The Ankle Joint and Leg Region Flashcards
What are the three joints between the tibia and fibula?
- proximal, intermediate and distal tibiofibular joints
Classify the proximal tibiofibular joint
synovial, mutliaxial, planar
What are the movements at the proximal tibiofibular joint?
- small ROM
- gliding motion in each of the major planes
What type of joint is the intermediate tibiofibular joint?
fibrous - very small ROM
What type of joint is the distal tibiofibular joint?
fibrous - tiny ROM
What movements result in the movement of tibiofibular joints?
movement at the ankle - moves upwards and rotates during dorsiflexion
What are the movements of the foot?
plantar flexion, dorsiflexion, eversion and inversion
What is the big toe termed anatomically?
hallux
Which digit has only 2 phlanages?
hallux
What forms the arches of the foot?
articulations between the various bones and connective tissue
How many arches of the foot are there?
3 - medial longitudinal, lateral longitudinal and transverse arches
What is the acronym for the tarsals?
Cute - Calcaneus Tina - Talus Never - Navicular Could - Cuboid Cooperate - Cuneiform (medial, intermediate and lateral)
How many tarsals are there?
7
Classify the talocrural joint (ankle)
synovial, uniaxial, hinge
What are the movements at the talocrural joint?
dorsiflexion and plantar flexion
What are the articular surfaces of the talocrural joint?
Malleolar mortise and Talus
When is the talocrural joint strongest? Why?
Dorsiflexion as facets grip the talus tightly and the trochlear of the talus is wider anteriorly.
What are the supporting ligaments of the ankle joint?
medial collateral/deltoid ligament and lateral collateral ligament
What is the structural differences between the lateral and medial collateral ligaments of the ankle joint?
- medial: large, expansive, triangular shaped
- lateral: smaller, less expansive
What are the 4 parts of the medial collateral ligament of the ankle joint? What do they each limit?
anterior tibiofibular - plantar flexion
posterior tibiofibular - dorsiflexion
tibionavicular (anterior)- plantar flexion
tibiocalcaneal (dorsiflexion)- dorsiflexion
What are the 3 parts of the lateral collateral ligament of the ankle joint? What do they limit?
anterior talofibular - plantar flexion
posterior talofibular - dorsiflexion
calcaneofibular - dorsiflexion
What does the medial collateral ligament of the ankle joint prevent?
subluxation of the joint during eversion
What does the lateral collateral ligament of the ankle joint prevent?
subluxation of the joint during inversion
Name the joints between the tarsals
subtalar joint
transverse tarsal joint - formed by taleocalcaneonavicular and calcaneocuboid joint
What is the classification of tarsal joints?
synovial, plane, multiaxial
What are the movements of tarsal joints?
inversion, eversion, plantar flexion and dorsiflexion
What are the benefits of inversion and eversion?
allows adjustment to uneven surfaces, increasing efficiency in gait and flexibility of the foot.
What are the surfaces of the Tarsometatarsal joints?
3 cuneiform ones and cuboid bone with the metatarsals
Classify the Tarsometatarsal joints
synovial, planar joints
Describe the movement at the tarsometatarsal joints
very little
What is the articulations of the metatarsophalangeal joints?
distal head of metatarsal base and base of adjacent phalanx at each digit
What is the classification of metatarsophalangeal joints?
synovial, biaxial, condyloid joints
What are the movements at the metatarsophalangeal joints?
flexion extension, abduction and adduction
What are the ligaments that support the metatarsophalangeal joints?
- collateral ligament
- planar ligaments
- deep transverse metatarsal ligaments
What is the function of the collateral ligaments at the metatarsophalangeal joints?
limits flexion
What is the function of the planar ligaments at the metatarsophalangeal joints?
limits extension
What is the function of the deep transverse metatarsal ligaments at the metatarsophalangeal joints?
keeps metatarsal head together during weight bearing, prevents splaying of metatarsals under load.
What is the classification of the interphalangeal joints of the foot?
synovial, uniaxial, hinge
What movements occur at the interphalangeal joints of the foot?
flexion and extension
What ligaments support the interphalangeal joints of the foot and what are their functions?
- collateral ligament: limits flexion
- planar ligament: limits extension
What bones allow the formation of arches of the foot?
tarsal and metatarsal bones
What is the purpose of arches of the foot?
enhance weight bearing ability of the foot
What supportive features of the arches of the foot are there?
plantar aponeurosis
long plantar ligament
calcaneonavicular ligament
muscles of the foot and lower leg
What are the dorsiflexors of the foot?
tibialis anterior, extensor hallucis longus, extensor digitorum longus and peroneus tertius
Where do the muscles that cause dorsiflexion lie in relation to the foot?
anterior
What is the most superficial and the most deep dorsiflexors?
- tibialis anterior (superficial)
- peroneus tertius (deep)
What are the attachments of the tibialis anterior?
arises from tibia and inserts of tarsals
What is the attachments of extensor hallucis longus?
fibular to proximal phalanx of hallux
What are the attachments of extensor digitorum longus?
fibular to digits 2 - 5
what are the attachments of peroneus tertius?
fibula to metatarsals
Where do muscles that cause eversion of the foot lie?
laterally
What are the everters of the foot?
peroneus longus and brevis
What are the attachments of peroneus longus?
fibula to medial cuneiform and metatarsal
What are the attachments of peroneus brevis?
fibula to metatarsal
What is peroneus longus and brevis innervated by?
superficial tibial nerve
What are the muscles in the superficial group that cause plantar flexion?
gastrocnemius, soleus and plantaris
What are the muscles in the deep group that cause plantar flexion?
tibialis posterior flexor digitorus longus and flexor hallucis longus
Which is deep to the other, gastrocnemius or soleus?
soleus
Where does the soleus muscle insert?
achilles tendon to pull foot up
What are the attachments of tibialis posterior?
tibia and fibula to navicular
What are the attachments of flexor digitorum longus?
tibia to distal phalanx 2 - 5
What are the attachments of flexor hallucis longus?
fibula to distal phalanx 1
What are the attachments of gastrocnemius?
femur condyles to achilles tendon
What are the attachments of soleus?
fibula to tendo calcaneus
What are the plantar flexors innervated by?
tibial nerve
What movement of the foot is a key propulsor in gait?
plantar flexion
What are the muscles that cause inversion?
tibialis anterior as it inserts on medial aspect of foot
What is the purpose of the superior and inferior peroneal retinaculum?
bind down the peroneus longus and brevis behind the lateral malleolus
Where do the peroneus longus and brevis muscles run behind?
lateral malleolus
What is the function of flexor retinaculum?
converts bony grooves into canals for tendons of the tibialis posterior flexor digitorum longus and flexor hallucis longus as they pass behind the medial malleolus
What is the function of the plantar aponeurosis?
binds the skin of the foot and provides an attachment sit for foot muscles and maintains the arches of the foot