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APMLE LEA > Manual 1-19: Bones > Flashcards

Manual 1-19: Bones Flashcards

1
Q

proximal row

A

calcaneus and talus

for these bones, the plantar surface is also called the distal surface

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2
Q

each of the tarsal bones is a …

A

short, irregular bone

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3
Q

found between the proximal and distal row

A

navicular

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4
Q

the width of the calcaneus is about the same as the height, both are about ______ of its length

A

50%

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5
Q

the dorsal surface of the calcaneus is _______ from front to back and is ___ from side to side.

A

concave; convex

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6
Q

the anterior third of the calcaneus contains what two facets?

A

anterior and middle - they articulate with the talus

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7
Q

what facet on the calcaneus is supported by the sustentaculum tali?

A

middle facet

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8
Q

deep depression on the anterior part of the dorsal surface of the calcaneus located between the middle and posterior facet

A

calcaneal sulcus

  • the calcaneal sulcus combinew with a deep groove on the plantar surface of the talus to form the tarsal sinus and tarsal canal
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9
Q

the tarsal canal lies _____ to tarsal sinus

A

medial

  • tarsal canal is directed anterolaterally and it is continuous with tarsal sinus
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10
Q

what lies within the tarsal canal?

A

talocalcaneal ligament

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11
Q

the tarsal sinus lies at the _________ end of the tarsal canal

A

lateral

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12
Q

name all the structures attached to the tarsal sinus

A

(7)

  • extensor digitorum brevis
  • inferior extensor retinaculum
  • inferior peroneal retinaculum
  • cervical ligament
  • bifurcate ligament
  • dorsal calcaenocuboid ligamnet
  • lateral calcenocuboid ligament ( sometimes absent)
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13
Q

largest facet on the dorsal surface of calcaneus

A

posterior articular facet

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14
Q

what is the shape of the posterior articular facet of the calcaneus?

A

oval shaped

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15
Q

what two ligaments attach at the posterior third of the dorsal surface of calcaneus?

A

posterior talocalcaneal

fibulocalcaneal

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16
Q

the plantar surface of the calcaneus is _______ side to side and wider _____ than ______ making it somewhat triangular in shape.

A

convex ; posteriorly than anteriorly

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17
Q

posterior limit of plantar surface of calcaneus

A

calcaneal tuberosity

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18
Q

describe the calcaneal tuberosity

A
    • depressed in the middle and prolonged into a lateral and a medial process on each side
    • lateral process small but very prominent
    • medial processs (posteromedial tubercle) is broader and larger than the lateral process
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19
Q

what structures attach to the lateral process (posterolateral tubercle) of calcaneus ?

A

(4)

  • abductor digiti quinti
  • lateral head of quadratus plantae
  • long plantar ligament
  • plantar aponeurosis
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20
Q

what structures attach to the medial process (posteromedial tubercle) of the calcaneus?

A

(7)

  • abductor hallucis
  • medial head of quadratus plantae
  • long plantar ligament
  • plantar aponeurosis
  • flexor retinaculum
  • flexor digitorum brevis
  • abductor digiti quinti
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21
Q

what structures have attachment to the depression between the medial and lateral processes of the calcaneal tuberosity?

A

long plantar ligament and abductor digit quiniti

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22
Q

where is the anterior tubercle of the calcaneus?

A

near the anterior border of the plantar surface of the calcaneus there is a tubercle for the plantar calcaneocuboid ligament (short plantar ligament)

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23
Q

what shape is the facet on the anterior surface of the calcaneus that articulates with the cuboid? what attaches to its medial margin?

A
  • triangular
  • the facet is convex transversely and concave vertically therefore it appears saddle-shaped
  • the plantar calcaneonavicular (spring) ligament attaches to the medial margin
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24
Q

the ______ area of the posterior surface of the calcaneus is smooth.

A
  • superior
  • it is covered by a bursa that lies deep to the tendo calcaneus
  • the inferior and middle are are roughened
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25
Q

which part of the calcaneus has a roughened area for the attachment of tendo calcaneus and plantaris?

A
  • middle area of the posterior surface of calcaneus

- at times the plantaris attaches medial to the tendo calcaneus, other times they attach together

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26
Q

the lateral surface of the calcaneus is broader _______ than _____.

A
    • posteriorly; anteriorly

- this surface can have 1-3 tubercles

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27
Q

tubercle directly posterior to the peroneal trochlea/tuberosity on the lateral surface of calcaneus

A
  • retrotrochlear eminence

- located in middle third of lateral surface

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28
Q

ridge of bone formed by a groove for the tendon of peroneus longus

A
  • peroneal trochlea
  • lies anterior to retrotrochlear eminence on lateral calcaneus
  • groove for the tendon of peroneus longus lies inferior and posterior to the peroneal trochlea
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29
Q

how often is the peroneal trochlea present?

A
  • 33% of time
  • rarely, there is second groove located superior to the peroneal trochlea and formed by the tendon of peroneus brevis (usually not present)
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30
Q

what attaches to the peroneal trochlea?

A

deep fibers of the inferior peroneal retinaculum

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31
Q

what 3 tubercles might be on the lateral side of calcaneus?

A
  • retrotrochlear eminence
  • peroneal tubercle
  • third tubercle (calcaneofibular tuberosity)
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32
Q

where would the third tubercle be found on the calcaneus?

A
  • lateral surface
  • posterior and superior to retrotrochlear eminence
  • serves as attachment for calcaneofibular ligament
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33
Q

how often is the third tubercle on lateral side of calcaneus present?

A

40-50%

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34
Q

the ______ ligament attaches just anterior and superior to the calcaneofibular ligament which partially overlies it on the lateral surface of calcaneus

A

lateral talocalcaneal ligament

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35
Q

the medial surface of the calcenus is deeply _______

A
  • concave

- plantar nerves and vessels are located in this hollow

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36
Q

the medial head of the quadratus plantae attaches to the medial surface of _____

A
  • calcaneus
  • ** this attachment of the medial head of quadratus plantae to the medial surface of the calcaneus is more extensive than its attachment to the medial process (plantar surface)
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37
Q

shelf-like projection from medial surface of calcaneus

A

sustentaculum tali

  • superior surface of sutentaculum tali articulates with talus
  • inferior surface is grooved by tendon of flexor hallucis longus
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38
Q

what structures attach to the sustentaculum tali?

A

(4)

  • tibiocalcaneal ligament (part of deltoid ligament)
  • medial talocalcaneal ligament
  • recurrent band of tibialis posterior (partial insertion)
  • plantar calcaneonavicular (spring) ligament
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39
Q

what tendons attach to the talus?

A

NONE!

no muscle or tendons attach to talus

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40
Q

the body of the talus is ____ in shape

A

cubical

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41
Q

the superior surface of the body of the talus is called the _______

A
  • trochlea
  • because it is shaped like a pulley
  • convex from anterior to posterior
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42
Q

what structures does the trochlea of talus articulate with?

A

(5)

  • tibial plafond (inferior surface of tibia)
  • medial malleolus of tibia
  • lateral malleolus of fibula
  • anterior (inferior) tibiofibular ligament
  • inferior transverse ligament, which is the deep portion of the posterior (inferior) tibiofibular ligament
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43
Q

the large, oval concave facet on the inferior surface of the body of the talus articulates with _______. The facet is named __________.

A
  • calcaneus at subtalar joint

- posterior articular facet

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44
Q

located at the union of the body and neck of talus on inferior surface

A

sulcus tali

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45
Q

comma-shaped facet on medial surface of talus articulates with _______.

A
  • medial malleolus
  • inferior to the surface the medial surface is rough where the anterior tibiotalar ligament (part of deltoid) is attached
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46
Q

the lateral surface of the body of talus has a ________ shape

A

triangular shape - apex pointing inferiorly

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47
Q

= inferior, tapered end of the lateral surface of body of talus

A
  • lateral process
  • has large triangular facet for the lateral malleolus
  • rough areas anterior and posterior to articular fact for attachment of anterior talofibular and posterior talofibular ligaments
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48
Q

there are usually ______ for the anterior talofibular ligament and a _____ for the posterior talofibular ligament on the ____ surface of the body of talus

A
  • two tubercles
  • groove
  • lateral
  • the lateral talocalcenal ligament attaches anteroinferior to the lateral malleolar surface
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49
Q

posterior surface of talus aka

A
  • posterior process

- ledge of bone that projects posteriorly and inferiorly

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50
Q

what divides the posterior surface of talus into medial and lateral tubercles?

A
  • posterior process is grooved by tendon of flexor hallucis longus, which divides the posterior process into medial and lateral tubercels
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51
Q

what attaches to the medial tubercle on posterior surface of talus?

A
  • medial talocalcaneal ligament and posterior tibiotalar ligament (part of deltoid)
  • if present, the medial band of posterior talocalcaneal ligament also attaches to medial tubercle
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52
Q

the lateral tubercle on posterior talus is larger than the medial. what three ligaments attach to it?

A
  • posterior talofibular
  • posterior talocalcaneal
  • fibulotalocalcaneal
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53
Q

when secondary ossification in the lateral tubercle of posterior process of talus fails to fuse it creates an accessory bone called __________

A

os trigonum

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54
Q

where is the neck of the talus seen most easily?

A
  • on lateral and superior surfaces

- on medial and inferior surfaces the neck is represented by a deep groove called the sulcus tali

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55
Q

the sulcus tali and calcaneal sulcus together form the …

A

tarasal sinus and tarsal canal

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56
Q

what does the tarsal canal contain?

A
  • interosseous talocalcaneal ligament
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57
Q

what attaches to the superior surface of the neck of the talus?

A

(dorsal) talonavicular ligament

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58
Q

how is the head of the talus directed?

A

anteriorly
medially
slightly inferiorly

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59
Q

the anterior surface of the head of the talus has a large _____, _________ facet for its articularion with navicular

A

ovoid, convex

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60
Q

how many facets are on the inferior surface of the head of the talus?

A
  • three
  • two facets articulate with calcaneus
  • third facet articulates with plantar calcaneonvaicular (spring) ligament (superior portion of ligament contains fibrocartilage upon which head of talus rests)
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61
Q

what facets are located on the inferior surface of the head of the talus?

A

anterior calcaneal facet – articulates with anterior talar facet
middle calcaneal facet – articulates with middle talar facet

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62
Q

the most lateral bone in distal row of tarsal bones

A

cuboid

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63
Q

orientation of the cuboid

A
  • superior surface is directed superolateral

- inferior surface is directed inferomedial

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64
Q

which ligaments attach on the superior surface of the cuboid?

A

(5)

  • dorsal calcaneocuboid
  • dorsal cuneocuboid
  • dorsal cuboideonavicular
  • two dorsal cuboideometatarsals (one ligament to 4th; one to 5th)
  • lateral calcaneocuboid
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65
Q

the “beak” of cuboid

A
  • the coronoid process

- located on plantar surface where the medial and posterior borders meet

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66
Q

what structures are on the plantar surface of the cuboid?

A
  • peroneal sulcus
  • peroneal ridge
  • both sulcus and ridge course obliquely from posterolateral to anteromedial
  • peroneal sulcus lies distal to the peroneal ridge
  • tendon of peroneus longus lies either in the peroneal groove or against the anterior aspect of the peroneal ridge
  • deep fibers of the long plantar ligament attach to the peroneal ridge
  • superficial fibers of the long plantar ligament course over the tendon of peroneus longus
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67
Q

what forms an osseofibrous canal for the tendon of the peoneus longus?

A
  • long plantar ligament and cuboid form an osseofibrous canal for the tendon of the peroneus longus
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68
Q

what structures are attached to the plantar surface of the cuboid?

A

(7)

  • long plantar ligament
  • short plantar ligament
  • plantar cuboideonavicular ligament
  • tibialis posterior
  • flexor hallucis brevis
  • plantar cuneocuboid ligament
  • two plantar cuboideometatarsals ligaments (one to 4th, one to 5th)
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69
Q

the peroneal ridge on cuboid terminates laterally as..

A

cuboid tuberosity

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70
Q

the cuboid tuberosity has an ______ facet

A
  • oval

- over which there is a sesamoid bone (os peroneum) in tendon of peroneus longus

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71
Q

located at the plantar edge of the lateral surface of cuboid

A

peroneal notch

- this notch marks the beginning of the peroneal sulcus

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72
Q

shape of the medial surface of cuboid

A

quadrilateral

  • has a triangular facet for lateral cuneiform at the dorsal, middle portion
  • can sometimes also be small facet for navicular
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73
Q

3 ligaments attached to medial surface of cuboid

A
  • interosseous cuboideonavicular
  • itneroseous cuneocuboid
  • calcaneocuboid portion of the bifurcated ligament
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74
Q

the posterior surface of the cuboid has a _____ shape facet for calcaneus

A

triangular

  • saddle-shaped
  • concave transversely and convex vertically
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75
Q

the anterior surface of the cuboid has a vertical ridge that separates two facets. Describe the shape of the medial and lateral facet.

A
  • medial facet is quadrilateral in shape and is for articulation with base of 4th metatarsal
  • lateral facet is triangular with apex directed laterally for articulation with 5th metatarsal
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76
Q

navicular is latin for …

A

navy

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77
Q

formerly known as scaphoid

A

navicular

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78
Q

describe shape of navicular

A
  • boat shaped
  • concave proximally and convex distally
  • articulates with talus, three cuneifroms and cuboid, rarely with calcaneus
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79
Q

the dorsal surface of the navicular is _________ and oriented ______.

A

convex; superomedially

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80
Q

what ligaments attach to dorsal surface of navicular?

A

(5)

  • three dorsal cuneonaviculars
  • dorsal cuboideonavicular
  • dorsal talonavicular
  • calcaneonavicular portion of the bifurcated ligament
  • tibionavicular portion of the deltoid ligament
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81
Q

what separates the navicular tuberosity from the plantar surface?

A

groove for tendon of tibialis posterior

- groove is for continuation of the tendon of tibialis posterior beyond its attachment to the tuberosity

82
Q

the ligaments attached to the plantar surface of the navicular bone are:

A

(3)

  • spring ligament (plantar calcaneonavicular)
  • plantar cuboideonavicular ligament
  • three plantar cuneonavicualr ligaments (one to each cuneiform)
83
Q

what attaches to the lateral edge/surface of the navicular?

A
  • lateral calcaneonavicular portion of the bifurcated ligament (also attaches dorsally)
  • cuboideonavicular ligament
84
Q

what attaches to the medial tuberosity on the navicular?

A
  • tibialis posterior (may have os tibiale externum accessory bone)
  • medial cuneonavicular ligament (attaches to medial cuneiform)
85
Q

the anterior surface of the navicular is _______ from side to side

A

convex

86
Q

describe teh facets on the anterior surface of the navicular.

A
  • large articular facet subdivided by tow vertical crests into 3 articular area
  • medial (largest) pear-shaped, triangular or quadrilateral in shape
  • middle and lateral are triangular
  • each facet articulates with appropriate cuneiform
87
Q

the posterior surface of the navicular is ______

A

concave

- contains a large oval/tear-shaped facet for articulation with head of talus

88
Q

cuneiform is latin for …

A

wedge

89
Q

smallest and most typical cuneiform

A

intermediate cuneiform

90
Q

the _____ surface of the medial cuneiform is its base.

A

plantar

91
Q

what tendons have partial insertion to the plantar surface of medial cuneiform

A
  • tibialis anterior
  • tibialis posterior
  • peroneus longus
92
Q

several ligaments attach to the plantar surface of the medial cuneiform. what are they?

A

(4)

  • plantar cuneonavicular
  • plantar intercuneiform
  • plantar cuneometatarsal (to first met)
  • plantar cuneometatarsal (to second met)
93
Q

medial surface of medial cuneiform has a ___ shape

A

quadrialteral

94
Q

why is the facet on anteroinferior aspect of medial cuneiform unique?

A
  • does not articulate with another tarsal bone but has small facet near its anteroinferior aspect
  • small bursa lies between this facet and a sesamoid bone within the tendon of tibialis anterior
95
Q

what ligaments attach to the medial surface of the medial cuneiform

A

(5)

  • medial cuneonavicular
  • dorsal cuneonavicular
  • dorsal intercuneiform
  • dorsal cuneometatarsal (to first met)
  • dorsal cuneometatarsal (to 2nd met)
96
Q

the lateral surface of the medial cuneiform is _____ and has __ facets

A
  • concave
  • two
  • small oval facet foudn anteriorly for the bas eof the second metatarsal
  • facet for intermeidate cuneiform has teh shape of an inverted L
  • horizontal part of L is superior and the vertical part is posterior
97
Q

what two ligaments attach to the lateral surface of the medial cuneiform

A
  • lisfranc’s ligament (interosseous tarsometatrsal ligament attached to lateral surface of medial cuneiform and second met)
  • interosseous intercuneiform ligament to intermediate cuneiform
98
Q

what is the shape of the anterior surface of the medial cuneiform>

A

kidney shaped/ reniform surface

- this surface articulates with base of the first metatarsal

99
Q

the posterior surface of the medial cuneiform is _______ and articulates with the navicular.

A
  • concave

- can be triangular, pear-shaped or quadrilateral

100
Q

what is the shape of the dorsal surface of the intermediate cuneiform?

A
  • quadrilateral or square

- the dorsal surface forms the base of the cuneiform and it sough

101
Q

there is a ligament to each of the 4 bones that articulate with the intermediate cuneiform. The ligaments are:

A
  • dorsal cuneonavicular
  • two dorsal intercuneiform
  • dorsal cuneometatarsal
102
Q

the ____ surface of the intermediate cuneiform is the the apex of wedge.

A
  • plantar

- thin, crest-like surface

103
Q

what ligaments attach to the plantar surface of the intermediate cuneiform?

A
  • plantar cuneonavicular

- two plantar intercuneiforms

104
Q

The anterior surface of the intermediate cuneiform has a ________ facet for its articulation with the ________ metatarsal.

A
  • triangular

- second metatarsal

105
Q

The posterior surface of the intermediate cuneiform has _______ facet for its articulation with the ______.

A
  • triangular

- navicular

106
Q

The ________ surface of the intermediate cuneiform has a articular facet shaped like an inverted L.

A
  • medial
  • the horizontal part is superior and the vertical part is posterior
  • non-articular area is for an interosseous intercuneiform ligament with the medial cuneiform
107
Q

The lateral surface of the intermediate cuneiform has both an articular area and a nonarticular area. The articular facet is smooth and has the shape of ______. The nonarticular area is for attachment of _______.

A
  • elongated oval, elongated in vertical direction

- interoseous intercuneiform ligament to the lateral cuneiform

108
Q

the dorsal surface of the lateral cuneiform is _______ in shape. what ligaments attach here?

A
  • rectangular
  • (4)
  • dorsal cuneocuboid
  • dorsal cuneonavicular
  • dorsal intercuneiform
  • two dorsal cuneometatarsal ligaments
109
Q

the ___ surface of the lateral cuneiform is the apex of the wedge. What muscles attach to this surface? What ligaments attach to this surface?

A
  • plantar
  • muscles: flexor hallucis brevis and tibialis posterior
  • ligaments: plantar cuneocuboid, plantar cuneonavicular, plantar intercuneiform, plantar cuneometatarsal
110
Q

the anterior surface of the lateral cuneiform has a ______ facet for articulation with the base of the ____ metatarsal.

A
  • triangular

- third

111
Q

The posterior surface of the lateral cuneiform is ____. It articulates with the ______.

A
  • triangular

- navicular

112
Q

the medial surface of the lateral cuneiform is ____ in shape. Posteriorly, there is a _____ facet for articulation with the _______ cuneiform. Anteriorly, there are _________ demarcates for articulation with the second metatarsal.

A
  • rectangular
  • vetically orientated oval facet
  • intermediate
  • two oval demarcates
113
Q

the only ligament attached to the medial surface of the lateral cuneiform is _______

A

interosseous intercuneiform

114
Q

the lateral surface of the lateral cuneiform is ______ with ___ facets.

A
  • rectangular
  • two facets
  • larger more posteriorly facet is triangular and for articulation with cuboid
  • smaller more anterior is oval for articulation with fourth metatarsal
115
Q

the only ligament attached to the lateral surface of the lateral cuneiform is the …

A

interosseous cuneocuboid

116
Q

the proximal extremity of the metatarsal is the _____ and the distal extremity is the ______

A
  • base

- head

117
Q

the bases of the metatarsal bone articulate with ________ and the bases of the lesser metatarsal also articulate with _______

A
  • distal row of tarsal bones

- with each other

118
Q

the shafts of the metatarsal have longitudinal curve that is _____ dorsally and ______ plantarly

A
  • convex

- concave

119
Q

the heads of the metatarsal are convex. The _____ surface of each head extends back proximally further than does the _____ surface.

A
  • proximally; dorsal
120
Q

what ligament is attached tot he heads of all five metatarsal bones?

A

deep transverse metatarsal ligament

121
Q

shortest metatarsal

A
  • first

- also thickest, heaviest and strongest

122
Q

the posterior surface of the base of the first met has a ________ facet for its articulation with the medial cuneiform

A
  • concave, reniform (kidney-shaped) facet
123
Q

how many surfaces does the base of the first metatarsal have?

A
  • inferior, medial and lateral (ellen: and posterior?)

- base is somewhat triangular

124
Q

what two tendons attach to the base of the first met?

A
  • tibialis anterior attaches to the medial surface of the base
  • peroneus longus attaches to the lateral surface of the base
  • these tendons attach inferiorly near the plantar surface
125
Q

what two ligaments attach to the base of the first met>

A
  • dorsal and plantar cuneometatarsal ligaments

- these attache to medial and inferior surfaces respectively

126
Q

the ___________ muscle is attached to the lateral surface of the shaft of first met.

A
  • medial head of the first dorsal interosseous muscle

- shaft has three surfaces: lateral, inferior, and dorsomedial

127
Q

on the plantar surface of the first met, the two facets for the medial and lateral sesamoid bones are separated by a small ridge of bone, ___

A
  • the median crista
128
Q

the ______ diameter of the head of the first met is greater than the ________ diameter. For the other four mets, the _______ diameter is greater than the transverse.

A
  • transverse; vertical

- vertical; transverse

129
Q

how is the second met unique compared to other mets?

A
  • longest of mets
  • extends more proximally
  • articulates proximally with all three cuneiforms
130
Q

base of the second met is ______ shaped. The borders are _____.

A
  • wedge-shaped or pyramidal with apex directed plantarly

- borders are dorsal, lateral, and medial

131
Q

The posterior surface of the second met base has a ____ facet for its articulation with intermediate cuneiform.

The medial surface of the base of the second met has a _______ facet for its articulation with the medial cueniform.

The lateral surface of the base has ____ facets for articulation with ________.

A
  • triangular
  • small, oval (occasionally a second small oval facet, located anterior and inferior to the facet for the medial cuneiform is present - it is a pressure facet for first met and forms from contact between the bones. )
  • two facets, one dorsal and one plantar. a ridge of bone separates each facet into demarcates.
  • the two anterior demarcates are for the third met. the two posterior demarcates are for the lateral cuneiform
132
Q

Four ligaments attach to the dorsal surface of the base of the second met:

A
  • dorsal intermetatarsal ligament to third met

- three dorsal cuneometatarsal ligaments, one for each cuneiform

133
Q

what structures attach to the plantar surface of the base of the second met:

A
  • long plantar ligament
  • tibialis posterior
  • plantar cuneometatarsal ligament
  • plantar intermetatarsal ligament
  • adductor hallucis (oblique head)
134
Q

two ligaments attach to the lateral surface of the base of the second met:

A
  • interosseous intermetatarsal

- interosseous cuneometatarsal

135
Q

what attaches to the medial surface of the base of the second met?

A

lisfranc’s ligament

136
Q

the shaft of the second met gives rise to what muscles ?

A
  • lateral head of first dorsal interosseous (from medial surface)
  • medial head of second dorsal itnerosseous (from lateral surface)
137
Q

the shafts of the second, third and fourth mets have how many surfaces?

A

3

  • dorsal
  • lateral
  • medial

in cross section the shaft of a metatarsal would appear triangular in shape

138
Q

the articular surface of the second met head diverges into medial and lateral condyles. what structure passes between these condyles?

A

flexor tendons

139
Q

where are the articular surfaces on the base of the third met?

A
  • one on posterior surface
  • one on the lateral surface
  • two on the medial surface
140
Q

the posterior surface of the base of third met has a _______ facet for the lateral cuneiform. the lateral surface of the base has a ________ facet for the fourth met. Just inferior to this facet, there is a distinctive ____________ characteristic of the bone.

A
  • triangular
  • small, oval
  • groove for the interosseous intermetatarsal ligament
141
Q

the medial surface of the base of the third met has _____ demarcates for articulation with ________. What attaches to the medial surface?

A
  • two, one dorsal and one plantar
  • second metatarsal
  • interosseous intermetatarsal ligament
142
Q

what three ligaments attach to the dorsal surface of the base of the third met?

A
  • two dorsal intermetatarsal ligaments

- dorsal cuneometatarsal ligament

143
Q

what structures attach to the crest of the base of the third met?

A

(6)

  • oblique head of adductor hallucis
  • tibialis posterior
  • long plantar ligament
  • plantar cuneometatarsal ligament
  • two plantar intermetatarsal ligaments
144
Q

how many muscles originate from the shaft of the third met?

A
  • lateral head of second dorsal interosseous
  • medial head of third dorsal interosseous
  • first plantar interosseous
145
Q

The posterior surface of the base of the fourth met has a _________ facet for its articulation with the ________.

The medial surface of the base of the fourth met has an _____ facet for its articulation with _______.

A
  • quadrilateral; cuboid

- oval, divided by a ridge; anterior articulates with third met and posterior articulates with lateral cuneiform

146
Q

what ligaments attach to the dorsal surface of the base of the 4th met?

A
  • two dorsal intermetatarsal

- dorsal cuboideometatarsals

147
Q

like the second and third met, the plantar surface of the base of the fourth met serves as origin for the _________.

A

oblique head of adductor hallucis

148
Q

what structures attach tot he plantar surface of the fourth met?

A
  • oblique head of adductor hallucis
  • tibialis posterior
  • long plantar ligamnet
  • plantar cuboideometatarsal ligament
  • two plantar intermetatarsal ligaments
149
Q

the lateral surface of the base of the 4th met has a _______ facet for ________.

A
  • large, triangular or oval
  • fifth metatarsal
  • an interosseous intermetatarsal ligament is attached to this surface
150
Q

the shaft of the fourth metatarsals serves as origin for what muscles?

A
  • lateral head of third dorsal interosseous
  • medial head of fourth dorsal interoseous
  • second plantar interosseous
151
Q

the apex of the 5ht met points _________.

A
  • plantarly and laterally

- known as the styloid process of the fifth

152
Q

the base of the 5th met is _______ in shape

A

triangular or pyramidal

153
Q

The posterior surface of the base of the 5th met has a _____ facet for the _______.
The medial surface has a ____ facet for the 4th met.

A
  • triangular; cuboid

- triangular or oval; fourth met

154
Q

primary feature of the lateral surface of the base of the 5th met

A

tuberosity of the 5th met

155
Q

what inserts onto the tuberosity of the 5th met?

A
  • peroneus brevis

- peroneus tertius inserts onto the dorsal surface of the base and the dorsal surface of the shaft of the 5th met

156
Q

what attaches to the medial surface of the 5th met?

A

an interosseous intermetatarsal ligament

157
Q

what structures attach to the dorsal surface of the base of 5th met?

A
  • peroneus tertius
  • dorsal cuboideometatarsals ligament
  • dorsal intermetatarsal ligament
158
Q

the plantar surface of the base of the 5th met is grooved by ______

A

tendon of abductor digiti quinti

159
Q

_________ takes partial origin from the surface of the base of the 5th met.

A

flexor digiti quint

160
Q

at times, an accessory muslce called abductor os metatarsi digit minimi also inserts ___________.

A

plantar surface of the base of the fifth metatarsal

161
Q

a thickening in the planatar aponerosis called the ______ ligament, attaches to the plantar surface of the base of the 5th met.

A

calcaneometatarsal ligament (plantar ligament of the sole

162
Q

what structures attach to the plantar surface of the base of the 5th met?

A
  • flexor digiti quinti brevis
  • plantar ligament of the sole
  • plantar cuboideometatarsals ligament
  • plantar intermetatarsal ligament
163
Q

the shaft of the 5th metatarsal serves as origin for what muscles?

A
  • lateral head of the fourth dorsal interoseous

- third plantar interosseous

164
Q

the shaft of the 5th met has a different orientation than those of the 2nd-4th. The surfaces are:

A

dorsal, medial, and inferior

165
Q

the large toe has __ phalanges. The lesser toes has ____ phalanges per toe.

A
  • two: proximal and distal

- three: proximal, middle and distal

166
Q

the proximal phalanx has a large base directed _______.

A

transversley

167
Q

oval, concave articular surface on great toe =

A

glenoid cavity

- glenoid cavity is smaller than the head of the metatarsal which articulates with it

168
Q

there is a transverse crest on the ______ surface of the proximal phalanx of great toe close to its base. What inserts on this crest?

A
  • transverse

- extensor hallucis brevis

169
Q

On the plantar surface of the proximal phalanx of great does, there are ____ tubercle near the base.

A
  • two
  • medial plantar tubercle is large; attached to it are teh medial head of glexor hallucis brevis and abductor hallucis
  • attached to lateral plantar tubercle are the lateral head of gleoxr hallucis brevis and sdductor hallucis
170
Q

the shaft of the proximal phalanx of the great toe is ______ plantarly. It is slightly grooved at each end by the ___________. The shaft of the proximal phalanx is _______ dorsally.

A
  • concave
  • tendon of flexor hallucis longus
  • convex
171
Q

Describe the head of the proximal phalanx of the great toe.

A
  • flat vertically

- articular surface trochlear; large and extends more plantarly than dorsally

172
Q

the distal phalanx of the great toe has ______ oriented base.

A
  • large, transversely oriented
173
Q

the distal phalanx of the great toe does not line up with the proximal phalanx on the same plane. How much does it deviate?

A

deviates laterally by 15 degrees

174
Q

on the dorsal surface of the distal phalanx of great toe, ___________ attaches to a tuberosity near the base.

However, on the plantar surface, ______________ attaches to an obliquely directed ridge which courses along the entire plantar surface.

A
  • extensor hallucis longus

- flexor hallucis longus

175
Q

true or false: the proximal phalanges of the lesser toes are longer than the middle and distal phalanges combined.

A

true

176
Q

the bases of the lesser toes have _______ facets for the metatarsal heads

A

oval

177
Q

each proximal phalanx has ____ plantar tubercels

A
  • two, one medial one lateral
178
Q

For toes three through five, the ___________ tuebrcle is for plantar interosei.

A
  • medial plantar tubercle
  • Both tubercles of toe two and the lateral tubercles for toes 3 and 4 are for dorsal interossei.
  • lateral tubercle of the fifth toe is for abductor digiit quinti and flexor digiti quinit (brevis)
179
Q

what attaches to the lateral tubercle of the fifth toe?

A

abductor digiti quinit and flexor digiti quinit (brevis)

180
Q

what are the two most constant sesamoid bones of the foot?

A
  • medial (tibial) and lateral (fibular) bones within the tnedons of flexor hallucis brevis
  • located at the first metatarsophalangeal joint
  • medial sesamoid bone is usually larger than the lateral
181
Q

Name the bone located within the tendon of the tibialis anterior as it crosses the smooth facet on the medial cuneiform.

A
  • no special name

- almost always present

182
Q

sesamoid bone located within the tendon of peroneus longus as it crosses the cuboid

A

os peroneum

183
Q

List of other sesamoid bones in order of decreasing frequency.

A
  1. w/i tendon of flexor digitorum brevis to the second toe, at the MPJ
  2. w/i tendon of flexor digitorum brevis to the fifth toe, at the MPJ
  3. w/i tendon of tibialis posterior, beneath the navicular
  4. w/i tendon of flexor digitorum brevis to third toe, at MPJ
  5. w/i tendon of flexor digitorum brevis to fourth toe at the MPJ
  6. w/i tendon of flexor hallucis longus at the IPJ
  7. w/i tendon of flexor digitorum longus at the proximal interphalangeal joints (freq 2,5,3,4)
  8. w/i any of follwing tendons as they cross malleoli: tibailis posterior, flexor digitorum longus, flexor hallucis longus, peroneus longus, perneus brevis
184
Q

name the most common accessory bones

A

os trigonum
os tibiale
os intermetatarseum

each of these bones is found in about 10% of the population

185
Q

accessory bone associated with the lateral tubercle of the posterior process of the talus

A

os trigonum

186
Q

accessory bone found when the secondary ossification center in the navicular tuberosity fails to fuse with the rest of the navicular

A

os tibiale externum

187
Q

accessory bone located between the emdial cuneiform and th abses of the first and second metatarsals

A

os intermetatarseum

188
Q

accessory bone associated with the lateral cuneiform

A

os uncinatum

189
Q

accessory bone associated with the tuberosity of the fifth metatarsal

A

os vesalinum (vesalius’ bone)

190
Q

what tarsal bone has more than one ossification center?

A
  • calcaneus has an epiphysis in the posterior extremity as well as a primary ossification center
  • all other tarsal have a single center
191
Q

what is the sequence of ossification in the foot bones? (when begin ossification)

A
  1. metatarsals and phalanges: 9-12 wks in utero
  2. calcaneus: months 4-7 in utero
  3. talus: month 6 in utero
  4. cuboid: birth
  5. lateral cuneiform: during year 1
  6. medial cuneiform: during year 2
  7. intermediate cuneifrom: during year 3
  8. navicular: during year 3 - last tarsal to begin ossification
  9. sesamoids: each has its own ossification center
192
Q

last tarsal bone to begin ossificiation

A

navicualr

193
Q

each metatarsal bone has __ ossification centers.

A
  • two
  • diaphysis in the shaft (appears during fetus)
  • first met: epiphysis at base (appears during year 3)
  • mets 2-5: epiphysis at the head (appears during years 5-8)
194
Q

each phalanx has _____ ossification centers

A
  • two
  • a diaphysis in the shaft
  • epiphysis at base
195
Q

what are the bones of the medial arch?

A

fist three metatarsals
all three cuneiforms
navicular
calcaneus talus

196
Q

what is the keystone of the medial arch

A

talus

197
Q

what are the bones of the lateral arch

A

mets 4 and 5
cuboid
calcaneus
talus

198
Q

what is the keystone of the lateral arch

A

cuboid

“although all the weight is transferred only via the talus, the cuboid is considered the keystone of this arch”

199
Q

where is the transverse arch of the foot located?

A

tarsometatarsal junction

200
Q

what bones form the transverse arch?

A

four tarsal bones of the distal row ( cuboid, 3 cuneiforms)

all five metatarsal bones

APMLE LEA (23 decks)

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