The Ankle and Foot

Question 1

Origin, insertion and action of Gastrocnemius

Question 2

Origin, insertion and action of Peroneus Brevis

Question 3

Origin, insertion and action of Flexor Digitorum Longus

Question 4

Origin, insertion and action of Soleus

Question 5

Origin, insertion and action of Plantaris

Question 5

Origin, insertion and action of Tibialis Posterior

Question 6

Origin, insertion and action of Flexor Hallucis Longus

Question 7

Origin, insertion and action of Peroneus tertius

Question 8

Origin, insertion and action of Peroneus Longus

Question 9

Origin, insertion and action of Extensor Hallucis Longus

Question 10

Origin, insertion and action of Tibialis anterior

Question 11

Origin, insertion and action of Extensor digitorum longus

Question 12

What are the stabilising features of the ankle?

Answer 12

Joint Capsule, deltoid/medial collateral ligament(Anterior tibiotalar, posterior tibiotalar, tibiocalcaneal and tibionavicular), Lateral collateral ligaments (Anterior talofibular, posterior talofibular and calcaneofibular)

Question 12

Explain what happens during an A/P to the ankle joint.

Question 12

Explain the ClosePpacked position of the ankle.

Answer 12

maximal dorsiflexion

Question 12

Why is the longitudinal stretch for Soleus different from the longitudinal stretch of Gastrocnemius if they both plantaflex the ankle?

Answer 12

The gastrocnemius is a multi-joint muscle crossing the knee joint and ankle joint and plantarflexes when the knee is extended whereas soleus is a single joint muscle crossing the ankle only and plantarflexes the foot when the knee is flexed.

Question 13

State the range of movement for dorsiflexion and state which muscles are involved in this movement.

Answer 13

Normal AROM 0-20o for dorsiflexions. The muscles involved are the tibialis anterior, extensor digitorum longus, extensor hallicus longus and Peroneus tertius.

Question 13

Identify and explain the end feel for inversion and how this can contribute to your clinical reasoning.

Answer 13

Firm end feel. This would indicate the surrounding structures are intact, if there was a different end feel that may suggest some sort of ankle pathology such as ligament injury, induces pain.

Question 14

Identify and explain which structures limit movement of ankle eversion.

Answer 14

Contact between the talus and calcaneus, tensions in the medial collateral ligaments,medial talocalcaneal ligament, medial joint capsule, tibalis posterior, flexor hallucis longus and flexor digitorum longus.

Question 15

Identify and explain the attachments of tibialis posterior.

Question 16

Identify and explain which structures lie in close proximity to the medial malleolus.

Answer 16

Talus apart of the talocrual joint (Ankle Joint), medial collateral/deltoid ligament
(anterior tibiotalar, posterior tibotalar, tibionavicular and tibiocalcaneal) which is a main stabilising feature of the ankle which limits increased foot eversion.
Tibialis anterior tendon (dorsiflexor and invertor), tibialis posterior muscle and tendon (Invertor and plantarflexor), flexor digitorum longus muscle and tendon (flexor of the lateral 4 toes), flexor hallicus longus muscle and tendon (Flexor of the big toe). Navicular and calcaneous. Flexor retinaculum which holds the tendons of flexor digitorum longus, flexor hallicus longus and tibialis posterior in position around the medial malleolus

Question 17

When testing the ATFL which other structures are also under stretch

Answer 17

Posterior talofibular ligament and calcaneofibular ligament.

Peroneus longus and brevis tendons

Question 18

Identify and explain which structures limit normal movement of inversion

Question 19

Identify and explain the end feel concept for ankle planta flexion and how this can contribute to your reasoning

Question 20

Identify and explain the attachments of tibialis anterior in detail

Question 21

Explain what is meant by passive insufficiency

Question 22

Identify and explain which structures limit normal movement of inversion.

Question 22

Identify and explain the muscles involved in dorsiflexuion.

Question 23

Identify and explain how shortness of gastrocnemius could affect active and passive movements at both the knee and the ankle joints.

Question 24

Identify and explain the other structures that insert around the posterior talofibular ligament( PTFL)

Question 24

Identify and explain the role of the tibialis posterior In inversion.

Question 25

Identify and explain how shortness of tibialis anterior could affect active and passive movements at the ankle joint

Question 26

Identify and explain normal and abnormal findings of talar tilt and how this can contribute to your reasoning

Answer 26

Talar tilt tests the amount of talar inversion present at the ankle mortise. A reduced or absent end-feel and clicking or clunking may indicate lateral ligament CFL injury.

Question 27

Identify and explain which other structures may be under stretch with the anterior drawer test