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Anatomy > Ankle Foot Study Guide > Flashcards

Ankle Foot Study Guide Flashcards

1
Q

. What are some unique features for each of the tarsal bones?

A

Talus:
-1st bone we come to if er move distally from leg bones
-Mortise, head, body, trochlea, articular cartilage
- Transfers wight from tibia to calcaneus and forefoot
- No tendon / muscle attachments

Calcaneus:
-Largest, strongest tarsal
-transfers weight from talus to ground
-Sustentaculum tali, calcaneal tuberosity

Navicular
- Navicular Tuberosity

Cuboid:

Cuneiform:
- Medial, intermediate, lateral

Transverse Tarsal Joint:
- Separates hindfoot and midfoot

Tarsometatarsal Joint
- Separates hindfoot and midfoot

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2
Q

Which bones make up Hindfoot

A

-talus
-Calcaneus

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3
Q

Which bones make up midfoot

A

-Navicular
-Cuboid
-1-3 Cuneiforms

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4
Q

Which bones make up the forefoot

A
  • 5 metatarsal bones
  • Phalanges
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5
Q

Primary/contributing muscles of Dorsiflexion

A

-Tibialis Anterior is the strongest Dorsiflexor
-Extensor Hallucis Longus does dorsiflexion and extension of great toe
-Extensor Digitorum Longus dorsiflexes ankle and Extends lateral 4 digits
-Fibularis Tertius Dorsiflexes ankle joint and aids in eversion if subtalar joint

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6
Q

Primary/contributing muscles of Plantarflexion

A
  • Gastrocnemius is the main plantar flexor
    -Soleus is the workhorse of plantarflexion; can plantarflex regardless of knee position because it does not cross the knee
    -Fibularis Longus/brevis both assist in plantarflexion
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7
Q

Primary/contributing muscles of inversion

A

Tibialis Posterior is the best invertor

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8
Q

Primary/contributing muscles of eversion (look up in book)

A
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9
Q

What is the best muscle to maintain longitudinal arch during weight bearing?

A

Tibialis Posterior

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10
Q

Describe the Longitudinal arch of foot ( Medial/Lateral)

A

Medial= calcaneus, talus, navicular, cuneiforms, medial 3 metatarsals

Lateral= Cuboid, cuneiforms, bases of metatarsal

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11
Q

Describe the Transverse arch of the foot

A
  • cuboid, cuneiforms, base of metatarsals
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12
Q

Explain the Passive and Dynamic supports of the foot

A

Passive:
-Noncontractile
-Bone shapes
-Plantar aponeurosis
-Plantar ligaments (Spring, Long, Short)

Dynamic:
- Contractile
- Intrinsic foot muscles
-Extrinsic (Tendons, FHL,FDL, Fibularis Longus, Tibialis Posterior

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13
Q

What happens to the Tibiofibular Syndesmosis during ankle Dorsiflexion?

a. Why does this occur?

b. What ligaments restrain this?
A
  • During ankle dorsiflexion the tibiofibular syndesmosis helps prevent mortis from splaying

A= Stability of ankle joint, keeps lateral malleolus firmly against lateral surface of talus

B= Union of Tibia and Fibula by interosseous membrane (shafts) and anterior, Interosseous and posterior tibiofibular ligaments (making up inferior tibiofibular joint uniting distal ends of bones)

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14
Q

Bones that make up Talocrural Joint

A
  • Mortis/ Talus
  • Hinge type joint
  • Has a capsule
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15
Q

Bones that make up Subtalar Joint

A
  • Talus/Calcaneus
    -Majority inversion/eversion occurs
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16
Q

Bones that make up the Metatarsophalangeal Joint

A

-Connects head of metatarsals with bases of proximal phalanges
-Toe flexion, extension, abduction, adduction

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17
Q

Bones that make up the Transverse Tarsal Joint

A
  • Made up of 2 separate Joints
    1. Talonavicular joint
    2. Calcaneal cuboid joint
    -Plays role in eversion and inversion
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18
Q

Bones that make up Tarsometatarsal Joint

A
  • Connects each tarsal bone to a metatarsal
  • Where forefoot begins
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19
Q

What bones make up the Proximal Interphalangeal Joint

A
  • Connects 1 phalanx to the next
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20
Q

What toe only has 1 IP joint ?

A

Great toe

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21
Q

A: Interphalangeal Joints can only…….
B: Interphalangeal joints can not do …..

A

A= can only do toe flexion/extension
B=Cannot do abduction/adduction

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22
Q

Which bones are connected by Anterior Talofibular ligaments & which motions are restrained

A
  • Flat weak band
    -Extends anteromedially from lateral malleolus to neck of the talus
    -resistant to inversion
23
Q

Which bones are connected by the Posterior Talofibular ligaments & which motions are restrained

A
  • Thick fairly strong band
    -Runs horizontally medially and slightly posteriorly from malleolar fossa of the fibula to the lateral tubercle of the talus
  • Resists ankle joint inversion
24
Q

Which bones are connected by the Calcaneofibular ligament and which motions are restrained

A
  • Round cord
  • Passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
    -Medial ankle: stabilizes the ankle joint during eversion and prevents subluxation
25
Q

Which bones are connected by the deltoid ligaments and which motions are restrained

A
  • Made up of 3 smaller ligaments
    1. Tibionavicular
    2. Tibiocalcaneal
    3. Tibiotalar part (posterior/anterior)
26
Q

Which Bones are connected by the calcaneonavicular (spring) and which motions are restrained

A

-Calcaneus to navicular
-The main ligament responsible for holding up the longitudinal arch of the foot

27
Q

Which bones are connected by the Long Plantar and which motion are restrained

A
  • Calcaneus to cuboid to metatarsal
28
Q

Which bones are connected by the Short Plantar ( Plantar calcaneocuboid ) and which motions are restrained

A
  • Plantar calcaneocuboid ligament
    -Calcaneus to cuboid
29
Q

Which 3 ligaments maintain longitudinal arch

A
  1. Calcaneonavicular ligament
  2. Long plantar
  3. Short plantar
30
Q

. Explain the function of the Extensor Expansions of the toes

(Look this up in the book)

A
31
Q

Tom, Dick, ANd Harry Mnemonic

A

Tom= Tibialis Posterior
Dick = flexor Digitorum longus
A=tibial Artery
N=tibial Nerve
Harry= flexor Hallucis longus

32
Q

Plantar fascia

A
  • Continuous with posterolateral deep fascia of leg
    -Medial and lateral parts
  • Central part strong = Plantar Aponeurosis
  • Continuous distally with fibrous digital sheaths
  • Reinforced at metatarsals heads by superficial transverse metatarsal ligament
    5 compartments
    1. Medial
    2. Central
    3. Lateral
    4. Interosseous
    5.Dorsal
33
Q

Plantar fascia: Medial

A

Contains :
-Adductor hallucis
- Flexor Hallucis Brevis
-Tendon of FHL
- Medial Plantar nerves/vessels

34
Q

Plantar Fascia: Central

A
  • Covered by Plantar aponeurosis
    Contains:
    -FDB
    -Tendons of FHL and FDL
  • Quadratus planta
  • Lumbricals
    -Adductor Hallucis
    -Lateral Plantar nerve/vessel
35
Q

Plantar Fascia: Lateral

A

Contains:
- Abductor/flexor digiti minimi brevis muscles

36
Q

Plantar Fascia: Interosseous

A

-Surrounded by plantar/dorsal interossei facias
Contains:
-Metatarsal bones
-Dorsal/ plantar interosseous fascia of mid/forefoot

37
Q

Plantar Fascia: Dorsal

A

-Lies Between dorsal fascia and tarsal bones and dorsal interosseous of mid/forefoot
Contains:
- EHB
-EDB
-Neurovascular structures of the foot

38
Q

Intrinsic Muscles Info

A

-Has 4 layers
- 20 muscles: 14 plantar, 2 dorsal, 4 intermediate
-Intrinsic muscles function as a group
- Maintains arches of foot, resists collapse during walking

39
Q

Intrinsic Layer 1

A
  • Adductor Hallucis
  • Flexor Digitorum Brevis
    -Adductor Digiti Minimi
40
Q

Intrinsic Layer 2

A

-Quadratus Plantae
-Lumbricals:
- Medial 2= Medial plantar nerve
- Lateral 2= Lateral plantar nerve
- Flex MTP’S but extends PIPs and DIPs

41
Q

Does the Hallux and 5th digit need dorsal interossei?

A

No, because they each have their own abductor muscles

42
Q

Dorsal Extrinsic

A

-Extensor Digitorum Brevis
-Extensor Hallucis Brevis
-Both innervated by Deep Fibular Nerve

43
Q

Describe arterial blood flow through the foot

A

Dorsal
Anterior Tibial Artery
Dorsalis pedis
-1st dorsal metatarsal artery
-deep plantar artery
- Lateral tarsal branch

Plantar
Posterior Tibial Artery
Medial Plantar Artery
- Deep and superficial branches
Lateral Plantar Artery
-plantar metatarsal arteries
-Plantar digit Arteries

44
Q

Veins of the foot

A

Superficial
Dorsal and plantar digital veins –> dorsal metatarsal veins–> Dorsal venous arch –> dorsal venous network–> Plantar venous network–>medial marginal vein (goes to great saphenous vein) Lateral marginal vein (goes to small saphenous vein

Deep
-Deep plantar arch to posterior tibial veins

45
Q

The 8 Gait Periods

A

Stance Phase:
1. Initial Contact
2. Loading response
3. midstance
4. Terminal Stance
5. Preswing

Swing Phase
6. Initial Swing
7. Midswing
8.Terminal Swing

46
Q

. What is an Os Trigonum?

A

Secondary ossification center ails to unite during development

Causes:
- Excessive of forceful plantarflexion early in teen years
-non-union fracture

Incidence:
-14-25% of adults
-ballet dancers, soccer players

47
Q

Hallux Valgus

A

-Causes:
- Footwear + DJD

  • Hallux points laterally
    -1st metatarsal shifts medially
    -Sesamoid shifts laterally
    -Medial longitudinal arch flattens
    -1st toe may overlap second
    -Bunions form
48
Q

Hammer Toe

A

-MTP hyperextension, PIP flexion, DIP hyperextension
-2nd toe most affected
-Weak lumbricals/interosseous membrane

49
Q

Claw Toes

A

-MTP hyperextension, PIP and DIP flexion
-Lateral 4 toes usually
-Callositeies and corns dorsal toe and or plantar metatarsal heads and toe tips

50
Q

Pes Planus

A

-Flat Feet
- Flexible
- Flat in WB, Arch present in NWB
- No passive support from ligaments
-Rigid
- Flat regardless of WB or NWB
- Aquired Flat foot
- Fallen arches
- Tibialis posterior dysfunction
- No dynamic support from muscles

Spring ligament can’t hold up talar head then the head falls inferomedially–> medial bulge in foot , loss of arch, lateral deviation of forefoot

51
Q

What is the mechanism of injury for ATFL, CFL, and Trimalleolar Fracture for these ankle sprains

Look up more in the book

A

ATFL= most common injured (inversion)

CFL= may sprain with ATFL (inversion)

Trimalleolar Fracture= Deltoid ligament sprains are rare from eversion
- Pott fracture/dislocation
-eversion injury
-Deltoid sprained and tears off medial malleolus
- Talus breaks lateral malleolus or fibula superior to syndesmosis
-Tibia moves anterior shearing off its posterior distal ends on talus

52
Q

What is Tarsal Tunnel Syndrome

A

Tarsal tunnel= formed by flexor retinaculum
-Tibial nerve can be compressed/trapped by: edema or tight synovial sheaths of inverter tendons

Symptoms:
- Heel pain
-Plantar foot parathesis
- Motor loss plantar foot muscles

53
Q

Describe the pathology of a Calcaneal Tendon rupture

A

Causes:
- Poor conditioning
- History of calcaneal tendinitis

Symptoms:
- Audible snap
-Palpable gap proximal to calcaneal attachment
- Excessive dorsiflexion
-Pain in the calf/lump in calf
-Inability to Plantarflex against resistance

Treatment:
- Surgical repair
-PT for safe progressive rehab

54
Q

Describe the pathology of Plantar Fasciitis

A

Inflammation of the plantar fascia

Causes:
- Biomechanical errors
-Overuse
-Improper footwear

Symptoms:
-Pain plantar foot and heel
- TP medial calcaneus
- Worse when trying to walk after periods of rest dissipates with activity
-Worse with passive toes extension and dorsiflexion

Calcaneal spur may develop from excessive pull of plantar fascia on origin

Anatomy (11 decks)

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