Lecture 25: Ankle joint and foot Flashcards
What is bones are in the hindfoot, mid foot and fore foot
Hindfoot = talus and calcaneus Midfoot= navicular, cuboid and 3 cuneiforms Forefoot= metatarsals and phalanges
What bones are part of the ankle joint and what actions permitted there, which is most stable.
Between the distal tibia and fibula which clamp around the Talus. The wider anterior face. Movement is 30’ of dorsiflexion and plantarflexion with dorsiflexion more stable because the anterior face of talus has a larger SA to articulate with the tibia and fibula compared to the posterior face.
What bones are part of the subtalar joint and what actions are permitted there
The inferior aspect of the talus with the superior aspect of calcaneus which allows inversion and eversion= anatomical subtalar joint, as well as the talocalceneonavicular joint which involves the navicular as well and has a bit of pronation/supination with some inversion and eversion.
What is the syndesmosis, injuries and repair
Syndesmosis is a thick ligament between the distal fibula and Tibia which holds the two bones together to give stability. Injury to this ligament allows the bones to shift away from each other and creates a gap between the bone and the talus not good alignment. This requires surgical repair.
What makes up the lateral ligament complex and its role
There is Anterior (weak) and Posterior Talofibular ligaments and the Calcaneofibular ligament which is in the middle. Ant + post Talofibular ligaments provides stability to the distal tibiofibular joint, and the complex itself prevents varus deformation at the ankle (apex outward)
What makes up the medial ligament complex= deltoid ligament and its role
It is made of multiple ligaments extending from the tibia down to the navicular, talus (ant+ post) and sustenaculum tail of the calcaneus.
Its role is to stabilise the medial sidqqe of the ankle joint.
What muscles cause dorsiflexion at the ankle joint and what is their myotome
Anterior compartment: Tib Ant (mostly), EDL, EHL, PT
Myotome: L4
What muscles cause plantarflexion at the ankle joint and what is their myotome
All in posterior compartment, but mainly Gastrocnemius and Soleus.
Myotome S1
What muscles cause inversion at the subtalar and what is their myotome
Muscles attached to medial bones: Tib Ant and Tib Posterior
Myotome: L4
What muscles cause eversion at the subtalar and what is their myotome and what other action is associated with this
Muscles attached to lateral side: Peroneus Longus, Brevis and Tertius
Myotome: L5, also big toe dorsiflexion
Which joints in the foot lead to the pronate and supinate
Joints in the hind foot and forefoot as well as in the forefoot itself.
Describe where the medial and lateral plantar arteries come from (from the popliteal fossa)
Popliteal artery branch: posterior tibial artery which travels down the posterior compartment before passing posterior to the medial malleolus in the tarsal tunnel and split into medial and lateral plantar arteries
Describe the cutaneous innervation of the plantar aspect of the foot
Sole of the foot cutaneous innervation is from the Medial and Lateral plantar nerves + tibial nerve (and sural)
Medial is larger and does medial + digital nerves for medial 3.5 toes.
Lateral does digital nerves for 1.5 toes and lateral sole with a small section by the sural nerve
Tibial nerve does the heel.
Describe the cutaneous innervation of the dorsal aspect of the foot
Mainly in the middle is the superficial peroneal nerve, with the 1st webspace by the deep peroneal nerve. A small lateral chunk by the sural nerve (runs with lesser saphenous vein) and small medial chunk by the saphenous nerve (runs with greater saphenous vein)
What is the Lis Franc injury
A fracture or dislocation of the 2nd tarso-metatarsal joint from forced plantar flexion of the foot (highheel). This disrupts the midfoot mechanics, causing significant pain and longterm disability if not diagnosed properly - lose of arch in the foot . Can also cause compartment syndrome as it is in the region of the dorsalis pedis.
