MSK - Foot and Ankle

Question 1

Which two muscles of the ‘leg’ (lower part of lower limb) can also flex at the knee? Why?

Answer 1

Gastrocnemius
Plantaris

Both originate above the knee on the femur

Question 2

What does the tibial and common peroneal branches of the sciatic nerve innervate?

Answer 2

Tibial - posterior

Common peroneal - lateral and anterior

Question 3

At which point is the common peroneal nerve most susceptible to injury? What clinical sign would you see with injury here?

Answer 3

At the top of the fibula - as it winds round the neck here. So any fracture here it can damage.

Supplies anterior and lateral compartments so get foot drop.

Question 4

What are the three superficial muscles of the posterior leg and where do they all insert into?

Answer 4

Gastrocnemius
Soles
Plantaris
all merge to calcaneon tendon

Question 5

What is the primary function of the soleus muscle?

Answer 5

Plantar flex at the ankle joint

Question 6

What is the role of the popliteus muscle?

Answer 6

To laterally rotate the femur on the tibia unlocking the knee so flexion can occur

Question 7

What are the 4 deep muscles of the posterior leg.

Answer 7

Popliteus
Flexor Hallucis longus
Flexor digitorum longus
Tibialis posterior

Question 8

You would think the flexor hallucis longus is medial due to the location of the great toe but it isn’t - where is it?

Answer 8

It is lateral to the tibialis posterior (middle) and flexor digitorum longus (medial)

Question 9

The common peroneal nerve splits into the superficial and the deep - which of these supplies the lateral compartment and which supplies the anterior compartment of the leg?

Answer 9

The superficial - lateral compartment

The deep - anterior compartment

Question 10

What do the fibularis longus and brevis do? What compartment are they in?

Answer 10

Eversion

Lateral compartment

Question 11

What does the tibilis anterior do?

Answer 11

Dorsiflexion and inversion of the foot

Question 12

What does the extensor hallucis longus do?

Answer 12

Extension of the great toe and dorsiflexion of the foot

Question 13

What does the extensor digitorum longus do?

Answer 13

Extension of the lateral 4 toes and dorsiflexion of the foot

Question 14

Where is most likely to rupture on the achilles tendon and why?

Answer 14

6cm above the calcaneon is the watershed area, which is the area with the poorest blood supply so most likely to rupture

Question 15

What is planovulgus?

Answer 15

Flat foot

Question 16

What is talar shift?

Answer 16

Talus is not anatomically below the tibia - shifted - normally laterally - e.g. if medial malleolus is fractured

Question 17

What is the medical term for bunions?

Answer 17

Hallux Valgus

Question 18

What is arthritis of the big toe called?

Answer 18

Hallux Rigidus

Question 19

What is Charcot arthropathy? What is the term used to a really severe case?

Answer 19

From diabetes - neuropathy - leads to massive deformity and bone loss - rocker bottom foot is severe

Question 20

Describe the Thompsons test for achilles tendon rupture

Answer 20

On squeezing calf normal test should plantar flex foot

Positive test would be no plantar flexion