Lecture 13: Ankle Complex Flashcards
Hind foot includes this bone: A. Navicular B. Calcaneus C. Cuboid D. Cuneiform
Ans: B Hindfoot: • Talus • Calcaneus Midfoot: • Navicular • Cuboid • Cuneiforms Forefoot: • Metatarsals • Phalanges
This is not part of a inferior tibiofibular joint:
A. Posterior tibiofibular ligament
B. Synovial plane joint with a capsule
C. Anterior tibiofibular ligament
D. Crural tibiofibular interosseous ligament
Ans B
Superior and Inferior Tibiofibular Joints
Superior tibiofibular joint: • Synovial plane joint with a capsule
Inferior tibiofibular joint: • Syndesmosis: • Posterior tibiofibular ligament • Anterior tibiofibular ligament • Crural tibiofibular interosseous ligament
Which is the tenon of the ankle joint?
A. Fibular malleolus
B. Tibial malleolus
C. Head of talus
D. Distal end of tibia
Ans D Talotibial (talocrural) Joint AKA: ankle joint Most congruent joint in the body Mortise and tenon joint: Mortise: • Fibular malleolus • Tibial malleolus • Distal end of tibia Tenon: • Head of talus Synovial hinge joint. Axis: • Toe out stance (= normal tibial torsion). • Pathological: external/internal tibial torsion. Movements: • Dorsiflexion = increased toe out. • Plantarflexion = decreased toe out. • Mostly occur in sagittal plane
Which is part of the lateral collateral ligaments? A. Tibionavicular B. Anterior talofibular C. Tibiocalcaneal D. Anterior tibiotalar
Ans: B Medial collateral: • AKA: deltoid • Components: • Tibionavicular • Tibiocalcaneal • Anterior tibiotalar • Posterior tibiotalar Lateral collateral: • Weakest of the collaterals • Components: • Anterior talofibular • Posterior talofibular • Calcaneofibular
Which of the following is part of the medial collaterals: A. Anterior talofibular B. Posterior talofibular C. Posterior tibiotalar D. Calcaneofibular
Ans: C Medial collateral: • AKA: deltoid • Components: • Tibionavicular • Tibiocalcaneal • Anterior tibiotalar • Posterior tibiotalar Lateral collateral: • Weakest of the collaterals • Components: • Anterior talofibular • Posterior talofibular • Calcaneofibular
Very stable, uniaxial, triplanar joint. It allows the inversion, adduction in the vertical axis, supination in the longitudinal axis and plantarflexion in the coronal axis. A. Talotibial joint B. Talocrural joint C. Tibiocalcaneal D. Talocalcaneal joint
Ans D
Ankle Joints and Ligaments
Talocalcaneal (subtalar) joint: • Very stable
• Uniaxial, triplanar
• Three surfaces: • Posterior: Concave facet on talus with
convex facet on calcaneus
• Anterior: Convex facets on body and neck of talus, Concave facets on calcaneus
• Tarsal tunnel: • Nonsynovial
• Ligament = talocalcaneal ligament
Movements: • Inversion: • Adduction (vertical axis)
• Supination (longitudinal axis)
• Plantarflexion (coronal axis)
• Eversion: • Opposite of inversion
The talocalcaneal ligament passes though this structure: A. Talonavicular joint B. Tarsal tunnel C. Talotibial joint D. Talocrural joint
Ans: B
Talocalcaneal (subtalar) joint: •Very stable •Uniaxial, triplanar •3 surfaces: •Posterior: Concave facet on talus with convex facet on calcaneus •Anterior: Convex facets on body and neck of talus, Concave facets on calcaneus
Tarsal tunnel: •Nonsynovial •Ligament = talocalcaneal ligament
Movements: •Inversion: •Adduction (vertical axis) •Supination (longitudinal axis) •Plantar flexion (coronal axis) •Eversion: •Opposite of inversion
Ligaments: •Interosseous talocalcaneal •Posterior and lateral talocalcaneal ligaments
This ligament is from sustentaculum tali to inferior navicular and continuous medially with deltoid ligament. It also continuous laterally with medial band of bifurcate ligament and helps to maintain medial longitudinal arch
A. Plantar aponeurosis
B. Interosseous talocalcaneal
C. Posterior and lateral talocalcaneal ligaments
D. Calcaneocavicular ligament
Ans: D
Calcaneonavicular (spring) ligament: •From sustentaculum tali to inferior navicular •Continuous medially with deltoid ligament •Continuous laterally with
medial band of bifurcate ligament •Helps to maintain medial longitudinal arch
Which joint is the traditional link btwn hindfoot and forefoot? A. Transverse tarsal joint B. Calcaneocuboid joint C. Talocalcaneal joint D. Talonavicular joint
Ans A transverse tarsal joint
Transverse tarsal joint: •Composite joint:Talonavicular +Calcaneocuboid
Function: •Traditional link between hindfoot and forefoot •Adds to inversion/eversion range •Compensates forefoot for hindfoot eversion •Keeps distal foot inverted with lateral surface in contact with ground while hindfoot is everted •Compensation between hindfoot and forefoot not possible when hindfoot is inverted.
Flexor retinacula morning binds which of these tendons? A. Tibialis anterior B. Tibialis posterior C. Peroneus tertius D. Extensor hallucis longus
Ans B
Superior/inferior extensor retinacula: Localized thickenings of anterior crural fascia
Bind down tendons of: •Tibialis anterior •Extensor hallucis longus •Extensor digitorum longus •Peroneus tertius
Covers: •Deep peroneal (fibular) nerve • Anterior tibial artery •Inferior retinaculum is “Y” shaped
Flexor retinaculum: Localized medial thickening of crural fascia Binds down tendons of: •Flexor hallucis longus •Flexor digitorum longus •Tibialis posterior
Covers: •Tibial nerve •Posterior tibial artery
Peroneal (fibular) retinaculum: Localized medial thickening of lateral deep fascia
Binds down tendons of:•Peroneus (fibularis) longus •Peroneus (fibularis) brevis
This is not a support ligament that supports the plantar arch: A. Marginal abductors B. Interosseous talocalcaneal C. Long plantar D. Plantar calcaneonavicular
Ans: B
Plantar Arches
Longitudinal: •Medial •Lateral
Pathologies: •Pes cavus •Pes planus
Support ligaments: •Plantar calcaneonavicular(spring): Primary support for medial longitudinal arch •Long plantar: Primary support for lateral longitudinal arch •Plantar aponeurosis •Plantar calcaneocuboid (short plantar) •Marginal abductors
Other arch support structures: •Shapes of bones •Peroneus longus
