Ankle and Foot

Question 1

deep fascia (of leg?)

• continues into…
• dorsal side characteristics
• plantar side characteristic and name

Answer 1

continuous with the deep fascia around talocrural joint (ankle)
dorsal surface
-thin and continuous with the inferior extensor retinaculum
plantar surface
-greatly thickened dense connective tissue
-spans entire plantar surface
-called the plantar aponeurosis

Question 2

plantar aponeurosis

• begins…
• travels to…
• encases…

Answer 2

begins on the tuber calcaneus
fans out into five separate bands distally toward the toes
encases the flexor tendons of digits

Question 3

plantar aponeurosis function

Answer 3

helps in supporting the longitudinal arches

Question 4

plantar aponeurosis vertical septa

-location/function

Answer 4

from deep side of plantar aponeurosis

divide the plantar side of the foot into medial, central, and lateral longitudinal compartments

Question 5

what do the medial, central, and lateral longitudinal compartments of the foot contain? (general)

Answer 5

muscles
nerves
vasculature

Question 6

ankle (talocrural) joint

-joint type

Answer 6

hinge type synovial joint

Question 7

what holds the tibia and fibula together at the ankle?

Answer 7

interosseus membrane (syndesmosis joint)
anterior inferior tibiofibular ligament
posterior inferior tibiofibular ligament

Question 8

ankle movements

Answer 8

plantar flexion/dorsiflexion
inversion/eversion
rotation (especially during plantar flexion)

Question 9

what is the closed packed position for the ankle?

-what is limited in this position

Answer 9

closed placked
-dorsiflexion
limits
-inversion/eversion
-rotation

Question 10

deltoid ligament (of ankle)

• which side of ankle
• connects _____ to _____

Answer 10

medial side
connects tibia to
-navicular
-anterior talus
-posterior talus
-calcaneus

Question 11

lateral ligaments of the ankle names

Answer 11

anterior talofibular
posterior talofibular
calcaneofibular

Question 12

strength of talocrural ligaments may result in…

Answer 12

avulsion fractures of the lateral and/or medial malleolus during forced inversion or eversion

Question 13

joints of the foot

• location of each
• function of each

Answer 13

subtalar joint
-between talus and calcaneus
-primary location of inversion/eversion
transverse tarsal joint
-combination of talocalcaneonavicular joint and calcaneocuboid joint
-facilitates inversion and eversion, pronation and supination

Question 14

arches of the foot

Answer 14

longitudinal arch
-medial and lateral parts
transverse arch

Question 15

longitudinal arch of the foot

-supported by which ligaments…

Answer 15

supported by

• plantar calcaneonavicular (spring) ligament
• long plantar ligament
• plantar aponeurosis
• short plantar ligament

Question 16

transverse arch

-supported by…

Answer 16

tendon of peroneus longus muscle

Question 17

digits of the foot

• numbered 1-5 in which direction
• how do we now define abduction/adduction

Answer 17

1-5 from medial to lateral

new axis running longitudinally from the calcaneus through toe 2

Question 18

arteries of the ankle and foot

Answer 18

dorsalis pedis
medial plantar
lateral plantar

Question 19

dorsalis pedis artery

• continuation of…
• when does the name change to dorsalis pedis?
• divides into the _____ and _____ near _____
• where can it be felt?

Answer 19

continuation of anterior tibial artery onto dorsum of foot
name changes once it passes deep to inferior extensor retinaculum
divides into deep plantar artery and arcuate artery near the MTP joint
can be felt over the navicular and cuneiform bones

Question 20

dorsalis pedis artery

• clinical importance
• what does a lack of or diminished dorsalis pedis pulse indicate?

Answer 20

important in diagnosing vascular efficiency in the LE
lack of or diminished
-indicator of vascular insufficiency, possibly from atherosclerotic changes

Question 21

deep plantar artery

-what does it join and how does it do it?

Answer 21

joins the deep plantar arterial arch by diving between the proximal phalanx bones of the hallux and second toe

Question 22

arcuate artery

-what branches off of it and where do they go?

Answer 22

dorsal digital branches and perforating branches

reach the plantar surface of the foot

Question 23

medial and lateral plantar arteries

• continuation of…
• run parallel to…

Answer 23

continuation of posterior tibial artery

run parallel to similarly named nerves

Question 24

lateral plantar artery

-location

Answer 24

runs anterolaterally to the base of the 5th metatarsal
branch runs medially to join the deep plantar branch from dorsalis pedis to form the deep plantar arterial arch
plantar digital branches then extend along the five digits

Question 25

medial plantar artery

-loction

Answer 25

extends along the lateral border of the 1st metatarsal to reach the hallux
less consistent superficial plantar arch is present off this artery

Question 26

anastomotic circulation of the foot and ankle

-comprised of…

Answer 26

anterior lateral malleolar network
AND
posterior medial malleolar network from the anterior tibial and posterior tibial arteries
other smaller branches also contribute to the vascular network

Question 27

nerves of the ankle and foot

Answer 27

medial plantar
lateral plantar
sural
saphenous
superficial fibular
deep fibular

Question 28

tibial nerve

• where does it divide
• what does it divide into

Answer 28

divides posterior to medial malleolus into medial and lateral plantar nerves

Question 29

medial and lateral plantar nerves

• supply…
• division between the two in terms of what they supply is where

Answer 29

supply all the muscles on the plantar surface of the foot
division is roughly medial to the first lumbrical
-located between digits one and two

Question 30

medial plantar nerve

• larger or small of the two branches?
• location
• innervates…
• ends as…

Answer 30

larger
location
-deep to abductor hallucis and runs anteriorly and medially
innervates the medial musculature on the plantar surface of the foot
ends as three cutaneous branches to medial three digits

Question 31

lateral plantar nerve

• location
• divides into…
• innervates…
• deep branch is entirely…
• superficial branch supplies…

Answer 31

location
-runs anterolateral between 1st and 2nd layer
divides into a superficial and deep branch
innervates the musculature on the lateral plantar side of the foot
deep branch is entirely muscular
superficial branch supplies muscles listed in table and cutaneous branches to lateral two digits

Question 32

sural nerve

• usually arises from…
• supplies…

Answer 32

usually arises from branches of the tibial nerve and common peroneal nerve at the level of the popliteal fossa
supplies cutaneous innervation to
-posterior and lateral distal third of the leg
-skin over lateral margin of foot
-5th digit

Question 33

saphenous nerve

• how does it begin?
• location
• supplies…

Answer 33

divides off the femoral nerve in the femoral triangle
descends along with the femoral artery and vein through the adductor canal and popliteal fossa
supplies cutaneous innervation
-over the anterior and medial parts of the leg
-along the medial side of the foot

Question 34

deep and superficial fibular nerve

• supplies
• deep peroneal specifically innervates…

Answer 34

continuations of these nerves into the skin supply the dorsum of the foot
deep peroneal
-innervates the two short extensor muscles found on the dorsum of the foot

Question 35

clinical testing (not sure what he’s really wanting us to know from these 2 sentences, but they’re here)

Answer 35

damage to superficial peroneal nerve at the level of the lateral compartment, at the level of the distal crural fascia
damage to deep peroneal nerve at the level of the anterior compartment, at the level of the distal crural fascia. Within the popliteal fossa at the level of the common peroneal nerve