Foot and Ankle Flashcards

1
Q

How many tarsal bones are there?

A

7

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2
Q

List the 7 tarsal bones

A

Calcaneous
Talus
Cuboid
Navicular
Medial cruneiform
Intermediate cruneiform
Lateral cruneiform

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3
Q

How many phalanges does the big toe have?

A

2 (same as thumb)!

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4
Q

Which tarsal bones are involved in the subtalar joint?

A

Talus
Calcaneous

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5
Q

Which tarsal bones are involved in the transverse tarsal joint?

A

Talus
Calcaneous
Navicular
Cuboid

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6
Q

Which bones are involved in the tarsal metatarsal joint?

A

Tarsals
Metatarsals

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7
Q

Which bones are involved in metatarsal phalangeal joint?

A

Metatarsal
Proximal phalanges

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8
Q

Which bones are involved in the interphalangeal joints?

A

Proximal phalanges
Distal phalanges

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9
Q

Which digit is the midline of the hand?

A

Digit 3

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10
Q

Which digit is the midline of the foot?

A

Digit 2

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11
Q

What is a hallux values deformity?

A

Bunion

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12
Q

What causes a bunion?

A

Abnormal stresses causing protuberance of bone and soft issue around the medial aspect of the first metatarsophalangeal joint

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13
Q

Describe the treatment of bunions

A

Change footwear
Anti inflammatory drugs
Surgery

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14
Q

How many intrinsic muscles are present on the dorsal surface of the foot?

A

2

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15
Q

Name the 2 intrinsic muscles on the dorsal surface of the foot

A

Extensor digitorum brevis
Extensor hallucis brevis

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16
Q

What innervates extensor digitorum brevis?

A

Deep fibular nerve

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17
Q

What is the action of extensor digitorum brevis?

A

Extends toes 2-5

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18
Q

Is extensor hallucis brevis widely accepted as an intrinsic dorsal muscle?

A

No, sometimes it is seen as being part of the medial aspect of digitorum bravis

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19
Q

How many muscles are in the plantar aspect of the foot?

A

10 intrinsic muscles

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20
Q

How many layers of muscles are there in the plantar aspect of the foot?

A

4

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21
Q

How many intrinsic muscle are in the first layer of the plantar aspect of the foot?

A

3

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22
Q

Name the 3 intrinsic muscles on the first layer of the plantar aspect of the foot

A

Abductor halluces
Flexor digitorum brevis
Abductor digiti minimi

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23
Q

Which 2 nerves innervate the plantar aspect of the foot?

A

Lateral plantar nerve
Medial plantar nerve

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24
Q

What innervates abductor halluces?

A

Medial plantar nerve

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25
Q

What is the action of abductor halluces?

A

Abducts and flexes big toe

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26
Q

What innervates flexor digitorum brevis?

A

Medial plantar nerve

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27
Q

What is the action of flexor digitorum brevis?

A

Flexes digits 2-5 at the proximal interphalangeal joints

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28
Q

What innervates abductor digiti minimi?

A

Lateral plantar nerve

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29
Q

What is the action of abductor digiti minimi?

A

Abduction of digit 5 (little toe)

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30
Q

What occurs with flexor digitorum longus and flexor digitorum brevis on digits 2-5?

A

Split tendon, flexor digitorum longus extend to distal phalanx, flexor digitorum brevis stops at the proximal phalanx

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30
Q

What occurs with flexor digitorum longus and flexor digitorum brevis on digits 2-5?

A

Split tendon, flexor digitorum longus extend to distal phalanx, flexor digitorum brevis stops at the proximal phalanx

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31
Q

How many intrinsic muscles are in the second layer of the plantar aspect of the foot?

A

2

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32
Q

Name the 2 muscles on the plantar aspect of the foot

A

Quadratus plantae
Lumbricals

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33
Q

How many lumbricals are present on each foot?

A

4

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34
Q

The tendons of which muscle run adjacent tot he lumbricals of the foot?

A

Flexor digitorum longus

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35
Q

What innervates quadratus plantae?

A

Lateral plantar nerve

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36
Q

What is the action of quadratus plantae?

A

Flexes digits 2-5 with flexor digitorum longus

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37
Q

What innervates the lumbricals?

A

Medial plantar nerve (first lumbrical)
Lateral plantar nerve (second, third, fourth lumbricals)

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38
Q

What is the action of the lumbricals?

A

Flexes the metatarsophalangeal joints
Extends the interphalangeal joints

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39
Q

How many intrinsic muscles are in the third layer of the plantar aspect of the foot?

A

3

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40
Q

Name the 3 muscles in the third layer of the plantar aspect of the foot

A

Flexor halluces brevis
Adductor halluces
Flexor digiti minimi brevis

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41
Q

How many heads does adducted halluces have?

A

2
One oblique head, one transverse head

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42
Q

How many heads does adducted halluces have?

A

2
One oblique head, one transverse head

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43
Q

What innervates flexor hallucis brevis?

A

Medial plantar nerve

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44
Q

What is the action of flexor hallucis brevis?

A

Flexion of the metatarsophalangeal joint of big toe

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45
Q

What innervates adductor hallcis?

A

Lateral plantar nerve

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46
Q

What is the action of adductor hallucis?

A

Adducts big toe at the metatarsophalangeal joint

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47
Q

What innervates flexor digiti minimi?

A

Lateral plantar nerve

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48
Q

What is the action of flexor digiti minimi/

A

Flexes the little toe at the metatarsopahalngeal joint

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49
Q

How many muscles are in the fourth layer of the plantar aspect of the foot?

A

2

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50
Q

Name the 2 muscles in the fourth layer of the plantar aspect of the foot

A

Plantar interossei
Dorsal interossei

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51
Q

What innervates the dorsal interossei?

A

Lateral plantar nerve
Deep fibular nerve (second and third digit)

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52
Q

What is the action of the dorsal interossei?

A

Abducts digits 2-5
Flexes metatarsophalangeal joint
Extends interphalangeal joints

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53
Q

What innervates the plantar interossei?

A

Lateral planter nerve

54
Q

What is the action of the plantar interossei?

A

Adducts toes 3-5
Flexes metatarsophalangeal joint
Extends interphalangeal joints

55
Q

How many retinacula are present in the ankle?

A

3

56
Q

Which retinaculum covers the flexor muscles?

A

The medial retinaculum

57
Q

Which retinaculum covers the extensor muscles?

A

The anterior retinaculum

58
Q

Which retinaculum covers the fibular muscles?

A

The lateral retinaculum

59
Q

Describe the position of the tarsal tunnel

A

Posterior and inferior to the medial malleolus

60
Q

What structure forms the ‘roof’ of the of the tarsal tunnel?

A

The medial retinaculum

61
Q

What structure forms the ‘roof’ of the of the tarsal tunnel?

A

The medial flexor retinaculum

62
Q

List the contents of the tarsal tunnel

A

Tendons of tibialis posterior
Tendons of flexor digitorum longus
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Tendons of flexor hallucis longus

63
Q

Where can the pulse of the posterior tibial artery be palpated?

A

Between the heel and the medial malleolus

64
Q

How many retinacula are part of the anterior extensor retinaculum?

A

2 - the superior extensor retinaculum and inferior extensor retinaculum

65
Q

What is the superior extensor retinaculum of the ankle joint attached to?

A

Attached to the tibia and fibula

65
Q

What is the superior extensor retinaculum of the ankle joint attached to?

A

Attached to the tibia and fibula

66
Q

The inferior extensor retinaculum is a specific shape. What shape is this?

A

Y shaped

67
Q

List the contents of the anterior extensor retinaculum

A

Tibialis anterior
Extensor hallucis longus
Dorsalis pedis
Extensor digitorum longus
Fibularis tertius

68
Q

The dorsals pedis can be palpated between which 2 tendons of the foot?

A

Flexor hallucis longus
Flexors digtiorum longus

69
Q

How many retinacula make up the lateral fibular retinaculum?

A

2 - superior fibular retinaculum and inferior fibular retinaculum

70
Q

Name the 2 muscles which tendons move underneath the lateral fibular retinaculum?

A

Fibularis longus
Fibularis brevis

71
Q

How many ligaments are part of the ankle joint?

A

6

72
Q

The ligaments of the ankle are divided into 2 groups. What are these?

A

Collateral ligament on lateral side of ankle
Deltoid ligament on medial side of ankle

73
Q

Name the 3 ligaments making up the collateral ligament of the ankle

A

Posterior talofibular ligament
Calcaneofibular ligament
Anterior talofibular ligament

74
Q

Name the 3 ligaments making up the deltoid ligament of the ankle

A

Posterior tibiotalar ligament
Tibiocalcaneal ligament
Anterior tibiotalar ligament

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

75
Q

What is the small cavity between talus can calcaneous called?

A

Sinus tarsi

76
Q

How many foot arches are there ?

A

3

77
Q

Name the 3 arches of the foot

A

Lateral
Medial
Transverse

78
Q

List the structures of the foot that help to maintain the foot arches

A

Shape of the bones
Connective tissue
Plantar aponeurosis
Ligament
Muscles

79
Q

What is the function oft he arches of the foot?

A

Acts like a spring for shock absorbing during locomotion

80
Q

Which arches of the foot are longitudinal?

A

The Lateral and Medial arch

81
Q

Which bone is the keystone for the transverse foot arch?

A

Intermediate cruneiform

82
Q

Which bone is the keystone for the medial foot arch?

A

Talus

83
Q

Which bone is the keystone for the lateral foot arch?

A

Cuboid

84
Q

What is the plantar aponeurosis?

A

Thick deep fascia of longitudinal bands form the calcaneous to the toes

85
Q

What does the spring ligament (plantar calcaneonavicular) attach to?

A

The sustentaculum tail of the calcaneus and the navicular

86
Q

What does the long plantar ligament attach to?

A

Calcaneus and the cuboid/metatarsal bones

87
Q

What does the short plantar ligament (plantar calcaneocuboid) attach to?

A

Anterior calcaneus to the cuboid

88
Q

Di the ligaments of the foot give active or passive support to the foot?

A

They give passive support

89
Q

Name the muscles which have tendons giving dynamic support to the foot

A

Flexor hallucis longus
Tibialis anterior
Tibialis posterior
Fibularis longus
Intrinsic muscles of the foot

90
Q

What does pes planus mean?

A

Flat feet

91
Q

What are the 2 types of flat feet?

A

Flexible flat feet
Rigid flat feet

92
Q

What is flexible flat feet?

A

The foot arch looks normal when the foot in unloaded, however becomes flat when weight is added

93
Q

What is rigid flat feet?

A

Foot is flat all the time, even when unloaded

94
Q

To whom does flexible flat feet most commonly occur?

A

In children

95
Q

Which branch of the popliteal artery enters the tarsal tunnel to the foot?

A

Posterior tibial artery

96
Q

What part of the foot does the posterior tibial artery supply?

A

The sole of the foot

97
Q

What are the 2 branches of the posterior tibial artery in the foot?

A

Medial plantar artery
Lateral plantar artery

98
Q

Does the medial or lateral plantar artery supply the big toe?

A

The medial plantar artery supplies the big toe

99
Q

Does there medial or lateral artery form the deep plantar arch?

A

The lateral plantar artery forms the deep plantar arch to supply each of the digits

100
Q

Which layer of the plantar aspect of the foot corresponds to the deep plantar arch?

A

The interossei

101
Q

Which part of the foot does the anterior tibial artery supply?

A

The dorsal part of the foot

102
Q

Which part of the foot does the anterior tibial artery supply?

A

The dorsal part of the foot

103
Q

What does the anterior tibial artery become when it passes in front of the ankle?

A

Dorsalis pedis

104
Q

What does dforsalis pedis become when it joins the deep plantar arch?

A

Deep plantar artery

105
Q

What 2 main branches does dorsals pedis give off?

A

Arcuate artery
First dorsal metatarsal

106
Q

What does the arcuate artery supply?

A

Supplies metatarsals and dorsal digital arteries

107
Q

What does the first dorsal metatarsal artery supply?

A

Digital branches to the first and second toes

108
Q

Which 2 veins join to form the dorsal venous arch?

A

Small saphenous vein
Great saphenous vein

109
Q

Which vein do the deep veins of the leg drain into?

A

Popliteal vein

110
Q

What 2 nerve branches does the lateral plantar nerve divide into?

A

Deep branch
Superficial branch

111
Q

What are the motor innervations of the medial plantar nerve?

A

Abductor hallucis
Flexor hallucis brevis
Flexor digitorum brevis
First lumbrical

112
Q

What are the sensory innervations of there medial plantar nerve?

A

Sole of foot
Medial 3.5 toes

113
Q

What are the motor innervations of the lateral plantar nerve?

A

Abductor digiti minimi
Quadratus plantae
2nd, 3rd, 4th lumbricals
Adductor hallucis
Flexor digiti minimi brevis
All interossei (apart form 1st and 2nd dorsal)

114
Q

What are the sensory innervations of the lateral plantar nerve?

A

Lateral sole
Lateral 1.5 toes

115
Q

What occurs in Morton’s neuroma?

A

Medial and lateral plantar nerve fuse and form a common plantar nerve - can be squeezed in walking, causes inflammation and pain

116
Q

What are the 2 main nerves that supply the dorsal surface of the foot?

A

Deep fibular nerve
Superficial fibular nerve

117
Q

What does the deep fibular nerve innervate?

A

Extensor digitorum brevis
First and second dorsal interossei
Skin between first and second toes

118
Q

What does the superficial fibular nerve innervate?

A

Sensory to dorsal aspect of skin apart from triangle between digits 1 and 2

119
Q

What is the most commonly injured nerve in the body?

A

Common fibular nerve

120
Q

Why is the common fibular nerve the most frequently injured?

A

It has a superficial position around the head and neck of the fibula

121
Q

What are the physical symptoms/implications of an injured common fibular nerve?

A

Foot drop!!!
Affects the eversion, dorsiflexion and extension of toes
High stepping gait
Sensory loss on dorsal aspect of foot

122
Q

What nerve gives sensory innervation to the most medial aspect of the foot and ankle?

A

Saphenous nerve

123
Q

From which nerve is the saphenous nerve branch of?

A

Femoral nerve

124
Q

What nerve gives sensory innervates to the more lateral part of foot and little toe?

A

Sural nerve

125
Q

From which nerve is the sural nerve a branch of?

A

Tibial nerve

126
Q

What branches of the tibial nerve supply the sole of the foot?

A

Calcaneal branches of the tibial nerve