Other

Question 1

What are the functions of the foot/ankle

Answer 1

• Stable base of support
• Rigid lever for propulsion
• absorb shock of body weight
• Conform to irregular terrain
• sensation/balance/proprioception
• adjustments for line of gravity

Question 2

Describe the intermuscular septum and Compartments of the lower leg

Answer 2

3 intermuscular septums = bands of tough fibrous tissue (continous with deep fascia of lower leg and fascia latae of upper leg) separate the lower leg into compartments
- anterior separates ant. + lat.
- posterior separates lat. + post
- transverse separates deep post + superficial
+ interosseous membrane, and bones separate ant + post compartments

Ant: TA/EDL/EHL/PT
Lat: PB/PL
Sup post: Gastroc/soleus/plantaris
Deep post: TP/FDL/FHL/popliteus

Question 3

Describe the tarsal tunnel: contents and borders

Answer 3

Body space that lies on inner aspect of ankle; posterior and inferior to medial malleolus
Floor= tibia/talus/calcaneus
Borders = tibia and tendocalcaneus
Contents ant to post = TP/FDL/post tib artery/tib nerve/FHL
Roof = flexor retinaculum

Question 4

Describe the retinaculum of the ankle/foot

Answer 4

Retinaculum = fibrous bands of fascia (dense CT) that cover/bind other body tissues
> Flexor Retinaculum
- from medial malleolus to calcaneus
- keeps contents of tarsal tunnel in place during movement (TP, FDL, Post tib artery, tib nerve, FHB)
> Extensor retinaculum
- Superior: ant tib to ant fib (prox to malleoli)
- Inferior: lateral malleolus to medial malleolus and medial cuneiform (anterior to ankle joint)
- both keep TA, EDL, EHL, PT + ant tib artery + deep peroneal nerve in place during movement
> Fibular retinaculum
- Superior: lateral malleolus to lateral calcaneus
-Inferior: inferior extensor retinaculum to lateral calcaneus
- both keep PL/PB + bursa in place during movement

Question 5

Describe the tendon sheaths of the ankle

Answer 5

• Prevent friction between tendons + retinaculum
• membrane around tendon with fibrous and synovial layers to keep tendon moist
  > anterior tendon sheaths
• TA: superior to inferior retinaculum (tendon splits to 2)
• EDL + PT: malleoli to level of base of 5th MT
• EHL: inferior retinaculum to level of base of 1st MT
  > Posterior tendon sheaths
• TP: above medial malleolus to level of navicular tuberosity
• FDL: above medial malleolus to level of navicular
• FHL: medial malleolus to level of base of 1st MT
  > Lateral tendon sheaths
• PL+PB - single proximally, 2 sheaths distally
  - 4cm above + below lateral malleolus

Question 6

Name the arches of the foot and describe their function

Answer 6

Arches
- Medial longitudinal 
- Lateral longitudinal 
- Transverse 
Function
- Add weight bearing capability
- provide resilience
- shock absorbers (distributes weight)
- allow foot to adapt to different surfaces

Question 7

Describe the medial longitudinal arch (bones/ligaments/muscles)

Answer 7

> Bones
Calcaneus>Talus>Navicular>Med Cuneiform>1st MT
(Talus = keystone)
> Ligaments
- Deltoid ligament
- Spring ligament
- Short plantar ligament
- Long plantar ligament 
\+ Plantar aponeurosis
> Muscles
- Tibialis Anterior 
- Tibialis Posterior
- Flexor Hallucis Longus
\+ abductor hallucis & medial flexor digitorum brevis

Question 8

Describe the lateral longitudinal arch

bone/ligaments/muscles

Answer 8

> Bones
Calcaneus>Cuboid>5th MT (not as high as medial)
(Cuboid = keystone)
> Ligaments
- Long Plantar
- Short Plantar 
\+ Plantar aponeurosis
> Muscles
- Peroneus Longus
- Peroneus Brevis
- Peroneus Tertius 
- FDL (4th+5th toes)
\+ FDB (lateral half) + Abductor Digiti Minimi

Question 9

Describe the Transverse arch of the foot

Bones/ligaments/muscles

Answer 9

> Bones: Proximal: Cuneiforms>Cuboid 
           (keystone = intermediate cuneiform)
             Distal: 1st> 5th MT head
> Ligaments: 
Proximal: long plantar
              : deep transverse metatarsal ligaments
Distal: deep transverse metatarsal ligaments
>  Muscles
Proximal: Tibialis Anterior
              : Tibialis Posterior
              : Peroneus Longus
Distal: Adductor Hallucis

Question 10

Describe the Plantar aponeurosis + Fascia of the foot

Answer 10

Aponeurosis

• central thickening of plantar fascia
• tough band of connective tissue from calcaneal tuberosity to metatarsal heads
• covers plantar intrinsic muscles
• supports the longitudinal arches of the foot

Fascia of the foot

• continuous with crural fascia of leg + retinaculum around ankle
• covers extensor tendons on dorsum of foot
• Individual fascia covers toes and is continuous with that on dorsum/plantar aspect of foot

Question 11

Describe the extensor hood/dorsal digital expansion

Answer 11

• Compound attachment site for EDL/Lumbricals and interossei + EDB (toes 2-4)
• triangular aponeurotic sheet with base at MTP joint and wrapping around laterally, then apex at base of distal phalanx
• thickest centrally where EDL runs (collateral slips at PIP joint with thick margins before converging at apex)
• thick at borders where lumbricals, interossei & EDB tendons attach