The Ankle Joint

Question 1

What type of joint is the ankle

Answer 1

Synovial Hinge Joint

Question 2

What articulations occur at the ankle?

Answer 2

Distal Tibia and Fibula articulate with the trochlea of the talus

Question 3

Movements of the Ankle

Answer 3

Dorsiflexion and plantarflexion

Inversion and Eversion AT SUBTALAR joint

Question 4

Why is dorsiflexion the most stable position

Answer 4

Trochlea of talus is wider anteriorly

In dorsiflexion, Tibia and Fibia are spread apart- tightening their grip on the talus

Question 5

Lateral Ligaments of the Ankle

Answer 5

Anterior and Posterior Talofibular ligaments

Calcaneofibular ligament

Question 6

Medial Ligaments of the Ankle

Answer 6

Medial/Deltoid Ligament

• Tibiotalar parts (anterior and posterior)
• Tibionavicular part
• Tibiocalcaneal part

Plantar Calcaneonavicular Ligament

Question 7

Are the medial or lateral ligaments stronger?

Answer 7

Medial Ligaments

Question 8

How do most Inversion injuries to the ankle occur?

Answer 8

Twisting of a plantar-flexed foot

May cause Lateral Malleolar/Distal Fibula #

Question 9

Why do torn ligaments predispose ankle dislocation

Answer 9

The ligaments are avascular, so heal slowly

Also, if detached from bone, are unlikely to grow back into it

Question 10

X-Ray findings in Ankle injury?

Answer 10

Uneven joint space- ‘Talar shift’ indicates dislocation

Question 11

What happens in an Eversion Injury to the ankle?

Answer 11

Stronger medial ligament is pulled, avulsing medial malleolus

Talus rotates laterally, fracturing the fibula

Question 12

Functions of the foot

Answer 12

Support/Transmit weight
Levers during propulsion
Resilient spring to absorb shock

Question 13

Joints involved in the Transverse Tarsal Joint

Answer 13

Talocalcaneonavicular Joint

Calcaneocuboid Joint

Question 14

Joint pathologies of the foot

Answer 14

Gout (affected by diet, medication)
Bunions (Hallux Valgus)
Arthritis (osteo or rheumatoid)

Question 15

Arches of the Foot

Answer 15

Medial Longitudinal Arch
Lateral Longitudinal Arch
Transverse Arch

Question 16

Function of the arches of the foot

Answer 16

Distribute weight, act as shock aborbers and increase foot flexibility, propulsion during walking

Question 17

Most important (and highest) arch

Answer 17

Medial Longitudinal

Question 18

Bones of the MLA

Answer 18

Calcaneus, Talus, Navicular, 3 Cuneiforms and Medial 3 Metatarsals

Question 19

Bones of the LLA

Answer 19

Calcaneus, cuboid and lateral 2 metatarsals

Question 20

Bones of the TA

Answer 20

Cuboid, 3 Cuneiforms and all metatarsal bases

Question 21

Passive support of the arches of the foot

Answer 21

Plantar Aponeurosis, Ligaments, shape of foot

Question 22

Dynamic support of the arches of the foot

Answer 22

Intrinsic Plantar Muscles

Extrinsic muscles

Question 23

What is Pes Planus, and who is most commonly affected

Answer 23

Flat foot- loss of arches due to loose/degenerative ligaments

Adolescents/adults

Question 24

Presentations of Pes Planus

Answer 24

Rigid (fusion of tarsal bones)

Flexible (more common) arches present when not weight-bearing

May cause ankle misalignment, ankle/knee pain, infero-medial talus displacement, lower back pain

Question 25

Movements of the digits of the foot

Answer 25

Flexion/Extension
Abduction/Adduction

Both limited

Question 26

What is Lisfranc Injury

Answer 26

Displacement of Metatarsal bones from the tarsus e.g. from a crush injury or a fall

Often hidden presentation

Question 27

Muscles supporting Medial Arch?

Answer 27

Tibialis Anterior and Posterior

Fibularis Longus

Question 28

Muscles supporting Lateral Arch

Answer 28

Extensor tendons

Intrinsic muscles acting on Toe 5