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Musculoskeletal System > Session 12 - The ankle > Flashcards

Session 12 - The ankle Flashcards

1
Q

What makes the ankle joint unstable?

A
  • Centre of gravity passes just in front

- Gravitational pull makes it unstable

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2
Q

What are the two main types of injuries which occur at the ankle?

A
  • Sprains

- Fracture

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3
Q

Why are the tendons of the foot susceptible to bow-stringing during movement? What prevents this?

A
  • The change in direction from the leg to the foot

- Flexor and extensor retinaculum (Crural fascia)

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4
Q

How is the ankle designed to support body weight?

A
  • Broad base
  • Robust
  • Stable when weight-bearing
  • Absorbs shock
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5
Q

How is the ankle designed to allow locomotion?

A
  • Loose to permit displacement of joint for walking (opposes robust)
  • Stable when moving
  • Light weight
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6
Q

What 3 bones make the ankle joint?

A
  • Tibia
  • Fibula
  • Talus
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7
Q

What articulations are made in the ankle joint?

A
  • Superior between tibia and talus
  • Medial between medial malleolus and talus
  • Lateral between lateral malleolus and talus
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8
Q

Where do the long and short saphenous veins run in relation to malleoli?

A
  • Long runs anteriorly to medial malleolus

- Short runs posteriorly to lateral malleolus

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9
Q

What ligaments support the distal tibio-fibular syndesmosis?

A

-Anterior and posterior tiobiofibular ligaments

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10
Q

What are the main functions of the ankle?

A
  • Transfer weight to the foot and bears all the body weight

- Integral to locomotion

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11
Q

What deepens the articulating surfaces of the ankle joint?

A

-Posterior tiobiofibular ligament

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12
Q

What type of joint is the ankle joint?

A

-Synovial hinge joint

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13
Q

What is the classical name for a synovial hinge joint?

A

-Ginglymus

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14
Q

Why is the ankle described as a mortise and tenon joint?

A
  • Distally the tibia and fibular form a concavity/box called a mortise
  • The talus inserts into the concavity and is the tenon
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15
Q

Why is the hinge-joint of the ankle different from other hinge joints?

A

-It is a rolling hinge joint as the superior surface of talus is rounded and allows axis rotation of the hinge, changing during dorsiflexion and plantar flexion

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16
Q

What bones make the ankle proper? What other bones are a pssibility of being involved in the ankle joint?

A
  • Tibia, fibular and talus

- Calcaneous

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17
Q

What are the stabilising features of the ankle joint proper?

A
  • Malleioli
  • Posterior tibiofibular ligament
  • Transverse tibiofibular ligament
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18
Q

Which bones in the ankle are weightbearing?

A

-Talus and tibia

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19
Q

What are the three arches present in the foot?

A
  • Medial longitudinal arch
  • Lateral longitudinal arch
  • Transverse arch
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20
Q

What makes the medial longitudinal arch?

A
  • Calcaneous
  • Talus
  • Navicular
  • 3 cuniforms
  • 1st, 2nd and 3rd metatarsals
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21
Q

What makes the lateral longitudinal arch?

A
  • Calcaneous
  • Cuboid
  • 4th and 5th metatarsals
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22
Q

What forms the transverse arch?

A

-Articulations between tarsals and metatarsals

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23
Q

What type of bones are the tarsals of the foot?

A

-Short bones

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24
Q

How many surfaces does each tarsal bone have?

A

-6

25
Q

What type of attachments does talus have?

A

-Ligamentous only

26
Q

In what direction is the long axis of talus lie?

A

-Antero-medial plane (oblique)

27
Q

Describe the superior surface of talus

A

-Rounded with convex medial and lateral edges and the central being concave

28
Q

What is another name for the superior surface of talus?

A

-Trochlear

29
Q

What is the main difference between the anterior and posterior surfaces of talus?

A

-Anterior is wider than posterior

30
Q

What bones does talus articulate with?

A

-Tibia, fibular and calcaneous

31
Q

What is the subtalar joint?

A

-The talo-calcaneal joint between talus and calcaneous

32
Q

What typf of joint is the subtalar joint?

A

-Uniaxial hinge joint

33
Q

What are the articulations between talus and calcaneous?

A
  • One anteriorly between a convex area of talus and a concave area of calcaneous
  • One posteriorly between the concave surface of talus and convex surface of calcaneous
34
Q

What is the tarsal canal?

A

-A deep groove which rune between the two articulations of the subtalar joint (also called sinus tarsi)

35
Q

What type of movement does ankle proper allow?

A

-Plantarflexion and dorsiflexion

36
Q

What type of movement does the subtalar joint allow?

A

-Inversion and eversion (Side to side motion of foot)

37
Q

What is the purpose of inversion and eversion?

A

-Allow walking on uneven ground

38
Q

What are the normal degrees of inversion and eversion?

A
  • Inversion = 30

- Eversion = 15

39
Q

What is dorsiflexion?

A

-Narrowing of the angle between the anterior surface of the leg and the dorsal surface of the foot

40
Q

What is plantarflexion?

A

-Widening of the angle between the anterior surface of the leg and the dorsal surface of the foot

41
Q

What happens to the articulations of ankle proper on dorsiflexion?

A

-Broad anterior portion of talus occupies and almost completely fills the mortise

42
Q

Why id dorsiflexion more stable than plantar flexion?

A

-Wide anterior portion fits tightly with the tibio-fibular syndesmosis contributing stability in extreme dorsiflexion

43
Q

What happens to the articulations of ankle proper in plantar flexion?

A

-Narrow posterior segment of talus occupies mortise

44
Q

Why is there some adduction and abduction in plantarflexion and not dorsiflexion?

A

-On plantarflexion, narrow talus in mortise allows some rotational movement

45
Q

When is the ankle proper least stable?

A

-Plantarflexion

46
Q

What nerve and corresponding roots enables dorsiflexion?

A

-Deep fibular nerve from roots L4-S3 (sciatic)

47
Q

What muscles are responsible for dorsiflexion?

A
  • Tibilis anterior
  • Extensor digitorum longus
  • Extensor hallucis longus
48
Q

What nerve and roots allows plantarflexion?

A
  • Tibial division of sciatic nerve

- L4-S3 (sciatic)

49
Q

What muscles are responsible for plantarflexion?

A

-Triceps surae (gastronemius and soleus)

Assisted by tibialis posterior, flexor hallucis longus and flexor digitorum longus

50
Q

Describe the medial ligament of the ankle

A
  • Also known as deltoid ligament
  • Strongest ankle ligament which re-enforces medial malleolus
  • Fan-shape, combined by 4 segments running inferiorly from medial malleolus
  • Has superficial and deep fibres
51
Q

Describe the superficial fibres of the medial ligament

A
  • Anterior tibia-navicular ligament
  • Middle calcaneo-tibial ligament
  • Posterior talo-tibial ligament
52
Q

Describe the deep fibres of the medial ankle ligament

A

-Anterior talo-tibial ligament

medial malleolus to medial talus

53
Q

What tendons cross the medial ankle ligament?

A
  • Tibialis posterior

- Flexor digitorum longus

54
Q

Describe the lateral ankle ligament

A
  • 3 separate bands radiating from lateral malleolus
  • Anterior and posterior attach to talus
  • Intermediate pass to calcaneus
55
Q

Name the ligaments of the ankle joint

A
  • Medial ligament (deltoid)
  • Lateral ligament
  • Syndesmosis
56
Q

Which bones are normally involved in a fractures ankle?

A

-Malleoli

57
Q

Why is it rare to break the ankle only on one side?

A

-The ankle joint forms a ring of bones and ligaments;
medial malleolus to talus via deltiod
talus to lateral malleolus via lateral ligament
fibula to tibia via syndesmosis
-So injuries commonly effect both the lateral and medial aspects of the joint

58
Q

What is potts fracture?

A

-A term applied loosely to a variety of bimalleolar ankle fractures

59
Q

What causes potts fracture?

A
  • Excessive eversion results in combined ABduction an lateral rotation which pulls on the strong medial ligament tearing off the medial malleolus
  • Talus then moves laterally and shears off the lateral malleolus and more commonly the tibio-fibular syndesmosis

Musculoskeletal System (34 decks)

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