MS 1 ankle 1
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sup tib/fib jnt articultes w what?
inf tib/fib jnt articulates w what?
- sup - nada - doesn't articulate w knee
- inf - forms top of ankle jnt
unlike elbow/wrist, the tib/fib jnts don't...?
add degrees of freedom to ankle, but may change its ROM if fused
small, runs inferomedially at distal end of tib/fib joint
texture of interosseous membrane
virtually woven - this allows the tib/fib joint to move
sup tib/fib jnt - resting pos, closed packed pos, capsular pattern
- resting pos - 25 degrees knee flex and 10 degrees PF
- closed packed and capsular pattern - none known
classification of sup tib/fib jnt
plane synovial jnt - bc the bones are flattish and slide against each other
the articular surfaces the sup tib/fib jnt
- tibia: convex, faces lateral, dorsal, caudal (lat, post, inf)
- fibula: concave, faces med, vent, cephal (med, ant, sup)
nerve supply to the sup tib/fib jnt
common peroneal nerve (aka fibular nerve) (leads to lat compartment of foot)
fib glide when foot does inversion
so for eversion it does sup/cephal/cranial
tib/fib joints - how they move in dorsiflex
- inf - seperate/expand
- sup - fib does IR
so, for PF it's the opposite (and ER/IR can be considered post/ant glide of fib)
talocrural jnt consists of what bones? how about the hindfoot?
- talocrural: tib, fib, talus
- hindfoot: talocrural + calcaneus
how does the tibial styloid process compare to the fibular styloid?
result of this?
- tib: higher, more anterior
- fib: lower, more posterior
the axis is skewed, on an angle, which is brilliant bc it helps us w shock absorption and accomodating to all sorts of terrain
- a slightly movable articulation where the contiguous bony surfaces are united by an interosseous ligament
- ex: inferior tib/fib jnt
clasification fo the inf tib/fib jnt
- syndesmosis - fibrocartilaginous junction
- this allows the jnt some rigidity despite its mobility
articular surfaces of the inf tib/fib jnt
- tib: concave, faces lat
- fib: convex, faces med
nerve supply for inf tib/fib jnt
deep peroneal and tibial nerve
in the top of the ankle, which jont is synovial, which isn't?
- syndesmosis btwn tib and fib
- synovial btwn tib and talus
crural tibiofibular interosseous ligament
- runs inferolat - oblique fibers
- serves as the axis of motion for the fibula
- allows for small amounts of distal tib/fib mvmnt and large amounts of prox mvmnt
ant and post tib/fib ligaments
how they run
inferolat from lat tib to fib
very strong - fib will fracture before these tear
inferior transverse tib/fib lig is where
inf joint, posterior
why are the post tib/fib and inferior transverse ligs oblique?
to let fib move
ways to mobilize fibula
- ant, post, cephal caudal
- can be done at prox or distal tib/fib jnt
how to do fib mobs proximally
- post: pt is supine w cushion under thigh so knee will be in resting pos
- stabilize tib w meat of inner hand, other hand's thenar eminence presses on fib
- ant: pt is prone w pillow under calf
- stabilize med tib shaft and press on fibula, being careful to avoid the nerve
how to do fib mobs distally
position the pt and then manipulate the lat malleoli
how to do cranal and caudal mobs for the fibula
sidelying or supine, press on lat malleolis
ant glide of fib done at sup tib/fib joint cause what in distal tib/fib ad ankle?
- distal fib goes post
from the prox tib/fib joint, how to trigger PF?
push fib post
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