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Semester 2 - MSK > 16. Functional anatomy of the foot and ankle > Flashcards

16. Functional anatomy of the foot and ankle Flashcards

1
Q

what is the function of the bones of the foot?

A

The bones of the foot provide mechanical support for the soft tissues; helping the foot to withstand the weight of the body whilst standing and in motion

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2
Q

What are the 3 groups that the bones of the foot can be divided into?

A
  1. Tarsal bone
  2. Metatarsals
  3. Phalanges
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3
Q

What are tarsal bones?

A

a set of seven irregularly-shaped bones, situated proximally in the foot

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4
Q

What are metatarsals?

A

five metatarsals (one for each toe) connect the phalanges to the tarsal bones.

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5
Q

What are phalanges?

A

the bones of the toes. Each toe has three phalanges (proximal, middle and distal), except the big toe, which only has two phalanges (proximal and distal)

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6
Q

What are the 3 regions that the foot can be divided into and what do the contain?

A

 Hindfoot – talus and calcaneus
 Midfoot – navicular, cuboid and cuneiforms
 Forefoot – metatarsals and phalanges.

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7
Q

Describe the position and function of the talus

A

The talus is the most superior of the tarsal bones. It transmits the weight of the body to the foot/ transmits forces from the tibia to the calcaneus (heel bone)

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8
Q

What are the 3 articulations of the talus?

A

 Superiorly: ankle joint, between the talus, tibia and fibula.
 Inferiorly: subtalar joint, between the talus and calcaneus.
 Anteriorly: talonavicular joint, between the talus and the navicular

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9
Q

Describe the trochlear of the talus including its shape

A

The trochlear of the talus is the part that articulates with the tibia and fibula. It is wider anteriorly compared with posteriorly; this shape provides additional stability to the dorsiflexed ankle

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10
Q

Do muscles originate from or insert into the talus?

A

Whilst numerous ligaments are attached to the talus, no muscles originate from or insert onto it

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11
Q

Describe the blood supply to the talus

A

Its blood supply is retrograde, which means that the arteries enter the bone at its distal end

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12
Q

Why is there a a high risk of avascular necrosis if the talus is fractured?

A

The lack of muscle attachments (which improve vascularity) and the retrograde blood supply mean that there is a high risk of avascular necrosis if the talus is fractured

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13
Q

What is the e calcaneus?

A

The calcaneus is the largest tarsal bone and is inferior to the talus. It constitutes the heel

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14
Q

What are the two articulations of the calcaneus?

A

 Superiorly: subtalar (talocalcaneal) joint, between the calcaneus and the talus.
 Anteriorly: calcaneocuboid joint, between the calcaneus and the cuboid.

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15
Q

What is the function of the calcaneus?

A

The calcaneus protrudes posteriorly and takes the full weight of the body when the heel contacts the ground when walking

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16
Q

What is the posterior aspect of the calcaneus marked by and what attaches to it?

A

calcaneal tuberosity to which the Achilles tendon attaches

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17
Q

What is the calcaneus and talus sometimes referred to as?

A

proximal row of tarsal bones

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18
Q

What does the intermediate row of tarsal bones contain?

A

The intermediate row of tarsal bones contains just one bone, the navicular

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19
Q

Describe the navicular bone

A

Positioned medially, it articulates with the talus posteriorly, all three cuneiform bones anteriorly, and the cuboid bone laterally. On the plantar surface of the navicular, there is a tuberosity for the insertion of part of the tibialis posterior tendon.

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20
Q

Which bones does the distal row of the tarsal bones contain?

A

In the distal row, there are four tarsal bones – the cuboid and the lateral, intermediate (or middle) and medial cuneiforms.

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21
Q

What is the position and shape of the cuboid bone? What does it articulate with?

A

The cuboid is furthest lateral and is cuboidal in shape. It articulates proximally with the calcaneus and distally with the fourth and fifth metatarsal

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22
Q

What is the inferior surface of the cuboid marked by?

A

The inferior (plantar) surface of thecuboid is marked by a groove for the tendon of peroneus (fibularis) longus.

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23
Q

describe the 3 cuneiforms

A

The three cuneiforms (medial, intermediate (or middle) and lateral) are wedgeshaped bones. They articulate with the navicular proximally, and the first, second and third metatarsals distally. The wedge shape of the cuneiform bones helps to form the transverse arch of the foot

24
Q

Where so the Tibialis anterior, tibialis posterior and peroneus (fibularis) longus all insert onto?

A

medial cuneiform.

25
Q

Where are the metatarsals located?

A

The metatarsals are located in the forefoot between the tarsal bones proximally and the phalanges distally

26
Q

Describe the metatarsals

A

They are numbered I-V from medial to lateral. Each metatarsal is convex dorsally and consists of a base (proximally), shaft, neck and head (distally).

27
Q

Describe the phalanges

A

The phalanges are the bones of the toes. The second to fifth toes all have proximal,
middle and distal phalanges. T
he great toe has only two; the proximal and distal phalanges.
The phalanges are similar in structure to the metatarsals; each phalanx consists of a base, shaft and head

28
Q

What type of joint is the ankle joint and what movements does it allow?

A

The ankle joint (or talocrural joint) is a synovial joint between the bones of the leg
(tibia and fibula) and the foot (talus). Functionally, it is a hinge joint, permitting
dorsiflexion and plantarflexion of the foot

29
Q

What are the tibia and fibula bound together by?

A

The tibia and fibula are bound together by strong tibiofibular ligaments at the distal tibiofibular joint

30
Q

What do the tibia and fibula form together?

A

Together, they form a bracket-shaped socket known as a mortise

31
Q

Where does the trochlea of the talus fit into?

A

The trochlea of the talus fits snugly into the ankle mortise (also known as the malleolar fossa).

32
Q

Describe the shape of the trochlea of the talus

A

As described previously, the trochlea of the talus is wedge shaped; it is broad anteriorly, and narrow posteriorly

33
Q

In dorsiflexion, which part of the trachlea is held in mortise? Does it make the joint more or less stable?

A

In dorsiflexion, the anterior part of

the trochlea is held in the mortise, and the joint is more stable as the anterior part is broad

34
Q

In platarflexion, which part of the trachlea is held in mortise? Does it make the joint more or less stable?

A

In plantarflexion, the posterior part of the trochlea is held in the mortise, and the joint is less stable as the posterior part is narrow so space for wiggle room

35
Q

Which movements take place at the ankle joint?

A

The only movements that take place at the ankle joint are dorsiflexion and plantarflexion.

36
Q

Which muscles produce plantarflexion of the ankle?

A

Plantarflexion of the ankle is produced by the muscles in the posterior compartment of the leg (gastrocnemius, soleus, plantaris and tibialis posterior).

37
Q

Which muscles produce dorsiflexion of the ankle?

A 
Dorsiflexion of the ankle is produced by the muscles in the anterior compartment of
the leg (tibialis anterior, extensor hallucis longus, extensor digitorum longus and peroneus tertius)
38
Q

What limits the range of dorsiflexion?

A

The range of dorsiflexion is usually limited by passive resistance in the muscles of the posterior compartment.

39
Q

which ligaments reinforce the ankle joint?

A

The ankle joint is reinforced by lateral and medial ligaments

40
Q

What are the 3 parts of the lateral ligament?

A

 The anterior talofibular ligament between the lateral malleolus and the neck of the talus
 The posterior talofibular ligament between the malleolar fossa and the lateral tubercle of the talus
 The calcaneofibular ligament between the tip of the lateral malleolus and the lateral surface of the calcaneus.

41
Q

What is the function of the 3 parts of the lateral ligament?

A

These ligaments resist inversion of the foot.

42
Q

What is the function of the medial ligament?

A

The medial (or deltoid) ligament is stronger and resists excessive eversion of the foot. Its fibres fan out from the medial malleolus to attach to the talus, calcaneus and navicular

43
Q

Where does inversion and eversion of the foot occur?

A

Inversion and eversion of the foot do not occur at the ankle joint but rather at the subtalar, calcaneocuboid and the talocalcaneonavicular joints of the midfoot.

44
Q

What is The functional significance of

inversion and eversion?

A

The functional significance of inversion and eversion is to allow walking on uneven surfaces.

45
Q

What is the subtalar joint?

A

The subtalar joint is the articulation between the talus and calcaneus. It is a plane type of synovial joint (see session 1 here). The subtalar joint is on an oblique axis and is the major joint within the foot at which eversion and inversion movements
take place

46
Q

Which muscles produce eversion of the foot?

A

Eversion is produced by the muscles of the lateral compartment of the leg (peroneus longus and peroneus brevis) and by peroneus tertius from the anterior compartment of the leg.

47
Q

Which muscles produce inversion of the foot?

A

Inversion is produced by the tibialis anterior (anterior compartment) and tibialis posterior (deep posterior compartment) muscles.

48
Q

What does the shape of its articulating

surface mean for the subtalar joint?

A

The shape of its articulating surface means that the subtalar joint has no role in plantar or dorsiflexion of the foot.

49
Q

which are the main weight bearing bones during standing?

A

The main weight bearing bones during standing are the heel and the heads of the metatarsals.

50
Q

How are the tarsal and metatarsal bones of the foot arranged?

A

The tarsal and metatarsal bones of the foot are traditionally described as being
arranged in medial longitudinal, lateral longitudinal and transverse arches

51
Q

How is the arch of the foot maintained?

A

The arches are maintained by the shape of the interlocking bones, the ligaments of the foot, the intrinsic muscles of the foot and the pull of the long tendons of extrinsic muscles (i.e. muscles in the anterior, lateral and posterior compartments of the leg)

52
Q

what is the transverse arch of the foot?

A

The transverse arch is a ‘half-arch’ two of which, when the feet are together, form a
complete arch.

53
Q

What is the medial longitundinal arch?

A

The medial longitudinal arch is of most importance clinically. It is formed by the calcaneus, talus, navicular, three cuneiforms and the medial three metatarsals

54
Q

WHich muscles play an important role in maintaining the integrity of the medial longitundinal arch?

A

The plantar aponeurosis and the spring ligament (plantar calcaneonavicular ligament; binding the calcaneum to the navicular), together with the tibialis anterior and the peroneus (fibularis) longus tendons play major roles in maintaining the integrity of this arch. The muscles supporting the medial longitudinal arch are the tibialis anterior, tibialis posterior, peroneus (fibularis) longus and flexor hallucis longus.

55
Q

What is the lateral longitudinal arch?

A

The lateral longitudinal arch is formed by the calcaneus, cuboid and lateral two
metatarsals. Contraction of the peroneus (fibularis) brevis muscle may help in supporting the lateral longitudinal arch.

56
Q

What happens to the arches of the foot in the standing position in comparison to during walking?

A

Standing: arches sink under body weight, individual bones lock together, ligaments binding them are under maximum tension and the foot becomes an immobile pedestal

Walking: tension released, unlock to become a mobile lever system with a spring- like action

Semester 2 - MSK (35 decks)

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