S5) The Ankle Flashcards

1
Q

What is the ankle joint?

A

The ankle joint (talocrural joint) is a hinge-type synovial joint located in the lower limb, formed by the bones of the leg and the foot – the tibia, fibula and talus

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2
Q

What is the mortise?

A
  • The mortise is the hyaline cartilage-covered socket formed by the binding of the tibia and fibula together by strong tibiofibular ligaments
  • The body of the talus fits snugly into the mortise
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3
Q

Describe the location and function of the medial ligament (deltoid ligament) of the malleolus

A
  • Location: attached to the medial malleolus and consists of 4 ligaments which fan out and attach to the talus, calcaneus and navicular bones
  • Function: resist over-eversion of the foot
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4
Q

Identify the different ligaments composing the medial ligament of the malleolus

A
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5
Q

Describe the location and function of the lateral ligament of the malleolus

A
  • Location: attached the lateral malleolus and consists of three ligaments which fan out and attach to the talus and calcaneus bones
  • Function: resists over-inversion of the foot
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6
Q

Identify the different ligaments composing the lateral ligament of the malleolus

A
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7
Q

Identify the possible movements of the ankle joint and the muscles involved

A
  • Plantarflexion – gastrocnemius, soleus, plantaris and posterior tibialis (posterior compartment of leg)
  • Dorsiflexion – tibialis anterior, extensor hallucis longus and extensor digitorum longus (anterior compartment of leg)
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8
Q

Describe the arterial supply of the ankle

A

Arterial supply via malleolar branches of the anterior tibial, posterior tibial and fibular arteries

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9
Q

Describe the innervation of the ankle joint

A

Innervation by tibial and deep fibular nerves

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10
Q

What is the subtalar joint?

A

The subtalar joint is a planar synovial joint formed from the articulation between two of the talus and calcaneus bones of the foot

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11
Q

Identify the articulating surfaces of the subtalar joint

A
  • Inferior surface of the body of the talus
  • Superior surface of the calcaneus
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12
Q

Identify the 3 ligaments which stabilise the subtalar joint

A
  • Posterior talocalcaneal ligament
  • Medial talocalcaneal ligament
  • Lateral talocalcaneal ligament
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13
Q

An additional ligament is also found in the subtalar joint – the interosseous talocalcaneal ligament.

Describe its location and function

A
  • Function: binds the talus and calcaneus together
  • Location: lies within the sinus tarsi (a small cavity between the talus and calcaneus)
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14
Q

Identify the possible movements of the subtalar joint and the muscles involved

A
  • Eversion — muscles of the lateral compartment of the leg
  • Inversion – tibialis anterior muscle respectively
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15
Q

Describe the arterial supply of the subtalar joint

A

Arterial supply via posterior tibial and fibular arteries

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16
Q

Describe the innervation of the subtalar joint

A
  • Plantar innervation – medial or lateral plantar nerve
  • Dorsal innervation – deep fibular nerve
17
Q

Identify the Ottawa Rules of when to X-ray an ankle fracture

A
  • Tenderness over the medial malleolus
  • Tenderness over the lateral malleolus
  • Tenderness over navicular
  • Tenderness over base of metatarsal
  • Inability to bear weight
18
Q

The ankle joint and the associated ligaments can be visualised as a ring in the coronal plane.

Identify and describe the borders of this ring

A
  • Upper part – formed by articular surfaces of tibia & fibula
  • Lower part – formed by subtalar joint
  • Sides – formed by medial and lateral ligaments
19
Q

In light of the ankle ring, discuss what is meant by stable and unstable ankle fractures

A
20
Q

What is an ankle sprain?

A
  • An ankle sprain is the partial/complete tear in the ligament of the ankle joint, occuring in a plantar-flexed weight bearing foot which is excessively inverted
  • The lateral ligament is damaged as its weaker and resists inversion
21
Q

What is a Pott’s Fracture-Dislocation?

A

A Pott’s fracture is a term used to describe a bimalleolar (medial & lateral malleoli) or trimalleolar (medial & lateral malleoli, distal tibia) fracture which occurs due to the force eversion of the foot