthened by collateral and plantar ligaments, and they let you flex and extend your toes.

• Metatarsophalangeal joints: They allow you to flex and extend your toes as well as move them apart and closer together.

• • •

Intermetatarsal joints Tarsometatarsal joints Cuboideonavicular joints

JOINTS

• • • Foot: • These two joints allow you to invert and evert the foot Subtalar joint: This joint is the posterior joint formed between the talus and the calcaneus. It’s a synovial joint, and it’s stabilized by medial, lateral, and interosseous talocalcaneal ligaments.

Transverse tarsal joint: The transverse tarsal joint is actually a combination of the following two joints: •

Talocalcaneonavicular joint

•

Calcaneocuboid

SUBTALAR JOINT

TRANSVERSE TARSAL JOINT

JOINTS

• • • Ankle: The ankle joint is a synovial hinge joint, so you can plantarflex and dorsiflex The ankle joint is made up of distal ends of the tibia and fibula

ROM

• Toes • Flexion/extension • Abduction/Adduction • Ankle • Dorsiflexion/plantarflexion • • Inversion/eversion Circumduction

TOE ROM

ANKLE ROM

PALPATIONS - ANKLE

HOW TO PALPATE

• • • “Palpate with a purpose” Head of Talus - felt just behind the navicular, by everting & inverting the midfoot.

Sustentaculum Tali - one fingerbreadth below medial malleolus. (serves as an attachment for the spring ligament & supports the talus); can be painful when palpated

WHAT TO PALPATE – BONY LANDMARKS

• • • • • • • • •

From distal to proximal:

Distal, Middle, Proximal Phalangeals Heads of the Metatarsals Metatarsals Navicular Tuberosity Styloid process of fifth metatarsal Sinus Tarsi - soft tissue depression just anterior to the lateral malleolus. Medial and Lateral Malleoli Head of the Talus Calcaneous

WHAT TO PALPATE – MUSCLES AND TENDONS

• • • • • • • • Gastrocnemius Soleus Achilles Tendon Tibialis Anterior Extensor Digitorum Longus Extensor Hallicus Longus Flexor Digitorum Longus Peroneus Longus Peroneus Brevis

PALPATIONS - FOOT

IN CLASS…

• • • Pair off and palpate the foot and ankle • Identify bones, muscles, and ligaments Begin to work on foot diagram • • • Must draw • Tibia • Fibula • All 26 bones of the foot Must be proportional in size Color bones • Sketch in muscles and ligament Skeleton will be cut out and assembled; must be able to move

WHAT YOU NEED TO KNOW FOR THE EXAM

• • Where to Palpate specific bones/ligaments ALL ROM

HOMEWORK

• Color pages 4 and 5 in the packet