Ankle and foot anatomy and clinical Flashcards
how many compartments does the leg have? name
3 - posterior, lateral and anterior
2 major arteries of leg
common fibular and tibial
common fibular branches
sup and deep fibular
What nerve does the tibila originate from?
sciatic nerve
what compartment of the leg does the tibial nerve supply and consequence of this
posterior - foot drop
What is the most frequently injured major joint in body?
ankle
describe ankle joint
uniaxial synovial hinge
dorsiflexion and plantarflexion
between distal tibia, fibula and upper talus
main function of ankle joint
critical in weight bearing and walking
2 surface landmarks of ankle joint
medial and lateral malleolus
What is the malleolar mortise?
socket which holds bone firmly with help of trochlea of talus and ligament
upper and lower tibiofibular joint types
upper = synovial plane lower = fibrous
most ankle injuries in which movement?
inversion and plantar flexion
when is malleolar grip tightest?
dorsiflexion
is the fibrous capsule thin or thick?
thin
What supports the fibrous capsule on both sides?
collateral ligaments
Strongest ankle ligament
medial
medial ligament describe
large and strong
3 slips - talus, calcaneus and navicular
when does medial ligament stabilise joint?
eversion
lateral ligament
3 slips and often injured
compartment responsible for dorsiflexion
anterior
4 dorsiflexor muscles
tibilais anterior
EDL
EHL
peroneus
3 main plantarflexors
gastrocnemius
soleus
popliteus
how many heads does gastrocnemius have?
2
footballers ankle is repeated strain on…?
anterior capsule
nerve compressed in tarsal tunnel syndrome
tibial deep to flexor retinacula
what is pott fracture?
dislocation of ankle
nerve and artery on sole of foot
medial and lateral plantar
what layer of sole of foot contain interossei?
4
interossei role in sole of foot
arch
function of feet
support body in standing and progression
lever it forward in walking, running and jumping
What joints do eversion and inversion occur?
subtalar and transverse tarsal
invertor muscles
tibilalis anterior and posterior
evertor muscles
fibularis longus and brevis
function of arches of feet
shock absorbers
springboard during walking and running
flexible and deform with ground contact
distribute weight over foot
Wat part of arch is higher and more important?
medial
5 things which maintain arches of feet
shape of bones plantar aponeurosis long and short plantar ligaments spring ligament = calcaneonavicular intrinsic muscles
why are flat feet common in under 3’s?
subcut fat
cause of acquired flatfeet
tibialis post dysfunction
Accessory bones
troublesome and destabilised by injury - navicular
tarsal coalitions
abnormal connection of tarsal bones - common
stiff hindfeet
bones joined in tarsal coalitions
45% talocalcaneal
45% calcaneonavicular
10% other
common cause of ankle arthritis
injury/post trauma
ankle arthritis - under 50 and no trauma?
haemachromatosis
how is achilles tendon formed?
gastroneumius and soleus
cavus
high arch
varus
hindfoot
common causes of cavovarus foot
neurological, congential, post trauma
5 questions you ask yourself with cavovarus feet
progressive? FH? muscle pain or weak? elevated CK? altered sensation?
pathogenesis of cavovarus foot - simple
weak intrinsic muscles leads to claw toes meaning shoe problems and calluses
plantarflexed MT
hindfoot varus - weak peroneus brevis
weak tibialis anterior alters gait
describe coleman block test - what it finds
forefoot driven hindfoot varus or hindfoot driven varus
describe how you would do coleman test
patient stands with 1st ray overhanging edge of block - if hindfoot varus corrects it is compensating for rigidly plantarflexed 1st MT
