ankle/foot anatomy Flashcards
tendons crossing lateral ankle (extrinsics)
peroneus longus, peroneus brevis
peroneus longus X to brevis, Y to ankle
lateral, proximal
peroneus brevis tendon X to longus, Y to ankle
anterior, distal
what secures peroneal tendons
2 retinaculum (superior and inferior)
lateral ankle ligaments
anterior inferior tibiofibular ligament, anterior talofibular ligament, posterior inferior tibiofibular ligament, calcaneofibular, posterior talofibular ligament
distal tibiofibular syndemosis
syndesmosis - bones connected by ligaments
- comprised of anterior inferior tibiofibular, posterior inferior tibiofibular, interosseous ligament, interosseous membrane
peroneus longus insertion
base of first metatarsal and medial cuneiform
peroneus brevis insertion
base of 5th metatarsal
tendons crossing medial ankle
tibialis posterior, flexor digitorum longus, flexor hallucis longus
medial ankle neurovascular structures
posterior tibial artery, tibial nerve
Tom, Dick, ANd Harry
Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, tibial Nerve, flexor Hallucis longus
- anterior to posterior
what secures plantar flexor tendons
flexor retinaculum
deltoid ligament
medial ankle, made up of posterior tibiotalar, tibiocalcaneal, anterior tibiotalar, and tibionavicular
- limits excessive inward and outward rotation
- stabilizes ankle
tibialis posterior insertion
navicular, 1&3 cuneiforms, cuboid, 3rd & 4th metatarsals
flexor digitorum longus insertion
base of distal phalanges of lateral 4 toes
flexor hallucis longus insertion
base of distal phalanx of great toe
tibiotalar joint
ankle joint, responsible for plantar and dorsiflexion
- tibia (medial), fibula (lateral), talus (below)
subtalar joint
responsible for inversion/eversion
- talus (above), calcaneous (below)
transverse tarsal joint
made up of talonavicular and calcaneocuboid joints
muscles responsible for inversion
tibialis anterior/posterior
muscles responsible for eversion
peroneus longus/brevis/tertius
calcaneonavicular ligament
spring (jumping) ligament, maintains longitudonal arch, supports head of talus
calcaneocuboid ligament
long and short plantar ligament, long is deep, longitudonal arch support
flat foot deformity
pes planovalgus, arch collapses, posterior tibial tendon dysfunction
-back: hindfoot valgus
-middle: pes planus, midfoot collapse
-forefoot: abduction/eversion collapse
triple arthrodesis
surgery that fuses subtalar, talonavicular, and calcaneocuboid joints
hollow foot
high arch
tarsal bones
calcaneous, talus, navicular, medial/middle/lateral cuneiforms, cuboid
cotton osteotomy
cut and reposition medial cuneiform
- used for forefoot valgus, flatfoot
hindfoot bones
calcaneous, talus
midfoot bones
navicular, medial/middle/lateral cuneiforms, cuboid
forefoot bones
5 metatarsals, 14 phalanges
extensor digitorum brevis
origin: dorsal lateral calcaneous, inferior extensor retinaculum
insertion: long extensor tendons of digits 2,3,4
innervation: deep peroneal
action: aids EDL in extending toes
extensor hallucis brevis
origin: dorsal lateral calcaneous, inferior extensor retinaculum
insertion: dorsal base of phalanx of great toe
innervation: deep peroneal
action:aid EHL in extending great toe at MTP joint
blood supply to dorsal foot
anterior tibial artery (branch of popliteal) becomes dorsalis pedis artery
branches of dorsalis pedis artery
lateral tarsal, arcuate –> dorsal metatarsal arteries
- becomes deep plantar artery
blood supply to toe
every toe has a digital artery that branches into medial and lateral
foot sensory innervation
saphenous - medial
sural - lateral
superficial peroneal - dorsum
deep peroneal - webspace btwn 1st and 2nd toes
tibial - plantar surface (medial and lateral plantar nerves)
superficial peroneal nerve branches
medial dorsal cutaneous, intermediate dorsal cutaneous
arches of the plantar foot
transverse arch (cross section), medial longitudinal arch, lateral longitudinal arch
plantar aponeurosis
plantar fascia, extends from calcaneal tuberosity to toes, windlass mechanism
windlass mechanism
plantar fascia tightens and elevates medial longitudinal arch when toes are extended, facilitates weight transfer and propulsion in walking/running
muscles in 1st layer of plantar foot
abductor hallucis, flexor digitorum brevis, abductor digiti minimi
muscles in 2nd layer of plantar foot
tendon of flexor hallucis longus, tendon of flexor digitorum longus, quadratus plantae, lumbrical muscles
muscles in 3rd layer of plantar foot
adductor hallucis (transverse and oblique head), flexor digiti minimi, flexor hallucis brevis (lateral and medial head)
muscles in 4th layer of plantar foot
dorsal and plantar interosseous muscles
function of plantar foot muscles
flex toes, maintain shape
blood supply to plantar foot
medial and lateral plantar artery (branches of posterior tibial)
innervation of plantar foot
medial and lateral plantar nerve, common (lateral) and proper (medial) plantar digital nerves (toes), medial calcaneal branch (heel), saphenous (medial), lateral cutaneous nerve of foot
tarsal tunnel syndrome
compression of tibial nerve as it runs behind medial malleolus and behind flexor retinaculum
symptoms: shooting pain, numbness, tingling over sole of foot
pilon ankle fracture
intraarticular, associated soft tissue injury, highly comminuted, high energy
treatment: splint, OR stabilization w/ external fixator, ORIF
rotational ankle fracture
twisting force, any energy, can involve 1, 2, or 3 malleoli (lateral, medial, posterior)
ankle mortise
joint formed by tibia, fibula, talus
lisfranc injuries
damage to lisfranc ligament - gap between 1st and 2nd metatarsals
- happens when foot is plantarflexed, forces metatarsals outward
TMT joint complex injuries
fractures at bases of the 5 metatarsals or dislocations of cuneiforms
5th metatarsal base fracture
zone 3: stress fracture
zone 2: jones
zone 1: pseudo jones -> boot
