Foot

Question 1

3 groups of bone

Answer 1

seven tarsal bones
metatarsal I to V
phalanges (Each toe has 3 other than great toe - 2)

Question 2

Tarsal

Answer 2

Proximal - talus, calcaneus
Intermediate - navicular
Distal - cuboid, 3 cuneiforms

Question 3

Cuboid articulation

Answer 3

Posteriorly with calcaneus, medially with lateral cuneiform and anteriorly with bases of lateral 2 metatarsals. tendon of peroneus longus lies in prominent groove on the anterior plantar surface

Question 4

Cuneiform articulation

Answer 4

with each other, posteriorly with navicular and anteriorly with base of medial three metatarsals

Question 5

Ankle joint

Answer 5

Synovial, talus of foot and tibia and fibula of leg

Question 6

Blood supply of talus

Answer 6

branches from dorsalis pedis - superior aspect of talar neck and dorsal portion of head and neck
branches from fibular artery - a small portion of lateral talus

Question 7

Medial (deltoid) ligament

Answer 7

large, strong and triangular in shape.
Apex attached above to medial malleolus and broad base is attached below to line that extends from tuberosity of navicular in front to medial tubercle of talus behind

Question 8

Parts of deltoid ligament

Answer 8

Tibionavicular
Tibiocalcaneal (most superficial)
Anterior and posterior tibiotalar. Anterior tibiotalar is deep to tibionavicular and tibiocalcaneal parts

Question 9

Plantar calcaneonavicular ligament (spring ligament)

Answer 9

connects navicular bone to sustentaculum tali of calcaneus bone behind
Supports head of talus, takes part in talocalcaneonavicular joint and resists depression of medial arch of foot

Question 10

Lateral ligament

Answer 10

3 separate ligaments
Anterior talofibular
Posterior talofibular
Calcaneofibular

Question 11

Intertarsal joint

Answer 11

Synovial joints which mainly invert, evert, supinate and pronate the foot

Question 12

Major joints of movements in intertarsal joints

Answer 12

subtalar, talocalcaneonavicular, calcaneocuboid,
Talocalcaneonavicular and calcaneocuboid forms the transverse tarsal joint
Between cuneiforms and cuneiform and navicular only allow limited movements
joint between cuboid and navicular (cubonavicular) normally fibrous

Question 13

Ottawa ankle rule

Answer 13

Ankle x ray if there is ankle pain and any of:

• bone tenderness in distal 6cm of posterior tibia and medial malleolus
• bone tenderness in distal 6cm of posterior fibula and lateral malleolus
• unable to walk for 4 steps

Foot x ray if there is midfoot pain and any of:

• bone tenderness at base of fifth metatarsal bone
• bone tenderness at navicular bone
• unable to walk for 4 steps

Question 14

Subtalar joint

Answer 14

between talus and calcaneus
allows inversion and eversion of foot
lateral, medial, posterior and interosseous talocalcaneal ligaments stabilize the joint

Question 15

Talocalcaneonavicular joint

Answer 15

allows inversion and eversion of foot, also pronation and supination
reinforced by interosseous talocalcaneal ligament posteriorly, superiorly by talonavicular ligament and inferiorly by spring ligament

Question 16

Calcaneocuboid joint

Answer 16

inversion and eversion of foot, pronation and supination of forefoot on hindfoot
Reinforced by bifurcate ligament and long plantar ligament and plantar calcaneocuboid ligament (short plantar ligament)
These ligaments resist depression of lateral arch of foot

Question 17

MTP joint

Answer 17

reinforced by medial and lateral collateral ligaments and plantar ligaments
Allows flexion, extension and limited abduction, adduction, rotation and circumduction

Question 18

Tarsometatarsal joint

Answer 18

plane joints, allow flexion, extension and rotation. Take part in pronation and supination of foot

Question 19

interphalangeal joints

Answer 19

hinge joints allowing flexion and extension.

Reinforced by medial and lateral collateral ligaments and plantar ligaments

Question 20

Tarsal tunnel borders

Answer 20

Posteromedial side of ankle
Formed by medial malleolus of tibia
medial and posterior surface of talus
medial surface of calcaneus
AND overlying flexor retinaculum

Question 21

Contents of tarsal tunnel

Answer 21

Medial to lateral (tom dick and harry)
Tibialis posterior
FDL
posterior tibial Artery
tibial Nerve
FHL

Question 22

Extensor retinaculum

Answer 22

superior and inferior

Question 23

Superior extensor retinaculum

Answer 23

superior to ankle joint and attached to anterior borders of fibula and tibia

Question 24

Inferior extensor retinaculum

Answer 24

y-shaped, base - lateral side of upper surface of calcaneus, medial side of plantar aponeurosis
Top attached to medial malleolus

Question 25

Structures passing under extensor retinaculum

Answer 25

Lateral to medial
Peroneus tertius
EDL
Dorsalis pedis (anterior tibial artery initially in between EHL and tibialis anterior but crosses laterally underneath EHL to end up lateral to EHL)
EHL
TIbialis anterior

Question 26

Ligaments supporting arch of foot

Answer 26

Plantar calcaneonavicular ligament
Long plantar ligament
Short plantar ligament
Plantar aponeurosis

Question 27

Muscles supporting arch of foot

Answer 27

Tibialis anterior
tibialis posterior
Peroneus longus

Question 28

Intrinsic muscles of foot

Answer 28

Dorsal aspect - EDB, EHB
Plantar side - 4 layers
All innervated by tibial nerve except EDB, EHB and first 2 dorsal interossei by deep peroneal nerve

Question 29

First layer of sole of foot

Answer 29

Medial to lateral
abductor hallucis
FDB
abductor digiti minimi

Question 30

2nd layer of sole of foot

Answer 30

tendons of FDL
quadratus plantae
four lumbrical muscles

Question 31

3rd layer of sole of foot

Answer 31

medial to lateral
flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis

Question 32

4th layer of sole of foot

Answer 32

4 dorsal interossei

3 plantar interossei

Question 33

Blood supply to foot

Answer 33

branches of posterior tibial (medial and lateral plantar) and dorsalis pedis