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in DF what does talus do to navicular
- as the talus moves back its head juts up, pushing the navicular up, raising the arch.
- PF in turn lowers the arch.
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inf fib goes cranial or caudal in DF?
cranial
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closed packed pos of talocrual joint?
maximum DF
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where is the capsule of the ankle thin and weak
ant and post -- this allows movement, and the ligs of the dist tib/fib, talocrural, and subtalar joints support the capsule
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Windlass mechansm
on toe-off during gait the ligs on plantar foot are stretched and hold the arch of the mid foot tight/high
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classification of talrural joint
synovial hinge
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components of deltoid lig from post to ant
- post tibiotalar
- tibial calaneal
- ant tibial-navicular
and the deep deltoid lig in front - ant tibiotalar
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function of deltoid lig
- check eversion and valgus forces
- limit PF and DF at endranges
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which lig is most often sprained?
anterior talofibular lig (it's a segment of the lat collateral lig) that checks PF
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3 segments of the lat collateral lig, and which checks what?
- anterior talofibular lig: checks PF
- calcaneofibular lig: checks inv
- posterior talofibular lig: checks DF
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main function of the lateral collateral lig
check varus forces, but parts of it check PF, inv, and DF
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DoF of talocrural joint
- 1 - PF and DF
- but... because of tibial torsion you kind of get some rotation
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inv/ev happens at which joint?
subtalar
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fib goes where in df?
cranial, and the distal end abducts and glides post (IR)
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talocrural distraction is to increase __?
DF
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ant and middle facets on talus are convex, and the post is...?
- concave on the talus
- each has a matching part on the calcaneus
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tarsal tunnel is where?
between ant/mid and post articulations of the talus and calcaneus
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interosseus talocalcaneal lig is where? does what?
runs thru tarsal tunnel, holds bones in the middle so they can in/evert, checks pronation
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talocalcaneal resting pos
- 10 degrees pf
- midway btwn sup and pro
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talocalcaneal close-packed pos
supination
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capsular pattern of talocalcaneal joint
- inversion > eversio
- sup > pro
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endfeel of hindfoot motions
tissue stretch
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talocrural joint distraction, how?
- pt supine
- PF to 10 degrees, foot off edge of table
- fixate lower leg to table w belt or firm grip
- lean backward and distract talus from tib and fib, grasping udner both malleoli
- useful for assessment and treatment for limited DF
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talocrural joint distraction - moves which bone from which, helps w what motion?
- pulls talus from tib/fib
- DF
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postioning for talocrural ant/post glides
- pt supine w knee flexed, heel on table, PF to 10 degrees
- stabilize around foot, near calcaneus
- mobilize distal tibia
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in talocrural ant/post glide, by moving the talus ant you accomplish what?
- relative post glide of talus
- helps w DF
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talocrural glide for PF?
push tibia post -- this relatively pushes talus ant --- helps w PF
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talocrural ant post glide w pt supine and you pushing/pulling on distal tib is for assessment. how to treat??
- To treat w ant glide: get the pt prone, ankle in resting pos, foot off table
- stabilize distal tib fib with one hand, press into ant distraction with web space of hand on post talus (just distal to malleoli)... helps w DF
- Hands shoudl be real close
- to do post glide: pt supine (can flex knee to 90), resting pos in ankle, stabilize tib/fib, mobilize w web space over ant talus ... helps w DF
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talocalcaneal-navicular joint is what kind of joint?
ball and socket
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subtalar joint is what?
talocalcaneal joint
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location of sustentaculum tali
med and ant to med malleolus
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lateral talocalcaneal lig, posterior talocalcaneal lig, lig cervicis, interoseus talocalc lig are in what joint?
subtalar (talocalcaneal)
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subtalar closed packed pos
DF and sup
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accessory motions of talocrural joint
- long axs ext (traction)
- ant post glide
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movements of subtalar joint
- talar rock
- talar tilt -med and lat
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how to do subtalar joint distraction w pt supine
- pt supine, ankle DF (held there w yr trunk against the forefoot)
- stabilize talus by holding ankle mortise (tib/fib)
- cup hand around calc
- lean back to distract
- do this ro test or treatment
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how to do subtalar joint distraction (treatment) w pt prone
- dorsum of foot on bed
- stabilize lower leg if necessary to achieve resting pos
- mobilize calcaneus inf to distract it from the talus
- *keep forearm in line w tibia (I guess of stabilizing arm)
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How to do the talar-rock?
- pt supine, foot in resting pos
- stabilize talus by holding mortise
- cup hand around calc
- scoop subtalar joint away from mortise to distract and rock talus - diff from distraction ...dunno how
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how to do the subtalar joint varus and valgus tilt
- pt supine, hip/knee flexed to 90, slight IR
- stabilize distal thigh agains yr body with yr arms (you're beside it, hugging it)
- mobilizing hand grasps around calcaneus, moving it med and lat
- for valgus, stabilize above the sustentaculum
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what glide mustn't you do for calcaneus
anterior
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midfoot (midtarsal) joints
- talocalcaneonavicular
- cuneonavicular
- cuboideonavicular
- intercuneiform
- cuneocuboid
- calcaneocuboid
and they're all synovial
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which bones are at the cuneonavicular joint?
nav and all three cunes
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bones of the midfoot
- talus
- navic
- cuboid
- 3 cuneiforms
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why is the med arch more pliable than the lat arch?
med has 3 cuneiforms while lat has a single cuboid
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Jones fracture
avulsion of base of 5th metatarsal
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Lis Frank fracture
base of 2nd metatarsal (fragile bc it's the longest)
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calcaneus - cuboid joint is in line with///
talo - navicular line
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midfoot's talocalcaneonavicular joint - type? degrees of freedom? close packed pos?
- ball and socket synovial
- 3
- supination
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3 ligs of the talocalcaneonavicular joint
- dorsal talonavicular
- bifurcated
- plantar calcaneonavicular (spring lig)
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capsular pattern of midfoot
DF > PF > add > med rot
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When standing, and you pull talus into DF, the navicular is going into PF grade positioning in relation to the talus. – pulling the arch up. (navicular keystone)
Oh yes.
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