88 - Tibiofibular and Ankle Joints

Question 1

Weight bearing bone of the leg

Answer 1

Tibia

Question 2

Role of fibula

Answer 2

Muscle attachments (non-weight-bearing)

Question 3

Only muscle that articulates with fibula

Answer 3

Biceps femoris

Question 4

Number of muscles originating from fibula

Answer 4

Eight

Question 5

Common association with fracture of either tibia or fibula

Answer 5

Tend to fracture both tibia and fibula together (as both bones are joined strongly)

Question 6

Part of tibia most vulnerable to fracture

Answer 6

Junction between inferior and mid 3rds of bone (where bone is the thinnest and has poorest blood supply)

Question 7

Features of superior tibiofibular joint
1
2

Answer 7

A plane synovial joint, which allows some gliding movement

Has anterior and posterior tibiofibular ligaments (reinforce the joint)

Question 8

Features of inferior tibiofibular joints

1-4

Answer 8

• Fibrous joint (syndesmosis), which prevents tibia & fibula from separating (in weight bearing)
• Has anterior, posterior and interosseous ligaments
• Large role is shock absorption
• Can be separated (diastasis)

Question 9

How can inferior tibiofibular joint be injured?

Answer 9

Falling from a height onto leg (diastasis, which is separation of syndesmosis (fibrous reinforcement of joint)

Question 10

Basic layout of bones of the foot

Answer 10

Similar to hand and wrist, but first two bone s(calcaneus, talus) are orientated vertically

Question 11

Bone of foot that articulates with tibia

Answer 11

Talus

Question 12

Bone of foot that is heel

Answer 12

Calcaneus

Question 13

Tarsal bones

1-5

Answer 13

Calcaneus
Talus
Navicular
Three cuneiform bones
Cuboid

Question 14

Metatarsal at risk of fracture

Answer 14

Second metatarsal

Question 15

Why is the second metatarsal at risk of fracture with repeated force?

Answer 15

Slender.
Connected to third metatarsal (limited movement).
‘March fracture’

Question 16

Phalanges of foot

Answer 16

Two in hallux (big toe)

Three in other toes.

Question 17

Sesamoid bones under first metatarsal

Answer 17

Two under first metatarsal, which form a channel

Question 18

Sesamoid bones of foot

Answer 18

All over foot, can be mistaken for a fracture

Question 19

Articulations of talus bone
1
2
3

Answer 19

Ankle joint above
Subtalar joints (below
Midtarsal joint (in front, talocalcaneonavicular joint and calcaneocuboid joint)

Question 20

Type of joint that the ankle is

Answer 20

Hinge

Question 21

Shape of ankle joint

Answer 21

‘Mortice’ formed between malleoli of tibia and fibula.
Mortice is deepened posteriorly by inferior transverse ligament.
Talus inserts into mortice

Question 22

Angle of ankle joint

Answer 22

Oblique angle (so with plantarflexion, sole of foot points medially)

Question 23

Ligaments of ankle joint

Answer 23

Medial side has a strong ligament, which is rarely injured.

Lateral ligament is made of three discrete bands (anterior and posterior talofibular and calcaneofibular).

Question 24

Most common foot position of ankle injury

Answer 24

Plantarflexion with foot inverted (sole facing inwards)

Question 25

Subtalar joint

Answer 25

Between talus and calcaneus

Question 26

Midtarsal joint

Answer 26

Between calcaneus, talus and naviculus.

Question 27

Joints between metatarsals 1 2 3

Answer 27

Tarsometatarsal joints metatarsophalyngeal joints Interphalyngeal joints

Question 28

Name of canal separating posterior surface of subtalar joint

Answer 28

Sinus tarsi

Question 29

Ligament of subtalar joint that resists inversion and eversion

Answer 29

Interosseous tali-calcaneal ligament

Question 30

Movements at subtalar joint

Answer 30

Inversion and eversion (inversion is greater than eversion)

Question 31

Movements at midtarsal joints

Answer 31

Pronation (eversion + abduction) | Supination (inversion + adduction)

Question 32

Movements of metatarsophalyngeal joints

Answer 32

Same as metacarpophalyngeal joints: | Flexion, extension, adduction, abduction

Question 33

Movements of interphalangeal joints of foot

Answer 33

Same as those of hand | Flexion and extension

Question 34

Plantar aponeurosis 1 2 3

Answer 34

Between calcaneus and heads of the metatarsals. It binds skin of foot for grip and protection. Maintains longitudinal arches of foot.

Question 35

Clinical significance of plantar aponeurosis

Answer 35

Plantar fasciitis (inflammation), which can lead to bony changes in plantar aponeurosis (bony spurs), which are very painful