Lecture 4: lower limb/ ankle & foot

Question 1

Bones of foot 3 groups**

Answer 1

1. tarsals
2. Metatarsals
3. Phalanges

Question 2

Regions of foot bones

Answer 2

1. hindfoot: talus and calcaneous
2. midfoot: navicular, cuboid, and cuneiforms
3. forefoot: matatarsals and phalanges

Question 3

Ankle ROM (4)

Answer 3

1. Dorsiflection: point toes up
2. Plantatflexion: point toes down
3. inversion: point toes medially
4. everysion: point toes laterally

Question 4

Ankle joint/tacrocural joint and its ligaments (2)

3 bones

Answer 4

synovial joint formed by the tibia, fibula, and talus
*hinge permitting dorsiflexion, plantarflexion

1. medial (deltoid)
2. lateral

Question 5

medial ligament in ankle joint

articulations (3 bones)
4 ligaments
resists?

Answer 5

attached to the medial malleolus, consists of 4 ligaments which fan out from malleolus, attaching to the talus, calcaneus, and navicular bones

*resists over-eversion

1. posterior tibiotalar
2. tibiocalcaneal
3. tibionavicular
4. anterior tibiotalar

Question 6

Lateral ligament in ankle joint

(3) ligaments included

Answer 6

originates from lateral malleolus

*resists over-inversion an comprised

1. anterior talofibular
2. posterior talofibular
3. cacaneofibular

Question 7

Ankle Sprain

due to ?
which ligaments more likely?
2 reasons why

Answer 7

refers to partial or complete tears of the ligaments of the ankle joint

due to excessive inversion to a plantar flexed and weigh-bearing foot

• lateral ligaments more likely
  1. lateral ligaments weaker
  2. lateral ligaments resist inversion

Question 8

Tarsals

how many?
location?

Answer 8

set of 7 irregular shaped bones

situated proximally in foot near ankle

Question 9

Metatarsals

where
how many?

Answer 9

connect phalanges to the tarsals

5 in number- one for each digit

Question 10

Phalanges

how many
location
*special notes

Answer 10

bones of the toes

each toe with three: proximal, distal, intermediate

*big toe with only 2

Question 11

Hindfoot (2)

Answer 11

talus and calcaneus

Question 12

midfoot (3)

Answer 12

navicular

cuboid

cuneiforms

Question 13

Forefoot (2)

Answer 13

metatarsals

phalanges

Question 14

Aterial supply

what three arteries?

Answer 14

supply to ankle joint derived from malleolar branches of

1. anterior tibial artery
2. posterior tibial artery
3. fibular artery

Question 15

Innervation of ankle (3)

Answer 15

1. tibial nerve
2. superficial fibular
3. deep fibular nerve

Question 16

Achillies Tenodn (calcanea)

Answer 16

1. largest, strongest in body
2. when cal muscles flex, achilles tendon pulls on heel
   - movement allows us to stand on out toes when walking, running, or jumping
3. despite strength: vulnerable to unjury
   - limited blood supply
   - high tensions places on tendon

Question 17

Thompson test

Answer 17

test for achilles tendon rupture

Question 18

Tendinitis of achilles

Answer 18

painful, inflammation, occurs in runners who run on hills or uneven surfaces (repetitive stress)

Question 19

retrocalcaneal bursitis

Answer 19

can affect achilles tendon

Question 20

Plantar fasciitis

Answer 20

1. heel spur syndrome
2. cause of heel pain, esp. in joggers and results from inflammation of plantar aponsuerosis at its point of attachment to the calcaneus
3. more common in females in obese patients
4. bony spur may develop, inflammation causes most of the pain
   - mediated by medial clcaneal branch of tibial nerve
5. exercises and orthotic devises are r/c in the initial course tx