Bones And Joints Of The Distal Lower Limb Flashcards
2 bones of the leg
Tibia
Fibula
What do the tibia and fibula articulate with distally
Talus at the ankle joint
How are the tibia and fibula connected
2 joints and a strong interosseous membrane
Shape of tibia
Thick and strong bone
Proximal part of tibia
Medial and lateral tibial condyles- superior surfaces are flattened to form plateaus
Intercondylar tubercles
Prominent ridges between the tibial plateaus
Which bones articulate to form the knee joint
Medial and lateral tibial plateaus with femoral condyles
Tibial tuberosity
Projects from upper anterior surface of tibia
Patellar ligament inserts here
Soleal line
Oblique ridge in posterior surface of the tibia
Medial malleolus
Projects medially from the distal end of the tibia and forms part of the socket for the talus
Shape of fibula
Slender bone
Where does the common fibular bone run close to
Neck of fibula
Lateral malleolus
Projects from the distal end of the fibula and forms part of the socket for the talus
Function of small joints in foot
Allow it to deform and absorb shock when walking over uneven ground
Function of the longitudinal and transverse arches of the foot
Allow shock absorption
Tarsal bones
Talus
Calcaneus
Navicular
Cuboid
Medial/intermediate/lateral cuneiforms
Which tarsal bones form the hindfoot
Talus and calcaneus
Which tarsal bones form the midfoot
Medial/lateral/intermediate cuneiforms
Navicular
Cuboid
Meaning of calcaneus
Chalk - dense white shape and appearance
Meaning of navicular
Boat-shaped
Meaning of cuneiform
Wedge-shaped
Which bones comprise the forefoot
Metatarsal and phalanges
Number of phalanges in toes 2-5
3
Number of phalanges in toe 1 (great toe)
2
Number of metatarsals
5
1 - 5 medial to lateral
Joints between metatarsal and proximal phalanges
Metatarsophalangeal joints
Joints between phalanges
Interphalangeal
Movements in the toes
Flexion
Extension
Abduction and Adduction
Why is Flexion of the metatarsophalangeal joint important
Pushing the foot off the ground and forward propulsion during walking and running
What type of joint is the ankle joint
Synovial hinge joint
Ankle mortise
Socket formed by the tibia and fibula for the talus
What ligaments support the ankle joint
Medial and lateral ligaments
Movements of the ankle joint
Dorsiflexion
Plantarflexion
Dorsiflexion
Bringing the toes closer to the shin
Plantarflexion
Pointing the toes
Number of lateral ligaments of the ankle
3
What do the lateral ligaments of the ankle attach to
Lateral malleolus
What do the medial ligaments of the ankle attach to
Medial malleolus
Subtalar joint
Articulation of talus with the calcaneus and navicular
Movements of the subtalar joint
Inversion
Eversiomn
Inversion
Bring sole of the foot medially
Eversion
Raises the lateral border of the foot
Brings sole of the foot laterally
Tibial fracture
High energy forces are required to fracture a healthy tibia. When the tibia fractures, the broken ends of the bone may break through the skin because there is little subcutaneous tissue between the anterior surface of the tibia and skin. If a there is broken skin overlying a fracture, or the bone penetrates out through the skin, it is called an ‘open’ or ‘compound’ fracture. Open fractures must be managed carefully to prevent infection from entering the exposed bone and ensuring the skin heals over the surface.
Intra-osseous vascular access
In critical emergency situations, where vascular access is required immediately to provide lifesaving treatment directly into the bloodstream, and there is difficulty or delay in accessing peripheral veins, vascular access can be gained through the bone. The flat antero-medial part of the proximal tibia is a common site for IO access. A small handheld drill is used to ‘drill’ a cannula into the bone, and into the medullary cavity, providing a route to give treatment.
Ankle sprain
Ankle sprains are very common and almost always result from a forced inversion of the foot. Forced inversion stretches and tears the lateral ligament of the ankle, resulting in pain and swelling over the lateral aspect of the ankle and foot.
Ankle fracture
An ankle fracture refers to a fracture of the lateral and/or medial malleolus. Small lateral malleolus fractures, depending on their exact location, may be treated conservatively (without surgery). However, medial malleolus fractures and more proximal lateral malleolus fractures, or fractures with a dislocation of the ankle joint will require surgical fixation.
- What complications can arise from an open fracture of the tibial shaft?
Infection of the bone- osteomyelitis
Poor wound healing as there is little subcutaneous tissue anterior to the tibial shaft
- What movements take place at the ankle joint?
Dorsiflexion
Plantarflexion
- What movements occur at the subtalar joint?
Inversion
Eversion
- What type of injuries sprain the medial and lateral ankle ligaments?
Medial = eversion
Lateral = inversion
- Which tarsal bone is in contact with the ground when standing?
Calcaneus
- What is the name of the flattened surface of the proximal tibia?
Medial and lateral plateaus
