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Ortho > Foot & Ankle > Flashcards

Foot & Ankle Flashcards

1
Q

What nerve is at risk during fibula ORIF?

A

Superficial peroneal nerve

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2
Q

Where does the SPN cross the fibula?

A

3-12cm proximal to the distal fibula

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3
Q

In which direction does the superficial peroneal nerve cross the fibula

A

Posterior to anterior

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4
Q

What nerve is at risk with open Achilles’ tendon repair?

A

Sural nerve

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5
Q

Where does the sural nerve cross the Achilles’ tendon?

A

10cm proximal to its insertion into the calcaneus

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6
Q

What tendon is directly medial to the Achilles’ tendon?

A

The plantaris tendon- can look like nerve intra-op

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7
Q

What happens to the ankle mortise as the ankle goes from plantarflexion to dorsiflexion?

A

Mortise widens

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8
Q

Which ligaments make up the syndesmosis?

A

AITFL, PITFL, IOL, Transverse tibiofibular ligament, inferior transverse ligament

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9
Q

In which direction is the syndesmosis most unstable?

A

Anterior to Posterior

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10
Q

Which bones does the spring ligament connect?

A

Calcaneus and navicular

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11
Q

What are the primary ligaments of the medial ankle?

A

Deltoid ligament, calcaneonavicular (spring) ligament

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12
Q

What are the layers of the deltoid ligament?

A

Superficial- attaches to the anterior colliculus of the tibia and spans the tibiotalar and subtalar joints
Deep- originated from the posterior colliculus of the tibia and only spans the tibiotalar joint

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13
Q

What are the primary ligaments of the lateral ankle?

A

ATFL, PTFL, CFL, LTCL

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14
Q

Which ankle ligament is the weakest and most likely to be Injured?

A

ATFL (Always Tears First)

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15
Q

Which lateral ankle ligament is the strongest?

A

PTFL

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16
Q

Which lateral ankle ligament is the primary restraint to inversion while the foot is in plantarflexion?

A

ATFL

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17
Q

Which lateral ankle ligament is the primary restraint to inversion while the foot is in neutral or dorsiflexion?

A

CFL

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18
Q

Where does the posterior tibialis tendon insert?

A

Navicular and medial cuneiform

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19
Q

What is the function of the posterior tibialis tendon?

A

Inversion and plantarflexion of the foot

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20
Q

What is the major antagonist to the posterior tibialis tendon?

A

Peroneus brevis

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21
Q

Where does the tibialis anterior tendon insert?

A

Medial cuneiform and 1st metatarsal

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22
Q

What is the function of tibialis anterior

A

Dorsiflexion and inversion

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23
Q

Where does peroneus longus insert?

A

1st metatarsal and medial cuneiform

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24
Q

What is the function of peroneus longus?

A

Plantarflexion and eversion

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25
Q

Where does peroneus brevis insert?

A

5th metatarsal base

26
Q

What is the function of peroneus brevis?

A

Plantarflexion and eversion

27
Q

How are the peroneal tendons orientated at the level of the ankle joint?

A

Peroneus brevis is anterior and longus posterior

Remember Brevis is closer to Bone (fibula)

28
Q

What is the name of the recesses on the distal tibia where the fibula sits?

A

Inicisura fibularis

29
Q

How many muscles or tendons attach to the talus?

A

0

30
Q

What percentage of the talus is covered with cartilage?

A

70%

31
Q

What is the blood supply of the talus?

A

Artery of the tarsal canal (from PT artery)
Anterior tibial artery
Artery of the tarsal sinus (from the anterior tibial and peroneal arteries)

32
Q

What is the main blood supply to the talus?

A

Posterior tibial artery

33
Q

Which branch of the artery of the tarsal canal supplies the medial talar body?

A

Deltoid artery

34
Q

What structure runs between the medial and lateral tubercles of the posterior process of the talus?

A

FHL

35
Q

What is the primary motion of the subtalar joint?

A

Inversion and eversion

36
Q

What are the three facets of the subtalar joint?

A

Anterior, middle, posterior

37
Q

Which facet of the calcaneus is the largest?

A

Posterior

38
Q

With the extensile lateral approach to the calcaneus, which structures are at risk?

A

Sural nerve, lateral calcaneal branch of the peroneal artery

39
Q

What are the 2 most common approaches to the calcaneus?

A

Extensile lateral and sinus tarsi

40
Q

What inserts into the base of the 5th metatarsal?

A

Peroneus brevis

Lateral band of the plantar fascia

41
Q

What is the origin of the plantar fascia?

A

Medial calcaneal tuberosity

42
Q

Which joints are referred to as the Chopart’s joints?

A

Calcaneocuboid and talonavicular joints

43
Q

The lis franc ligament connects which 2 bones?

A

Medial cuneiform and 2nd metatarsal

44
Q

Which bones make up the medial column of the foot?

A

1st metatarsal, medial cuneiform and navicular

45
Q

Which bones make up the middle column of the foot?

A

2nd and 3rd metatarsals, middle and lateral cuneiforms

46
Q

Which bones make up the lateral column of the foot?

A

4th and 5th metatarsals, cuboid

47
Q

Which column of the foot is most rigid?

A

Middle

48
Q

Which column of the foot is most flexible?

A

Lateral

49
Q

Which column of the foot should not be fused?

A

Lateral column

50
Q

Why should the lateral column of the foot not be fused?

A

Allows for functional motion

51
Q

Which column of the foot carries the most load in weightbearing?

A

Medial column

52
Q

What muscles and nerve roots are tested during neurovascular exam of the foot?

A

Tibialis anterior- ankle dorsiflexion- L4
EHL- great toe extension- L5
Gastrocnemius/ soleus complex- ankle plantarflexion S1

53
Q

What are the 5 sensory nerves to the foot?

A 
Saphenous nerve- medial foot
DPN- 1st web space
SPN- Dorsum of the foot
Sural- lateral foot
Tibial- sole of foot
54
Q

Which 3 vessels supply the foot?

A

Posterior tibial
Anterior tibial
Peroneal arteries

55
Q

How many compartments are in the foot?

A

9- Medial, lateral, 4 interosseus, 3 central

56
Q

What is the non-union rate for talus fractures?

A

5%

57
Q

What is the most common complication of talar neck fractures?

A

Subtalar arthritis

58
Q

What is the rate of arthritis in talar neck fractures?

A

50-100%

59
Q

What is the rate of tibiotalar (ankle joint) arthritis following talar neck fracture?

A

33%

60
Q

If AVN occurs post talar neck fracture, where abouts does it occur?

A

The talar body

61
Q

What is the only remaining blood supply to the talus with displaced talar neck fractures?

A

The deltoid branch of the artery of the tarsal canal from the posterior tibial artery

Ortho (11 decks)

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