Ankle Flashcards
What are the 3 divisions of the foot and their subdivisions?
Hindfoot- Talus and Calcaneus
Midfoot- Navicular, Cuboid, and Cuneiforms
Forefoot- Metatarsals and Phalanges
Describe the superior tibiofibular joint
Synovial plane joint with a capsule
Describe the inferior tibiofibular joint. What 3 ligaments bind this joint?
Syndesmosis:
Posterior tibiofibular ligament
Anterior tibiofibular ligament
Crural tibiofibular interosseous ligament
What is another name for the ankle joint?
Talotibial (Talocrural) joint
What are the 2 joints involved in the ankle joint AKA Talotibial (Talocrural) joint?
Mortise Joint:
Fibular malleolus
Tibial malleolus
Distal end of tibia
Tenon Joint:
Head of talus
Describe the axis of the Talotibial (Talocrural) joint. In what plane does this mostly occur in?
Toe out stance= normal tibial torsion
Pathological: External/Internal tibial torsion
What are the movements involved in the ankle joint/ Talotibial (Talocrural) joint? What plant does this occur in?
Dorsiflexion= increased toe out
Plantarflexion= decreased toe out
Mostly occur in the saggital plane
What are the 2 major ligaments of the ankle joint?
Medial Collateral- Strongest
Lateral Collateral- Weakest
What are the components of the Medial Collateral Ligament?
Tibionavicular
Tibiocalcanean
Anterior Tibiotalar
Posterior Tibiotalar
What are the components of the Lateral Collateral Ligament?
Anterior Talofibular
Posterior Talofibular
Calaneofibular
Describe the Talocalcaneal (subtalar) Joint. What are the 3 surfaces of the Talocalcaneal (subtalar) Joint.
Very Stable
Uniaxial, triplanar
3 Surfaces:
Posterior- Concave facet on talus with convex faceton calcaneus
Anterior- Convex facets on body and neck of talus.
- Concave facets on calcaneus
Describe a unique structure associated with the Talocalcaneal (subtalar) Joint.
Tarsal Tunnel:
- Nonsynovial
- Ligament=talocalcaneal ligament
What are the movements that the Talocalcaneal (subtalar) Joint allows for?
Inversion:
- Adduction
- Supination
- Plantarflexion
Eversion:
-Opposite of inversion
What are the ligaments of the Talocalcaneal (subtalar) Joint?
Interosseous talocalcaneal
Posterior and lateral talocalcaneal ligaments
What are the 2 composite joints of the Talocalcaneonavicular Joint?
Talocalcaneal joint
Talonavicular joint
What are the 2 movements that the Talocalcaneonavicular Joint allows for?
Inversion (close packed)
Eversion
What is the ligament associated with the Talocalcaneonavicular Joint and what is the function of it?
Calcaneonavicular (spring) ligament:
- From sustentacuum tail to the inferior navicular
- Continuous medially with the deltoid ligament
- Continuous laterally with the medial band of the bifurcate ligament
- Helps maintain the medial longitudinal arch
What is the composes the composite joint of the Transverse Tarsal joint?
Talonavicular and the Calcaneocuboid
What are the 5 functions of the Transverse Tarsal joint?
Link between the hindfoot and the forefoot
Adds to the inversion and eversion range
Keeps distal foot inverted with the lateral surface in contact with the ground while the hindfoot is everted
Compensates forefoot for hindfoot eversion
Compensation between hindfoot and forefoot not possible when the hindfoot is inverted
What are the 3 main Retinacula?
What is a retinacula?
Superior/inferior Extensor Retinacula
Flexor Retinacula
Peroneal (fibular) Retinaculum
A retinacula is a thin band of connective tissue that typically binds down tendons, nerves, and blood vessels
Describe the Superior/inferior Extensor Retinacula
*Thickening of what?
Localized thickenings of the anterior crural fascia
*Inferior retinaculum is “Y” shaped
What 4 tendons does the Superior/inferior Extensor Retinacula bind down?
Tibialis anterior
Extensor halllucis longus
Extensor digitorum longus
Peroneus tertius
What 2 structures does the Superior/inferior Extensor Retinacula cover?
Deep peroneal (fibular) nerve Anterior tibial artery
Describe the Flexor Retinaculum
*Thickening of what?
Localized medial thickening of the crural fascia
What 3 tendons does the Flexor Retinaculum bind down?
Flexor halucis longus
Flexor digitorum longus
Tibilias posterior
What 2 structures does the Flexor Retinaculum cover?
Tibial nerve
Posterior Tibial Artery
Describe the Peroneal (fibular) Retinaculum
*Thickening of what?
Binds down tendons of:
Peroneus (fibularis) longus
Peroneus (fibularis) brevis
Localized medial thickening of the lateral deep fascia
What 2 tendons does the Peroneal (fibular) Retinaculum bind down?
Peroneus (fibularis) longus
Peroneus (fiibularis) brevis
In what directions do the plantar arches support the foot longitudinally?
Medial
Lateral
What are the 2 pathologies associated with the plantar arches?
Pes Cavus- high arch
Pes Planus- flat foot
What are the 5 Support Ligaments associated with the Plantar Arches?
Plantar Calcaneonavicular (spring)- primary support for medial longitudinal arch
Long Plantar- Primary support for lateral longitudinal arch
Plantar Aponeurosis
Plantar Calcaneocuboid (short plantar)
Marginal Abductors