06b: Leg, Ankle, Foot Flashcards by Nuna H

The formal name(s) of the ankle joint(s):

Talocrural

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Which bones articulate at talocrural joint?

Tibia, fibula, and talus

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The (X)-sided configuration of the talocrural joint is referred to as (Y) and is crucial for (Z).

X = 3
Y = mortise
Z = stability

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T/F: The mortise of the ankle is crucial for stability, so it’s fairly static.

False - it’s dynamic

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There’s a change in size of the ankle mortise during (X) actions because:

X = Dorsiflexion and plantarflexion

Talus is wider anteriorly

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Superior tibiofibular joint is what type of joint?

Plane (synovial)

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Inferior tibiofibular joint is what type of joint?

Syndesmosis (fibrous)

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A trimalleolar fracture involves which structure(s)?

Lateral and medial malleoli

2. “Posterior malleolus” (distal posterior tibia)

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List the lateral ankle ligaments. Star the weakest and double-star the strongest.

Anterior* and posterior** talofibular

2. Calcaneofibular

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List the medial ankle ligaments.

Deltoid ligament (contains the following fibers):

Anterior and posterior tibiotalar
Tibionavicular
Tibiocalcaneal

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The (X) fibers of (Y) ligament attach to tibia and (Z) of calcaneus

X = tibiocalcaneal
Y - deltoid
Z = sustentaculum tali

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In general, (medial/lateral) ankle ligaments are stronger and less prone to injury.

Medial

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There are (X) articulations in the (Y) joint, between calcaneus and talus. List/describe locations of the articular surfaces.

X = 3 
Y = subtalar

Anterior, Posterior, Middle talar articular surfaces (on calcaneus)

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Interosseous (X) ligaments, located in (articular/non-articular) (Y), bind the talus and calcaneus.

X = talocalcaneal
Non-articular;
Y = sinus tarsi

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(X) joint is very important in absorbing rotational loads imposed by proximal lower limb.

X = subtalar

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List the transverse tarsal joints.

Talonavicular

2. Calcaneocuboid

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(X) joints are very important in compensatory movements that allow forefoot to remain on ground when hind foot is supinated/pronated.

X = transverse tarsal, intertarsal, tarsometatarsal, intermetatarsal

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Intertarsal joints are what type of joint? What motions?

Plane; gliding

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Tarsometatarsal joints are what type of joint? What motions?

Plane; gliding

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MTP joints are what type of joint? What motions?

Condyloid; F/E and Abd/add

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Interphalangeal joints in foot are what type of joint? What motions?

Hinge; F/E

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List compartments of the leg.

Anterior, posterior (superficial and deep), lateral

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(X) compartment of leg divided into superficial and deep by (Y).

X = posterior
Y = transverse intermuscular septum

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Nerve and blood supply to anterior compartment of leg.

Nerve: Deep peroneal nerve
Blood: Anterior tibial artery

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Nerve and blood supply to lateral compartment of leg.

Nerve: Superficial peroneal nerve Blood: Peroneal artery

Nerve and blood supply to superficial posterior compartment of leg.

Nerve: Tibial nerve Artery: Posterior tibial artery

Nerve and blood supply to deep posterior compartment of leg.

Nerve: Tibial nerve Artery: Posterior tibial artery (and a bit from peroneal artery)

List muscles in superficial posterior compartment of leg.

1. Gastrocnemius 2. Soleus 3. Plantaris

One would have more passive dorsiflexion with a (flexed/extended) knee.

Flexed

List muscles in deep posterior compartment of leg.

1. Tibialis posterior 2. FDL 3. Flexus hallicus longus 4. Popliteus

Deep posterior leg gets blood supply from (X), which branches off of (Y) at which landmark?

``` X = posterior tibial artery Y = tibial artery ``` Inferior border of popliteus

The tibial nerve terminates as:

Medial and lateral plantar nerves

The tibial artery terminates as:

Medial and lateral plantar arteries

TDAVNH structures pass (anterior/posterior) to (X). List them.

Posterior; X = medial malleolus 1. (T)ibialis posterior tendon 2. F(D)L tendon 3. Posterior tibial (a)rtery and (v)ein 4. Tibial (n)erve 5. Flexor (h)allicus longus tendon

TDAVNH pass deep to (X), through (Y).

``` X = flexor retinaculum Y = tarsal tunnel ```

T/F: Posterior tibial artery can be palpated.

True - at medial malleolus

(X) tunnel syndrome in the foot involves compression of which structure(s)?

X = tarsal Tibial nerve

List muscles in lateral compartment of leg.

Peroneus longus and brevis

List muscles in anterior compartment of leg.

1. Tibialis anterior 2. Extensor digitorum longus 3. Extensor hallicus longus 4. Peroneus tertius

The (X) artery can be palpated on the dorsum of the foot. This is a (branch/continuation) of (Y).

X = dorsalis pedis Continuation; Y = Anterior tibial artery

(X) nerve supplies cutaneous innervation to (most/all) dorsum of foot. List exceptions, if any.

X = superficial peroneal Most; 1. Lateral strip over digit 5 (sural nerve) 2. Wedge between first two toes (deep peroneal nerve)

The "hind foot" includes which structures?

Talus and calcaneus

The "mid foot" includes which structures?

Navicular, cuboid, cuneiforms

The "fore foot" includes which structures?

Metatarsals and phalanges

List the arches of the foot.

1. Medial and lateral longitudinal | 2. Transverse

The spring, aka (X), ligament is important for (Y). What does it attach to?

``` X = Plantar calcaneonavicular Y = Foot arch support ``` Sustentaculum tali of calcenus to navicular

The short plantar, aka (X), ligament is important for (Y). What does it attach to?

``` X = plantar calcaneocuboid Y = Foot arch support ``` Calcaneus to cuboid

The long plantar ligament is important for (X). What does it attach to?

X = Foot arch support Calcaneus to cuboid and metatarsal bases (2-4/5)

The (short/long) plantar ligament is more superficial.

Long

The plantar aponeurosis attaches to:

Calcaneus to proximal phalanges of digits 1-5

T/F: The plantar aponeurosis attaches to the skin.

True - via some superficial fibers

Functions of plantar aponeurosis

1. Absorbs load during heel strike to mid stance | 2. Contributes to rigidity for effective push off

Right before push off, the plantar aponeurosis (loosens/tightens) over (X) joints, causing (Y) to displace (proximally/distally).

Tightens; X = MTP Y = calcaneus Distally ("locks it")

List the extrinsic foot muscles that support foot arches.

1. Tibialis anterior and posterior 2. Fibularis longus 3. FHL 4. FDL

Layer 1 foot muscles

1. FDB 2. Abductor digiti minimi 3. Abductor hallucis

Layer 2 foot muscles

1. Quadratus plantae | 2. Lumbricals

Layer 3 foot muscles

1. Adductor hallicus 2. Flexor digiti minimi (brevis) 3. Flexor hallicus brevis

Layer 4 foot muscles

Plantar and dorsal interossei

Most plantar (intrinsic) foot muscles are innervated by (X) nerve. List exceptions, innervated by (Y) nerve.

``` X = lateral plantar Y = medial plantar ``` 1. Abductor hallicus 2. FDB 3. Lumbrical 1 4. Flexor hallicus brevis

Most of the medial plantar surface, including medial (X) number of toes, gets cutaneous innervation from (Y).

``` X = 3.5 Y = medial plantar nerve ```

Most of the lateral plantar surface, including lateral (X) number of toes, gets cutaneous innervation from (Y).

``` X = 1.5 Y = lateral plantar nerve ```

List intrinsic dorsal muscles of foot.

1. EDB | 2. EHB

Most dorsal (intrinsic) foot muscles are innervated by (X) nerve. List exceptions, innervated by (Y) nerve.

X = Deep peroneal Both are - no exceptions

Dorsalis pedis can be palpated between which structures?

EHL tendon and first EDL tendon

At (X) landmark, dorsalis pedis gives rise to:

X = proximal to first dorsal interosseous muscle 1. Arcuate artery 2. Deep plantar artery

Arcuate artery, a branch of (X), travels in which direction?

X = dorsalis pedis Laterally, over base of metatarsals

Dorsal digital arteries arise from (X), which arise from (Y).

``` X = dorsal metatarsal arteries Y = either arcuate artery or dorsalis pedis ```

(X), a branch of (Y), passes deep - from dorsal to plantar surface - to anastamose with (Z).

``` X = Deep plantar artery Y = dorsalis pedis Z = Deep plantar arch ```

The deep plantar arterial arch receives contributions from:

1. Lateral plantar artery | 2. Deep plantar artery (from dorsalis pedis)

The deep plantar arterial arch gives rise to:

Plantar metatarsal arteries (which then give rise to plantar digital arteries)

The gait cycle starts at:

Heel strike

Gait cycle is series of events that starts from (X) and ends with (Y).

``` X = heel strike of reference limb Y = heel strike of SAME reference limb ```

Patient with lesion to right superior gluteal nerve will demonstrate deficit in which phase of gait cycle?

Right mid stance (high demand of musculature on right lower limb)

Primary concern with subcaptial femoral neck fracture is:

Interrupted blood supply to femoral head (especially via medial circumflex fem artery)

Hemiarthroplasty is defined as (X) in which (Y) is (removed/replaced).

``` X = partial arthroplasty (hip replacement) Y = only femoral (not acetabular) component ``` Replaced

If popliteal artery occluded, which arteries can supply blood to lower leg?

1. Descending genicular | 2. Descending branch of lateral circumflex femoral