anatomy of the foot and ankle

Question 1

what are the three divisions of the bones in the foot

Answer 1

tarsal bones- 7 irregularly shaped bones situated proximally in the foot
metatarsals- 5 bones that connect the phalanges to the tarsal bones
phalanges- bones of the toe. each doe has 3 phalanges except the big toe which has only 2.

Question 2

what bones are in the hindfoot

Answer 2

talus

calcaneus

Question 3

what bones are in the mid foot

Answer 3

navicular
cuboid
cuneiforms

Question 4

what bones are in the forefoot

Answer 4

metatarsals

phalanges

Question 5

function of talus

Answer 5

to transmit forces from tibia to the calcaneus

the trochlear of the talus is the part that articulates with the tibia and fibula. its wider anteriorly than posteriorly

Question 6

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

Answer 6

• lack of muscle attachments on talus

- retrograde blood supply- the arteries enter the bone at its vital end

Question 7

what type of joint is the ankle joint and what movement does it allow

Answer 7

synovial joint
hinge joint
permits dorsiflexion and plantar flexion of the foot

Question 8

explain position of talus in dorsi and plantar flexion

Answer 8

the distal tibiofibular joint forms a bracket shaped socket known as a mortise. the trochlea of the talus cuts into the ankle mortise (aka malleolar fossa). in dorsiflexion the anterior part of the trochlear of the talus is held in mortise and joint is more stable. in plantar flexion posterior part of trochlea is held in the mortise and the joint is less stable.

Question 9

what muscles allow plantarflexion od the ankle

Answer 9

gastrocnemius
soleus
plantaris
tibialis posterior

Question 10

what muscles allow dorsiflexion of the ankle

Answer 10

tibialis anterior
extensor hallucis longus
extensor digitorium longus
peroneus tertius

Question 11

what are the lateral ligaments in the ankle joint and what do they do

Answer 11

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

they resist inversion of the foot

Question 12

what does the medial ligament in the ankle joint do

Answer 12

Aka deltoid ligament
resists excessive eversion of the foot
its fibres fan out from the medial mallelous to attach to the talus, calcaneus and navicular.

Question 13

at what joints do eversion and inversion of the foot occur

Answer 13

subtalar, calcaneocuboid and the talocalcaneonavicular joints of the mid foot.

Question 14

what muscles bring about eversion of the foot

Answer 14

lateral compartment of leg: peroneus longus and peroneus brevis
anterior compartment : peroneus tertius

Question 15

what muscles bring about inversion of the foot

Answer 15

tibialis anterior 
tibialis posterior (deep posterior compartment) muscles.

Question 16

how can power of tibialis anterior be tested

Answer 16

ask patient to stand on their heels with their forefeet raised not the ground.

Question 17

tibialis anterior:origin, insertion, action, innervation

Answer 17

originates from lateral surface of tibia and inserts onto medial cuneiform and the base of the first metatarsal.
-dorsiflexion and inversion of the foot
supplied by deep pernoneal(fibular) nerve

Question 18

extensor digitorum longus: origin, insertion, action, innervation

Answer 18

originates from lateral condyle of the tibia, medial surface of fibula and interosseous membrane. fibres merge into a single tendon into the ankle where it divides into 4 tendons on dorsal of the foot.
actions: extension of the lateral 4 toes and assist in dorsiflexion of the foot
innervation : deep fibular nerve

Question 19

extensor hallucis longus:origin, insertion, action, innervation

Answer 19

originates from medial surface of the fibular shaft attaches to the base of the distal phalanx of the great toe
action: extension great toe and dorsiflexion of the foot
innervation - deep fibular nerve.

Question 20

peroneus (fibularis) tertius :origin, insertion, action, innervation

Answer 20

not present in everyone.
originates from medial surface of the fibula and descends with the EDL then diverges from it and inserts onto the base of the fifth metatarsal.
action : eversion and assist in dorsiflexion of the foot
innervation: deep fibular nerve.

Question 21

what muscles are in lateral compartment of the leg

Answer 21

fibularis longus

fibularis brevis

Question 22

fibulas longus :origin, insertion, action, innervation

Answer 22

orginates from upper lateral surface of the fibula and the lateral tibial condyle and inserts onto the plantar surface of the medial cuneiform and base of the first metatarsal.
action : peroneus longus everts and assists in plantar flexion of the foot. also support the medial and transverse arches of the foot.
innervation : superficial fibular nerve

Question 23

fibularis brevis:origin, insertion, action, innervation

Answer 23

originates from inferolateral surface of the fibular shaft and insert onto a tubercle on the base of the fifth metatarsal.
actions : eversion of the foot and supports lateral longitudinal arch
innervation : superficial fibular nerve

Question 24

what are the muscles in the superficial posterior compartment of the leg

Answer 24

gastrocnemius
plantaris
soleus

Question 25

what is the nurse associated with the calcaneal tendon and what is its role

Answer 25

subcutaneous calcaneal bursa- between the skin and the calcaneal tendon deep calcaneal bursa -between calcaneal tendon and the calcaneus to reduce friction during movement

Question 26

gastrocnemius:origin, insertion, action, innervation

Answer 26

has two heads originates from the lateral femoral condyle, and medial head from the medial femoral condyle. fibres converge and form a single tendon with the soleus and planataris to form the calcaneal tendon which inserts into the calcaneal tuberosity Actions: It plantarflexes at the ankle joint Innervation: Tibial nerve

Question 27

plantaris:origin, insertion , action , innervation

Answer 27

has a long thin tendon that can be mistaken for. nerve originates from lateral supracondylar line of femur action : very weak plantar flexor of foot and flexor of knee so is harvested by plastic surgeons innervation : tibial nerve

Question 28

soleus:origin, insertion , action , innervation

Answer 28

originates from shell line of the tibia and proximal fibula and inserts onto calcaneal tuberosity. actions: soleus plantar flexes the foot at the ankle joint innervation: tibial nerve

Question 29

muscles in deep posterior compartment of leg

Answer 29

popliteus tibialis posterior flexor digitorum longus flexor hallucis longus

Question 30

politeus:origin, insertion , action , innervation

Answer 30

originates from the tibial proximity to the solar line and inserts onto the lateral condyle of the femur and the posterior horn of the lateral meniscus. actions: laterally rotates the femur on the tibia unlocking the knee joint so that flexion can occur. innervation : tibial nerve

Question 31

tibialis posterior :origin, insertion , action , innervation

Answer 31

Originates from the interosseous membrane between the tibia and fibula and attaches to the plantar surfaces of the medial tarsal bones. Actions: Inverts and plantarflexes the foot, maintains the medial arch of the foot. Innervation: Tibial nerve.

Question 32

Flexor Digitorum Longus:origin, insertion , action , innervation

Answer 32

Attachments: Originates from the medial surface of the tibia, attaches to the plantar surfaces of the lateral four digits. Actions: Flexes the lateral four toes. Innervation: Tibial nerve.

Question 33

Flexor Hallucis Longus:origin, insertion , action , innervation

Answer 33

Attachments: Originates from the posterior surface of the fibula, attaches to the plantar surface of the phalanx of the great toe. Actions: Flexes the great toe. Innervation: Tibial nerve.

Question 34

what are the nerve roots of the tibial nerve

Answer 34

L4-S3

Question 35

what does the tibial nerve innervate

Answer 35

innervates skin of :posterolateral side of leg ,lateral foot ,sole of foot provides motor innervation to :deep and superficial posterior compartments of leg.

Question 36

name the muscles the tibial nerve supplies

Answer 36

posterior thigh: long head of biceps femoris , semimembranosus, semitendinosus, hamstring compartment of adductor Magnus superficial posterior compartment of leg: planters, soleus, gastrocnemius deep posterior compartment of the leg: popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

Question 37

what are the sensory branches of the tibial nerve

Answer 37

medial sural cutaneous nerve medial calcaneal branches medial plantar nerve lateral plantar nerve

Question 38

root values of common perineal (fibular nerve )

Answer 38

L4-S2

Question 39

muscles supplied by common perineal nerve

Answer 39

short head of biceps femoris

Question 40

the cutaneous supply of the common perineal nerve is :

Answer 40

skin of upper lateral leg | lateral sural cutaneous nerve

Question 41

what muscles are supplied by the superficial peroneal nerve

Answer 41

peroneus (fibularis) longus | peroneus (fibularis) brevis

Question 42

where is the cutaneous supply of the superficial fibular nerve to ?

Answer 42

dorsum of the foot excluding dorsum of the first webspace and the medial and lateral borders of the foot.

Question 43

which compartment of the leg is innervated by the deep perineal nerve

Answer 43

anterior compartment

Question 44

which muscles are supplied by the deep peroneal nerve

Answer 44

tibialis anterior extensor hallucis longus extensor digitorum longus fibularis tertius

Question 45

where is the cutaneous innervation of the deep fibular nerve to?

Answer 45

dorsum of the first webspace

Question 46

where does the superficial femoral artery become the popliteal artery

Answer 46

when it passes through the adductor hiatus

Question 47

what does the popliteal artery divide into at the inferior border of the popliteus muscle

Answer 47

anterior tibial artery and tibioperoneal trunk. tibioperoneal trunk becomes posterior tibial and the fibular arteries

Question 48

what does the anterior tibial artery become when it passes into the dorsum of the foot

Answer 48

dorsalis pedis artery

Question 49

arrangement behind the medial mallelosu

Answer 49

``` tibialis posterior tendon flexor digitorum longus tendon posterior tibial artery posterior tibial vein tibial nerve flexor hallucis longus ```

Question 50

what artery supply the foot

Answer 50

dorsalis pedis | posterior tibial

Question 51

the pulses of the lower limb

Answer 51

femoral pulse popliteal artery dorsalis pedis posterior tibial

Question 52

borders of the popliteal fossa

Answer 52

superomedial border: semimembranosus superolateral border: biceps femoris inferomedial border : medial head of the gastrocnemius ininferolateral border: lateral head of the gastrocnemius and plantaris

Question 53

what forms the floor and roof of the popliteal fossa

Answer 53

The floor of the popliteal fossa is formed by the posterior surface of the knee joint capsule, popliteus muscle and posterior femur. The roof is made of up two layers: popliteal fascia and skin.