1. Anatomy Flashcards
1
Q
how many bones are in the foot?
A
26
(*not including sesamoids)
2
Q
how many joints are in the foot?
A
35
3
Q
name the accessory ossicle:
between 1st cuneiform and 1st & 2nd metatarsal bases
A
os intermetatarsium
4
Q
name the accessory ossicle:
proximal 5th metatarsal base
A
os vesalianum
5
Q
name the accessory ossicle:
accessory navicular
A
os tibiale externum
6
Q
name the accessory ossicle:
dorsal aspect of navicular
A
os supranaviculare
7
Q
name the accessory ossicle:
sesamoid bone in PB tendon
A
os peroneum
8
Q
name the accessory ossicle:
dorsal, anterior process of calcaneus
A
os calcaneus secondarius
9
Q
name the accessory ossicle:
posterior aspect of sustentaculum tali
A
os sustentaculi
10
Q
name the accessory ossicle:
posterior aspect of talus (Steida process)
A
os trigonum
11
Q
name the accessory ossicle:
distal to medial malleolus
A
os subtibiale
12
Q
name the accessory ossicle:
distal to lateral malleolus
A
os subfibulare
13
Q
name avascular necrosis of:
tibial sesamoid
A
Renandier
14
Q
name avascular necrosis of:
fibular sesamoid
A
Trevor
15
Q
name avascular necrosis of:
phalanges
A
Theiman
16
Q
name avascular necrosis of:
metatarsal heads
A
Freiberg
17
Q
name avascular necrosis of:
5th metatarsal base
A
Iselin
18
Q
name avascular necrosis of:
cuneiforms
A
Buschke
19
Q
name avascular necrosis of:
navicular
A
Kohler
20
Q
name avascular necrosis of:
cuboid
A
Lance
21
Q
name avascular necrosis of:
talus
A
Diaz
22
Q
name avascular necrosis of:
calcaneus
A
Severe (?)
23
Q
name avascular necrosis of:
proximal, medial tibial epiphysis
A
Blount
24
Q
name avascular necrosis of:
tibial tuberosity
A
Osgood-Schlatter
25
name avascular necrosis of:
## Footnote
**femoral epiphysis**
Legg-Calve-Perthes
26
what attaches **periosteum to bone?**
Sharpey fibers
27
what are the 3 different types of coalitions?
syndesmosis, synchondrosis, synostosis
* syn**DESMOSIS -** _fibrous_
* syn**CHONDROSIS -** _cartilaginous_
* syn**OSTOSIS -** _osseous_
28
what is the difference between a **coalition** and a **bar**?
* **coalition -** intra-articular fusion of 2 bones
* **bar -** EXTRA-articular fusion
29
what is the most common **coalition in the foot?**
distal and middle phalanx of 5th digit
30
what is the most common **coalition in the rearfoot**?
talocalcaneal
31
what is a **steida process?**
enlarged Os Trigonum
32
what is the only bone in the foot
## Footnote
**without any muscle origin or tendon insertion?**
talus
33
what are the **plantar muscle layers** of the foot
from superficial to deep?
1. (_superficial_) abductor hallucis, flexor digitorum brevis, abductor digiti minimi
2. quadratus plantae, 4 lumbricals
3. flexor hallucis brevis, adductor hallucis, flexor digiti minimi
4. 3 plantar interossei, 4 dorsal interossei (_deep_)
34
what _layer_ of the foot does the **Flexor Digitorum Longus** run?
2nd layer;
it is the origin of the lumbricals AND the insertion of quadratus plantar
35
what deformity will result from cutting Quadratus Plantae (QP)?
digits 4 and 5 will become adductovarus
*(because action of QP is to assist FDL with flexion of DIP joints)*
36
how is Extensor Digitorum Longus (EDL) attached to the proximal phalanxes?
sling wraps around the capsule --\>
which attaches to plantar plate, deep transverse metatarsal ligament (DTML), and flexor sheath --\>
thus attaching to plantar proximal phalanx
\*there is NO DIRECT INSERTION to proximal phalanx\*
37
what is the origin and insertion of the
## Footnote
**capsularis tendon?**
**o:** extensor hallucis longus (EHL) muscle or tendon
**i:** first metatarsophalangeal joint capsule (1st MTPJ capsule)
38
**Master Knot of Henry:**
define
**fibrous** connection between the _FHL and FDL tendons_
39
which structures attach to the **FIBULAR SESAMOID**?
6 total attachments
1. plantar metatarsal-phalangeal ligament
2. lateral metatarsal-sesamoidal ligament
3. intersesamoidal ligament
4. phalangeal-sesamoidal ligament
5. FHB (flexor hallucis brevis) tendon
6. ADH (adductor hallucis tendon)
40
are the sesamoids capsular or extra-capsular?
CAPSULAR
sesamoids are found within joint capsule
41
**Lisfranc ligament:**
define
attaches lateral aspect of medial cuneiform
to medial base of 2nd metatarsal
42
what structures in the Lisfranc joint are NOT connected by ligaments?
1st and 2nd metatarsals
43
**spring ligament:**
true name
plantar calcaneonavicular ligament
| (*plantar CN ligament*)
44
which ligaments compose the
## Footnote
**bifurcate ligament**
dorsal calcaneonavicular, and
calcaneocuboid ligaments
*(bifurcate lig = dorsal CN and CC ligaments)*
45
**bifurcate ligament:**
other names, and course
aka internal calcaneocuboid, interosseous ligament, or bifurcated ligament
* strong band, attached behind to the deep hollow on the upper surface of the **calcaneus** and
* dividing in front in a Y-shaped manner into a **calcaneocuboid** and a **calcaneonavicular** part
46
which is stronger?
deltoid ligament or lateral ankle ligaments
deltoid ligament
(*deltoid is stronger than lateral ankle ligaments, and therefore provides more medial ankle stability --\> this is why lateral ankle sprains are more common than medial)*
47
components of deltoid ligament
* _Superficial_: tibionavicular, tibiocalcaneal, posterior tibiotalar
* _Deep_: anterior tibiotalar
## Footnote
*(4 total: 3 superficial, 1 deep)*
48
what tendons pass OVER the deltoid ligament?
tibialis posterior & flexor digitorum longus (FDL)
*(2 tendons: PT, FDL)*
49
**lateral ankle ligaments**
list
* anterior talofibular
* calcaneofibular
* posterior talofibular
50
what angle do the **ATFL and CFL create?**
105 degrees
51
what is the **strongest** **lateral** ankle ligament?
posterior talofibular (PTFL)
(*lateral ankle ligaments rupture in order of ATFL, CFL, PTFL - most common to least commonly ruptured)*
52
which ankle ligaments are EXTRA-CAPSULAR versus CAPSULAR?
calcaneofibular ligament (CFL) is EXTRA-CAPSULAR;
all others are capsular
53
which tendons pass over the:
lateral ankle ligaments?
PB and PL
## Footnote
*(peroneus brevis and peroneus longus pass over lateral ankle ligaments)*
54
which ligaments support the:
## Footnote
**ankle syndesmosis**
* anterior-inferior tibiofibular ligament
* posterior-inferior tibiofibular ligament
* interosseous tibiofibular ligament
*(3: AITFL, PITFL, Interosseous ligaments)*
55
**Basset ligament**
define
anterior-inferior tibiofibular ligament
*(AITFL is Bassett ligament)*
56
another name for **flexor retinaculum**
**laciniate** ligament
*(origin: Mid 18th century from Latin **lacinia** meaning ‘**fringe, hem, flap of a garment**’)*
57
another name for **superior extensor retinaculum**
transverse crural ligament
58
another name for **inferior extensor retinaculum**
cruciate crural ligament
59
**plantaris**:
insertion
i: medial aspect of tendo-achilles into calcaneus
* (o: Lateral supracondylar ridge of femur above lateral head of gastrocnemius,*
* a: Plantar flexes foot and flexes knee)*
60
**peroneus quartus:**
incidence
7%
*(only 7% of patients have a QP)*
61
**Hoke tonsil** (or Hoke's):
define
a fibrous, fatty plug within the _sinus tarsi_
62
**pes anserinus**
define
insertion of Sartorius, Gracilis, and Semitendinosus (anteromedial aspect of proximal tibia) where bursa may cause knee pain
*(CC: pes anserinus bursitis)*
63
**Baker's cyst**
define
swelling of the bursa between the tendons of the medial head of the **gastrocnemius** and the **semimembranosus** muscles
64
**fabella**
define
sesamoid bone occasionally found in the tendon of **lateral head of gastrocnemius**
65
which nerves form the **sural nerve**
* **medial sural cutaneous nerve** - branch of the tibial nerve
* **sural communicating branch** - branch of the lateral sural cutaneous nerve, which originates from the common peroneal nerve
66
does a neuroma lie dorsal or plantar to the deep transverse intermetatarsal ligament?
plantar
67
where do these muscles run in relation to the deep transverse intermetatarsal ligament?
(interossei, lumbricals)
* Interossei – dorsal
* Lumbricals – plantar
68
in which layers of the foot do the plantar nerves run?
* Medial plantar nerve – in the 1st layer (between FDB and abductor hallucis)
* Lateral plantar nerve – between the 1st and 2nd layers
69
what is the innervation to the plantar muscles of the foot?
blood supply?
**(Never LAFF at A FAD)**
* N – medial plantar Nerve
* L – 1st Lumbrical
* A – ABH
* F – FHB
* F – FDB (innervated by both medial and lateral plantar nerves)
* A – medial plantar Artery
* F – FDB
* A – ABH
* D – 1st Dorsal interossei
70
what are the branches of the femoral nerve?
* *-Nerve to femoral artery
- Small muscular branch to pectineus
- Anterior division (cutaneous)**
* Anterior femoral cutaneous
* Nerve to sartorious
* Intermediate femoral cutaneous nerve
* Medial femoral cutaneous nerve
**-Posterior division (muscular)**
* Saphenous nerve
* Infrapatellar branch
* Medial crural cutaneous nerve
* Nerve to rectus femorus
* Nerve to vastus medialus
* Nerve to vastus intermedialus
* Nerve to vastus lateralus
71
what are the branches of the femoral artery?
* Superficial epigastric artery
* Superficial circumflex iliac artery
* Superficial external pudendal artery
* Deep femoral (profunda femoris) artery
* Medial femoral circumflex artery
* Lateral femoral circumflex artery
* Descending genicular artery
* Femoral artery continues as the popliteal artery
72
Trace the path of a drop of blood from **left ventricle** to the **hallux**
* **Ascending aorta →**
* aortic arch →
* descending aorta →
* thoracic aorta →
* abdominal aorta →
* common iliac artery →
* external iliac artery →
* femoral artery →
* deep femoral artery →
* popliteal artery →
* anterior tibial artery →
* dorsalis pedis →
* 1st dorsal metatarsal artery →
* 1st dorsal common digital artery →
* **1st dorsal proper digital artery**
73
what are the sources of blood supply to the talus?
Essentially the 3 major blood supplies to the foot:
* **Superior surface of head and neck** – artery of sinus tarsi and branch from anterior tibial artery or dorsalis pedis
* **Medial side of body** – artery of tarsal canal and posterior tibial artery
* **Lateral turbercle** – anastamosis of branch of peroneal artery with medial calcaneal branch
74
what are the sources of blood supply to tendons?
1. myotendinous junction
2. paratenon
3. at the insertion to bone
