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Y2 CONTROL & MOVEMENT > Leg & Ankle > Flashcards

Leg & Ankle Flashcards

1
Q

What bones are involved in forming the ankle joint?

A

it is formed by the articulation between:

  1. distal tibia
  2. distal fibula
  3. talus
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2
Q

What are the only 2 movements present at the ankle joint?

A

it is a synovial hinge joint that permits:

  1. dorsiflexion (extension)
  2. plantarflexion
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3
Q

What factors help to contribute to the stability of the ankle joint?

A
  1. there is good congruity between the malleolar mortice and trochlea of the talus

the malleoli grip the talus and keep it in place

  1. very strong ligaments
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4
Q

Label the components of the ankle joint

A
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5
Q

Why is dorsiflexion the most stable position of the ankle joint?

A
  1. the trochlea of the talus is wider anteriorly than posteriorly
  2. during dorsiflexion, the anterior part of the trochlea moves between the malleoli
  3. this spreads the tibia and fibula slightly and increases their grip on the talus
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6
Q

What are the 2 ligament complexes that stabilise the ankle joint?

A

lateral ligament complex

medial ligament complex (or deltoid)

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7
Q

What are the 3 ligaments of the lateral ligament complex?

A
  1. anterior talofibular ligament
  2. posterior talofibular ligament
  3. calcaneofibular ligament
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8
Q

label the lateral ligaments of the ankle joint

A
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9
Q

What are the attachments involved with the medial ligament?

A

it is attached to the medial malleolus and fans out to attach to the talus, navicular and calcaneus

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10
Q

What movements of the ankle joint are shown?

A
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11
Q

What movements are shown?

A
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12
Q

Which joint is responsible for eversion and inversion?

A

subtalar joint

this is the between the talus and the calcaneus (heel bone)

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13
Q

Which muscles are involved in dorsiflexion?

A

anterior compartment of the leg

tibialis anterior (TA)

extensor hallucis longus (EHL)

extensor digitorum longus (EDL)

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14
Q

What is the artery and the nerve of the anterior compartment of the leg?

A

deep fibular (peroneal) nerve

anterior tibial artery

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15
Q

What are the muscles involved in plantarflexion?

A

posterior compartment of the leg

  1. tibialis posterior
  2. flexor hallucis longus
  3. flexor digitorum longus
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16
Q

What is the artery and the nerve of the posterior compartment of the thigh?

A

tibial nerve

posterior tibial artery

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17
Q

What are the 3 muscles of the anterior compartment of the thigh?

What is their function?

A
  1. tibialis anterior (TA)
  2. extensor digitorum longus (EDL)
  3. extensor hallucis longus (EHL)

they are involved in dorsiflexion of the ankle and extension of the toes

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18
Q

What is the insertion of the tibialis anterior?

A

it originates from the lateral surface of the tibia and interosseous membrane

it inserts on the base of the first metatarsal bone

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19
Q

What is the origin and insertion of extensor hallucis longus?

What is significant about the insertion of its tendons?

A

it arises from the middle portion of the fibula and the interosseous membrane

its tendon inserts on the distal phalanx of the big toe

this allows it to extend the big toe

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20
Q

What is the origin and insertion of extensor digitorum longus?

What is significant about the insertion of its tendons?

A

it originates from the lateral condyle of the tibia and interosseous membrane

its tendons insert onto the middle and distal phalanges of digits 2-5

this allows it to extend the toes

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21
Q

label the anterior leg muscles

A
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22
Q

How are the posterior leg muscles divided?

A

there are 3 deep compartment muscles and 2 superficial compartment muscles

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23
Q

What are the 3 muscles of the deep group of the posterior compartment?

A
  1. tibialis posterior (TP)
  2. flexor hallucis longus (FHL)
  3. flexor digitorum longus (FDL)

they are involved in plantarflexion and flexion of the toes

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24
Q

what is the origin and insertion of tibialis posterior?

A

it originates from the tibula and fibula

it inserts onto the navicular and medial cuneiform bone

it can cannot flex the toes

25
Q

What is the origin and insertion of flexor digitorum longus?

What does the insertion of its tendons allow it do?

A

it originates from the posterior surface of the tibia

it inserts onto the plantar surface of the base of the distal phalanges of digits 2-5

this allows it to flex the toes

26
Q

What is the origin and insertion of flexor hallucis longus?

What does the insertion of its tendon allow it to do?

A

it originates from the fibula

it inserts onto the plantar surface of the distal phalanx of the big toe (hallux)

this allows it to flex the big toe

27
Q

Why does flexor hallucis longus play such a crucial role?

A

plantar flexion is crucial to walking as the final stage in walking is pushing off of the ground with the big toe (toe-off)

(going on tip toes is also plantar flexion when the foot is fixed on the ground)

28
Q

label the deep muscles of the posterior leg

A
29
Q

What are the 2 superficial muscles of the posterior leg?

A

gastroenemius is the most superficial muscle

soleus is attached to the soleal line and covers all of the deep muscles

30
Q

What are the functions of the superficial muscles of the posterior leg?

A

they are plantarflexors of the ankle

soleus contracts to squeeze the underlying deep veins of the leg to force the blood back to the heart

31
Q

What is the Achilles tendon?

Where does it insert?

A

both soleus and gastroenemius insert onto the calcaneum via the Achilles tendon

32
Q
A
33
Q

Label the superficial muscles of the posterior leg

A
34
Q

What are the 2 muscles of the lateral compartment of the leg?

What is their function?

A

fibularis longus and fibularis brevis

they are involved in eversion

35
Q

What are the 2 divisions of the sciatic nerve?

Which compartments of the leg are innervated by which divisions?

A

tibial division:

  • this innervates all the muscles in the posterior compartment

common fibular division:

  • this divides into the superficial fibular nerve that innervates the lateral compartment
  • and the deep fibular nerve that innervates the anterior compartment
36
Q

What action are most ankle injuries caused by?

A

most ankle sprains are inversion injuries with twisting of a plantar-flexed foot

this causes tearing and stretching of the lateral ligaments

37
Q

Why do ligaments heal slowly?

A

they are relatively avascular

38
Q

what happens if a ligament is detached from bone?

A

fibres do not grow back into the bone cortex as extensively

this means that the healed ligament is usually weaker

39
Q

How do torn ligaments affect the ankle joint?

What ligaments of the ankle joint are weaker?

A

they predispose to dislocation

the lateral ligament is weaker than the medial ligament, particularly the anterior talofibular part

40
Q

What injury is shown?

What usually causes this?

A

ankle fracture

this is caused by fracture of the lateral malleolus

it may be coupled with fracture of the medial malleolus

41
Q

What causes an eversion injury?

What injuries are associated with this?

A

they are caused by the foot being forced into an eversion position

this pulls the medial ligament and causes avulsion of the medial malleolus

this causes the talus to rotate laterally and fractures the fibula

42
Q

What injury is shown here?

A

fracture dislocation

this tends to be obvious as there is not much fat or subcutaneous tissue around the ankle

43
Q

what injury is shown here?

A

osteoarthritis of the ankle joint

44
Q

What are the tarsal bones?

A
45
Q

Why is the foot a series of small bones and ligaments?

A

this allows the foot to deform to absorb shock and adapt to walking on uneven surfaces

if the foot was rigid, each impact with the ground would generate large forces

46
Q

What are the roles of the tarsal bones?

A
  1. to support and transmit body weight
  2. acts as a lever to propel body forward during motion
  3. acts as a resilient spring to absorb shock
47
Q

What are the roles of the arches of the feet?

A

STABILITY

they help to distribute weight, act as shock absorbers and increase the flexibility of the foot

they also act as springboards for propulsion during walking, running and jumping

48
Q

What are the 3 arches of the foot?

A
  1. medial longitudinal
  2. lateral longitudinal
  3. transverse
49
Q

What are the methods of passive and dynamic support of the foot arches?

A

passive support:

ligaments and the shape of the bones

dynamic support:

intrinsic and extrinsic muscles of the foot

50
Q

What would happen if the arches of the foot were not supported?

A

they would flatten out due to the weight of the body when standing

51
Q

What condition is shown?

A

pes planus

this is seen in adolescents or adults

it is usually caused by loose of degenerating ligaments

52
Q
A
53
Q

What are the 2 types of pes planus?

A

flexible and rigid

flexible is more common - this is where the arch is present when not bearing weight but absent when standing

54
Q

What are the exacerbating factors in pes planus?

A

gaining weight and/or spending a long time standing

55
Q

Why must pes planus be treated even if it is asymptomatic?

A

it can result in displacement of the talus infero-medially

this causes misalignment of the ankle and knee causing pain in these areas

this can also decrease shock absorption by the foot leading to lower back pain

56
Q

What is the treatment for pes planus?

A

orthotics (specialised insoles) that support the arches of the foot

57
Q

What movements are present at the toes?

Which joints are involved?

A

flexion and extension:

acheived by the metatarsophalangeal joints, PIPJs, DIPJs

abduction and adduction:
limited abduction and adduction occurs at the metatarsophalangeal joints

58
Q
A

Y2 CONTROL & MOVEMENT (69 decks)

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