Ankle OP

Question 1

Gastrocnemius

Answer 1

Posterior compartment - superficial
Origin = lateral condyle of femur
Insertion = calcaneal tendon
Actions = PF and knee flexion

Question 2

Plantaris

Answer 2

Posterior compartment - superficial
Origin = lateral supracondylar ridge of femur (just above lateral condyle of femur)
Insertion = calcaneal tendon
Actions = PF and knee flexion

Question 3

Soleus

Answer 3

Posterior compartment - superficial
Origin = head of fibula and medial tibia
Insertion = calcaneal tendon
Actions = PF

Question 4

Popliteus

Answer 4

Posterior compartment - superifical
Origin = lateral condyle of femur
Insertion = proximal tibia on medial side
Actions = knee flexion, medial rotation of tibia

Question 5

Tibialis Posterior

Answer 5

Posterior compartment - deep
Origin = tibia, fibula, interosseous membrane
Insertion = broad attachment on plantar surface of foot
Actions = PF, inversion

Question 6

Flexor Digitorum Longus

Answer 6

Posterior compartment - deep
Origin = posterior surface of tibia
Insertion = distal phalanges of digits 2-5
Actions = PF, toe flexion, slight inversion

Question 7

Flexor Hallicus Longus

Answer 7

Posterior compartment - deep
Origin = posterior inferior surface of fibula
Insertion = distal phalanx of digit 1
Actions = ankle flexion, flexion of big toe, slight inversion

Question 8

Tibialis Anterior

Answer 8

Anterior compartment - superficial
Origin = lateral condyle of tibia, tibia and interosseous membrane
Insertion = metatarsal 1, medial cuneiform
Actions = DF, inversion

Question 9

Extensor Digitorum Longus

Answer 9

Anterior compartment - superficial
Origin = lateral condyle of tibia, fibula and interosseous membrane
Insertion = middle and distal phalanges of digits 2-5
Actions = DF, extension of toes

Question 10

Extensor Hallicus Longus

Answer 10

Anterior compartment - deep
Origin = anterior surface of fibula and interosseous membrane
Insertion = distal phalanges of bit toe
Actions = DF, extension of big toe

Question 11

Fibularis/Peroneus Tertius

Answer 11

Anterior compartment - deep
Origin = distal surface of fibula and interosseous membrane
Insertion = base of 5th metatarsal
Actions = eversion, DF

Question 12

Fibularis Brevis

Answer 12

Lateral compartment - superficial
Origin = fibula
Insertion = base of 5th metatarsal
Actions = eversion, PF

Question 13

Fibularis Longus

Answer 13

Lateral compartment - deep
Origin = head and body of fibula
Insertion = metatarsal 1 and medial cuneiform
Actions = eversion, PF

Question 14

What plexus supplies lower limbs?

Answer 14

Sacral plexus (L4-S4)

Question 15

Which nerves do sacral plexus bifurcate to? Name some of the muscles innervated by these nerves

Answer 15

Tibial:
- tibialis posterior, soleus, gastroc, flexors
Fibular:
- tibialis anterior, peroneus tertius, extensors, fibularis longus

Question 16

What are the landmarks in Ottawa Ankle Rules and what are the criteria for it?

Answer 16

Lateral and medial malleolus, navicular, base of the 5th metatarsal
Pt can or cannot take 4 steps
Weight bearing immediately after injury or not

If any tenderness in 2 or more of the landmarks and they cannot weight bear immediately after injury and cannot take more than 4 steps, this is indicative of a fracture and should be sent for imaging

Question 17

Describe talar tilt test

Answer 17

Used to test for injury to lateral ligaments
- PTFL > DF and invert
- CFL > neutral and invert
- ATFL > PF and invert

Question 18

What can compression/squeeze test be used for?

Answer 18

High ankle sprain > AITFL and PITFL

Question 19

Name the lateral ligaments

Answer 19

Anterior talofibular ligament, posterior talofibular ligament, calcaneofibular ligament

Question 20

What is the origin insertion of the CFL?

Answer 20

Origin = lateral malleolus
Insertion = lateral calcaneus

Question 21

What is the origin insertion of the ATFL?

Answer 21

Origin = lateral malleolus
Insertion = lateral aspect of talar neck

Question 22

What is the origin insertion of the PTFL?

Answer 22

Origin = posterior aspect of distal fibula just posterior to lateral malleolus
Insertion = lateral tubercle of posterior talus

Question 23

What is the deltoid ligament composed of?

Answer 23

Tibionavicular ligament, tibicalcaneal ligament, anterior tibiotalar ligament and posterior tibiotalar ligament
Origin of all 4 = medial malleolus

Question 24

What special test is used for deltoid ligament?

Answer 24

Kleiger’s test > neutral position then rotate ankle externally