Kines 266 Ch. 14 The foot (Oct 19, 21)
Kines 266 Ch. 14 The foot (Oct 19, 21) Kines 266
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This 8 page Class Notes was uploaded by JustAnotherStudent on Sunday October 25, 2015. The Class Notes belongs to Kines 266 at Washington State University taught by in Fall 2015. Since its upload, it has received 26 views. For similar materials see Care and Prevention of Athletic Injuries in Kinesiology at Washington State University.
Reviews for Kines 266 Ch. 14 The foot (Oct 19, 21)
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Date Created: 10/25/15
October 16 and 19 Class was canceled on the 215 Kines 266 Chapter 14 The Foot and Toes Overview pg 2 o Bony anatomy o Zones of the foot 0 3 arches of the foot 0 Muscle anatomy o Neurovascular anatomy 0 Assessing injuries 0 Recognition and management of injuries The Foot pg 3 0 Must function both to absorb forces and to provide stable base of support during walk running and jumping 0 Contains 26 bones that are held together by network of ligaments and fascia o 33 joints 0 Will not be held accountable for these o Moved by complex system of muscles Bony Anatomy pg 4 o 26 bones o Tarsals 7 Calcaneus Talus Navicular Cu boid Intermediate cuneiform Medial cuneiform Lateral cuneiform o Metatarsals 5 lSt metatarsal 2nd metatarsal 3rd metatarsal 4th metatarsal 5th metatarsal o Phalanges l4 Proximal Middle Distal o The gredT Toe does noT hove This Hollux 0 Only on The gredT Toe o Sesomoid 2 Two liTTle bones feels like lenTils under pod of gredT Toes Zones of The Foof pg 5 8 0 RedrfooT hindfooT o Calcaneus ldrgesT bone of fooT used To bedr body s weighT dnd creoTes leverage for The Triceps surde gdsTroc soleus complex muscle group gdsTrocnemius amp soleus To propel body fonNdrd o m orTiculoTes wiTh molleoli To creoTe onlltle morTise SupporT dnd dTTdchmenT siTe for ligdmenTs of dnlte o MidfooT 0 Shock obsorbing segmenT of fooT Also supporTed by fdscid muscles dnd ligdmenTs o Noviculor o Cuneiforms o Medidl o lnTermedidTe o LoTerdl o Cuboid o ForefooTampToes o MeToTorsols o Phdldnges o Sesomoids Arches of The Foof pg 9 o MeToTorsol Arch 0 dlSiCll o Trdnsverse Arch 0 proximdl o Medidl longiTudindl Arch 0 Medidl side 0 LoTerdl longiTudindl Arch 0 LoTerdl side Muscle Anafomy pg 10 i o Muscles dnd Tendons run 0 course ThoT is opfimol for biomechdnicol odvonToge o Refindculums dnd bony prominences help creoTe odvonToges o Dense fibrous Tissue connecTive Tissue sTrop ThoT folds everyThing in pldce o For This cldss we will group muscles by dcTions o AdducTion supindTors Tom Dick dnd Horry Muscles from group pdss bolh behind and in fronl of medial malleolus o Tibidlis poslerior o behind Flexor digilorium longus o behind Flexor hollicis longus o behind Tibidlis dn rerior o In fron r Exlension hollicis longus o behind Abduclion prondlors Muscles from group pass in fronl and behind laleral malleolus o Peroneus fibeolus longus o Culs behind o Peroneus brevis o Culs in fron r o Peroneus lerlius o Culs behind o Exlensor digilorium longus o Culs in fron r Toe e on On plantar ospec r of fool This lexl siles 2 layers olher lexls sile more Than 2 don l need To know all The specific layers 0 Flexor digilorium brevis o Flexor digilorium longus o Flexor hollucis brevis o Flexor hollucis longus o Quondrolus pldnlde o Lumbricoles Toe exlensors On dorsal side of fool Top 0 Exlensor digilorium brevis o Exlensor digilorium longus o Exlensor hollucis longus Toe ddduclion Adduclion hollucis Pldnldr inlerrosi Toe obduclors Abduclor hollucis o The fool hos ils own pldne mid line sepdroles gredl loe from all The res r of Them Dorsol inlerrosi Abductor digiti minimi Neurovascular Anatomy pg 17 18 0 Sensory and motor nerve supply to the foot is compartmentalized 0 Lateral foot sural nerve Wraps around calcaneus Dorsal foot deep amp superficial peroneal nerve Medial foot saphenous nerve Plantar foot lateral and medial plantar nerve o Posterior calcaneal tibial nerve o Dorsal surface supplied by dorsal pedal artery 0 Take pulse up towards the ankle mortis o Posterior tib o Plantar surface supplied by posterior tibial artery 0 Venous drainage occurs via medial and lateral marginal vein into the great saphenous vein and small saphenous vein 000 o Histom questions that identify symptoms what the patient reports to you subjective 0 Observation What the clinician observes objective 0 Palpation Identifies landmarks feel of abnormal tissues 0 Special Tests Things that are quantified o Ranae of Motion PROM passive AROM active RROM resistive 0 Manual Muscle Tests Numeric score of strength of muscle group tested compared bilaterally 0 Special Tests Musculosllteletal tests for specific pathologies rule in or rule out o Neuroloaic Screen Distal pulses Dermatomes sensory nerves Myotomes motor nerves History amp Observation 0 Mechanism describe what happened 0 Acutechronic when did it happen 0 Pain rate it numeric pain scale 0 M describe it dull sharp throbbing 0 Sounds did you hear anything Pop cracllt etc 0 Symptoms other key elements o HurTs in The AM PM WiTh sTairs ETC 0 Observation beqins aT The door 0 All aspecTs of gaiT o Demeanor Muscle guarding Guarding Swelling DeformiTy Bruising Aches Bunions BlisTers OOOOOOO PalpaTion o W O 3 lt Calcaneus Dome neck of Talus Navicular Medial malleolus LaTeral malleolus Base of 5Th meTaTarsal MeTaTarsal heads Sesamoid bones 00000000 0 SofT SofT ligamenT Flexor hallucis longus ExTensor hallucis longus ExTensor digiTorium brevis PlanTar fascia OOOOO Range of MoTion of FooT amp Toes o AdducTionsupinaTion Towards midline o AbducTionpronaTion away from midline o Toe flexion bend Toes o Toe exTension exTends Toes o Toe abducTion away from midline of foolL beTween greaT Toe and 2nd o Toe adducTion Toward midline of foolL beTween greaT Toe and 2nd ray Measuring ROM goniomeTer quanTifies in degrees disTance Traveled or available compared To average of healthy population as well as uninjured side Special TesTs o Valaus sTress Test sTresses medial ligamenT MTP amp IP joinT o Varus sTress Test sTresses laTeral ligamenT of MTP amp IP joinT o Infermefafqrsal qlidesfresses deep fransverse mefafarsal ligamenfs 0 Long Bone compression fesf compress proximal ampdisfal heads of bone fo find fracfure o Inferdiqifal neuroma fesf squeezing mefafarsal heads fo find Morfon s Neuroma NGUI39OVCISCUICII39 screen 0 Dermafomes 0 L4 medial aspecf of foof 0 L5 dorsum of foof a Si laferal aspecf of foof o Myofomes 0 L5 greaf foe exfension 0 Vascular o Dorsal pedal arfery o Posferior fibial arfery o Capillary bed refill Injuries 0 Refrocalcaneal Bursifis plump bump o What is if lnflammafion of fhe bursae befween calcaneus and Achilles fendon a Cause consfanf rubbing or pressure form shoe 0 Signs Tenderness swelling warmfh redness lf serve fhere will also be palpable boney bump o Treafmenf doughnuf pads heel liff shoe wifh heel counfer o Planfar Fasciifis o Whaf is if Pain in fhe anferior medial heel origin of planfar fascia a Cause Uneven leg lengfh inflexible gasfro soleus complex lack of arch suppon 0 Signs Pain in fhe morning orweighf bearing a Treafmenf nighf splinf heel pad arch faping or supporf o Mefafarsal Fracfures pg 10 o Whaf is if If is difficulf fo isolafe fracfure midfoof pain from mefafarsal sprains Cause Direcf force kicking sfubbing dropping Signs Occasional visible or palpable deformify X ray needed fo rule in or rule ouf Treafmenf PRICE shorf leg walking casf for 3 6 weeks surgery shoe wifh large foe box 0 Jones Fracfure o Whaf is if Fracfure near fhe proximal end of fhe 5ih mefafarsal a Cause Overuse injury high velocify rofafional force sfress fracfure OOOO 0 Signs Sharp pain on lateral side of foot usually a loud pop is heard poor blood supply and delayed healing 0 Treatment non weight bearing short leg cast 6 8 weeks surgery for highly active patient 0 Toe Fracture What is it Fracture of the phalanges Cause Occur by kicking or stubbing toe or dropping object on toes Signs Swelling pain bruising discoloration Treatment buddy tape ice decrease activity for 3 4 weeks modified limiting weight bearing Great toe fractures should be referred to physician 0 Bunions Hallux Valgus Deformity o What is it Also referred to as exosfosis Painful deformity of the 1 metatarsal head Boney enlargement 0 Cause Shoes that are too tight small pointed 0 Signs Tender red swelling pain 0 Treatment Widen toe box of shoe bunion tape or foe spacers surgery 0 Longitudinal Arch Sprain o What is it Pain occurs during running 0 Cause Pain below medial malleolus amp posterior tibial tendon o Swelling tenderness medial aspect of foot 0 Signs Pes planus flat feet 0 Treatment PRICE arch taping supportive insoles rest 0 Morton s Neuroma o What is it Entrapment of nerves between metatarsal heads Enlargement of common plantar nerve 0 Signs Burning and numbness in forefoot often localized to space between 3039 and 4Th metatarsal heads Hyperextension and pressure can increase symptoms Severe pain from the distal metatarsal heads to tip of toes 0 Treatment Teardrop shaped padding to encourage toe splay in weight bearing Wear shoes with wider toe box 0 Turf Toe 15 MTP Sprain o What is it Hyperextension of lsl MTO 0 Cause Usually from turf but can happen on grass too Turf shoes are generally more flexible allowing greater dorsiflexion of the great toe Can also occur form kicking stationary object 0 Signs Pain when pushing off of great toe Sometimes effusion swelling 0 Treatment tape steel sole inserts ultra sound ice 0 Subungual Hematoma o What is it Blood accumulation under toenail OOOO Cause Being slepped on dropping of on objech on loe kicking dnolner objech Signs Bluepurple discoloration under offech loendil poinful especidlly when genlle pressure is dpplied Treatment Ice elevolion drilling ndil bed lo reledse pressure