Foot And Ankle Region Flashcards
Name the 7 functions of the ankle joint
Gives a stable base of support
Provides a rigid lever for push off
Absorbs shock of body weight
Conforms the foot to irregular terrain
Important role in sensation/ proprioception/ balance
Allows adjustment of line of gravity in standing
Provides propulsion and restraint in walking
What is the medial weight bearing bone of the lower leg?
Tibia
What is the bony protuberance at the distal end of the tibia called?
Medial malleolus
What does the inferior surface of the tibia articulate with?
Talus
What does the tibia articulate with on its lateral surface?
Fibula
What does the bony protuberance on the lateral side of the fibula form?
Lateral malleolus
What is the classification of the superior tibio-fibular joint?
Synovial plane joint
Name the articulating surfaces of the superior tibio-fibular joint
Head of fibula
Tibial lateral condyle
Capsule attached around joint margins
Name the ligaments of the superior tibio-fibular joint?
Anterior and posterior ligaments of the fibular head
What movements occur at the superior tibio-fibular joint?
Small rotational movements during ankle dorsiflexion/plantarflexion and gliding
What is the interosseous membrane?
A tough, fibrous sheet of connective tissue
What distance does the interosseous membrane span?
The distance between the borders of the tibia and fibula
What does the interosseous membrane do?
Provides attachment for muscle
Separates anterior and posterior compartments
What allows vessels to run between the anterior and posterior compartments created by the interosseous membrane?
A hiatus
What type of joint is the inferior tibio-fibular joint?
A fibrous syndesmosis
What are the ligaments of the inferior tibio-fibular joint?
Anterior inferior, posterior inferior and transverse tibio-fibular ligaments
What movement occurs at the inferior tibio-fibular joint?
Slight roatation of the fibula on the tibia during ankle dorsiflexion
Name the tarsal bones
Talus
Calcaneus
Cuboid
Navicular
Cuneiforms
What are the names of the 3 cuneiforms?
Medial
Intermediate
Lateral
How many metatarsals are there?
5
How many phalanges are there?
14
Where is the talus situated?
Above the calcaneus
How many articular facets does the body of the talus have?
3
What are the names of the talus’s articular facets?
Superior facet
Medial facet
Lateral facet
What is the classification of the ankle joint?
A synovial hinge joint
What is the ankle joint covered in?
Hyaline cartilage
What is the ankle joint enclosed by?
Joint capsule
What is the ankle joint lined with?
Synovial membrane
What movements does the ankle joint allow?
Dorsiflexion and plantarflexion
What articulation occurs at the subtalar joint?
It is where talus articulates with calcaneus
What movements occur at subtalar joint?
Inversion (calcaneus tilts inwards) and eversion (calcaneus tilts laterally)
What is the classification of the subtalar joint?
A plane (modified saddle) synovial joint
What is the subtalar joint surrounded by?
Weak articular capsule
What is the subtalar joints weak articular capsule supported by?
Talocacanean ligaments
What is the subtalar joint stabilised by?
Interosseous talocalcanean ligament
What is the classification of the mid-tarsal joint?
Synovial ball and socket joint
What is the classification of the cuneo-navicular joints?
Synovial plane joints
What movements occur at the cuneo-navicular joints?
Gliding and sliding
What do all metatarsals have?
A proximal head
Neck
Shaft
Base
What type of bone is embedded within the tendon of Flexor Hallucis Brevis on the 1st metatarsal?
2 sesamoid bones
What do all phalanges have?
Neck
Head
Shaft
Base
What are the names of the 3 different types of phalanges?
Distal
Middle
Proximal
What is the classification of the tarsal metatarsal joints?
Synovial plane
What is the classification of the metatarsal phalanges joints?
Synovial ellipsoid
What is the classification of the proximal interphalnageal joint and distal interphalangeal joint?
Synovial hinge
What movement can occur at metatarsal phalanges joint?
Flexion/extension
Abduction/adduction
What movements can occur at the interphalangeal joints?
Flexion/extension
Where do pronation and supination occur in the foot?
At the mid-tarasal joint
What are the weight bearing surfaces of the ankle joint?
Trochlear surfaces of the tibia and talus
What are the stabilising surfaces of the ankle joints?
Medial and lateral malleoli that grip the body of the talus
When is the ankle joint most stable/ what is its close packed position?
Dorsiflexion
How many degrees of freedom does the ankle joint have?
1
What muscle is dorsiflexion of the ankle joint produced by?
Tibialis anterior
What muscles assist dorsiflexion of the ankle joint?
Extensor digitorum Longus
Extensor hallucis longus
Peroneus tertius
What is dorsiflexion of the ankle joint limited by?
Tension in antagonists
Posterior part of deltoid ligament
Calcaneofibular ligament
Wedging of talus between malleoli
What muscle produces plantarflexion in the ankle joint?
Gastrocnemius
What muscles assist plantarflexion in the ankle joint?
Tibialis posterior
Peroneus longus and brevis
Flexor hallucis longus
Flexor digitorum longus
What is plantarflexion of the ankle joint limited by?
Tension in antagonists
Anterior part of deltoid ligament
Anterior tall fibular ligament
What is the classification of the subtalar joint?
A synovial modified saddle joint
What movements occur at the subtalar joint?
Inversion and eversion of the foot
What ligaments are at the subtalar joint?
Medial,posterior and lateral talocalcanean ligaments
What is the neutral position of the foot called?
Plantigrade
Transverse tarsal joint is the functional description of which joints?
Talocalcaneonavicular joint and the calcaneocuboid joint
What are the movements of the transverse tarsal joint?
Pronation and supination
What movements produce inversion in the foot?
Adduction of the forefoot
Supination
Plantarflexion of ankle
What movements produce eversion of the foot?
Abduction of forefoot
Pronation
Dorsiflexion of ankle
What movements in the foot cant occur as pure movements?
Adduction/abduction
Supination/pronation
What muscles produce inversion in the foot?
Tibialis anterior
Tibialis posterior
What muscles assist inversion?
Extensor and Flexor Hallucis Longus
What is inversion in the foot limited by?
Dorsal talonavicular ligament
What muscles produce eversion in the foot?
Peroneus Longus, Brevis and Tertius
What limits eversion in the foot?
Impact of talus on floor of sinus tarsi
Plantar calcaneocuboid ligament
What is the classification of the calcaneocuboid-cuboid joint?
Synovial plant or synovial saddle joint (not completely agreed on)
What is the longest of all ligaments between tarsal bones?
Long plantar ligament
Where is the long plantar ligament in comparison to short plantar calcaneocuboid ligament?
Long plantar ligament is superficial to short plantar calcaneocuboid ligament
Name the intertarsal joints of the foot
Subtalar
Midtarsal
Cuneonavicular
Intercuneiform
Cunecubois
Tarsometatarsal
Name 6 functions of the foot
Dynamic and strong to support body weight
It serves as lever for propulsion
Spring and lift for many activities
Adapts to uneven surfaces
It is flexible and resilient to absorb the shock of weight bearing
It provides a stable base for proximal function
What do the arches of the foot do?
Add weight bearing capabilities and resilience to the foot
Act as shock absorbers in standing and propulsive movement
Enable the foot to adapt to different surfaces and to weight changes
Name the 3 arches of the foot
Medial longitudinal arch
Lateral longitudinal arch
Transverse arch
Name 3 factors maintaining arches
Bony configuration
Strong ligaments
Muscle tone
Name the 4 ligaments if the medial longitudinal arch
Plantar aponeurosis
Plantar calcaneonavicular ligament
Short plantar ligament
Long plantar ligament
Name the 3 ligaments of the lateral longitudinal arch
Long plantar ligament
Short plantar ligament
Plantar calcaneonavicular ligament
Name the ligaments of the transverse arch
Collateral ligaments
Name the accessory movements of the talocrural joint
Longitudinal distraction
AP
PA
Name the accessory movements of the subtalar joint
Distraction
Rock of talus on calcaneus
Side tilt medially
Side tilt laterally
What are the 4 compartments of the calf and foot?
Anterior
Lateral
Superficial posterior
Deep posterior
Name the 3 muscles ion the superficial posterior compartment
Gastrocnemius
Soleus
Plantaris
What do all muscles of the superficial posterior compartment have in common?
Insert into the calcaneus vis the tendocalcaneus
Muscles plantarflex the foot
Innervated by the tibial nerve
Where does gastrocnemius originate?
Lateral head - posterior aspect of the lateral femoral condyle
Medial head - posterior aspect of the medial femoral condyle
Where does gastrocnemius insert?
Posterior surface of calcaneus via the tendocalcaneus
What are the actions of gastrocnemius?
Powerful plantarflex or of the foot
Knee flexion
What nerve innervates gastrocnemius?
Tibial nerve S1, S2
Where does Soleus originate?
Soleal line, posterior surface of tibia
Posterior surface of upper 1/3 of fibula including the head
Where does Soleus insert?
Fuses with tendon of gastrocnemius to form upper part of tendocalcaneus into posterior surface of the calcaneus
What is the action of the Soleus?
Plantarflexion of the foot
What is the innervation of Soleus?
Tibial nerve S1-2
Where is the origin of Plantaris?
Lateral supracondylar ridge of femur, above lateral head of gastrocnemius
Adjacent part of popliteal surface of femur
Where does Plantaris insert?
Medial side of tendocalcaneus, posterior surface of the calcaneus
What is the action of Plantaris?
Insignificant plantar flexor of the foot
Weak knee flexor
What is the innervation of Plantaris?
Tibial nerve S1, S2
What are the 4 muscles of the deep posterior compartment?
Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
What do all muscle of the deep posterior compartment have in common?
Muscles are supplied by the tibial nerve
All muscles except popliteus assist in plantarflexion of the ankle
Where does popliteus originate?
Outer surface of lateral femoral condyle, below epicondyle
Where does popliteus insert?
Posterior surface of proximal tibia, above soleal line
What action is produced by popliteus?
Laterally rotates the femur on the tibia
What is the innervation of popliteus?
Tibia nerve L5
Where does Tibialis posterior insert?
Medial part - posterior surface of the tibia and interosseous membrane
Lateral part - proximal posterior surface of fibula
Where does Tibialis posterior insert?
Tubercle in medial side of navicular and plantar surface of medial cuneiform
Slips to plantar surfaces of all tarsal bones except talus
What are the actions of Tibialis posterior?
Inversion of foot
Assists plantarflexion at ankle
Assists in support of the medial longitudinal arch
What is the innervation of Tibialis Posterior?
Tibial nerve L4-5
Where does Flexor Digitorum Longus originate?
Medial aspect, posterior surface of tibia
What is the insertion of Flexor Digitorum Longus?
4 tendons to plantar aspect of the bases of distal phalanges
What are the actions of Flexor Digitorum Longus?
Flexion of toes 2-5 at distal interphalangeal joint, proximal interphalangeal joints and metatarsal phalanges joint
Assists plantarflexion of foot
What is the innervation of Flexor Digitorum Longus/
Tibial nerve L5, S1-S2
Where does Flexor Hallucis Longus originate?
Lower 2/3 of posterior surface of fibula and interosseous membrane
Where does Flexor Hallucis Longus insert?
Plantar surface of the base of the distal phalanx of the great toe
What are the actions of Flexor Hallucis Longus?
Flexion of all joints of great toes
Assists plantarflexion of the foot at the ankle joint
What is the innervation of Flexor Hallucis Longus?
Tibial nerve S1-S2
What tunnel do Tom, Dick and Harry go through?
Tarsal tunnel
What is the ceiling of the tarsal tunnnel?
Flexor reticulum
What is the flexor reticulum>
A tough band of connective tissue from medial malleolus to medial wall of calcaneum
Name the blood vessel and nerve that go through the tarsal tunnel
Posterior tibial artery
Tibial nerve
What muscle unlocks the knee?
Popliteus
What are the 4 muscles of the anterior compartment of the foot and ankle?
Tibialis anterior
Extensor digitorum Longus
Extensor Hallucis Longus
Peroneus Tertius
What is common in all muscles of the anterior compartment of the foot and ankle?
All muscles supplies by the deep peroneal nerve
All muscles assist in dorsiflexion at the ankle
Where does Tibialis Anterior originate?
Upper 1/2 to 2/3 lateral surface of tibia and adjacent interosseous membrane
Where does Tibialis Anterior insert?
Medial surface of medial cuneiform and base of 1st metatarsal
What does the insertion of Tibialis Anterior blend with?
Peroneus Longus
What are the actions of Tibialis Anterior?
Dorsiflexion of ankle
Inversion of the foot
What is the innervation of Tibialis Anterior?
Deep peroneal nerve L4/5
Where does Extensor Digitorum longus originate?
Upper 2/3 anterior surface of fibula
Upper part of interosseous membrane
Lateral tibial condyle
Where does Extensor Digitorum Longus insert?
Extensor hood (dorsal digital expansion), base of middle and distal phalanges of toes 2-5
What are the actions of Extensor Digitorum Longus?
Extension of lateral 4 toes at metatarsal phalanges joints
Extension of interphalangeal joints
Assists dorsiflexion of ankle
What is the innervation of Extensor Digitorum Longus?
Deep peroneal nerve L5, S1
Where does Extensor Hallucis Longus originate?
Middle 1/2 if anterior surface of fibula and adjacent interosseous membrane
Where does Extensor Hallucis Longus insert?
Dorsal surface, base of distal phalanx of the great toe
What are the actions of extensor hallucis Longus?
Extends all joints of great toe, mainly metatarsal phalange joint
Powerful dorsiflexor
What is the innervation of Extensor Hallucis Longus?
Deep peroneal nerve L5, S1
Where does Peroneus Tertius originate?
Lower 1/4 of medial fibular and adjacent interosseous membrane
Where does Peroneus tertius insert?
Styloid process of base of 5th metatarsal and dorsal aspect
What are the actions of Peroneus Tertius?
Weak dorsiflexor of foot
Weak Everton of foot
What is the innervation of Peroneus tertius?
Deep peroneal nerve L5, S1
Name the 2 muscles of the lateral compartment of the foot and ankle
Peroneus (Fibularis) Longus
Peroneus (Fibularis) Brevis
Where does Peroneus Longus originate?
Lateral tibial condyle
Upper 2/3 lateral surface of fibula
Lateral side of fibular head
What are the 2 slips of insertion for Peroneus Longus?
Base of 1st metatarsal
Medial cuneiform (plantar and lateral surfaces)
What are the actions of Peroneus Longus?
Eversion and plantarflexion of foot
Supports the arches of foot
What is the innervation of Peroneus Longus?
Superficial peroneal nerve L5, S1
Where is Peroneus Brevis in comparison to Peroneus Longus?
Peroneus Brevis is more anteriorly placed than Peroneus Longus
Where does Peroneus Brevis originate?
Lower 2/3 of lateral surface of fibula
Where does Peroneus Brevis insert?
Tubercle on the lateral side of base of 5th metatarsal
What are the actions of Peroneus Brevis?
Eversion of the foot
Plantarflexion at the ankle
What is the innervation of Peroneus Brevis?
Superficial Peroneal Nerve L5, S1
Where does Extensor Digitorum Brevis originate?
Anterior part of calcaneus and inferior extensor retinaculum
Where are the insertions of Extensor Digitorum Brevis?
Medial tendon -to bade, proximal phalanx of great toe
Tendons 2-4 - to lateral side of extensor hood
What is the innervation of Extensor Digitorum Brevis?
Deep peroneal nerve L5, S1
What are the actions of Extensor Digitorum Brevis?
Extension at metatarsal phalanges joints
Assists limb rivals to extend interphalangeal joints
What muscle support the medial longitudinal arch?
Flexor Hallucis Longus
Abductor Hallucis
Flexor Digitorum Brevis
Tibialis Anterior
Tibialis Posterior
What muscles support the lateral longitudinal arch?
Peroneus Longus
Peroneus Brevis
Peroneus Tertius
Flexor Digitorum Longus (4th and 5th toes)
Flexor Digitorum Brevis
Adductor Digiti Minimi
