1. 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

2. 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.

3. 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

4. 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

5. 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

6. 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.

7. 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.

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

9. 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.

10. 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.

11. 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.

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

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

14. 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.

15. 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.

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

17. 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. 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

51. 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

52. 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

53. 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

54. 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

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

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

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

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

59. 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

60. 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

61. 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

62. 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