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Lower Extremity Anatomy > Foot and Ankle Joints/Ligaments: Part 1 > Flashcards

Foot and Ankle Joints/Ligaments: Part 1 Flashcards

1
Q

Distal (inferior) tibiofibular joint

A
  • Fibular notch and medial triangular area of fibula
  • Syndesmosis, amphiarthrosis
  • Ligaments (prevent separation of tibia and fibula, and talar wedging)
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2
Q

Ligaments of distal tibiofibular joint

A
  • Distal anterior tibiofibular
  • Interosseous tibiofibular
  • Distal posterior tibiofibular
  • Inferior transverse tibiofibular
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3
Q

Distal anterior tibiofibular ligament

A
  • Trapezoid shape

- Anterior border of fibular notch to anterior edge of triangular area (fibula)

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4
Q

Interosseous tibiofibular ligament

A
  • Continuation of interosseous membrane

- Strong ligament found centrally within the articulation

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5
Q

Distal posterior tibiofibular ligament

A
  • Triangular shape

- Posterior border of fibular notch to posterior edge of triangular area (fibula)

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6
Q

Inferior transverse tibiofibular ligament location

A
  • Most inferior aspect of DPTL

- Posterior to ankle joint

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7
Q

Inferior transverse tibiofibular ligament attachments

A
  • Posterior-inferior aspect of fibular notch
  • Sometimes reaches medial malleolus
  • Lateral malleolar fossa (superior edge) on the fibula
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8
Q

Inferior transverse tibiofibular ligament cartilage

A
  • Articular cartilage on deep surface
  • Articulates with posterior lateral aspect of trochlea
  • Deepens articular surface
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9
Q

Distal (inferior) tibiofibular joint blood supply

A
  • Perforating fibular

- Anterior/posterior lateral malleolar

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10
Q

Posterior intermalleolar ligament location

A
  • Posterior to ankle joint
  • Anatomical appearance varies
  • Between transverse tibiofibular and posterior talofibular ligaments
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11
Q

Posterior intermalleolar ligament attachments

A
  • Superior edge fibular malleolar fossa
  • Posterior tibia and medial malleolus (via septa of flexor retinaculum)
  • Lateral and medial talar processes
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12
Q

Posterior intermalleolar ligament function

A
  • Tensed during dorsiflexion

- Can be a cause of posterior impingement

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13
Q

Ankle joint/talocrural joint/tibiotalar

A
  • Articulation between talus and the tibia and fibula

- Synovial joint, hinge (ginglymus); diarthrosis

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14
Q

Ankle joint/talocrural joint/tibiotalar functions

A
  • Primarily dorsiflexion and plantarflexion
  • More mobile/less stabile in plantarflexion
  • Trochlea is more narrow posteriorly
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15
Q

Ankle joint/talocrural joint/tibiotalar major blood supply

A
  • Medial and lateral malleolar plexuses
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16
Q

Ankle mortise

A
  • Concavity form by the tibia, fibula, and inferior transverse tibio-fibular ligament
  • Talus articulates with mortise
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17
Q

Joint capsule (fibrous) attaches to

A
  • Borders of tibia and malleoli
    articular margins of trochlea
  • Talar neck on the dorsum
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18
Q

Joint capsule (fibrous) strength

A
  • Weak anteriorly and posteriorly
  • Reinforced by collateral ligaments of the ankle medially and laterally
  • Anteriorly attaches to the neck of the talus
  • Synovium lines fibrous capsule
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19
Q

Medial collateral ligaments of the ankle (deltoid ligament) structure

A
  • Thick and strong
  • Blends with capsule
  • Divided into superficial and deep layers, consisting of 3-5 ligaments
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20
Q

Tibionavicular ligament (superficial) attachments

A
  • Anterior border of anterior colliculus

- Dorsal aspect of navicular tuberosity

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21
Q

Tibionavicular ligament (superficial) pathway

A
  • Crosses ankle joint

- Crosses talonavicular portion of midtarsal joints

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22
Q

Tibiospring ligament (superficial) attachments

A
  • Anterior colliculus (proximal and posterior to tibionavicular)
  • Spring ligament (plantar calcaneonavicular ligament)
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23
Q

Tibiospring ligament (superficial) pathway

A
  • Crosses ankle joint and subtalar joint
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24
Q

Superficial posterior tibiotalar ligament attachents

A
  • Posterior colliculus and intercollicular groove

- Medial tubercle of posterior process of talus

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25
Q

Superficial posterior tibiotalar ligament function

A
  • Taut in dorsiflexion

- Limits dorsiflexion and posterior displacement of talus

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26
Q

Superficial posterior tibiotalar ligament pathway

A
  • Can blend with the deep posterior talofibular

- Crosses ankle joint

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27
Q

Superficial ligaments of the ankle

A
  • Tibionavicular
  • Tibiospring
  • Tibiocalcaneal
  • Superficial posterior tibiotalar
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28
Q

Deep ligaments of the ankle

A
  • Deep anterior tibiotalar (anterior tibiotalar)

- Deep posterior tibiotalar

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29
Q

Medial collateral ligaments of the ankle (deltoid ligament) function

A
  • Stabilizes medial ankle

- Limits ankle eversion, external rotation, and lateral translation

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30
Q

Deep anterior tibiotalar ligament (anterior tibiotalar) attachments

A
  • Anterior inferior aspect of the anterior colliculus

- Medial aspect of talar body

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31
Q

Deep anterior tibiotalar ligament (anterior tibiotalar) pathway

A
  • Deep to tibionavicular antanterior tibiospring ligaments

- Fibers can blend with tibionavicular ligament

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32
Q

Deep anterior tibiotalar ligament (anterior tibiotalar) function

A
  • Taut in plantarflexion

- Limits plantarflexion and anterior displacement of talus

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33
Q

Deep posterior tibiotalar ligament

A
  • Largest and thickest component of deltoid ligament
34
Q

Deep posterior tibiotalar ligament attachments

A
  • Posterior/anterior colliculi and intercollicular groove

- Medial talar body

35
Q

Deep posterior tibiotalar ligament pathway

A
  • Deep to tibiocalcaneal

- Superficial posterior tibiotalar

36
Q

Deep posterior tibiotalar ligament function

A
  • Taut in dorsiflexion

- Limits dorsiflexion and posterior displacement of talus

37
Q

Lateral collateral ligaments of the ankle

A
  • Anterior talofibular
  • Calcaneofibular
  • Posterior talofibular
  • All resists inversion
38
Q

Anterior talofibular ligament

A
  • Capsular ligament
  • Crosses ankle joint
  • Most commonly injured in an plantarflexion inversion ankle sprain
39
Q

Anterior talofibular ligament attachments

A
  • Anterior inferior edge of lateral malleolus

- Lateral talar neck

40
Q

Anterior talofibular ligament function

A
  • Taut in plantarflexion
  • Resist excessive plantarflexion
  • Resist anterior talar displacement
41
Q

Calcaneofibular ligament

A
  • Extracapsular ligament
  • Crosses ankle joint and subtalar joint
  • Torn in more severe lateral ankle sprains
42
Q

Calcaneofibular ligament attachments

A
  • Lateral malleolus apex (summit)

- Peroneal spine (lateral calcaneus superior to retrotrochlear eminence)

43
Q

Calcaneofibular ligament function

A
  • Taut in dorsiflexion

- Resists excessive dorsiflexion

44
Q

Posterior talofibular ligament

A
  • Capsular ligament
  • Crosses ankle joint
  • Not commonly torn in ankle sprains
45
Q

Posterior talofibular ligament attachments

A
  • Runs horizontally
  • Lateral malleolar fossa
  • Lateral tubercle of posterior process
46
Q

Posterior talofibular ligament function

A
  • Taut in dorsiflexion

- Resist dorsiflexion

47
Q

Subtalar joint located between

A
  • Facets of calcaneus

- Facets of talus

48
Q

Subtalar joint is divided into anterior/posterior articulations by

A
  • Sinus tarsi
  • Tarsal canal
  • Interosseous talocalcaneal ligament
49
Q

Anterior division of subtalar joint

A
  • Talocalcaneonavicular
50
Q

Posterior division of subtalar joint

A
  • Posterior talocalcaneal

- Some refer to the posterior as the anatomic subtalar joint

51
Q

Talocalcanial joint

A
  • Within subtalar joint
  • Planar (gliding)
  • Synovial joint
52
Q

Talocalcaneal joint movement

A
  • More complex because of concave/convex surfaces

- Allows translation and rotation

53
Q

Joint capsule of subtalar joint

A
  • Attaches to articular margins

- Weak portion of subtalar joint

54
Q

Subtalar joint arterial supply

A
  • Lateral tarsal
  • Lateral malleolar
  • Perforating fibular
  • Artery to tarsal canal
  • Artery to sinus tarsi
55
Q

Ligaments supporting the subtalar joint

A
  • Talocalcaneal (posterior, lateral, medial, and interosseous)
  • Cervical
  • Tibiocalcaneal
  • Calcaneofibular
56
Q

Posterior talocalcaneal ligament (subtalar joint) attachments

A
  • Posterior process of talus

- Superior calcaneus

57
Q

Lateral talocalcaneal ligament (subtalar joint)

A
  • From lateral process of talus to lateral surface of calcaneus
  • Deeper plane than calcaneofibular ligament (medial to it)
58
Q

Medial talocalcaneal ligament (subtalar joint) attachments

A
  • Medial tubercle of posterior process of talus

- Posterior edge of sustentaculum tali

59
Q

Interosseous talocalcaneal ligament (subtalar joint)

A
  • Found within the sinus tarsi/tarsal canal

- Strong bond between talus and calcaneus

60
Q

Interosseous talocalcaneal ligament (subtalar joint) separates

A
  • Anatomic subtalar joint

- Talocalcaneonavicular joint

61
Q

Interosseous talocalcaneal ligament (subtalar joint) attachments

A
  • Sulcus tali

- Sulcus calcanei

62
Q

Interosseous talocalcaneal ligament (subtalar joint) location function

A
  • Fibers angled inferolaterally

- Resists eversion

63
Q

Cervical ligament (subtalar joint)

A
  • Superolateral calcaneus (within sinus tarsi)
  • Neck of talus
  • Resists inversion/supination
64
Q

Talocalcaneonavicular joint articulates between

A
  • Anterior/middle facets of talus and calcaneus
  • Head of talus and spring ligament
  • Head of talus and posterior facet of navicular (talonavicular)
65
Q

Talocalcaneonavicular joint

A
  • Multiaxial ball and socket joint with talar head

- Synovial joint; diarthrosis

66
Q

Talocalcaneonavicular joint arterial supply

A
  • Medial tarsal

- Medial plantar

67
Q

Joint capsule of talocalcaneonavicular joint

A
  • Capsule is weak
  • Reinforced by tibionavicular ligament (medial side)
  • Reinforced by calcaneonavicular ligament (lateral side)
68
Q

Acetabulum pedis

A
  • Deep socket that receives the talar head
69
Q

Acetabulum pedis is formed by

A
  • Posterior navicular facet
  • Anterior/middle facets of calcaneus
  • Plantar calcaneonavicular ligament (spring)
  • Dorsal calcaneonavicular ligament (part of bifurcate)
70
Q

Functional subtalar joint

A
  • Anatomic subtalar joint + talocalcaneonavicular joint

- Between posterior, middle, anterior facets of talus and calcaneus

71
Q

Functional subtalar joint function

A
  • Forms triple joint complex with midtarsal joint

- Triplanar joint: pronation and supination

72
Q

Functional subtalar joint ligament support

A
  • Combined ligaments that support anatomic and talocalcaneal part of TCN joint
73
Q

Talocalcaneonavicular ligament support

A
  • Cervical ligament
  • Dorsal talonavicular
  • Bifurcate ligament
  • Spring ligament (plantar calcaneonavicular ligament)
74
Q

Dorsal talonavicular ligament (TCN joint) attachments

A
  • Dorsal aspect of talar neck

- Dorsal aspect of navicular

75
Q

Bifurcate ligament (Y-shaped) proximal attachment

A
  • Y-shaped ligament

- Anterior process of calcaneus

76
Q

Bifurcate ligament (Y-shaped) distal attachment

A
  • Dorsolateral navicular,
  • Dorsal calcaneonavicular ligament
  • Dorsomedial cuboid
  • Calcaneocuboid ligament
77
Q

3 components of spring ligament (plantar calcaneonavicular)

A
  • Superomedial
  • Inferoplantar longitudinal
  • Medioplantar oblique
78
Q

Superomedial spring ligament attachements

A
  • Sustentaculum tali and edge of middle calcaneal facet

- Mediosuperior navicular tuberosity

79
Q

Inferoplantar longitudinal spring ligament attachments

A
  • Coronoid fossa

- Navicular beak

80
Q

Medioplantar oblique spring ligament attachments

A
  • Notch between anterior/middle facets of calcaneus

- Inferomedial navicular

81
Q

Spring ligament (plantar calcaneonavicular) pathway

A
  • Fuses with deltoid ligament (tibionavicular and tibiospring)
  • Deep to tibialis posterior tendon
82
Q

Fibrocartilagenous facet on dorsal surface of spring ligament (superomedial part)

A
  • Supports head of talus and medial longitudinal arch

Lower Extremity Anatomy (35 decks)

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