Ankle And Foot

Question 1

Describe the deep fascia on the dorsal surface

Answer 1

• thin

- continuous with the inferior extensor retinaculum

Question 2

Deep fascia-what is it?

Answer 2

Greatly thickened dense connective tissue that spans the entire plantar surface of the foot (plantar aponeurosis)

Question 3

What does the deep fascia/plantar aponeurosis encase?

Answer 3

Flexor tendons of digits

-it helps support the longitudinal arches

Question 4

What type of joint is the ankle (talocrural)?

Answer 4

Hinge type synovial joint

Question 5

What holds the tibia and fibula together?

Answer 5

• Interosseus membrane

- anterior and posterior inferior tibiofibular ligaments

Question 6

What position limits inversion/eversion of the foot?

Answer 6

Closed pack position (dorsiflexion)

Question 7

Deltoid ligament

Answer 7

4 parts connecting tibia to navicular, talus (2 anterior, posterior) and calcaneus

Question 8

Lateral ligaments of the ankle

Answer 8

anterior, posterior talofibular and calcaneofibular

Question 9

What may cause avulsion fractures of the lateral and/or medial malleolus during forced inversion or eversion?

Answer 9

The strength of the lateral ligaments

Question 10

Subtalar joint

Answer 10

• Between the talus and calcaneus

- primary location of inversion-eversion

Question 11

Transverse tarsal joint

Answer 11

Combination of talocalcaneonavicular joint and calcaneocuboid joint
-facilitates inversion and eversion, pronation and supination

Question 12

What supports the longitudinal arch?

Answer 12

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

Question 13

What supports the transverse arch?

Answer 13

Tendon of peroneus (fibularis) Longus muscle

Question 14

Dorsalis pedis artery -what does it do?

Answer 14

• Direct communication of the anterior tibial artery onto the dorsum of the foot
• important in diagnosing vascular efficiency in the lower extremity

Question 15

What does the artery pass before it is named Dorsalis Pedis?

Answer 15

Once it has passed deep to the inferior extensor retinaculum

Question 16

Dorsalis Pedis pulse

Answer 16

An indicator of vascular insufficiency (possibly from atherosclerotic changes)
-felt over the navicular and cuneiform bones

Question 17

What does the Dorsalis pedis artery divide into?

Answer 17

• Deep plantar artery

- Arcuate artery

Question 18

Where is the deep plantar artery?

Answer 18

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

Question 19

What branches off the arcuate artery?

Answer 19

Dorsal digital branches and perforating branches that reach the plantar surface of the foot

Question 20

What arteries extend off the posterior tibial artery?

Answer 20

Medial and lateral plantar arteries

Question 21

Lateral plantar artery

Answer 21

• 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

Question 22

Medial plantar artery

Answer 22

Extends along the lateral border of the 1st metatarsal to reach the hallux

Question 23

What does the anastomotic circulation of the ankle consist of?

Answer 23

Anterior lateral malleolar network and posterior medial malleolar network from the anterior tibial and posterior tibial arteries

Question 24

Tibial nerve divides posterior to medal malleolus to form what nerves?

Answer 24

Medial and lateral plantar nerves

Question 25

What do the medial and lateral plantar nerves supply?

Answer 25

All of the muscles on the plantar surface of the foot

Question 26

What layer of the plantar muscles are the lumbricals located?

Answer 26

2nd layer

Question 27

Medial plantar nerve

Answer 27

• 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

Question 28

Lateral plantar nerve

Answer 28

• 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

Question 29

Sural nerve

Answer 29

• 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

Question 30

Saphenous nerve

Answer 30

• 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

Question 31

Deep and superficial fibular nerves

Answer 31

• skin supply of the dorsum of the foot

- deep Peroneal nerve also innervated the 2 short extensors muscles on the dorsum of the foot