Foot And Ankle Anatomy Flashcards
Medial longitudinal arch of the foot, construction, function and factors that maintain it
Construction - calcaneus, talus and navicular. 3 cuneiforms and 3 medial metatarsals
Function - it’s a high arch that is concerned with elastic propulsion whilst walking
Factors maintaining - ligaments - interposes, plantar aponeurosis, long plantar ligament, deltoid and spring ligaments. Muscles - tib ant and tib post, short muscles of big toe and FHL.
Lateral longitudinal arch of the foot: construction, function and factors maintaining
Construction - calcaneus, cuboid and 2 lateral metatarsals.
Function - low arch for bodyweight transmission
Factors maintaining - interposes Piaget, plantar aponeurosis, short plantar ligament. 3 Peronei muscles and short muscles of little toe
Transverse arch of the foot: construct, function and factors maintaining
Construct: cuboid, cuneiforms and base of metatarsals
Function: both elastic propulsion and bodyweight transmission
Factors maintaining - interosseous ligaments, peroneus longus and adductor hallicus
Spring ligament
Calcaneonavicular
Deltoid ligament
Medial side. 4 parts. 3 anterior 1 posterior.
Anteriorly: from the anterior colliculus anteriortibiotalar attaches to the anteromedial surface of the talus; tibiobavicular to the navicular tuberosity and tibiocalcaneal to the suscentaculum tali on the calcaneus.
Posterior: posterior tibiotalar from posterior colliculus to the medial talus
Lateral collateral ligament of the ankle
3 parts.
From the lateral maleoloud to the talus - anterior and posterior fibulotslar ligaments
From the lateral mal to the posterior calcareous - calcaneofilbular.
Attachments of the deltoid ligament
Colliculi of the medial mal
Neck and body of the talus
Suscentaculum tali of calcaneus
Navicular tuberosity
Spring ligament
Subdesmotic components
Anterior and posterior inferior tobiofibulsr ligaments
Inferior Transverse liagemt
Interosseous membrane
Anterior chaput tubercle. Posterior volkmann .
Midtarsal joint of chopart
Transverse tarsal joint
calcaneocuboid saddle joint and talcalcenonavicular ball and socket
What movements occur at the subtalar joint
Inversion and eversion
Which muscles perform the movements at subtalar joint
Inversion: tin ant and tin post
Eversion; peroneus longus and brevis
What type of joint is the subtalar joint
Synovial hinge
What bones form the ankle
Tibia, fibula and talus (trochlear surface)
Muscles involved in plantar flexing
Posterior compartments
Gastrocnemius, soleus, plantar is, tib post, flexible hallicus longus and flexor digitorum longus
Muscles involved in dorsiflexiln
Anterior compartment
TiB ant
Peroneus tertius
EHL
EDL
Why is the ankle most stable in dorsiflexikn
Because the talar surface is not uniform, it is widest anteriorly so is stabilised in dorsiflexilm.
In paltarflexion the narrower posterior part of the trochlea is articulating with the tibia which is less stable as it does not fill the space on the tibia and allows more movement
What type of joint is the inferior tibiofibulsr
Syndesmosis
Type of joint inferior tibiofibulsr
Syndesmosis
Associated injury sundesmotic fracture
Lateral malleolus
Muscles that make up the Achilles tendon
Gastroc, soleus, plantaris
What makes up the Achilles tendon
Gastroc, soleus, plantar is
Structures passing behind the medial malleolus
Tarsal tunnel
Tom Dick and Very Nervous Harry
Tibialis posterior, flexor digitorum longus, posterior tibial vessels, posterior tibial nerve and flexor hallicus longus
Structures deep to the extensor retinculjm
Anterior
Tom has very nice dogs and pigs
Tib ant
EHL
Tib ant vessels
TiB ant nerve
EDL
Peroneus tertius
Dorsalis pedis artery
Continuation of anterior tibial when it crosses the ankle joint
Passes anteriorly over the dorsal aspect of talus, navicular and cuneiforms then passes inferior as the deep plantar artery between the two heads of the first dorsal interposes muscles to join the deep plantar arch
Medial and lateral plantar arteries
Supply the sole of the foot
Branches of posterior tibial
I’m the sole between 1st and second layers of muscle
Lateral planter forms the deep plantar arch with the deep plantar artery from DP
Where to palpate DP and TP arteries
Lateral to EHL tendon
Halfway between posterior border medial mal and Achilles
What movements does the extensor hallicus Longus perform?
Extension of the great toe
Dorsiflexion of the foot
Some assistance with inverson
What movements does extensor Hallicus Longus perform?
Extension of the great toe
Dorsiflexion of the foot
Some assistance with inversion
What vessels would you find deep to EHL?
Anterior tibial artery and vein
What nerve lies deep to EHL?
Deep peroneal
Where do you test sensation for s1
Lateral foot
Where do you test L4
Medial malleolous
Where do you test deep peroneal nerve
1st web space
Where do you test superficial peroneal nerve
Dorsum of the foot
Where do you test Sural nerve
lateral malleolus
Leg reflex
Ankle s1
Knee L3/4
How do you describe dorsiflexion
Movement of the foot, upwards, towards the leg
At what joint does dorsiflexion occur
Tib fib talus
What muscles are involved in dorsiflexion of the foot
Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus
Peroneal tertius
= the anterior compartment
How would you describe plantarfkexion
The downwards movement of the foot in relation to the leg
What muscles are involved in plantar flex ion
Posterior compartments
Gastroc, soleus, plantaris
Tibialis posterior, flexor hallicus longus and brevis, popliteus
What happens when tib ant and tib post contract together
Inversion of the foot
What joint does inversion and evrsi9n occur at
Subtalar
What muscles are responsible for ankle eversion
Lateral compartment
Peroneal longus and brevis
What motor and sensory function is lost with damage to the superficial peroneal nerve
Inability to evert the foot and loss of sensation over the dorsal aspect of the foot (except from 1st web space)
Describe the Dermatome of the leg
L1 groin
L2 thigh
L3 knee
L4 shin and big toe
L5 muscle lower leg and 3 toes
S1 lateral foot and heel
S2 back of the leg
S3 toilet seat area
S4 and S5 perineum
Myotomes leg
L1 and 2 hip flex ion
L3 knee extension
L4/5 ankle dorsiflexion
L5 big toe extension
S1 plantarflexion
Findings L2 nerve root compression
Sensory loss anteromedial thigh
Iliopsoas weak
Findings L3 nerve root compression
Lower thigh and knee sensation loss
Quads extension
Findings L4 nerve root compression
Anteromedial lower leg numbness
Loss of tib ant
Findings L5 nerve root compression
Anteromedial lateral lower leg numbness and dorsum of foot
Loss of EHL and gluteus medius
Findings S1 nerve root compression
Numbness lateral foot and heel
Gastrosoleus complex and gluteus maximus
Findings S234 nerve root compression
Perinatal numbness
Bowel/bladder dysfunction
Cremasteric reflex
