Ankle and Foot Flashcards
What is the function of the foot and ankle?
Stable base of support, rigid lever for push off, absorb shock of body weight, conforms the foot to irregular terrain, proprioception and balance, adjustment of line of gravity, propulsion and restraint when walking
Describe the tibia, note shape and articulations
Weight bearing, larger of two bones, forms part of the ankle, distally shaped like a rectangular box with medial malleolus, on the lateral side there is a deep groove where it articulates with the fibula (for inferior tibio-fibular joint, distally articulates with talus to form ankle
Describe the fibula, note bony points and articulations
On lateral side of leg, articulates proximally with lateral condyle of tibia distally with inferior tibia and talus (for ankle), bony lateral protuberance is the lateral malleolus, facet on medial surface for articulation with the talus, fibular notch on the distal end of tibia
Describe the location, shape and function of the talus
- Location - above calcaneus, head and neck directed forwards and medially
- Shape - body is wedged shape and lies between malleoli, superior surface of body wider anteriorly (locks in dorsiflexion), body has 3 articular facets (superior with trochlear and medial and lateral), body convex anterior to posterior and concave side to side (pulley)
- Function - wedge shape prevents posterior displacement of foot during sudden jumps and stops
Describe the calcaneus, note the 6 surfaces, sustentaculum tali and attachment of tendocalcaneus
- Anterior, posterior, inferior, superior, lateral, medial
- Medial shelf to support medial head of talus
- Posterior surface roughened for attachment
List cuboid articulations and joints
Posterior - with calcaneus (calcaneocuboid joint)
Medial - with lateral cuneiform (cuneocuboid joint)
Anterior - 4th and 5th MT (tarsometatarsal joint)
Where is the navicular tuberosity?
Medial
List the navicular shape and articulations
Anterior - head of talus and medial malleolus, 3 facets for cuneiforms
Posterior - concave surface articulates with the head of talus
List cuneiform articulations
Each other and navicular
Which metatarsal has a tuberosity at the base?
V
What do MT 1-3 articulate with?
Cunieforms
What do MT 4 and 5 articulate with?
Cuboid
Where are the two sesamoid bones in MT?
Embedded within tendon of flexor hallucinations brevis I
List the 6 intertarsal joints
Cuneonavicular, intercuneoform, cuneocuboid, tarsometatarsal, subtalar, midtarsal
Which type of joint is the tarsometatarsal?
Synovial plane
Regarding the subtalar joint, note type, articulations, ligaments and movements
- type-synovial plane
- articulations-distal to ankle joint, where talus articulates with calcaneus
- ligaments-surrounded by weak articular capsule that’s supported medially, laterally and posteriorly by talocalcaneal ligaments, stabilised by interosseous talocalcaneal ligament
- movements-inversion and eversion
Describe the type of joint and movements at the midtarsal joint
Synovial ball and socket (s shape), pronation and supination (combined with subtalar inversion and eversion)
What type of joint is the metatarsophalangeal?
Synovial ellipsoid with two degrees of freedom
What types of joints are the proximal and distal interphalangeal?
Synovial hinge with one degree of freedom
Describe the superior tibiofibular joint - note type, articulations, ligaments and movements
- type -synovial plane
- articulations- head of fibula, tibial lateral condyle, capsule attached around joint margins
- ligaments -anterior and posterior ligaments of the fibular head
- movements -small rotations during ankle PF and DF with gliding
Describe the interosseous joint
A tough, fibrous sheet of connective tissue spanning borders of tibia and fibular, most fibres decend obliquely, providing attachment for muscles, separating anterior and posterior compartments
Describe the inferior tibiofibular joint, note type, articulations, ligaments and movements
Fibrous syndesmosis, medial aspect of fibular and fibular notch on lateral aspect of tibia
Ligaments are anterior inferior, posterior inferior and transverse tibiofibular
Movements are slight rotations of fibula on tibia during DF
Describe the talocrural joint, note type and articulations
Synovial hinge, weight bearing surface is trochlear notch of tibia and talus and stabilising surface is medial and lateral malleolus gripping body of talus
Describe the talocalcaneonavicular joint, note type and articulations/ ligaments
Synovial ball and socket (ball = head of talus, socket = part bone, part ligament.
Anterior - navicular
Posterior - sustentaculum tali and calcaneus
Medially - plantar calcaneonavicular (spring) ligament
Laterally - calcaneonavicular part of bifurcate ligament
For talocrural dorsiflexion, list degrees, muscles and limits
20-30 in extension and 35 with flexed knee
Tibialis anterior assisted by extensor digitorum longus, extensor hallucis longus and peronus tertius
Limits - antagonist tension, posterior part of deltoid ligament, calcaneonavicular ligament, wedging of talus between malleolus
Regarding talocrural plantarflexion, list degrees, muscles, limits
50, gastrocnemius, soleus, assisted by tibialis posterior, peroneus longus and brevis, flexor hallucis longus and flexor digitorum longus, limited by tension in antagonists, anterior part of deltoid ligament, anterior talo fibular ligament
Regarding subtalar and midtarsal inversion, list degrees, muscles and limits
45-60, tibialis anterior and posterior, assisted by extensor and flexor hallucis longus, limited by dorsal talonavicular ligament
Regarding subtalar and midtarsal eversion, list degrees, muscles and limits
15-30, peroneus longus, brevis and tertius, limited by impact of talus on floor of sinus tarsi and plantar calcaneocuboid ligament
What type of joint is the metatarsophalangeal?
Synovial ellipsoid
Regarding flexion at the MTP joint, list degrees and muscles
40-45 (great toe), flexor digitorum longus, flexor digitorum brevis, flexor hallucis longus, flexor hallucis brevis, lumbricals, interossei, assisted by flexor digitorum, accesorius flexor digitorum minimi brevis
Regarding extension at the MTP joint, list degrees, muscles and limits
40 and 70 (great toe), extensor digitorum longus, extensor digitorum brevis, extensor hallucis longus (great toe), limited by tension in antagonists and plantar ligaments
Regarding abduction at the MTP joint, list muscles and limits
Abductor hallucis (great toe), abductor digiti minimi, dorsal interossei, limited by tension in antagonists
Regarding adduction at the MTP joint, list muscles and limits
Adductor hallucis, plantar interossei, toe spread to measure, limited by apposition of soft tissue
Regarding flexion at the interphalangeal joint, list degrees and muscles
PIP: 35
DIP: 60
IP great toe: 90
Flexor hallucis longus, flexor digitorum longus and brevis, assisted flexor digitorum accessorius
Regarding extension at the interphalangeal joint, list degrees and muscles
PIP: 0
DIP: 30
IP great toe: 0
Extensor hallucis longus, extensor digitorum longus and brevis, assisted by lumbricals
Limits - tension in antagonists and plantar ligaments
Describe the medial ligament, note shape and attachments
Deltoid
Strong, flat, triangular band, made up of four ligaments, tibia to navicular, calcaneus to talus, attached to apex and anterior and posterior borders of medial malleolus
Describe the lateral ligament, note attachments and features
Anterior talo-fibular ligament, calcaneofibular ligament, posterior talofibular ligaments, weaker than deltoid and more commonly injured
