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Orthopaedic Anatomy > Ankle/Foot Anatomy > Flashcards

Ankle/Foot Anatomy Flashcards

1
Q

which parts of the foot are considered ‘midfoot’?

A

navicular

cuboid

3 cuneiforms

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2
Q

what is the name of the joint that separates the hindfoot and midfoot?

A

Chopart

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3
Q

what is the name of the joint that separates the midfoot and forefoot?

A

Lisfranc

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4
Q

3 ligaments that arise from distal fibula

A

ATFL

PTFL

CFL

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5
Q

when does the calcaneous ossify?

A

body at 6mo

tuberosity not until 9 years old!

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6
Q

which facet of the calcaneous is most vulnerable to #

A

posterior

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7
Q

where does FHL pass on the plantar surface of the foot?

A

between medial and lateral tubercles of the talus

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8
Q

which muscle passes through the groove on the plantar side of the cuboid?

A

peroneus longus

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9
Q

when do the distal fibula and tibia fuse?

A

18-20 years old

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10
Q

when do the metatarsals fuse?

A

birth

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11
Q

name 2 accessory ossicles in foot

A

os trigonum

accessory navicular

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12
Q

what is the ‘Mortise’?

A

the arch formed by the malleoli and the plafond

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13
Q

what is the incisura?

A

the lateral groove in the tibia into which the fibula fits

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14
Q

what does syndesmosis mean?

A

to bind together

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15
Q

what are the 4 components of the syndesmosis?

A

AITFL

PITFL

inferior transverse ligament

interosseous ligament

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16
Q

what are the names of the 3 common fragments that can avulse from the syndesmosis?

A

chaput = anterolateral tibial tubercle

wagstaff = anterior fibula tubercle

volkman = posterolateral tibial tubercle

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17
Q

only bone in the foot without muscular tendon attachments

A

talus

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18
Q

5 arteries that supply the talus

A

artery of tarsal canal

deltoid artery

direct superomedial artery

artery of tarsal sinus

direct posterior artery

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19
Q
A

perforating peroneal artery

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20
Q
A

anterior lateral malleolar artery

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21
Q
A

artery of the tarsal sinus

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22
Q
A

lateral tarsal artery

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23
Q
A

medial tarsal artery

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24
Q
A

artery of tarsal canal

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25
Q
A

deltoid artery

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26
Q

how many articulations does the talus have with the calcaneous?

A

3

anterior

posterior

middle

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27
Q

what is the sustenaculum tali?

A

an anteromedial shelf that supports the middle talar articular surface and under which passes the tendon of FHL

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28
Q

where is the sinus tarsi?

A

lateral to the anterior and middle facets of the calcaneous

it is a soft spot just distal to the fibular tip and an anatomical space that is medially continuous with the tarsal canal

boundaries:

superior - talus

inferior - calcaneous

anterior - talocalcaneonavicular joint

posterior - posterior facet of the subtalar joint

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29
Q

what motion occurs at chopart’s joint?

A

abduction/adduction

occuring at 2 joints:

talonavicular

calcaneocuboid

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30
Q

what is the consequence of the unique anatomy of the middle cuneiform?

A

it does not extend as far distally, so the 2nd MT becomes the keystone of the transverse arch of the foot

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31
Q

what are the plantar cristae?

A

the articular surfaces on the plantar 1st MT that articulate with the sesamoids

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32
Q

how is the Lisfranc joint held together?

A

with 3 groups of ligaments:

1) the transverse ligaments that attach adjacent metatarsal bases 2-5 (*nb none between 1-2)
2) longitudinal ligaments that attach MT bases to cuneiforms/cuboid (*nb one for each MT)
3) the oblique ligaments from the 2nd MT to the medial cuneiform. there are 3:

dorsal

plantar

Lisfranc

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33
Q

ligament that connects the metatarsal heads

A

deep transverse

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34
Q

what is a Morton neuroma?

A

entrapment of an intermetatarsal plantar nerve in the transverse metatarsal ligament

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35
Q

primary stabilizer of the MTP joint

A

plantar plate

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36
Q

describe the anatomy of FHB

A

originates from tendon of tib post

inserts into sesamoids on plantar surface of 1st MTP joint and then continues as the phalangealsesamoid ligament which are also stabilized by medial and lateral metarsosesmoid ligaments

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37
Q

only tendon that isn’t always black on MRI

A

FHL, because of fluid in its sheath

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38
Q

where is tibialis posterior tendon most vulnerable?

A

under medial malleolus

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39
Q

what is the knot of Henry?

A

where the FDL finally crosses the FHL in a tendon sheath communication on the plantar midfoot

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40
Q
A

Peroneus longus

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41
Q
A

peroneus brevis

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42
Q
A

EDL

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43
Q
A

EHL

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44
Q
A

tibialis anterior

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45
Q
A

tibialis posterior

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46
Q
A

FDL

47
Q
A

posterior tibial artery

posterior tibial vein

tibial nerve

48
Q
A

FHL

49
Q
A

plantaris

50
Q
A

achilles

51
Q

what is unique about the achilles tendon?

A

a couple things:

largest tendon in the body

has a paratenon instead of a sheath - which means fat surrounding the tendon (associated with Kager’s fat pad anteriorly)

52
Q

where do the peroneal tendons lie?

A

together as a common sheath 4cm above the joint as they pass under the lateral malleolus

PB is deep to PL

pass through the fibro-osseous tunnel inferior to fibula

split into individual sheaths just distal to lateral malleolus

53
Q

the primary restraint to lateral instability of the peroneal tendons

A

the superficial peroneal retinacula

superior - from periosteum of distal fibula to lateral wall of calcaneous

inferior - over the lateral wall of calcaneous

54
Q

3 ligaments deep to tendons in the fibro-osseous tunnel of the fibula?

A

PITFL

PTFL

CFL

55
Q

what is the tarsal tunnel?

A

fibroosseous tunnel created by the posterior medial malleolus, medial wall of the calcaneous and talus and the flexor retinaculum

56
Q

second most commonly torn tendon of the lateral ankle

A

CFL

57
Q

which motion tightens ATFL?

A

plantar flexion

58
Q

which motion tightens CFL?

A

inversion

59
Q
A

AITFL

60
Q
A

ATFL

61
Q
A

CFL

62
Q
A

PTFL

63
Q
A

PITFL

64
Q

4 parts of the deltoid ligament

A

anterior tibiotalar

tibionavicular

tibiocalcaneal

posterior tibiotalar (deep)

65
Q
A

posterior tibiotalar ligament

66
Q
A

tibiocalcaneal ligament

67
Q
A

anterior tibitalar ligament

68
Q
A

tibionavicularligament

69
Q

strongest subtalar ligament

A

interosseous talocalcaneal

(aka cervical ligament)

70
Q

what is the bifurcate ligament?

A

the calcaneo-cuboid/navicular ligament

71
Q

anatomy of the long plantar ligament

A

from calcaneous to cuboid and 1-5 metatarsals

72
Q

anatomy of the short plantar ligament

A

from the calcaneous to the cuboid

73
Q

what is the spring ligament

A

from the susentaculum tali to the navicular

74
Q

frequency of os trigonum

A

5-15%

75
Q

frequency of accessory navicular

A

10%

76
Q

what is the os peroneum?

A

plantar to CC joint

77
Q

list the intrinsic dorsal muscles of the foot

A

EDB

EHB

78
Q

list the intrinsic plantar muscles of the foot

A

1st layer: abductor hallucis, abductor digiti minimi, FDB

2nd layer: quadratus plantae, lumbricals

3rd layer: FHB, FDM, adductor hallicus

4th layer: dorsal interossei, plantar interossei

79
Q

which layer houses the knot of Henry?

A

the 2nd - this is where FHL and FDL tendons are

80
Q

which tendons run in the 4th layer of the foot?

A

peroneus longus

posterior tibialis

81
Q

insertion of quadratus plantae

A

lateral FDL tendon

82
Q

where does the nerve to ADM get trapped?

A

fascia of abductor hallucis

83
Q

which foot layer houses the medial and lateral plantar nerves?

A

2nd

84
Q

which interossei are larger?

A

dorsal

85
Q

muscles of the first plantar layer

A

flexor digitorum brevis

abductor hallucis

abductor digiti minimi

86
Q

origin and insertion of plantar lumbicals

A

from medial FDL tendon to medial PP and EDL tendons

87
Q

origin and insertion of flexor hallucis brevis

A

cuboid and lateral cuneiform to PP 1st toe

88
Q

origin and insertion of adductor hallucis

A

2-4 MT to 1st PP

89
Q

origin and insertion of flexor digiti minimi brevis

A

base of 5 MT head to 5 PP

90
Q

3 portions of the plantar fascia

A

central band from calc to flexor tendon sheaths

medial band

lateral band

91
Q

what is the truss and windlass mechanism?

A

where the plantar fascia pull together to force the arch of the foot rostral

92
Q

9 compartments of the foot

A

medial - AbdH, FHB, FHL tendon

lateral - ADM, FDM

superficial central - FDB, lumbircals, FDL tendons

deep central - QP, posterior tibial NVB

adductor - AddH

interosseus 1-2 - dorsal only

interosseus 2-3 - both

interosseus 3-4 - both

interosseus 4-5 - both

93
Q

where does the tibial nerve run in the foot?

A

between 1st and 2nd layers on QP

94
Q

where does the tibial nerve split?

A

in tarsal tunnel (90%)

95
Q

3 branches of the tibial nerve in the foot

A

medial calcaneal

medial plantar

lateral plantar

96
Q

what is baxter’s nerve?

A

first branch of the lateral plantar nerve

supplies the quadratus, FDB and ADM

its impingement causes medial heel pain colloquially known as plantar fasciitis

97
Q

1

A

saphenous nerve

98
Q

2

A

deep peroneal

99
Q

3

A

superficial peroneal

100
Q

4

A

medial plantar

101
Q

5

A

lateral plantar

102
Q

6

A

medial calcaneal branch of tibial nerve

103
Q

7

A

sural

104
Q

course of the deep peroneal nerve in the foot

A

travels lateral to and with dorsalis pedis artery

emerges distal to inferior extensor retinaculum

travels lateral to EHL

tracks down first web space

105
Q

4 main branches of the dorsalis pedis

A

medial tarsal

lateral tarsal

arcuate - forming the dorsal arch

deep plantar - forms the deep arch

106
Q

weakness of hindfoot eversion

A

superficial peroneal nerve

107
Q

weakness of hindfoot inversion

A

tibial nerve

108
Q

weakness of great toe extension

A

deep peroneal

109
Q

weakness of great toe flexion

A

tibial nerve

110
Q

weakness of ankle plantar flexion

A

tibial nerve

111
Q

borders of sinus tarsi

A

superior: talus
inferior: calcaneus
anterior: talocalcaneonavicular joint
posterior: posterior facet of the subtalar joint

112
Q

4 ligaments of the syndesmosis

A

AITFL

PITFL

inferior transverse ligament

interosseous ligament

113
Q

which facet of the subtalar joint is most often affected in tarsal coalition

A

middle

114
Q

2 intrinsic muscles of the foot innervated by deep peroneal nerve

A

EDB

EHB

Orthopaedic Anatomy (15 decks)

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