5/11/2015 "Gross Anatomy Leg/Ankle/Foot Miriam L. Donohue"

Question 1

Does the fibula participate in weight bearing?

Answer 1

Yes, but minimally compared to the larger tibia.

Question 2

What is the role of the fibula in the formation of the knee joint?

Answer 2

No part!

Question 3

What is the role of the fibula in the formation of the ankle joint?

Answer 3

The medial aspect of the fibula forms part of the ankle joint, together with the lateral malleolus of the tibia and the trochlea of the talus.

Question 4

Describe the clinical consequences of damage to the common fibular nerve.

Answer 4

Foot drop, loss of sensation on top of foot

Inability to heel walk (dorsiflexion)

Question 5

How is the common fibular nerve typically damaged?

Answer 5

Trauma to the neck of the fibula, which the common fibular nerve winds around.

Question 6

List the bones that participate in the formation of the ankle joint.

Answer 6

Tibia (medial malleolus)
Fibula (lateral malleolus)
Trochlea of talus

Question 7

What ligaments stabilize the ankle joint?

Answer 7

Lateral and medial deltoid ligaments

Anterior and posterior inferior tibiofibular ligaments

Question 8

In what position is the ankle most stable?

Answer 8

Dorsiflexed position

Question 9

What are the muscles involved in dorsiflexion (heel walk)?

Answer 9

Anterior crural compartment muscles
Tibialis anterior, extensor digitorum longus, extensor hallicus longus, fibularis tertius
Innervated by deep branch of common fibular nerve

Question 10

What are the muscles involves in plantar flexion (toe walk)?

Answer 10

Superficial posterior crural compartment muscles (gastrocnemius and soleus)
Innervated by tibial nerve

Question 11

Drop foot is caused by a lesion of what nerve/nerve root?

Answer 11

Common fibular nerve/L5 root damage

Question 12

A lesion of what nerve/nerve root will make it difficult to heel walk?

Answer 12

Impaired dorsiflexion

Damage to common fibular nerve/L5

Question 13

A lesion of what nerve/nerve root will make it difficult to toe walk?

Answer 13

Impaired plantar flexion

Damage to tibial nerve/S1 nerve root

Question 14

What is pronation/eversion of the feet?

Answer 14

Can’t hold soup between both feet, pinky toes up

Question 15

What is supination/inversion of the feet?

Answer 15

Hold soup between both feet, big toes up

Question 16

What muscles are responsible for pronation/eversion of the feet?

Answer 16

Fibularis longus
Fibularis brevis
(both lateral crural compartment)
Innervation by superficial branch of common fibular nerve

Question 17

What muscles are responsible for supination/inversion of the feet?

Answer 17

Tibialis anterior, innervation by deep branch of common fibular nerve
Tibialis posterior, innervation by tibial nerve

Question 18

Which is more common, pronation or supination injuries of the foot?

Answer 18

Inversion (supination) injuries, bc the lateral ligament (resists excessive supination) of the ankle is not as strong as the deltoid ligament (resists excessive pronation)

Question 19

How can a traumatic eversion injury result in fracture/dislocation of the lateral malleolus?

Answer 19

Aka a Potts fracture-dislocation
the medially-directed force of the trauma tears the deltoid ligament causing a fracture of the medial malleolus, subsequent movement of the talus and tibia can result in fracture of the lateral malleolus or the fibula.

Question 20

Damage to what ligament results in flat feet?

Answer 20

Spring ligament

Question 21

What are the clinical symptoms of a tibial nerve lesion?

Answer 21

Impaired toe walking (plantar flexion)
Difficulty flexing the ankle
Walking can be near impossible