FOOT AND ANKLE JOINTS PALPATIONS ROM BELL RINGER

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 • Deltoid Ligament • ATFL (Anterior Talofibular Ligament)

JOINTS: • A synovial joint, also known as a diarthrodial , is the most common and most movable type of joint in the body • Other types: Amphiarthrodial, Synarthrodial • Diarthordial joints are divided into two subdivisions. What are they? • • Main structural differences between diarthrodial and Synarthrodial/Amphiarhtordial 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: • The following 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 hinge joint, so you can plantarflex and dorsiflex • The ankle joint is comprised of: • distal ends of the tibia and fibula • talus

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

TOE ROM

ANKLE ROM

PALPATIONS - ANKLE

PALPATIONS “ Palpate with a purpose” • Palpate to feel: • Tenderness • Inflammation • Crepitus • Deformity

WHAT TO PALPATE – BONY LANDMARKS From distal to proximal: • Distal, Middle, Proximal Phalangeals • Heads of the 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 Brevis

SOME PALPATIONS REQUIRE ROM • 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

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 by category • 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