Gross 2 Foot and Ankle Flashcards
What bones make up the Hindfoot?
Talus and Calcaneus
What bones make up the Midfoot?
Navicular, Cuneiform, Cuboid
What bones make up the Forefoot?
Metatarsals, and Phalanges
Describe the Dorsum of the foot/ Dorsal surface of the foot.
Skin is thinner and looser
Describe the Sole of the foot/Plantar Surface.
-Skin is thicker and highly innervated
-Heel: Part of the sole under the calcaneus
-Fat pad for shock absorption
-Ball of the foot: part of the sole under the metatarsal heads
What are the requirements of the Ankle?
Must be both rigid and mobile:
-Rigid for propulsion for walking, running, jumping
-Mobile to accommodate to uneven terrain, absorb shock and control proximal forces
What are the ten articulations of the foot?
1) Inferior TibioFibular
2) Talocrural (Ankle)
3) Talocalcaneal (Anatomical subtalar)
4) Talocalcaneonavicular (Transverse Tarsal Joint)
5) Calcaneocuboid (Transverse Tarsal Joint)
6) Cuneonavicular
7) Tarsalmetatarsal
8) Intermetatarsal
9) Metatarsalphalangeal
10) Interphalangeal
What are the three motions that take place when you Doriflex?
-Inversion
-Adduction
-Dorsiflexion
What are the three motions that take place when you platarflex?
-Eversion
-Abduction
-Platarflexion
What limits the spreading of the distal tibio-fibular articulation?
Interosseous Fibular Ligament
A high grade sprain of the interosseous (Crural) Fibular Ligament would result in excessive motion at which joint?
Distal Tibiofibular Joint
What bones make up the articulation of Talocrural joint?
Talus with the distal tibia/fibula
What type of joint and what motions does the Talocrural joint produce?
Type:
Hinge type synovial joint
Movement:
Dorsiflexion and Platarflexion
What ligaments help stabilize the Talocrural Joint?
Lateral and Medial Collateral Ligaments
-As well as the ligaments of the inferior tibiofibular joint
What are the Lateral Collateral Ligament of the Ankle? (3)
-Anterior Talofibular
-Posterior Talofibular
-Calcaneal Fibular
What are the four Deltoid Ligaments?
Anterior Tibiotalar Lig.
Posterior Tibiotalar Lig.
Tibionavicular Lig.
Tibiocalcaneal Lig.
What are the Lateral Collateral Ligaments of the ankle?
-Anterior Talofibular Lig.
-Calcaneal Fibular Lig.
-Posterior Talofibular Lig.
What type of joint and what movements does the TaloCalcaneal (Subtalar) Joint Provide?
Type: Plane of Synovial Joint
Movement: Eversion/Inversion
What ligaments help support the Talocalcaneal (Subtalar) Joint?
Medial, Lateral, Posterior and Interosseous Talocalcaneal Ligament: binds bones together
-Calcaneal Fibular limits excessive inversion
-Tibiocalcaneal fibers of deltoid limits excessive eversion
What type of joint is Transverse Tarsal?
A Compound Joint
What two joints make up the Transverse Tarsal Joint?
Talonavicular and Calcaneocuboid
What is the articulation for Talonavicular (Transverse Tarsal)?
Articulation with head of talus to posterior aspect of navicular bone
What is the articulation for Calcaneocuboid (Transverse Tarsal)?
Anterior end of calcaneus articulates with posterior surface of cuboid
What are the movements of the Transverse Tarsal Joint?
Supination and Pronation
What ligaments help stabilize the Calcaneocuboid?
Dorsal Calcaneocuboid ligament, Plantar Calcaneocuboid (short plantar), Long Plantar Ligament support
What bones make up the Medial, Intermediate, and Lateral Tarsometatarsal Joints?
Medial: Medial Cuneiform with the 1st metatarsal
Intermediate: Intermediate and lateral cuneiform with 2nd-3rd metatarsal
Lateral: Cuboid and the 4th-5th metatarsal
What are the motions for the Tarsometatarsal Joint?
-Small amount of flexion and extension
-Limited rotation and abduction at the 1st TMT
What are the three Intertarsal Joints?
Cuneonavicular
Intercuneiform
Cuneocuboid
What type of joint and what articulations make up Metatarsal Phalangeal Joint?
-Condyloid Synovial Joint
-Heads of metatarsal bones articulate with bases on proximal phalanges
What ligaments help support the Metatarsal Phalangeal Joint?
Collateral ligaments support capsule on each side; Plantar ligaments supports plantar part of capsule
What motions does the Metatarsal Phalangeal Joint produce?
Flexion, Extension
Some Abduction, Adduction and Circumduction
What type of joint and what articulations make up the Interphalangeal Joint?
Hinge Synovial Joint
Head of proximal phalanx articulates with the base of distal phalanx
What ligaments help support the Interphalangeal Joint?
Collateral and Plantar ligaments
What motions does the Interphalangeal joint produce?
Flexion and Extension
What are the three major ligaments of the foot?
-Plantar Calcaneonacivular Ligament (Spring Ligament)
-Long Plantar Ligament
-Plantar Calcaneocuboid Ligament (Short Plantar Ligament
What is the first layer of intrinsic muscles of sole? (3)
- Abductor Halluces
- Flexor Digitorum Brevis
- Abductor Digiti Minimi
What is the second layer of intrinsic muscles of sole? (2)
- Quadratus Plantae
- Lumbricals
What is the third layer of intrinsic muscles of sole? (3)
- Flexor Halluces Brevis
- Adductor Halluces
- Flexor Digiti Minimi Brevis
What is the fourth layer of intrinsic muscles of sole? (2)
- Planter Interossei
- Dorsal Interossei
What are the two dorsal muscles of the foot?
- Extensor Digitorum Brevis
- Extensor Halluces Brevis
How is weight bearing distributed in the foot?
- Tibia loads body weight onto talus
- Then to the Calcaneus
- From the calcaneus to the ball of the foot
- These weight bearing areas are supported by 3 elastic arches
What is the Medial Longitudinal Arch composed of?
Calcaneus, Talus, navicular, cuneiforms, and 3 metatarsals
What is the Lateral Longitudinal Arch Composed of?
Calcaneus, Cuboid, and lateral metatarsals
What is the Transverse Arch composed of?
Cuboid, cuneiforms, and bases of metatarsals
What are the Passive supports that support the arch?
-Shapes of bones
-Plantar Aponeurosis
-Long Plantar Ligaments
-Short Plantar Ligaments
-Spring Ligaments
What are the Dynamic Supports that support the arch?
-Active bracing of intrinsic muscles
-Active contraction of the long tendons (extrinsic muscles) acting on the arch
–FHL, FDL-> Longitudinal Arch
–Fibularis Longus/Brevis and Tibialis Posterior -> Transverse arch
What make up the Planter Fascia?
Medial Plantar Fascia
Plantar Aponeurosis
-Distally 5 bands
-Reinforced by the superficial transverse metatarsal ligaments
Lateral Plantar Fascia
Which arteries supply the nail beds and distal phalanges?
Plantar digital Artery and their dorsal branches from Medial and Lateral Plantar A.
Where are the Superficial veins formed? Where do the Great and Small Saphenous vein run?
Formed at the Dorsal venous arch of the foot.
- The Great Saphenous vein runs medially
- The Small Saphenous vein runs laterally
The Deep vein communicates with which vein on the pathway back to IVC?
The Superficial Vein (Great and Small Saphenous)
What nerve innervates the Extensor Digitorum Brevis?
Deep Fibular Nerve
What nerve innervates Abductor Hallucis?
Medial Plantar N.
What nerve innervates Quadratus Plantae?
Lateral Plantar N.
What nerve innervates First Lumbrical?
Medial Plantar N.
What nerve innervates Abductor Digiti Minimi?
Lateral Plantar N.
What nerve supplies skin of the medial side of the SOLE of foot and sides of first 3 digits?
Medial Plantar N.
What nerve innervates Digiti Minimi Brevis?
Lateral Plantar N.
What nerve innervates the Dorsal Interossei?
The Deep Branch of Lateral Plantar N.
What nerve innervates the Lateral Three Lumbricals?
The Deep Branch of Lateral Plantar N.
What nerve innervates Adductor Hallucis?
The Deep Branch of Lateral Plantar N.
What nerve supplies the the skin on sole lateral to a line splitting the 4th digit?
The Deep Branch of Lateral Plantar N.
