19-1 Kinesiology for Manual Therapies Chapter 19 The Ankle and Foot Joints McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-2 Learning Outcomes McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved o 19-1 Define key terms. o 19-2 Identify on a human skeleton the most important bony features, ligaments, and arches of the ankle and foot.

19-3 Learning Outcomes (cont.)  19-3 Draw and label on a skeletal chart the muscles, including the origins and insertions, of the ankle and foot.  19-4 Demonstrate the active and passive movements of the ankle and foot with a partner. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-4 Learning Outcomes (cont.)  19-5 Explore on a partner the superficial joint structures and muscles, including origins and insertions, of the ankle and foot.  19-6 List and organize the muscles that produce movement of the ankle and foot and list their antagonists. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-5 Learning Outcomes (cont.)  19-7 Practice flexibility and strengthening exercises for each muscle group. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-6 Introduction McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  Good shoes, proper foot mechanics, massage therapy, strength training, and appropriate stretching can support health feet.

19-7 Walking Gait Cycle McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  Walking and running consist of stance and swing phases.  The stance consists of heel-strike, midstance, and toe-off.  The swing phase occurs when the foot leaves the ground.

19-8 Walking Gait Cycle McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-9 Gait Assessment for Muscle Weakness McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  The Trendelenburg test assess gluteus medius weakness.  This test is important for gait assessment and a weak gluteus medius can affect the low back.

19-10 Bones McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  Each foot has 26 bones.  The body weight is transferred from the tibia to the talus and the calcaneus.  There are 5 other tarsals including the 3 cuneiform bones, the navicular, and the cuboid.

19-11 Bones (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  There are 5 metatarsals and 14 phalanges.  The bony protrusions of the distal tibia and fibula are known as the malleoli.

19-12 Bones (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-13 Bones (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-14 Joints McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  The tibia and fibula form the tibiofibular joint connected by ligaments.  The ankle joint is called the talocrural joint and is a hinge or ginglymus-type joint.

19-15 Joints (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  Inversion and eversion occur in the subtalar and transverse tarsal joints and are classified as gliding or arthrodial.  The metatarsophalangeal (MP) joints are condyloid-type joints.  The phalanges have hinge joints in the IP and DIP joints.

19-16 Joints (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-17 Joints (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved  All 26 bones are connected with ligaments.  The ankle is often sprained in an inversion sprain.  There are two longitudinal arches; the medial longitudinal arch and the lateral longitudinal arch.  There is also a transverse arch.

19-18 Joints (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-19 Movements McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-20 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-21 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-22 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-23 Movements (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-24 Ankle and Foot Muscles McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-25 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-26 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-27 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-28 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-29 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-30 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-31 Ankle and Foot Muscles (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-32 Nerves McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-33 Individual Muscles of the Leg, Ankle, and Foot – Posterior Compartment Gastrocnemius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-34 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Gastrocnemius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-35 Individual Muscles of the Leg, Ankle, and Foot – Posterior Compartment Soleus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-36 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Soleus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-37 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Tibialis Posterior McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-38 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Tibialis Posterior McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-39 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Flexor Digitorum Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-40 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Flexor Digitorum Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-41 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Flexor Hallucis Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-42 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Posterior Compartment Flexor Hallucis Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-43 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-44 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-45 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Brevis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-46 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Brevis McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-47 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Tertius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-48 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Lateral Compartment Peroneus Tertius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-49 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Tibialis Anterior McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-50 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Tibialis Anterior McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-51 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Extensor Digitorum Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-52 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Extensor Digitorum Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-53 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Extensor Hallucis Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-54 Individual Muscles of the Leg, Ankle, and Foot (cont.) – Anterior Compartment Extensor Hallucis Longus McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-55 Intrinsic Muscles of the Foot McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-56 Intrinsic Muscles of the Foot (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-57 Intrinsic Muscles of the Foot (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-58 Intrinsic Muscles of the Foot (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-59 Chapter Summary The bones, joints, movements, muscles, and nerves of the leg, ankle, and foot are explored in this chapter. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-60 Chapter Summary (cont.)  Individual muscles of the leg, ankle, and foot are reviewed in depth with regard to palpation, origin, insertion, action, and innervation.  Each muscle includes information with clinical notes, muscle specifics, clinical flexibility and strengthening. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-61 Chapter Review  The Chapter Review is divided into true and false, short answers, and multiple choice questions.  The questions are designed for the students to test their knowledge.  Worksheets are at the end of the text as an aid for learning. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

19-62 Explore and Practice  Students should utilize the questions and charts at the end of the chapter to help focus on the content of the chapter. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved