03-12: Ankle and Foot

Question 1

Bones of the ankle joint (3)

Answer 1

• Tibia, Fibula, Talus
• Talus articulates with Tibia and Fibula
• Tibia + Fibula = Mortis

Question 2

Plantarflexion/Dorsiflexion (Planes of motion)

Answer 2

• Talocrural joint

- Sagittal plane about a frontal axis

Question 3

Inversion/Eversion (Planes of motion)

Answer 3

• T/C, Subtalar & Midtarsal joints

- Frontal plane about a sagittal axis

Question 4

Abduction/Adduction (Planes of motion)

Answer 4

• T/C, Subtalar & Midtarsal joints

- Rotation about a vertical axis

Question 5

Pronation/Supination (Planes of motion)

Answer 5

• Subtalar and midtarsal
• Combination of three planes about an oblique axis
• Pronation: Dorsiflexion, Eversion, Abduction
• Supination: Plantarflexion, Inversion, Adduction

Question 6

Forefoot (joints of the foot)

Answer 6

MTP joints - biaxial (PF/DF and ABD/ADD)

IPs - Uniaxial (PF/DF)

Question 7

Midfoot or mid-tarsal (joints of the foot)

Answer 7

TMT joints - non-axial (gliding, allows feet to conform)

Midtarsal joint - triplanar (majority of pronation/supination occurs)

Question 8

HIndfoot (joints of the foot)

Answer 8

Subtalar joint - triplanar/uniaxial (oblique)

Talocrural joint

Question 9

Toe motions

Answer 9

Flexion (curl), Extension (stretch out)

Abduction/Adduction (midline is from 2nd digit)

Question 10

Calcaneus Valgus

Answer 10

Lateral deviation from neutral

Question 11

Calcaneus Varus

Answer 11

Medial deviation from neutral

Question 12

Ankle joint (3)

Answer 12

Talus articulates with tibia and fibula

Question 13

Subtalar joint (2)

Answer 13

Talus articulates with calcaneus

Question 14

Transverse tarsal joint (4)

Answer 14

Talus and calcaneus articulate with navicular and cuboid

Question 15

Deltoid ligaments

Answer 15

• Triangular grouping of medial ankle ligaments

- Prevents excessive ankle eversion, calcaneal valgus

Question 16

Lateral ligaments

Answer 16

• Anterior talofibular ligament, posterior talofibular ligament, Calcaaneofibular ligament
• Prevents excessive ankle inversion, calcaneal varus
• More prone to injury - inversion sprain

Question 17

Optimal weight-bearing areas of foot

Answer 17

1st metatarsal, 5th metatarsal, calcaneus

Question 18

Feiss Line

Answer 18

Navicular tubercle, medial malleolus and head of 1st metatarsal should line up

Question 19

Plantar ligaments (function for arch)

Answer 19

Acts as spring when foot flattens out to put foot back into arch

Question 20

Gastrocnemius

Answer 20

O: Medial and lateral condyles of femur
I: Calcaneus via calcaneal tendon
A: Plantar flexion of ankle, assists with knee flexion
N: Tibial Nerve

Question 21

Soleus

Answer 21

O: Posterior aspect of tibia and fibula
I: Calcaneus via calcaneal tendon
A: Plantar flexion of ankle
N: Tibial Nerve

Question 22

Triceps Surae

Answer 22

• Grouping of Gastrocnemius and Soleus
• Primary plantar flexors
• “triceps” of the leg

Question 23

Plantaris

Answer 23

O: Lateral condyle of femur
I: Calcaneus via calcaneal tendon
A: Plantar flexion of ankle, knee flexion
N: Tibial Nerve

Question 24

Tibialis Posterior

Answer 24

O: Posterior tibia and fibula, interosseous membrane
I: All tarsal bones except talus, base of metatarsals 2, 3, 4
A: Plantar flexion of ankle, inversion (w/ tibialis anterior)
N: Tibial Nerve

• Functional purpose: Maintains arch of foot

Question 25

Flexor Hallicus Longus

Answer 25

O: Mid-portion of fibula, interosseous membrane I: Plantar surface of distal phalange of great toe A: Flexes great toe (IPs, MTPs), Assist with plantar flexion, inversion N: Tibial Nerve

Question 26

Flexor Digitorum Longus

Answer 26

O: Posterior tibia I: Plantar surface of base of distal phalanges 2-5 A: Flexes DIPs, IPs, MTPs; Assists with plantar flexion, inversion N: Tibial Nerve

Question 27

Tom Dick Harry (Posterior)

Answer 27

- TOM (Tibialis Posterior) - DICK (Flexor Digitorum Longus) - Bloody Nerves (Tibial Nerve, Posterior Tibial artery) - HARRY (Flexor Hallicus Longus)

Question 28

Tibialis Anterior

Answer 28

O: Lateral aspect of condyle of tibia, Interosseous membrane I: Base of 1st metatarsal and medial cuneiform (1st) A: Prime dorsiflexion, inversion (w/ tibialis posterior) N: Deep peroneal nerve - Largest of pre-tibial muscles

Question 29

Extensor Hallicus Longus

Answer 29

O: Distal 1/3 of fibula, Interosseous membrane I: Base of dorsal aspect of distal 1st phalange A: Extends great toe (IP, MTP), assists with dorsiflexion N: Deep peroneal nerve

Question 30

Extensor Digitorum Longus

Answer 30

O: Lateral condyle of tibia, fibula, interosseous membrane I: Distal phalanges of digits 2-5 A: Extends DIPs, IPs, MTPs of digits 2-5, assists with dorsiflexion N: Deep peroneal nerve

Question 31

Peroneus Tertius

Answer 31

O: Distal end of fibula I: Base of 5th metatarsal A: Dorsiflexion N: Deep peroneal nerve muscles

Question 32

Tom Harry Dick Pete (Anterior)

Answer 32

- TOM (Tibialis Anterior) - HARRY (Extensor Hallicus Longus) - Bloody Nerves (Dorsalis Pedis) - DICK (Extensor Digitorum Longus) - PETE (Peroneus Tertius)

Question 33

Dorsalis Pedis (Pulse in foot)

Answer 33

Lies between Extensor Hallicus Longus and Extensor Digitorum Longus

Question 34

Peroneus Longus

Answer 34

O: Upper 2/3 of fibula I: Medial cuneiform and base of 1st metatarsal A: Eversion, plantar flexion N: Superficial peroneal nerve

Question 35

Peroneus Brevis

Answer 35

O: Lower 1/3 of fibula I: Base of 5th metatarsal A: Eversion N: Superficial peroneal nerve

Question 36

Extensor Digitorum and Hallicus Brevis

Answer 36

O: Calcaneus I: Extensor tendons of hallicus and digitorum A: Extension of digits 1-5 N: Deep peroneal nerve - Only muscle on dorsum of foot

Question 37

Layers of plantar surface of foot

Answer 37

Layer 1: Plantar fascia Layer 2: Abductors of digits and great toe (1st, 5th) Layer 3: Lumbricals of tendons of digitorum Layer 4: Adductors of great toe, Interossei - All innervated by medial and plantar nerve (sciatic)

Question 38

Thompson Test

Answer 38

- Squeeze gastroc, foot should plantar flex | - if ruptured, foot will not move