Ankle And Foot Flashcards
Describe the deep fascia on the dorsal surface
- thin
- continuous with the inferior extensor retinaculum
Deep fascia-what is it?
Greatly thickened dense connective tissue that spans the entire plantar surface of the foot (plantar aponeurosis)
What does the deep fascia/plantar aponeurosis encase?
Flexor tendons of digits
-it helps support the longitudinal arches
What type of joint is the ankle (talocrural)?
Hinge type synovial joint
What holds the tibia and fibula together?
- Interosseus membrane
- anterior and posterior inferior tibiofibular ligaments
What position limits inversion/eversion of the foot?
Closed pack position (dorsiflexion)
Deltoid ligament
4 parts connecting tibia to navicular, talus (2 anterior, posterior) and calcaneus
Lateral ligaments of the ankle
anterior, posterior talofibular and calcaneofibular
What may cause avulsion fractures of the lateral and/or medial malleolus during forced inversion or eversion?
The strength of the lateral ligaments
Subtalar joint
- Between the 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
What supports the longitudinal arch?
- Plantar calcaneonavicular (spring) ligament
- long plantar ligament
- plantar aponeurosis
- short plantar ligament
What supports the transverse arch?
Tendon of peroneus (fibularis) Longus muscle
Dorsalis pedis artery -what does it do?
- Direct communication of the anterior tibial artery onto the dorsum of the foot
- important in diagnosing vascular efficiency in the lower extremity
What does the artery pass before it is named Dorsalis Pedis?
Once it has passed deep to the inferior extensor retinaculum
Dorsalis Pedis pulse
An indicator of vascular insufficiency (possibly from atherosclerotic changes)
-felt over the navicular and cuneiform bones
What does the Dorsalis pedis artery divide into?
- Deep plantar artery
- Arcuate artery
Where is the deep plantar artery?
It joins the deep plantar arterial arch between the proximal phalanx bones of the hallux and second toe
What branches off the arcuate artery?
Dorsal digital branches and perforating branches that reach the plantar surface of the foot
What arteries extend off the posterior tibial artery?
Medial and lateral plantar arteries
Lateral plantar artery
- Runs anterolaterally to the base of the 5th metatarsal
- A branch runs medially to join the deep plantar branch from Dorsalis pedis artery to form the deep plantar arterial arch
Medial plantar artery
Extends along the lateral border of the 1st metatarsal to reach the hallux
What does the anastomotic circulation of the ankle consist of?
Anterior lateral malleolar network and posterior medial malleolar network from the anterior tibial and posterior tibial arteries
Tibial nerve divides posterior to medal malleolus to form what nerves?
Medial and lateral plantar nerves
What do the medial and lateral plantar nerves supply?
All of the muscles on the plantar surface of the foot
What layer of the plantar muscles are the lumbricals located?
2nd layer
Medial plantar nerve
- Larger of the 2 branches
- deep to abductor Hallucis
- runs anteriorly and medially
- Innervates the medial musculature on the plantar surface of foot
- ends as 3 cutaneous branches to 3 medial digits
Lateral plantar nerve
- runs anterolateral between 1st and 2nd layer
- divides into a superficial and deep ranch
- Innervates muscles on the lateral plantar side of the foot
- deep branch is entirely muscular
- superficial branch supplies muscles and cutaneous branches to lateral two digits
Sural nerve
- arises from branches of tibial and common Peroneal nerves at popliteal fossa
- supplies cutaneous innervation to posterior and lateral distal third of the leg, then the skin over the lateral margin of foot and 5th digit
Saphenous nerve
- descends with the femoral a. and vein thru the adductor canal and popliteal fossa
- supplies the cutaneous innervation over the anterior and medial parts of the leg and along the medial side of the foot
Deep and superficial fibular nerves
- skin supply of the dorsum of the foot
- deep Peroneal nerve also innervated the 2 short extensors muscles on the dorsum of the foot
