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FOOT AND ANKLE JOINTS, PALPATIONS, & ROM 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