Foot and Ankle Flashcards

1
Q

What forms the medial longitudinal arch of the foot?

A

Calcaneus, Talus, Navicular, 3 cuneiforms, 3 medial metatarsals

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2
Q

What is the function of the medial longitudinal arch?

A

High arch concerned with the elastic propulsion of the foot during walking

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3
Q

Which factors help to maintain the medial longitudinal arch of the foot

A

Ligaments
- interosseous ligaments
- plantar aponeurosis
- long plantar ligament
- deltoid and spring ligaments

Muscles
- tibialis anterior and posterior
- short muscles of the big toes
- FHL

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4
Q

Which bones form the lateral longitudinal arch of the foot?

A
  • calcaneus
  • cuboid
  • 2 lateral metatarsals
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5
Q

What is the function of the lateral longitudinal arch of the foot?

A

Low arch concerned mainly with body weight transmission

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6
Q

Which factors help to maintain the lateral longitudinal arch of the foot?

A

Ligaments
- Interosseous ligaments
- plantar aponeurosis
- short plantar ligament

Muscles
- 3 peronei muscles
- short muscles of the little toe

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7
Q

What bones form the construction of the transverse arch of the foot?

A
  • cuboid, 3 cuneiforms and bases of metatarsals
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8
Q

What is the function of the transverse arch of the foot?

A

Elastic propulsion of foot and body weight transmission

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9
Q

What structures are involved in maintaining the structures of the transverse arch of thef foot?

A

Ligaments
- interosseous ligaments

Muscles
- Peroneus brevis
- Transverse head of the adductor hallucis

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10
Q

What are the attachments of the deltoid ligament?

A

Superior
- medial malleolus
Inferior
- tuberosity of the navicular
- spring ligament
- neck of talus
- sustentaculum tali
- body of talus

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11
Q

What are the parts of the deltoid ligament?

A

Anterior tibiotalor ligament
Tibionavicular
Tibiocalcaneal
Posterior tibiotalar

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12
Q

Which ligaments make up the Lateral collateral ligament of the foot?

A

Anterior talofibular
Posterior talofibular
Calcaneofibular

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13
Q

What ligaments make up the syndesmotic complex of the foot?

A

Anterior tibiofibular
Posterior tibiofibular
Inferior transverse tibiofibular (deep fibres of posterior tibiofibular)

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14
Q

What makes up the Midtarsal joint?

A

Midtarsal joint of Chopart
- articulation of the calcaneus with the cuboid (saddle)
- articulation of the talus with the navicular (Ball and socket)

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15
Q

What movements occur at the subtalar joint?

A

Inversion and eversion of the foot

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16
Q

Which muscles perform movement at the subtalar joint

A

Inversion - tibialis anterior and posterior
Eversion - peroneus longus and brevis

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17
Q

What type of joint if the subtalar joint?

A

Synovial plane joint

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18
Q

What type of joint is the ankle joint?

A

Synovial hinge joint

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19
Q

What are the bones which form the ankle joint?

A

Trochlear surface of the talus, lower end of the tibia and fibula

20
Q

What movements happen at the ankle joint and which muscles are involved in them?

A

Plantar flexion
- gastrocnemius
- soleus
- plantaris
- tibialis posterior
- flexor digitorum longus
- flexor hallucis longus

Dorsiflexion
- tibialis anterior
- extensor digitorum longus
- extensor hallucis longus
- peroneus tertius

21
Q

Why is the ankle joint more stable in dorsiflexion?

A

In dorsiflexion the talus is stabilised due to the wider anterior side of the trochlea being immobilised by the tibial articulation

In plantarflexion, the narrower posterior side is articulating more and more movement is possible since it does not completely fill the space

22
Q

What type of joint is the inferior tibiofibular joint?

A

Syndesmosis

23
Q

What injury is associated with a syndesmotic fracture?

A

fractures of the lateral malleolus

24
Q

Which muscles make up the achilles tendon?

A

Three muscles insert into the Achilles or calcaneal tendon
- soleus
- gastrocnemius
- plantaris

25
Q

Which structures pass behind the medial malleolus

A

Structures passing to the deep flexor retinaculum

  • Tom does very nice hats
    Tibialis posterior tendon
    Flexor digitorum longus
    posterior tibial vessels
    Posterior tibial nerve
    hallucis longus
26
Q

which structures pass deep to the extensor retinaculum?

A

Tom has very nice dogs and pigs

Tibialis anterior
Extensor hallucis longus
Anterior tibial vessels
anterior tibial nerve
extensor digitorum longus
peroneus tertius

27
Q

Name the arteries of the foot?

A

Dorsalis pedis artery
Medial and lateral plantar arteries

28
Q

What is the course of the dorsalis pedis artery?

A

Continuation of anterior tibial artery and begins as the anterior tibial artery crosses the ankle joint
It passes anteriorly over the dorsal aspect of the talus, navicular and intermediated cuneiform bones
THen passes inferiorly as the deep plantar artery between the two head of the first dorsal interosseous muscle to join the deep plantar arch in the sole of the foot

29
Q

What is the course of the medial and lateral plantar arteries?

A

Arteries which supply the sole of the foot
Branches of the posterior tibial artery
They run in the sole between the 1st and 2nd layer of muscles
the lateral plantar artery form the plantar arch along with dorsalis pedis artery

30
Q

What movements does extensor hallucis longus perform?

A

Extends the big toes, dorsiflexes the foot and assists with inversion of the foot

31
Q

What vessels would you find deep to extensor hallucis longus?

A

Anterior tibial artery and vein

32
Q

What nerve lies deep to the extensory hallucis longus?

A

The deep peroneal nerve

33
Q

Where would you test sensation of S1, L4, deep and superficial peroneal nerve and the sural nerve?

A

S1- lateral aspect of the foot
L4 - over the medial malleolus
Deep peroneal - first web interspace
Superficial peroneal - dorsum of the foot, other than the first web interspace
sural - lateral malleolus

34
Q

What nerve root do the knee and ankle reflexes originate from?

A

Ankle S1
Knee L3/4

35
Q

which muscles are involved in dorsiflexion of the foot?

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
peroneus tertius

36
Q

What muscles are involved in ankle plantarflexion?

A

superficial posterior compartment muscles
- gastrocnemius
- soleus
- plantaris

Deep posterior compartment
- flexor hallucis longus
- flexor digitorum longus
- tibialis posterior
- popliteus

37
Q

Which movement occurs when tibialis anterior and posterior contract together?

A

Ankle inversion

38
Q

At which joint does ankle inversion occur?

A

Subtalar joint - inversion and eversion

39
Q

Which muscles are responsible for ankle eversion? Which nerve innervates them?

A

peroneus brevis and longus

Superficial peroneal nerve

40
Q

What motor and sensory function is lost with damage to the superficial peroneal nerve?

A

Inability to evert the foot and loss of sensation over the dorsum of the foot apart from the first web space

41
Q

Name the myotomes of the lower limb

A

Hip flexors - L1-L2
Knee extensors (quads) - L3
Ankle dorsiflexion (tibialis anterior) - L4-L5
Toe extensors (hallucis longus) - L5)
Ankle plantar flexion (gastrocnemius) S1

42
Q

What are the findings in L2 nerve root compression?

A

Sensory deficit
- anteromedial thigh

Muscles weakness
- illiopsoas

reflex changes
- none

43
Q

What are the findings in nerve root compression at L3

A

Sensory Deficit
- anterior thigh

Muscle Weakness
- Qaudriceps

Reflex changes
- none

44
Q

What are the findings in L4 nerve root compression?

A

Sensory deficit
- anteromedial leg

Muscles weakness
- tibialis anterior

Reflex changes
- patella tendon

45
Q

What are the findings in L5 nerve root compression?

A

Sensory Deficit
- Lateral leg
- Dorsum of the foot/big toe

Motor weakness
- Extensor hallucis longus
Gluteus medius

Reflex changes
- medial hamstring

46
Q

What are the findings in a S1 nerve root compression>

A

Sensory deficit
- Posterior calf and plantar foot

Muscle weakness
- gastrosoleus complex
- gluteus maximus

reflex changes
- achilles tendon

47
Q

What are the findings in S2, 3, 4 nerve root compression?

A

Sensory deficit
- perianal

Muscle weakness
- bowel and bladder

Reflex changes
- cremasteric