Anatomy Plantar Foot Flashcards
How many tarsus bones do we have in the foot?
7 bones
How many metartarsus bones do we have in the foot?
5
How many phalanges do we have in the foot?
14
What makes up the hindfoot?
talus and calcaneus
What makes up the midfoot?
navicular, cuboid, and cuneiforms
What makes up the forefoot?
metatarsals and phalanges
What ligament connects the tibia and the fibula anteriorly?
Is there a posterior one of these?
anterior tibiofibular ligament ;)
yes, the posterior tibiofibular ligament
When will your ankle joint become tighter, when you are undergoing dorsal flexion or plantar flexion?
dorsal flexion
Since your ankle joint will become tighter in dorsal flexion, when will you most likely get an eversion or inversion sprain?
during plantar flexion
Is the ankle joint biaxial, multiaxial or uniaxial?
uniaxial (can only undergo flexion and extension)
What three tendons pass posterior to the medial malleolus? Which of these three sits in the sustentaculum tali groove?
posterior tibial, flexor digitorum longus, flexor hallucis longus
flexor hallucis longus
What are all the ligaments that make up the talocrural (ankle) joint?
posterior tibiofibular ligament
posterior talofibular ligament
calcaneofibular ligament
medial (deltoid) ligament
What are the three joints that work as inverters and everters?
Which of the three is not that important?
subtalar joints
transverse tarsal joints
tarsometatarsal joints
tartsometatarsal
What are the lateral ligaments of the ankle?
posterior talofibular ligament (strong)
anterior talofibular ligament (weak ligament)
calcaneofibular ligament
when you have an ankle sprain on your lateral side, what is the most commonly injured ligament and how?
the anterior talofibular ligament via an inversion injury
What is the medial ligament of the ankle and how is this damaged?
deltoid ligament (superior strong) eversion injury, pott's fracture-dislocation
What are the two arches of the foot?
longitudinal arch
transverse arch
How are the arches of the foot maintained?
by the shape of the bones of the foot and by the ligaments of the foot
Is arch support dyamic or static/
dynamic
Where does the dynamic arch support come from?
long tendons of muscles like the peroneus longs, tibialis posterior, flexor hallucis longys, flexor digitorum longus and probably to a lesser extend the tibialis anterior
What do the arches of the foot do?
they adapt foot to weight and surface changes.
What underlies the heads of the medial two metatarsals?
the ball of the foot
Where will you most likely get edema in your foot?
in the subcutaneous tissue of the dorsal surface and anterior to and around the medial malleolus
Are the muscles of the foot important individual or together? Why?
together, because we dont care about fine motor skills of individual toes, instead they are used for stabilizing stance. `
the (blank) is most active during the push-off phase of stance in pulling the lateral four metatarsals toward the great toe, fixing the transverse arch of the foot and resisting forces that would spread the metatarsal heads as weight and force are applied to the forefoot.
adductor hallucis
(blank) interossei adduct and arise from a single metatarsal as unipennate muscles.
Plantar (three of them)
(blank) interossei abduct and arise from two metatarsals as bipennate muscles.
dorsal interossei (four of them)
The (blank) nerve divides posterior to the medial malleulus into the medial and lateral planter nerves
tibial
What does the saphenous nerve do and where does it come from?
cutaneous branch off of femoral nerve. Supplies cutaneous innervation to anteromedial aspect of the leg, ankle joint, medial side of foot and to the head of 1st metatarsal
The femoral sheath has three compartments, what are they and what are within them?
lateral compartment: femoral artery
intermediate compartment: femoral vein
medial compartment: femoral canal (lymphatics)
What is another name for the ankle joint?
talcocrural articulation
The (blank) is the rounded superior articular surface of the talus on the foot
trochlea
The distal ends of the tibia and fibula form a (blank) into which the pully shaped trochlea of the talus fits (articulating process of the foot).
mortise
The (blank) grip the talus tightly as it rocks in the mortise during movement. Which surface of the talus is wider and why is this significant?
malleoli grip
the anterior surface, significant because when you dig your heels in (dorsiflexion) it will wedge this wider anterior part of the talus mortise which will cause it to be tight and stable. this is why the joint is most stable when you dig your heels in
Why is the ankle joint relatively unstable during plantarflexion?
because the trochea is narrower posteriorly and therefore lies loosely within the mortise
The fibrous layer of the joint capsule of the ankle is attached superiorly to the borders of the articular surfaces of the tibia and the malleoli and inferiorly to the the talus. The synovial membrane is loose and lines the fibrous layer of the capsule. The synovial cavity often extends superiorly between the tibia and the fibula as far as the (blank)
interosseos tibiofibular ligament
How many parts to the medial ligament of the ankle is there?
four parts
What ligament stabilizes the ankle joint during eversion ad prevents subluxation (partial dislocation) of the joint?
the medial ligament of the ankle(deltoid ligament)
What ligaments limit dorsiflexion?
medial and lateral ligaments
What is the nerve supply to the ankle joint?
tibial and deep fibular nerve
What are the three important intertarsal joints of the foot?
What do these function as?
subtalar joint
transverse tarsal joint
tarsometatarsal joint
Invertors and everters
Which longitudinal arch is the most important and why?
the medial longitudinal arch because its higher
lateral longitudinal
What are the three important ligaments that support the longitudinal arch?
long plantar ligament short plantar ligament spring ligament (aka calcaneonavicular ligament)
Why do we call the calcaneonavicular ligament the spring ligament?
because the talus will push down onto it when you walk and then spring off of it.
the (blank) ligament attaches to the calcaneous and fans out onto the metatarsals.
the long plantar ligament
the (blank) ligament attaches to the calcaneous and goes to the cuboid.
short plantar ligament
Tell me about flatfootedness
before age 3 it is completely normal due to thick fat pad in the sole. Typically the foot will look normal without weight but then when you put weight on it, it will become flat footed.
Does flatfootedness happen in the medial or longitudinal direction? Is this more or less severe than a high arch?
longitudinal direction
less severe
what does pes planus mean?
flat footed
What bears a ton of weight, is extremely movable, and is a great shock absorber?
the knee joint
What does the large synovial membrane/capsule provide for on the the distal femur?
provides for a lot of movement (i.e its baggy)
The intercondylar fossa is the site of two (blank) ligaments which are more specifically called what?
intracapsular ligaments.
the anterior and posterior cruciate ligaments
Since the condyles of the femur are round and the tibia has tibial plateaus that are flat articulate with this, what does this mean for the knee joint?
that only a small amount of the condyle is touching the plateau at any given time which means this lack of contact will make for a very loosely packed joint.
What is significant about going from flexion to extension at the knee joint?
you will continue medial rotation but stop lateral rotation so you will have slight medial rotation at locked knee
What attaches to gerdy’s tubercle?
the IT band
What is the platellar ligament an extension of and where does this attach?
the platellar tendon
tibial tuberosity
THe most important muscle in stabilizing the knee joint is the (blank)
quadriceps femoris (vastus medialis and vastus lateralis)
When is the knee joint most stable?
in the erect extended state
What is the famous little bone in the lateral head of the gastrocnemius?
the fabella
the connection between the inferior aspect of the patella and the tibial tuberosity has a specific distance that never does what? What does it do?
changes Changes tension (that is put on the quadriceps)
What is the main reason we have a platella?
to increase the power, fulcrom of the quadriceps
What are the five ligaments of the knee joint?
tibial collateral ligament fibular collateral ligament (w/ relation to popliteus tendon) anterior cruciate ligament (ACL) posterior cruciate ligament (PCL) posterior meniscofemoral ligament
What are the three kinds of ligaments?
capsular, intracapsular, extracapsular
What is an extracapsular ligament of the knee joint?
fibular collateral ligament
What is a capsular ligament of the knee joint because it attaches to the medial mensiscus
What is worrisome if you tear this?
tibial collateral ligament (medial ligament)
You might accidently tear part of the meniscus off
Which ligament of the knee joint will prevent genuovarus movement?
the fibular collateral ligament (lateral ligament)
Which ligament of the knee joint will prevent genovalgus movement?
the tibial collateral ligament (medial ligament)
What is the q angle?
it is the difference between straight down from your pelvis through to the tibia (axis of rotation) and the axis which the femur runs
Who has a bigger q angle, women or men?
women because they have wider hips
If you have a very large q angle what will your stance be like?
you will have valgus stance
What way do the quadriceps tend to pull at the knee cap?
laterally
How can you replicate the orientation of the PCL and ACL with tow fingers?
Cross your third finger over your second and place them on your knee and this is the orientation of the ACL (top finger) and PCL (remember to go from front to back)
Does the knee joint undergo abduction or adduction? Which ligaments prevent this?
Neither!
abduction ->medial collateral (tibial collateral ligament)
adduction -> lateral collateral (fibular collateral ligament)
How does the ACL travel? What does it function in?
travels anterior medial of the tibia to posterior lateral of the femur
-> it prevents anterior displacement of the tibia
How does the PCL travel? What does it function in?
posterior lateral of tibia to anterior medial of femur
-> it prevents posterior displacement of the tibia
If you are running and you suddenly stop, what prevents your femur from sliding forward?
your PCL
Which is stronger the PCL or ACL?
PCL
Why is ACL commonly damaged?
cuz of the types of hits people take (typically anterior medial hits)
What is this:
C-shaped; firmly attached to tibial collateral ligament; vulnerable to injury
medial meniscus
What is this:
O-shaped; not attached to fibular collateral ligament; distinctly mobile; horns of menisci are attached to bone of tibia
lateral meniscus
Which one is bigger the lateral or medial meniscus? Why is this significant?
the medial cuz it allows for more lateral rotation
because when you knee is fully flexed you get more lateral rotation when your knee is flexed
The tibial collateral ligament is also called the (blank)
Medial collateral ligament (MCL)
What are baker cysts/ popliteal cysts?
popliteal cysts are fluid-filled herniations of the synovial membrane of the knee joint
What muscle crosses the knee joint but has very little role in flexion of the knee due to its close proximity to the transverse axis-and aids in derotating the knee from a fully locked position?
the popliteus muscles
What is the innervation to the popliteus muscles?
the tibial nerve
What muscles cross the knee joint posteriorly ?
popliteus, gastroch, and plantaris muscles
What ligaments cross the knee joint posteriorly?
tibial collateral ligament (TC)
Fibular collateral ligament (FC)
What tendons cross the knee joint posteriorly?
adductor magnus tendon (AM) semimembranosus tendon (SM) biceps femoris tendon (BF)
What are the three parts to the acetabulum?
Margin (limbus)
lunar surface
acetabular notch
What artery passes by the acetabulum?
the obturator artery
When is the femur the strongest and closest to the acetabulum?
in full extension (cuz you wind your ligaments tighter)
The hip joint is a tight packed joint, why is this?
What are the ligaments called that do this?
Which of the ligaments is the strongest?
because of the capsular ligaments which are the ileofemoral, ischicalfemoral and pubofemoral
iliofemoral ligament (its what you rest on)
What is the main blood supply to the femur?
from the medial and lateral femoral circumflex
ligaments of the joint capsule of the hip joint tighten in (blank) and loosen in (blank)
extension
flexion
When do you get a hip dislocation?
really rare, but will happen in MVAs when you hip joint is flexed, adducted and medially rotated (as if you are driving in a car)
What can a broken hip compromise?
the blood supply can be compromised to the femoral neck and head resulting in avascular necrosis
What is a broken hip?
the fracture of the femoral head
When does bone density decrease yearly?
Where do you first see this?
after age 40 (both male and female).
in the femoral neck
What are very common in elderly people and result in a high mortality rate?
femoral neck fractures
What is the major blood supply to the femoral head and neck?
femoral circumflex arteries (especially medial, very little from the obturator artery)
Before you get a slipped capital femoral epiphysis (SCFE), what will you get?
a slight widening of the physis and blanching (losing color)
What happens if you get a slipped capital femoral epiphysis (SCFE)?
you lose blood supply to the head of the femur
