Ankle Joint

Question 1

Why is the femur angled?

Answer 1

so the knees can be closer to the midline and under the centre of gravity

Question 2

Where is the tibial tuberosity?

Answer 2

proximal of the anterior shaft of tibia

Question 3

What attaches to the tibial tuberosity?

Answer 3

patella tendon, mediating the quadricep muscles

Question 4

When we get a fracture on the tibia, we are likely to get a fracture on the fibula as well. Why is that?

Answer 4

tibia and fibula form a ring

Question 5

Why is the distal tibia more likely to fracture?

Answer 5

It is relatively thin and does not have a good blood supply

Question 6

What is the name of the oblique line down the posterior tibia?

Answer 6

soleal line

Question 7

What is the muscle type of soleus?

Answer 7

it’s a slow twitch muscle, working at a steady and low level, important for maintaining posture

Question 8

Why do we tend to fall forward when we faint in the up right position?

Answer 8

We lose the soleus support, and the centre of gravity will push the body forward

Question 9

If we fracture our fibula, how long will it take before we can move again?

Answer 9

Pretty quickly, because the fibula is non-weight bearing and has good blood supply

Question 10

Because of the extensive blood supply of the fibula, we often use the fibula as _______

Answer 10

bone graft

Question 11

T/F interosseous membrane of the tibia and fibula is a completely sealed membrane

Answer 11

False, it has two foramen, one superiorly, one inferiorly

Question 12

What kind of joint is the superior tibialfibular joint?

Answer 12

plain synovial

Question 13

What are the ligaments supporting the superior tibialfibular joint?

Answer 13

anterior ligament, posterior ligament and the lateral collateral ligament

Question 14

T/F inferior tibialfibular joint has the same joint type as superior tibialfibular joint

Answer 14

False, it is a fibrous syndemosis, hence stronger than the superior joint

Question 15

Why have we lost pronation and supination in our lower limbs?

Answer 15

humans are bipedal. We trade the mobility for stability of lower limbs

Question 16

What are the three crucial bones of the ankle (for most of the movements)

Answer 16

talus
calcaneus
navicular

Question 17

T/F Lower limbs undergo internal rotation during development

Answer 17

True, so the big toe is medial.

External rotation occurs with the upper limbs

Question 18

What’s the common location for “march fracture”

Answer 18

the second metatarsal, because it is the thinnest and the articulation is wedged between first and third metatarsal. Hence stress fractures are very common

Question 19

What are the functions of seasamoid bones?

Answer 19

provide a passage for tendons, so they have a cushioning effect and also create a space for neurovascular structures to pass

Question 20

Where in the bone does an accessory bone form?

Answer 20

in the secondary ossification centres

Question 21

What are two common places for accessory bones in the lower limbs?

Answer 21

in the talus or around the navicular

Question 22

List the three main joints associated with the ankle

Answer 22

talocrural, above the talus
subtalar joint, below the talus
midtarsal joint, anteriorly

Question 23

What does the “mortice” compose of?

Answer 23

body of the talus surrounded between the malleoli, protected by posterior tibiofibular ligament and inferior transverse ligament

Question 24

What kind of joint is the talocrural joint? What movements does it produce?

Answer 24

synovial hinge joint, producing dorsiflexion and plantarflexion

Question 25

Why is dorsiflexion often associated with eversion at the ankle joint?

Answer 25

Because of the oblique axis between the two malleoli, lateral one extending more inferiorly

Question 26

T/F the ankle is more stable on plantarflexion

Answer 26

False. On plantarflexion, the posterior, narrower part of the talus is enclosed by the malleoli. There is therefore a greater range of movement, and less stable

Question 27

How far does the ankle joint capsule extend?

Answer 27

down to the neck of the talus

Question 28

T/F The lateral collateral ligaments of the ankle are weaker than the medial collateral ligaments

Answer 28

True, because they are three separate bands while the medial ligaments are almost fused

Question 29

What do the lateral collateral ligaments of the ankle attach to?

Answer 29

to the calcaneus, anterior talus, and posterior talus

Question 30

Why is the anterior talofibular ligament (one of the lateral collateral ligaments) most likely to be injured

Answer 30

Ankle is mostly injured on plantarflexion. In that position, the ATL is stretched, contributing to the risk of injury

Question 31

An ankle ligament injury laterally is often accompanied by a generalised soreness. How does that occur?

Answer 31

Due to muscular strain on fibularis longus and brevis, which travels posterior to the lateral malleolus

Question 32

What is a “Pott’s fracture”

Answer 32

Fracture of the fibula shaft together with fracture of malleoli

Question 33

What movement occurs at the subtalar joint?

Answer 33

inversion and eversion

Question 34

What sits on the spring ligament? What is the function of this ligament?

Answer 34

the head of the talus

maintains the orientation of the head of talus

Question 35

When you run and land on your foot, is the foot in eversion or inversion?

Answer 35

foot down = dorsiflexion = eversion

Question 36

Where is the sinus tarsi and what is its function?

Answer 36

In the gap between TCN joint and the posterior subtalar joint

it contains the blood supply, via vascular sling through the sinus tarsi

Question 37

What are the two midtarsal joints?

Answer 37

TCN and calcaneocuboid

Question 38

What movements occur at the calcaneocuboid joint?

Answer 38

pronation and supination

arch support in shoe design is based on the degree of this movement

Question 39

Where do Lisfranc fractures occur?

Answer 39

at the tarsometatarsal joints

Question 40

Metatarsophalangeal joints are all ______ joints

Answer 40

condylar

Question 41

T/F Lateral arch of the foot is always higher than the medial arch

Answer 41

False, medial arch is higher