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Musculoskeletal System > Session 5 - Foot And Ankle > Flashcards

Session 5 - Foot And Ankle Flashcards

1
Q

What are the 3 groups of bones of the foot?

A

Tarsal bones
Metatarsals
Phalanges

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2
Q

What are tarsal bones?

A

Set of 7 irregularly shaped bones situated proximally in foot

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3
Q

What are metatarsals?

A

Five metatarsals connecting the phalanges to the tarsal bones

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4
Q

What are phalanges?

A

Bones of the toes

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5
Q

How many phalanges does each toe have?

A

Each toe has 3 except big toe which has 2

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6
Q

What are 3 regions can the foot be divided into?

A

Hind foot
Mid foot
Forefoot

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7
Q

What are the 2 bones that the hind foot is made up of?

A

Talus and calcaneus

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8
Q

What are the 3 bones that midfoot is made up of?

A

Navicular
Cuboid
Cuneiform

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9
Q

What are 2 bones that the forefoot is made up of?

A

Metatarsals

Phalanges

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10
Q

What is the function of the talus?

A

Transmits weight of body from tibia to calcaneus

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11
Q

What are the 3 articulations of the talus?

A

Ankle joint
Subtalar joint
Talonavicular joint

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12
Q

Why is there a high risk of avascular necrosis if talus is fractured?

A

Lack of muscle attachments and retrograde blood supply

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13
Q

What are the 2 articulations of the calcaneus?

A

Subtalar joint

Calcaneocuboid joint

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14
Q

What is the function of the calcaneus?

A

Take full weight of the body when heel contacts the ground when walking

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15
Q

What is the function of the calcaneal tuberosity?

A

Achilles tendon attaches

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16
Q

What are the 2 bones of the proximal row of tarsal bones?

A

Calcaneus

Talus

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17
Q

What is the bone in intermediate row of tarsal bones?

A

Navicular

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18
Q

What are the 4 tarsal bones in the distal row?

A

Cuboid

Lateral, intermediate and medial cuneiforms

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19
Q

What is the shape of cuneiforms?

A

Wedge shaped

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20
Q

What are the 3 muscles that insert onto the medial cuneiform?

A

Tibialis anterior
Tibialis posterior
Peroneus longus

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21
Q

What are tarsometatarsal joints?

A

Joint between metatarsal bones and tarsal bones

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22
Q

What are intermetatarsal joints?

A

Joints between metatarsals and adjacent metatarsals

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23
Q

What are metatarsophalangeal joints?

A

Joints between metatarsal head and proximal phalanx

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24
Q

What kind of joint is the ankle joint?

A

Hinge

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25
Q

What are the movements that are permitted by ankle joint?

A

Doris flexion

Plantarflexion

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26
Q

What fits into the ankle mortise?

A

Trochlea of the talus

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27
Q

What are the 3 parts of the lateral ligament?

A

Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament

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28
Q

What does the lateral ligament resist?

A

Inversion

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29
Q

What is another name for the medial ligaments?

A

Deltoid

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30
Q

What is the function of the medial ligament?

A

Resists excessive eversion

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31
Q

What is the functional significance of inversion and eversion?

A

Allow walking on uneven surfaces

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32
Q

What is the function of the subtalar joint?

A

Where eversion and inversion takes place

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33
Q

What are the main weight bearing bones during standing?

A

Heel

Head of metatarsals

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34
Q

What are the 3 arches of the foot?

A

Anterior transverse
Medial longitudinal
Lateral longitudinal

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35
Q

What are the 4 muscles in the anterior compartment of the leg?

A

Tibialis anterior
Extensor digitarum longus
Extensor hallucis longus
Peroneus tertius

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36
Q

What are the 2 movements of the anterior muscles of the leg?

A

Dorsiflex

Inversion

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37
Q

What are the 2 muscles in the anterior compartment of the leg that extends the toes?

A

Extensor digitorum longus

Extensor hallucis longus

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38
Q

What is the muscles in the anterior compartment innervated by?

A

Deep peroneal nerve

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39
Q

What provides blood supply to anterior compartment of leg?

A

Anterior tibial artery

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40
Q

What are the 2 movements of tibialis anterior?

A

Dorsiflexion and inversion of foot

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41
Q

What is the innervation of tibialis anterior?

A

Deep peroneal nerve

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42
Q

What are the 2 actions of the extensor digitorum longus?

A

Extension of 4 lateral toes and dorsiflexion of foot

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43
Q

What is extensor digitorum longus innervated by?

A

Deep fibular nerve

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44
Q

What are the 2 actions of extensor hallucis longus?

A

Extension of great toe

Dorsiflexion of foot

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45
Q

What is innervatioon of extensor hallucis longus?

A

Deep fibular nerve

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46
Q

What are the 2 actions of the peroneus tertius?

A

Eversion

Dorsiflexion of the foot

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47
Q

What is the innervation of peroneus tertius?

A

Deep fibular nerve

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48
Q

What are the 2 muscles in the lateral component of the leg?

A

Peroneus longus

Peroneus brevis

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49
Q

What is the function of the peroneus longus and brevis?

A

Few degrees of eversion and prevent excessive inversion

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50
Q

What are the 3 actions of peroneus longus?

A

Everts
Assists in plantarflexion
Supports medial and transverse arches

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51
Q

What is the innervation of peroneus longus?

A

Superficial fibular nerve L4-S1

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52
Q

What are the 2 actions of the peroneus brevis?

A

Everts

Support lateral longitudinal arch

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53
Q

What is the innervation of peroneus brevis?

A

Superficial fibular nerve L4-S1

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54
Q

What are the 2 smaller compartments of the posterior leg?

A

Deep and superficial

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55
Q

What are the 2 actions of the posterior compartment?

A

Plantar flex

Inversion

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56
Q

What is the posterior compartment of the leg innervated by?

A

Tibial nerve

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57
Q

How do the muscles of superficial posterior compartment of the leg insert into the calcaneus?

A

Calcaneal / Achilles’ tendon

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58
Q

What are the 2 bursae associated with the calcaneal tendon?

A

Subcutaneous calcaneal bursa

Deep calcaneal bursa

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59
Q

What are the 2 actions of the gastrocnemius?

A

Plantar flex foot

Knee flexion

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60
Q

What is the innervation of the gastrocnemius?

A

Tibial nerve

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61
Q

What are the 2 functions of the plantaris?

A

Weak plantarflexor and knee flexor

62
Q

What is innervation of the plantaris?

A

Tibial nerve

63
Q

What is the action of the soleus?

A

Plantarflex foot

64
Q

What is the innervation of the soleus?

A

Tibial nerve

65
Q

What are the 4 muscles in the deep posterior compartment of the leg?

A

Popliteus
Tibialis posterior
Flexor hallucis longus
Flexor digitorum longus

66
Q

What is the action of the popliteus?

A

Laterally rotate femur on tibia to unlock knee joint so flexion can occur

67
Q

What is the innervation of popliteus?

A

Tibial nerve

68
Q

What is are the 3 actions of the tibialis posterior?

A

Inversion
Plantar flexion
Maintain medial arch

69
Q

What is the innervation of tibialis posterior?

A

Tibial nerve

70
Q

What is the action of the flexor digitorum longus?

A

Flexes lateral 4 toes and assists in plantarflexion of ankle and inversion of midfoot

71
Q

What is flexor digitorum longus innervated by?

A

Tibial nerve

72
Q

What is flexor hallucis longus action?

A

Flexes great toe and assists in plantar flexion of ankle and inversion of midfoot

73
Q

What is flexor hallucis longus innervated by?

A

Tibial nerve

74
Q

What is the tibial nerve?

A

Larger terminal branch of sciatic nerve

75
Q

What is the root values of tibial nerve?

A

L4-S3

76
Q

What are the 3 parts of the thigh and leg that tibial nerve supplies?

A

Posterior thigh
Superficial posterior leg
Deep posterior leg

77
Q

What is the common peroneal nerve?

A

Smaller terminal branch of sciatic nerve

78
Q

What are the root values of the common peroneal nerve?

A

L4-S2

79
Q

What is the muscle supplied by the common peroneal nerve?

A

Short head of biceps femoris

80
Q

Which compartment of the leg does the superficial peroneal nerve innervate?

A

Lateral compartment of leg

81
Q

What is the compartment that the deep peroneal nerve innervates?

A

Anterior compartment of leg

82
Q

What are the 6 structures that pass behind the medial malleolus?

A 
Tibialis posterior 
Flexor Digitorum longus 
Posterior tibial Artery 
Posterior tibial Vein 
tibial Nerve 
Flexor Hallucis longus
83
Q

What are the 4 pulses in the lower limb?

A

Femoral
Popliteal
Dorsalis pedis
Posterior tibial

84
Q

How to palpate femoral pulse?

A

Mid inguinal point

85
Q

How to palpate popliteal pulse?

A

Slightly flex leg, press fingers deep behind knee in the popliteal fossa

86
Q

How to palpate dorsalis pedis?

A

Dorsum of foot, immediately lateral to extensor hallucis longus tendon

87
Q

How to palpate tibial pulse?

A

Below and behind medial malleolus

88
Q

What are the 4 borders of the popliteal fossa?

A

Semimembranosus
Biceps femoris
Medial head of gastrocnemius
Lateral head of gastrocnemius and plantaris

89
Q

What is compartment syndrome?

A

Trauma to fascial compartment leads to haemorrhage and oedema and cause a rise in intra-compartmental pressure

90
Q

What are 2 clinical signs of compartment syndrome?

A

Severe pain in limb, excessive for degree of injury

Exacerbated by passive stretch of muscles

91
Q

What should be performed to treat compartment syndrome?

A

Fasciotomy

92
Q

What is are 3 short term consequences of compartment syndrome?

A

Rhabdomyolysis
Distal paraesthesia
Loss of motor function

93
Q

What are 2 long term consequences of compartment syndrome?

A

Acute kidney injury

Volkmann’s ischaemic contracture if necrotic muscle undergoes fibrosis

94
Q

What are 2 most common ankle fractures?

A

Inversion or eversion

95
Q

What is a fracture blister?

A

Overlying soft tissues blister

96
Q

What are open ankle fractures?

A

Skin barrier is breached and there is direct communication between fracture and external environment

97
Q

What is a talar shift?

A

Ankle mortise becomes unstable and widens so talus can shift medially or laterally within the ankle joint

98
Q

How are stable ankle fractures treated?

A

Air cast boot or fiberglass cast

99
Q

How are unstable ankle fractures treated?

A

Surgical stabilization

100
Q

What is an ankle sprain?

A

Partial or complete tear of one or more ligaments of ankle joint

101
Q

Which ligament is most at risk of ankle sprains?

A

Anterior talofibular ligament

102
Q

What are 3 ways to rupture Achilles’ tendon?

A

Making a forceful push off with extended knee
Fall with ankle dorsiflexed
Falling from a height

103
Q

What are 5 symptoms and signs of Achilles’ tendon rupture?

A 
Sudden and severe pain at back of ankle 
Sound of a loud pop or snap 
Palpable gap or depression in tendon 
Pain and swelling and bruising 
Cannot tip toe or push off while walking
104
Q

What test to use for ruptured Achilles’ tendon?

A

Thompson’s test or Simmonds Test

105
Q

What is the Simmons test?

A

Foot cannot plantar flex

106
Q

What are the 3 features of hallux valgus?

A

Varus deviation of the first metatarsal
Valgus deviation of hallux
Prominence of first metatarsal head

107
Q

What is hallux rigidus?

A

Osteoarthritis of 1st metatarsophalangeal joint resulting in stiffness

108
Q

What is arthroplasty?

A

Joint replacement

109
Q

What is arthrodesis?

A

Joint fusion

110
Q

What is excision arthroplasty?

A

Surgical removal of joint with interposition of soft tissue

111
Q

What is osteotomy?

A

Surgical cutting of bone to allow realignment

112
Q

What is claw toe?

A

Affects 4 lateral toes, flexed at PIP a joint

113
Q

What usually causes claw toe?

A

Neurological damage

114
Q

What is Achilles tendinopathy?

A

Degenerative process of Achilles’ tendon

115
Q

What is flat foot?

A

Medial arch collapsed

116
Q

What is flexible flat feet?

A

No medial arch when standing normally but normal medial arch appears when standing on tip toe

117
Q

How does rigid flat feet occur?

A

Tarsal coalition - tarsal bones did not separate during embryonic development

118
Q

How do you acquire flatfoot in an adult?

A

Dysfunctional tibialis posterior tendon

119
Q

What is Charcot arthropathy?

A

Progressive destruction of bones, joints and soft tissues in ankle and foot

120
Q

What is gait?

A

Mechanism by which the body is transported using coordinated movements of the major lower limb joints

121
Q

What are 2 phases of gait?

A

Stance and swing

122
Q

What is stance phase?

A

Time in which foot is in contact with ground and is bearing weight

123
Q

What is swing phase?

A

Time during which foot is not in contact with ground

124
Q

What is gait cycle!

A

Period of time from initial contact to next initial contact on same side of the body

125
Q

What are 5 important attributes needed for normal gait?

A 
Stability in stance
Foot clearance during swing 
Pre positioning for initial contact
Adequate step length
Energy conservation
126
Q

What are periods of double support?

A

When both feet are in contact with the ground

127
Q

What is double float?

A

When neither foot is in contact with the ground

128
Q

What are the 5 subdivisions of stance phase?

A

Initial contact
Loading response
Mid stance terminal stance
Pre swing

129
Q

What are the 3 subdivisions of swing phase?

A

Initial
Mid
Terminal

130
Q

What is stride?

A

Distance from initial contact with one leg to the next initial contact with the same leg

131
Q

What is step?

A

Distance from initial contact with one leg to initial contact with opposite leg

132
Q

What is cadence?

A

Number of steps per minute

133
Q

What is kinematics?

A

Motion

134
Q

What is kinetics?

A

Forces and moments that cause motions

135
Q

What is concentric contraction?

A

Shortening of muscle

136
Q

What is the purpose of concentric contraction?

A

Acceleration and power generation

137
Q

What is eccentric contraction?

A

Lengthening

138
Q

What is the purpose of eccentric contraction?

A

Deceleration and shock absorption

139
Q

What is the purpose of isometric contraction?

A

Stability

140
Q

What is antalgic gait?

A

Walks with a limp to reduce pain

141
Q

How to treat antalgic gait?

A

Use walking stick with hand opposite painful limb to shift their center of gravity away from painful limb

142
Q

What is Tredelenburg gait?

A

Pelvis drops on unaffected side, line of gravity might shift toward affected hip

143
Q

What is a hemipelgic gait?

A

Paralysis of one side of body, flexed upper limb and extended lower limb, leans towards unaffected side and circus duct the paralysed leg

144
Q

What is dipelgic gait?

A

Spasticity affects both limbs, narrow gait, drags both legs and scissoring foot,

145
Q

What is high stoppage gait?

A

Weakness of ankle dorsiflexion, flexes hip much higher to lift their foot high off the ground, foot slaps down onto ground

146
Q

What is Parkinsonian gait?

A

Short step, flexes neck and leans forward to move their centre of gravity in front, shuffling gait, loss of arm swing

147
Q

What is ataxic gait?

A

Lumpy, staggering movements with broad base, arms outwards to improve balance, body may sway back and forth

148
Q

How to remember tendon insertion in the pes aserinus?

A

Say - sartorius
Grace - gracillus
Before
Tea - semitendinosus

149
Q

How to remember action of muscles supplied by common peroneal nerve?

A

PED - common peroneal everts and dorsiflexes

150
Q

How to remember action of muscles supplied by tibial nerve?

A

TIP

tibial inverts and plantar flexes - cannot walk on tip toes

Musculoskeletal System (9 decks)

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