Ligaments & Joints Flashcards
What is the talocrural joint aka?
ankle joint
what type of joint is the talocrural joint?
hinge (or ginglymus type of synovial joint)
the trochlea of the talus fits into a socket formed by what structures?
- tibia
- fibula
- anterior inferior tibiofibular ligament
- inferior transverse ligament
which joint is especially important for maintaining stability of the ankle joint?
distal (inferior) tibiofibular joint
which ligaments are associated with the distal tibiofibular joint?
- interosseous tibiofibular ligament
- anterior inferior tibiofibular ligament
- posterior inferior tibiofibular ligament
which ligament is NOT part of the ankle joint?
the interosseous tibiofibular ligament
Where can the interosseous tibiofibular ligament be found?
(is the lowermost portion of the interosseous mb btwn the tibia and fibula)
where is the anterior inferior tibiofibular ligament found? what shape is this ligament?
(triangular in shape) extends from the anterior border of the fibular notch of the tibia to the anterior border of the shaft of the fibula and the lateral malleolus
where is the posterior inferior tibiofibular ligament found? what shape is this ligament?
(quadrilateral in shape) extends from the posterior border of the fibular notch of the tibia to the upper part of the lateral malleolar facet
*this ligament has 2 portions, superficial and deep
what is the deep portion of the posterior inferieor tibiofibular ligament called?
inferior transverse ligament
what is the inferior transverse ligament?
(deep portion of the posterior inferieor tibiofibular ligament) that helps form the tibial plafond
Name which surfaces of the talus articulate at the ankle joint, and what they articulate with.
dorsal surface –> tibial plafond
medial surface –> lateral surface of medial malleolus (tibia) *recall that this is the comma-shaped facet
lateral surface –>medial surface of lateral malleolus (fibula) *recall that these have triangular facets
Describe the articular capsule of the ankle joint.
it is thin anteriorly and posteriorly;
but is thickened medially and laterally as the collateral ligaments
what is the medial ligament of the ankle?
deltoid ligament
deltoid ligament has 4 distinct bands, name them.
- anterior tibiotalar
- posterior tibiotalar
- tibionavicular
- tibiocalcaneal
of the 4 bands in the deltoid ligament, which lies deep?
anterior tibiotalar ligament lies deep. The other 3 ligaments are located superficially.
superiorly, what does the deltoid ligament attach to?
medial malleolus (specifically, it is attached to the anterior surface, apex, and posterior surface of the medial malleolus)
what does the anterior tibiotalar ligament attach to?
(part of deltoid lig) attaches to medial surface of the talus
where is the posterior tibiotalar ligament attached to?
(part of deltoid lig)
medial tubercle of the posterior surface of teh talus
where is the tibiocalcaneal ligament attached to?
(part of deltoid lig)
attaches to sustentaculum tali of calcaneus inferiorly
what is the strongest part of the deltoid ligament?
tibiocalcaneal ligament
where does the tibionavicular ligament attach to?
(part of deltoid lig)
navicular tuberosity
*blends in with spring ligament
what is the weakest part of the deltoid ligament?
tibionavicular ligament
the tibionavicular ligament lies superficial to what structure?
anterior tibionavicular ligament
the tendons of which 2 muscles lie superficial to the deltoid ligament?
tibialis posterior
flexor digitorum longus
what 3 ligaments make up the lateral collateral ligament of the ankle?
- calcaneofibular
- anterior talofibular
- posterior talofibular
what is the weakest part of the lateral collateral ligament of the ankle?
calcaneofibular ligament
where is the attachments for the calcaneofibular ligament?
apex of lateral malleolus –> to an unnamed tubercle on the lateral surface of calcaneus
the calcaneofibular ligament is covered by which tendons?
peroneus longus and peroneus brevis
what is the shortest of the lateral ligaments?
anterior talofibular ligament
what is the attachment for the anterior talofibular ligament?
(part of LCL of ankle)
anterior margin of lateral malleolus –> neck of talus
which ligament is most commonly injured in an inversion-type sprained ankle?
anterior talofibular ligament (of LCL)
which ligament overhangs the tarsal sinus?
anterior talofibular ligament (of LCL)
which is the deepest and strongest lateral collateral ligament of the ankle?
posterior talofibular ligament (of LCL)
describe the attachments for the posterior talofibular ligament.
(part of LCL of ankle) fibers course horizontally between lateral malleolar fossa and the lateral tubercle of the posterior surface of teh talus
which ligament is NOT classified as part of the LCL of teh ankle eventhough it is located at the posterolateral aspect of teh ankle joint?
fibulotalocalcaneal ligament
describe the superior border of the fibulotalocalcaneal ligament.
is attached along the posterior border of the lateral malleolus where it blends with the posterior tibiofibular ligament
inferiorly, the fibulotalocalcaneal ligament divides into two laminae: superomedial and inferolateral. describe the superomedial band of the fibulotalocalcaneal ligament.
attaches to lateral tubercle of the posterior process of teh talus
describe the inferolateral band of the fibulotalocalcaneal ligament.
attaches to posterior 1/3 of dorsal surface of calcaneus
Name the 4 intertarsal joints.
- talocalcaneal
- talocalcaneonavicular
- calcaneocuboid
- great tarsal
what is the talocalcaneal joint?
aka subtalar joint (btwn talus & calcaneus)
what is the talocalcaneal joint formed by?
- concave posterior facet on the plantar surface of the talus
- convex posterior facet on the dorsal surface of the calcaneus
what separates the talocalcaneal joint from the talocalcaneonavicular joint?
tarsal sinus and tarsal canal
Name the ligaments that make up the articular capsule of the talocalcaneal joint.
- medial talocalcaneal
- posterior talocalcaneal
- lateral talocalcaneal
- interosseous talocalcaneal
- anterior talocalcaneal
Where does the medial talocalcaneal attach?
(talocalcaneal joint)
attached to medial tubercle of talus and to the posterior aspect of teh sustentaculum tali and the medial surface of teh calcaneus posterior to the sustentaculum tali
the medial talocalcaneal ligament blends with what ligament superficially and with what ligament that lies deep?
deltoid ligament- lies superficial
interosseous talocalcaneal ligament- lies deep
where does the posterior talocalcaneal ligament attach?
(talocalcaneal joint) extends between the lateral tubercle of the posterior surface of the talus & the dorsal surface of calcaneus
*may also form a Y-shaped band if there is another attachment to medial tubercle on posterior surface of talus
where does the lateral talocalcaneal ligament attach?
(talocalcaneal joint) extends btwn the lateral surface of the talus beneath its fibular facet to teh lateral surface of teh calcaneus
recall which ligament lies in the tarsal canal.
interosseous talocalcaneal ligament
where does the interosseous talocalcaneal ligament attach?
(talocalcaneal joint) runs obliquely from sulcus tali to sulcus calcanei
where does the anterior talocalcaneal ligament (aka cervical ligament) attach?
(talocalcaneal joint) attaches to neck of talus
*is the most anterior part of the interosseous talocalcaneal ligament
which ligament is aka cervical ligament?
anterior talocalcaneal ligament (part of talocalcaneal joint)
true or false: calcaneus articulates with the navicular.
FALSE- it does not articulate with the navicular
Where does the talocalcaneal portion of the talocalcaneonavicular joint lie? what articulates with what?
(anterior to tarsal canal)
in this portion of the joint, the anterior and middle calcaneal facets of the talus articulate with the anterior and middle talar facets of the calcaneus
what articulates with what in the talonavicular portion of the joint?
convex head of the talus articulates with the concave proximal surface of the navicular
since the articular capsule of the talocalcaneonavicular joint is weak, what other ligaments does this joint have for reinforcement?
- interosseus talocalcaneal ligament
- dorsal talonavicular ligament
- calcaneonavicular part of bifurcated ligament
- spring ligament
recall what is the spring ligament
plantar calcaneonavicular ligament
where does the dorsal talonavicular run?
located betwen the neck of the talus and the dorsal surface fo the navicular
what are the 2 parts of the bifurcated ligament?
- calcaneonavicular
2. calcaneocuboid
where does the spring ligament attach?
(plantar calcaneonavicular)- posteriorly is attached to anterior border of sustentaculum tali
anteriorly, the ligament is attached to the plantar surface of the navicular and to navicular tuberosity
what is the function of spring ligament?
support head of the talus, thereby maintaining the medial longitudinal arch
what type of joint is the calcaneocuboid joint?
saddle type of synovial joint
what ligaments make up the calcaneocuboid joint?
- calcaneocuboid part of the bifurcated ligament
- long plantar ligament
- plantar calcaneocuboid ligament
what is the attachment of the long plantar ligament?
superiorly: medial & lateral processes and the depression between these processes fo the calcaneus
anteriorly: ligament splits into deep and superficial fibers. Deep fibers attach to peroneal ridge of cuboid. Superficial fibers attach to bases of mets 2-4
what is the short plantar ligament aka?
plantar calcaneocuboid
what is the attachments of the short plantar ligament?
anterior tubercle of the calcaneus proximally cuboid distally (posterior to peroneal ridge & to coronoid process)
recall what structures attach to the tarsal sinus.
*mnemonic- ICE BILD Inferior extensor retinaculum Cervical ligament Extensor digitorum brevis Bifurcate ligament Inferior peroneal retinaculum Lateral calcaneocuboid ligament Dorsal calcaneocuboid ligament
recall which ligaments attach to the posterior 1/3 of the dorsal surface of the calcaneus.
posterior talocalcaneal
fibulocalcaneal
recall which structure attaches to the anterior tubercle of the calcaneus.
short plantar lgiament (calcaneocuboid)
recall what structure attaches to the un-named third tubercle on the lateral surface of the calcaneus.
calcaneofibuar ligament
recall which structures are attached to the sustentaculum tali.
- tibiocalcaneal ligament (a part of deltoid)
- medial talocalcaneal ligament
- recurrent band of tibialis posterior
- spring ligament
what ligaments attach to the medial tubercle of the posterior process of the talus?
medial talocalcaneal ligament
and the posterior tibiotalar ligament ( part of deltoid ligament )
what ligaments attach to the lateral tubercle of teh posterior process?
- posterior talofibular
- posterior talocalcaneal
- fibulotalocalcaneal
what structures attach to the superior (dorsal) surface fo the cuboid?
- dorsal calcaneocuboid
- dorsal cuneocuboid
- dorsal cuboideonavicular
- two dorsal cuboideometatarsals (one to the 4th met, the other to the 5th met)
- lateral calcaneocuboid (variable)
Which ligament helps to check over-inversion?
cervical ligament (anterior talocalcaneal lig) *is part of the subtalar joint articular capsule
which ligament is a ligament of the subtalar joint and the talocalcaneonavicular joint?
interosseous talocalcaneal ligament
Which boens are invovled in the great tarsal joint?
5 of the 7 tarsal bones (all except for the talus and calcaneus) and the 3 metatarsals (2,3,4)
what articulation is not part of the great tarsal joint in some feet?
articulation btwn 3rd and 4th metatarsal
the great tarsal joint consists of 3 classes of joints- what are they?
- intertarsal
- tarsometatarsal
- intermetatarsal
for bones that articulate at proximal-distal surfaces, how many ligaments are there? which is strongest?
2 ligaments: dorsal and plantar
- plantar ligament is stronger
- dorsal ligament is weaker
for bones that articulate at medial-lateral surfaces, how many ligaments are there? which is strongest?
3 ligaments: dorsal, plantar, and interosseous
*interosseous is the strongest and dorsal is teh weakest
how many anatomical and how many functional intertarsal joints are there?
4 anatomical joints but only 2functional intertarsal joints
*the great tarsal joint does not participate in either functional joint
what does the functional subtalar joint consist of?
anatomical subtalar joint (btwn posterior articular facets of talus and calcaneus)
and the talocalcaneal portion of talocalcaneonavicular joint (which adds anterior & middle facet)
what does the transverse tarsal joint (aka midtarsal joint) consist of?
- calcaneocuboid joint
2. talonavicular portion of TCN joint
Name the functional intertarsal joints.
functional subtalar
transverse tarsal joint
Name the 4 intertarsal joints.
subtalar
talocalcaneonavicular
calcaneocuboid
great tarsal
which joint participates in both functional joints?
talocalcaneonavicular joint
which joint does NOT participate in either functional joint?
great tarsal joint
which bones are anterior to teh transverse tarsal joint? posterior?
anterior- navicular & cuboid
posterior- talus and calcaneus
what are teh 3 joint cavities for the tarsometatarsal articulations?
- medial tarsometatarsal joint
- great tarsal joint
- lateral tarsometatarsal joint
what does the medial tarsometatarsal joint consist of?
1st metatarsal - medial cuneiform
what does the great tarsal joint conssit of?
2nd metatarsal- intermediate cuneiform
3rd metatatarsal- lateral cuneiform
what does teh lateral tarsometatarsal joint consist of?
4th metatarsal - lateral cuneiform and cuboid
5th metatarsal- cuboid
Name the ligaments of the joint cavities for the tarsometatarsal articulations.
- dorsal tarsometatarsal
- plantar tarsometatarsal
- interosseous tarsometatarsal
how many dorsal tarsometatarsal ligaments are there?
7
*these are STRONG, flat bands
how many plantar tarsometatarsal lgiaments are there?
(3-5)
they are weak and irregular
How many interosseous tarsometatarsal ligaments are there?
3
*two attach to 2nd met and two attach to lateral cuneiform
what is lisfranc’s ligament?
(interosseous tarsometatarsal ligament)
from 2nd metatarsal to lateral surface of medial cuneiform
what 3 lgiaments support the articulation between 2 metatarsals?
- plantar intermetatarsal
- dorsal intermetatarsal
- interosseous intermetatarsal
what union is unique to the human foot?
union betwen the heads of the 1st and 2nd metatarslas
*note that the bases of the 1st and 2nd mets don’t attach
what is the relationship betwen the deep transverse metatarsal ligament to the interossei and lumbricals?
lumbricals- pass plantarly
interossei- pass dorsally to the ligament
each of the five MP joints contain which ligaments?
- articular capsule
- medial collateral ligament
- lateral collateral ligament
- glenoid ligament
what is the glenoid ligament?
aka the plantar metatarsophalangeal ligaments that attach to plantar plates
what % of feet is the 5th toe only have 2 IP joints?
60%
*in 40% of feet, the middle and distal phalanges are fused –> therefore only one IP joint
what are the ligaments of the IP joint?
articular capsule
MCL
LCL
plantar interphalangeal ligament
