16 Flashcards
Recap of the knee joint - lowkey dont learn this no exam questions
Tibofemotal (condylar joint - flexion extention and a bit of rotation) and patellofemoral joints (plane synovial joint - small sliding movements in all directions)
Joint capsule :
Ligaments of the knee joint:
- collateral
- cruciate
- patellar ligament
Menisci
Muscles
What is the role of the foot and ankle?
Stability
• Stable base to support body weight during stance and locomotion
• Rigid lever for effective push-off during gait
Mobility
• Influences other joints
• Flexible for shock absorption
• Conform to changing surfaces
Lateral malleolus belongs to the fibular
Medial malleolus belongs to the tibia
Most of weight bearing of the leg is through which bone
Tibia - 90%
What are the tibia and fibular joined by?
Interosseous membrane
What kind of joint is the superior tibiofibular joint
Synovial
What kind of joint is the inferior tibiofibular joint
Fibrous
What is the superior tibiofibular joint and inferior tibiofibular joint reinforced by?
– Anterior tibiofibular ligament
– Posterior tibiofibular ligament
What kind of joint is the middle tibiofibular joint?
Low key not a real joint
- but fibrous
Interosseous membrane
- what kind of tissue
DFCT
Function of the Interosseous membrane
- keeps the tibia and fibula together - joins them
- stable joint not much movement
- helps compartmentalise the leg
- site of muscle attachment
How many bones in the foot
28
How many composite joints in the foot
25
Tarsal bones
Bones of the feet
How many phalanges
14
How many metatarsals
5
Three feet arches
Medial longitudinal arch
Lateral longitudinal arch
Transverse arch
Transverse arch
Three arches of the foot
• Medial longitudinal
• Lateral longitudinal
• Transverse
What are the arches off the foot formed and supported by
Bones, ligaments, plantar fascia, muscles, tendons
What do the arches of the foot provide ?
• Stability and flexibility
• Absorb and distribute force
• Aid propulsion
Joint classification of the ankle joint
Synovial
Hinge (one plane)
Movements of the ankle joint
Dorsiflexion, plantar flexion
Muscles that pass over the dorsal (top) surface of the foot cause what movements?
Dorsiflexion of the ankle joint
Extention of the toes
Muscles that pass over the plantar surface of the the foot cause what movement?
– plantarflex the ankle joint, and/or
– flex the toes
What bones form the ankle joint socket ?
• Medial malleolus (tibia)
• Lateral malleolus (fibula)
• Inferior surface of the distal end of tibia
The tibia and fibula articulate with the talus (trochlea surface)
What joint allows for inversion and eversion
The subtalar joint (between the talus and calcaneus)
Where is the subtalar joint ?
between the talus and calcaneus
Where does the joint capsule attach ?
Around joint margins
What is the ankle joint capsule strengthened by?
strong collateral ligaments (which are capsular ligaments)
What does the joint capsule do in the Sagittarius plane
AIDS stability
Two capsular ligaments that stabilise the ankle
Lateral collateral ligaments
Medial collateral (deltoid) ligament
Function of the lateral collateral ligament
Restricts inversion
Function of the medial collateral ligament
Restricts eversion
What is the functions of the medial collateral ligament
Restricts eversion
Which is stronger the lateral collateral ligament or the medial collateral ligament
Medial
Which ligament is commonly damaged in ankle sprain
Lateral collateral ligament
How many parts are there of the posterior compartment of the leg
Two parts
Superficial and deep
What nerves supply the leg and foot?
Gastocnemois and solues are part of the superficial / posterior plantar flexor component
Yes
Origin and insertion of gastrocnemius
Origin
- medial and lateral femoral condyles
Insertion
- calceneus via calcaneal (archilles) tendon
Function of the gastrocnemius at the knee
Flexion
Function of the gastrocnemius at the ankle
Plantarflexion
Function of the gastrocnemius during gait
Propulsion
Where is the soleus located in relation to the gastrocnemius
Deep
- does not cross the knee joint
Origin and insertion of the soleus
Origin:
- tibia and fibula (upper third)
- interosseous membrane
Insertion:
- calcaneus via calcaneal (archilles) tendon
Function of the soleus muscle at the knee
No action
Function of plantarflexors at the ankle
Plantarflexion
What else is the soleus important for?
postural muscle (e.g., during standing,
propulsion during gait)
what is an extrensic foot muscle
- muscle in the leg
- long tendon attaching to foot
Features of extrinsic muscles
- control various foot movements
- each muscle has a muscle belly in the leg and a long tendon attaching to the foot
What holds the tendons of extrinsic foot muscles in place ?
Retinacula
What are retinacula ?
Thickenings of the deep fascia of the leg
What are the tendons of extrensic foot muscles surrounded by as they pass under the retinacula?
Synovial tendon sheaths
(To reduce friction)
What is the function for the retinacula
- hold tendons down as they pass around the joint - prevents floppy tendons
Where are the deep flexors located?
Deep posterior compartment of the leg
3 deep flexors
• Tibialis posterior (TP)
• Flexor digitorum longus (FDL) (goes to toes 2-5)
• Flexor hallucis longus (FHL) (goes to big toe)
Where do the tendons of the deep flexors pass in relation to the medial malleolus
Posterior
This tells us they are involved in Plantarflexion
Origin and interior of tibialis posterior
Origin:
Tibia
Interssous membrane
Insertion:
Medial cuneiform and navicular
Insertion of the deep flexors - FDL and FHL
FDL: distal phalanges of toes 2-5
FHL: distal phalanx big toe
Where is the ankle do deep flexors + ect pass through
Pass through tarsal tunnel (transition from leg to foot, under flexor retinaculum)
Order of structures from closest of medial melleolus
• Tom Tibialis posterior
• Dick Flexor Digitorum longus
• And Artery (posterior tibial)
• Very Vein (posterior tibial)
• Nervous Nerve (tibial)
• Harry Flexor Hallucis longus
Function of FHL and FDL at the ankle
Plantarflexion
Function of FHL at the toes
Flex big toe
Function of FDL at the toes
Flex toes 2-4
What other functions do deep flexors have
• Stabilise medial longitudinal arch (especially tibialis posterior)
• Propulsion at toe-off (FHL)
What supports the head of the talus and why?
• Spring ligament supports the head of the talus
• Further supported by the tibialis posterior tendon to
maintain the medial longitudinal arch
What causes flat foot deformity ?
a ruptured tibialis posterior tendon
What is the third most frequent tendon rupture in the lower limb?
a ruptured tibialis posterior tendon
What does a ruptured tibialis posterior tendon result from?
aging, trauma or denervation
Three anterior muscles of the leg
• Tibialis anterior
• Extensor digitorum longus (EDL)
• Extensor hallucis longus (EHL)
Nerve supply of the anterior muscles of the leg
Deep fibuar nerve
Blood supply of the anterior muscles of the leg
Anterior tibial artery and vein
Function of the anterior muscles of the leg
- dosriflexion
- extension of the knee
Where is the tibialis anterior located?
• Upper 2/3 of tibia and adjacent interosseous membrane
Where does the tibialis anterior arise from? Where does it insert into?
Origin: Tibia
Insertion: • Medial cuneiform, base of 1st metatarsal
Where does Extensor digitorum longus (EDL) and Extensor hallucis longus (EHL) originate and insert into?
Insertions (dorsal surface)
EDL: Distal phalanges of toes 2–5 EHL: Distal phalanx big toe
Where do the tendons of the anterior muscles of the leg pass under?
The extensor retinacula
What is the function of the anterior leg muscles at the ankle
Dorsiflexion
What is the function of the anterior leg muscles at the toes
Extension of the hallux/big toe (EHL), extension toes 2–5 (EDL)
What is the function of the anterior leg muscles at the subtalar joint
Inversion
What other functions does anterior muscles of the leg have?
Stabilise medial longitudinal arch (tibialis anterior)
Two lateral muscles of the leg
Fibularis (peroneus) longus
Fibularis (peroneus) breves
Origin of the Fibularis (peroneus) longus and Fibularis (peroneus) brevis
Fibular
Insertion of • Fibularis (peroneus) longus
• Fibularis (peroneus) brevis
• Fibularis longus: base of 1st metatarsal
(passes under foot)
• Fibularis brevis:base of 5th metatarsa
What does fibularis longus do?
Helps stabilise the transverse and lateral longitudinal arches of the foot
Function of lateral muscles of the leg at the ankle
Plantarflexion (weak)
Function of lateral muscles of the leg at the subtalar
Eversion
Function of the lateral muscles of the leg at the toes
No action
Other functions of the lateral muscles of the leg
- both stabilise the lateral longitudinal arch
- fibularislongus stabilises the transverse arch (due to its course along plantar surface of foot)
What tendons stabilise the medial longitudinal arch?
Medial longitudinal arch is supported by tendons that pass on the medial aspect of the foot such as tendons from:
- tibialis anterior
- tibialis posterior
- long toe flexor tendons (when walking)
What tendons is the lateral longitudinal arch supported by?
Lateral longitudinal arch is supported by tendons that pass on the lateral aspect of the foot
- fibularis longus
- fibularis brevis
What tendons support the transverse arch?
The transverse arch is supported by tendons that pass transversely
- fibularis longus
- small intrinsic muscles of the foot also support the arch
Whats in the superficial posterior compartment compared to the deep posterior compartment
Superficial posterior compartment
- gastrocnemius
- soleus
Deep posterior compartment
- tibialis posterior
- flexor hallucis longus
- flexor digitorum longus
