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MSK Anatomy > Foot and Ankle > Flashcards

Foot and Ankle Flashcards

1
Q

Where is the sural nerve found

A

Lateral foot - behind malleolus

Can be used for biopsy and grafting

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2
Q

Which ligaments are found in the lateral part of the foot

A

Anterior talofibular ligament

Calcaneofibular ligament

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3
Q

Which ligaments are found in the medial part of the foot

A

Posterior tibial
Flexor digitorum longus
Flexor hallucis longus

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4
Q

What are the 3 normal ‘rockers’ of someone’s gait

A

1st - heel strikes to flat foot
2nd - mid stance
3rd - heel rises

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5
Q

Which nerves supply the foot

A 
saphenous
sural 
deep peroneal 
superficial peroneal 
tibial 
medial and lateral plantar
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6
Q

Pes planus is always a problem - true or false

A

False
Common problem that doesn’t often cause problems or need treated
All children will be flat footed until about 6 or 7

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7
Q

Describe the path of tibialis posterior

A

Courses immediately posterior to medial malleolus

Attaches on to navicular tuberosity and plantar aspect of medial and middle cuneiforms

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8
Q

What is the function of tibialis posterior

A

Stabiliser of medial longitudinal arch

Inverts foot and plantar-flexes

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9
Q

What are some risk factors for tibialis posterior dysfunction

A 
Obesity 
Females 
Flat footed 
Hypertension 
Diabetes
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10
Q

What are some symptoms of tibialis posterior dysfunction

A

Pain and/or swelling posterior to medial malleolus
Change in foot shape Decrease in balance
Pain in lateral wall, midfoot and ankle

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11
Q

How do you treat tibialis posterior dysfunction

A

Physio
Insole to support arch
Orthoses to accommodate foot shape
Surgery - fusion in extreme cases

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12
Q

What are some causes of pes cavus

A

Idiopathic
Neurological issues - HSMN, polio, spina bifida
Club foot

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13
Q

What are the symptoms of plantar fasciitis

A

Pain after rest
Worse after exercise
Fullness/swelling of plantarmedial aspect of heel
Tenderness over plantar aspect of heel

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14
Q

What are some causes of plantar fasciitis

A

Physical overload - excessive weight or exercise
Seronegative arthropathy
Diabetes
Abnormal foot shape

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15
Q

How does hallux valgus present

A

Deformity at first MCP
Pain and discomfort (due to inflamed bursae)
Problems with shoes
Cosmetic concerns

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16
Q

What causes hallux valgus

A

Familial - laxity and alignment of joints
Footwear
General joint laxity
Rheumatoid conditions

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17
Q

Which sex is hallux valgus most common in

A

Females

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18
Q

How can you treat hallux valgus

A

Shoe modification
Padding
Surgery - osteotomy

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19
Q

What is hallux rigidus

A

Osteoarthritis of the 1st MTP joint in foot

20
Q

How can you treat Morton’s neuroma

A

Insoles
Injections into area
Surgery to excise fibrosis and nerves

21
Q

What causes Achilles tendinosis

A

Repetitive micro-trauma to the tendon
Damage occurs faster than it can be repaired
Failure of collagen repair with loss of fibre alignment

22
Q

What are the symptoms of Achilles tendinosis

A

Pain
Morning stiffness
Eases with walking or heat

23
Q

How do you treat Achilles tendinosis

A 
Activity modifications 
Analgesia 
NSAID
Orthotics 
Physio 
Surgery - severe cases
24
Q

Which patients commonly rupture their Achilles

A

Over 40’s

Pre-existing tendinosis

25
Q

What are the symptoms of a ruptured Achilles

A

Unable to bear weight
Weak plantar flexion
Palpable painful gap
Positive calf squeeze (Simmonds) test

26
Q

How do you manage a ruptured Achilles

A

Either operate or cast

Both have long recovery and involve time in a cast

27
Q

What ligaments are most commonly affected in ankle sprains

A

Lateral ligaments

Anterior talofibular and calcaneofibular

28
Q

What are the signs of an ankle sprain

A

History of twisting injury

Pain, bruising and tenderness

29
Q

How do you manage an ankle sprain

A

Physio - build up strength and stability

RICE - rest, ice, compression and elevation

30
Q

What classification is used for ankle fractures

A

Weber classification

A, B and C

31
Q

List the joints of the foot

A

Subtalar - between talus and calcaneus
Midtarsal - made of 2 joints: calcaneocuboid & talocalcaneonavicular
Tarsometatarsal- between cuneiforms and cuboid and metatarsals
Metatarsal phalangeals
Interphalangeal

32
Q

Describe the midtarsal joint

A

Made of 2 joints: calcaneocuboid & talocalcaneonavicular
Synovial joint
Movement is inversion and eversion of the foot

33
Q

Describe the metatarsophalangeal joints

A

Synovial joints

Allow flexion, extension, abduction, adduction and circumduction of the digits

34
Q

Describe the interphalangeal joints

A

Synovial hinge joints

Allow flexion and extension of toes

35
Q

What are the functions of the arches of the foot

A

Shock absorption
Increased capacity for weight bearing - redistributes it across foot
Push-off spring function

36
Q

What is the plantar aponeurosis

A

Thickened central area of plantar fascia
Helps support the arches
Protects foot from puncture wounds

37
Q

List the arches of the foot

A

Medial longitudinal
Lateral longitudinal
Transverse

38
Q

Describe the medial longitudinal arch

A

Composed of bones of medial foot - calcaneus, talus, navicular, cuneiforms and metatarsals 1-3
Supported by FHL and attachments of tibialis anterior and fibularis longus

39
Q

Describe the lateral longitudinal arch

A

Formed by calcaneus, cuboid and metatarsals 4&5
Less important than medial
Usually weight bears when standing

40
Q

Describe the transverse arch

A

Consists of the cuboid, cuneiforms and the bases of all 5 metatarsals
Supported by fibularis longus and tib post

41
Q

What arteries supply the foot

A

Dorsalis pedis - branch of anterior tibial, gives off the arcuate artery on dorsum

Medial and lateral plantar arteries - branches from posterior tibial, contribute to deep plantar arch

Deep plantar and arcuate give off metatarsal which branch into digital

42
Q

What does the dorsal venous arch of the foot give rise to

A

Great and small saphenous veins (superficial veins)

43
Q

List the deep veins of the foot

A

anterior and posterior tibial and the fibular veins

These all joint to form the popliteal vein

44
Q

Which nerve gives motor supply to the intrinsic muscles of the foot

A

Tibial nerve to sole

Deep fibular to dorsum

45
Q

Which nerves give sensory supply to the dorsum of the foot

A

Mainly superficial fibular nerve
Deep fibular nerve supplying the first interdigital cleft
Sural nerve supplying the proximal lateral border
Saphenous nerve supplying the proximal medial border

46
Q

Which nerves give sensory supply to the plantar surface of the foot

A

Mainly tibial nerve to the heel and majority of sole
Sural nerve supplying the proximal lateral border
saphenous nerve supplying the proximal medial border

MSK Anatomy (4 decks)

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