Foot & Ankle

Question 1

Talocrural joint

Answer 1

hinge joint, AOR through the malleoli

Question 2

Subtalar joint

Answer 2

greatest amount of movement occurs here, frontal plane only (inversion and eversion), AOR anterior to posterior

Question 3

Intrinsic muscles

Answer 3

support the arches, both attachments within the foot (ex: brevis)

Question 4

Extrinsic muscles

Answer 4

cross the ankle, proximal attachment is outside the foot (ex: longus)

Question 5

Flexor retinaculum

Answer 5

runs from medial malleolus to calcaneus

Question 6

Plantar blood supply

Answer 6

posterior tibial artery, medial and lateral plantar artery,

lateral plantar artery: to deep plantar arch, to plantar MT artery, to proper plantar digital arteries

Question 7

Dorsal blood supply

Answer 7

anterior tibial artery, to dorsal pedal artery and lateral tarsal artery
dorsal pedal artery: to arcuate artery, to dorsal MT arteries, to dorsal digital arteries

Question 8

Four Layers of Foot (3,4,3,4)

Answer 8

1: FDB, abd H, abd DM
2: (FDL, FHL), QP, lumbricles,
3: FHB, add H, FDMB
4: (TA, PL), DABs, PADs

Question 9

Medial plantar nerve only innervates four muscles…

Answer 9

FDB, FHB (medial), 1st lumbrical, abductor hallicus

Question 10

Tibiofibular joint: 3 ligaments

Answer 10

1. anterior and posterior ligaments of fibular head
2. interosseus membrane
3. anterior and posterior tibiofibular ligaments

Question 11

Anterior and posterior ligaments of fibular head:

Answer 11

anterior aspect of fibular head to lateral condyle of tibia. Gliding joint, slight movement.

Question 12

Interosseous membrane

Answer 12

syndesmosis, joined by the interosseous membrane (both this and the inferior joint)
have a little bit of movement
anterior tibial artery (popliteal is nearest parent vessel) goes through the hole

Question 13

Anterior and posterior tibiofibular ligaments

Answer 13

distal aspects of tibia and fibula. syndesmosis (like the interosseous membrane).

Question 14

Talocrural joint: fit and implications in DF and PF?

Answer 14

wider anteriorly than posteriorly
has implications for ROM, and how tightly the bones fit together during DF and PF
DF: articulating with wider surface, more stability and boney congruence
PF: greater stress on the ligaments, because they are needed more the stabilize the joint

Question 15

Talocrural joint: (medial) deltoid ligament

Answer 15

origin: medial malleolus to: 
–  Anterior tibiotalar: anterior talus
–  Tibionavicular: navicular 
–  Tibiocalcaneal: calcaneus 
–  Posterior tibiotalar: posteior talus

Question 16

What movement damages the medial talocrural ligaments?

Answer 16

eversion

Question 17

Talocrural joint: lateral ligaments

Answer 17

origin: lateral malleolus to:
- Anterior talofibular: anterior talus
- calcanealfibular: calcaneus
- Posterior talofibular: posterior talus

Question 18

What movement damages the lateral talocrural ligaments?

Answer 18

Inversion

Question 19

Why are inversion sprains more common?

Answer 19

1. the fibula hangs below the tibia, so bone creates more congruency
2. strong deltoid ligament prevents eversion sprains more
   position of foot in sagittal plane determines the injury

Question 20

Most commonly ligaments in inversion ankle sprain?

Answer 20

PF: ATF
DF: CF

Question 21

Intertarsal joints: subtalar and transverse tarsal joint

Answer 21

gliding joint, supports body, movements responsible for locomotion, and shock absorption

Question 22

Subtalar joint

Answer 22

inversion/eversion movements greatest amount of motion

talocalcaneal ligament: talus to calcaneus

Question 23

Transverse tarsal joint

Answer 23

Talonavicular & Calcaneocuboid
Allows forefoot to remain in contact w/ ground during triplanar movements of hindfoot
Helps increase movement of subtalar joint

Question 24

Tarsometatarsal joint

Answer 24

synovial gliding joints, MTs wedged in there, only a little movement

Question 25

Metatarsophalangeal joint (MTP)

Answer 25

bi-planar (flexion/extension, and ab/ adduction) - sagittal and transverse plane

Question 26

MTP joint ROM

Answer 26

70 degrees flexion, 45 degrees extension

Question 27

Hallux valgus

Answer 27

change in the joint angle of the 1st MTP joint

abductor hallicus become an adductor

Question 28

Interphalangeal joint

Answer 28

hinge joint, sagittal plane movement only (flexion, extension)
DIPS and PIPS
ROM: 80 degrees of flexion

Question 29

Arches of the foot

Answer 29

Function: dampening shock absorption
Wedging of tarsals for 3 arches of the foot
– Bones form the arches
– Ligaments support them

Question 30

Medial longitudinal arch

Answer 30

supported by FHL, attaches on distal proximal phalanx

Question 31

Proximal transverse arch

Answer 31

formed by tarsals from cubiod to medial cuneiform, with keystone being the navicular
distal formed by heads of metatarsals

Question 32

Distal transverse arch

Answer 32

formed by distal heads of tarsals 1-5

Question 33

Primary support ligaments: spring ligament

Answer 33

calcaneus to navicular, supported by tibialis posterior tendon
supports talo-navicular joint, longitudinal arch, and transverse arch

Question 34

primary support ligaments: Long plantar ligament

Answer 34

inferior calcaneus to distal cubiod, to base of lateral MT
longest ligament in foot
supports the calcanealcuboid joint

Question 35

primary support ligaments: plantar aponeurosis

Answer 35

proximal calcaneus to proximal phalange

supports the longitudinal arch

Question 36

primary support ligaments: Short plantar (plantar calcaneocuboid) ligament

Answer 36

from calcaneus to proximal cubiod supports the longitudinal arch

Question 37

primary support ligaments: Deep transverse metatarsal ligament

Answer 37

just above the adductor hallicus, transverse head, between each MTP joint