foot and ankle

J O I N T S , PA L PAT I O N S , & R O M

FOOT AND ANKLE

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

ROM

WHAT TO PALPATE – BONY LANDMARKS

From distal to proximal:• Distal Phalangeals• Heads of the Metatarsals• Styloid process of fifth metatarsal• Sinus Tarsi - soft tissue depression just anterior to the

lateral malleolus. (Sinus Tarsi is filled with EDB & fat pad)• Medial and Lateral Malleoli• Head of the Talus• Calcaneous• Shaft of the Tibia and Fibula• Head of the fibula• Tibial Tuberosity

WHAT TO PALPATE – MUSCLES AND TENDONS

• Gastrocnemius• Soleus• Achilles Tendon• Tibialis Anterior• Extensor Digitorum Longus• Flexor Digitorum Longus• Peroneus Longus

PALPATIONS - FOOT

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

PALPATIONS - ANKLE

IN CLASS…

• Pair off and palpate 3 different people’s foot and ankle• Identify bones and ligaments

• Continue to work on foot diagram if needed

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