Chapter 11
The Ankle and Foot Joints – Lecture Outline Notes

PE 3320

The Ankle and Foot Joint

___________ bones

___________ large muscles

Many small (intrinsic) muscles

More than 100 ligaments

Support & propulsion

–Foot trouble - common ailment

–Poor foot mechanics leads to foot discomfort

–No substitute for adequate muscular development, strength, & proper foot mechanics

Bones

26 bones in each foot that form arch

Body weight is transferred from ____________________________________

5 other rear & midfoot tarsal bones

–Navicular - between talus & 3 cuneiform bones

–Cuboid - between calcaneus and 4^th & 5^th metatarsals

–5 metatarsals - anterior to tarsals

–5 phalanges

3 phalanxes in each except 1^st toe (2 phalanxes)

2 sesamoids beneath 1^st metatarsophangeal joint

Distal malleoli of tibia & fibula

–Enlarged & protrude horizontally & inferiorly

–Serve as _________________ posterior tendons to increase mechanical advantage of muscles in performing inversion & eversion actions

Pulley for posterior tendons

________________ & ______________ - immediately behind lateral malleolus

“________ _________ ___________” muscles immediately posterior to medial malleolus

__________________________

Joints

__________________________ joint

–Syndesmotic amphiarthrodial joint

–Joined at both proximal & distal __________________________ joints

–Ligaments and a strong, dense __________________ membrane between tibia & fibula shafts provide support

–_______________movement possible

–Distal joint becomes _________________ occasionally in heavy _________ sport

Tibiofibular joint

–Syndesmosis joint sprain

“__________ __________ sprain” primarily involves anterior inferior _______________ ligament

More severe injuries can involve posterior __________________ _______________ __________________

Ankle joint (_________________ joint)

–_____________ or ginglymus-type joint

–Talus, distal tibia, & distal fibula

–Greater range of dorsiflexion with knee ______________ (reduces gastrocnemius tension)

–Fibula rotates 3 to 5 degrees externally with ankle dorsiflexion & 3 to 5 degrees internally during plantarflexion

–Syndesmosis joint widens by 1 to 2 millimeters during full dorsiflexion

Subtalar & transverse tarsal joints

–___________ & ________ occurs here

–Classified as gliding or arthrodial

Intertarsal & tarsometatarsal joints

–Arthrodial

–Minimal movement

Ankle sprains very common injury

–Sprains involve _____________ or _____________ of one or more ligaments

–Most common ankle sprain results from excessive _______________ that causes damage to __________ ligamentous structures, primarily __________ __________ ligament & __________________ ligament

Ankle sprains very common injury

–Excessive eversion forces injures ______________ ligament (medially) - less common

Transverse arch

–extends ______________ foot from 1^st metatarsal to the 5^th metatarsal

Movements

__________________________

–movement of top of ankle & foot toward anterior tibia

__________________________

(extension)

–movement of ankle & foot away from tibia

__________________________

–turning ankle & foot outward; abduction, away from midline; weight is on medial edge of foot

__________________________

–turning ankle & foot inward; adduction, toward midline; weight is on lateral edge of foot

__________________________

–movement of toes toward plantar surface of foot

__________________________

–movement of toes away from plantar surface of foot

__________________________

–combination of ankle dorsiflexion, subtalar eversion, & forefoot abduction (toe-out)

__________________________

–combination of ankle plantar flexion, subtalar inversion, & forefoot adduction (toe-in)

Muscles

Group according to location & function

–Anterior ankle & foot - __________________________

flexors

–Posteriorly - __________________________

flexors

triceps surae

–gastrocnemius & soleus

–Laterally - evertors

–Medially - invertors

Ankle & foot joint muscles by function

Plantar flexors

–__________________________

Ankle & foot joint muscles by function

__________________________

–Peroneus (fibularis) longus

–Peroneus (fibularis) brevis

–Peroneus (fibularis) tertius

–Extensor digitorum longus

__________________________

–Tibialis anterior

–Peroneus (fibularis) tertius

–Extensor digitorum longus (extensor of lesser toes)

–Extensor hallucis longus (extensor of great toe)

__________________________

–Tibialis anterior

–Tibialis posterior

–Flexor digitorum longus (flexor of lesser toes)

–Flexor hallucis longus (flexor of great toe)

Muscles

Ankle & foot joint muscles by compartment

__________________________compartment

–Tibialis anterior

–Extensor hallucis longus

–Extensor digitorum longus

–Peroneus (fibularis) tertius

__________________________compartment

–Peroneus (fibularis) longus

–Peroneus (fibularis) brevis

__________________________compartment

–Flexor digitorum longus

–Flexor hallucis longus

–Tibialis posterior (Tom, Dick, Harry)

__________________________compartment

–Gastrocnemius (medial head)

–Gastrocnemius (lateral head)

–Soleus

Gastrocnemius Muscle

Plantar flexion of ankle

Soleus Muscle

Peroneus Longus (fibularis) Muscle

Eversion of foot

Peroneus Brevis (fibularis) Muscle

Peroneus Tertius (fibularis) Muscle

Extensor Digitorum Longus Muscle

Extensor Hallucis Longus Muscle

Tibialis Anterior Muscle

Tibialis Posterior Muscle

Flexor Digitorum Longus Muscle

Flexor Hallucis Longus Muscle

Intrinsic Muscles of the Foot

All originate & insert within the foot

Extensor digitorum brevis is on dorsum of foot

Remainder are in a plantar compartment in 4 layers on plantar surface of foot

Ankle Dorsiflexion

Agonists

–__________________________

__________________________

Ankle Plantar Flexion

Agonists

–__________________________

__________________________

Transverse Tarsal & Subtalar Inversion

Agonists

–Tibialis anterior

–Tibialis posterior

Flexor digitorum longus

Flexor hallucis longus

Transverse Tarsal & Subtalar Eversion

Agonists

–Peroneus (fibularis) longus

–Peroneus (fibularis) brevis

–Peroneus tertius

–Extensor digitorum longus

Toe Flexion

Agonists

–Flexor hallucis longus

–Flexor digitorum longus

Toe Extension

Agonists

–Extensor hallucis longus

–Extensor digitorum longus

Common Muscles Injuries

Painful cramps - acute muscle spasm in gastrocnemius & soleus

–Occur somewhat commonly

–May be relieved through active & passive dorsiflexion

Complete rupture of Achilles tendon

–very disabling injury

Several ankle & foot muscles produce more than one movement