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Yr 2 Movement - term 2 and 3 > The Foot and Ankle > Flashcards

The Foot and Ankle Flashcards

1
Q

What is the ankle joint formed by?

A

Articulation between the distal tibia & fibula with the talus.

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2
Q

What type of joint is the ankle joint?

A

Synovial hinge joint.

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3
Q

What movements does the ankle joint permit? (2)

A
  • Dorsiflexion

- Plantar flexion

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4
Q

What is dorsiflexion?

A

Pointing the foot upwards.

-dorsum towards shin

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5
Q

What is plantar flexion?

A

Pointing foot downwards.

-dorsum away from shin

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6
Q

Give 2 example of synovial joint problems that affect the ankle.

A
  • Sepsis

- Rheumatoid arthritis

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7
Q

What helps to stabilise the ankle? (2)

A
  • Good congruity between malleolar mortice and trochlea (talus)
  • Very strong ligaments
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8
Q

Where is the trochlea (talus) widest?

A

Anteriorly.

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9
Q

What is the malleolar mortice?

A

Rectangular socket formed by the flat surface of the talus and the 2 malleoli (tibia & fibula).

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10
Q

How do the malleolar mortice and the trochlea of the talus help to stabilise the ankle during dorsiflexion?

A

During dorsiflexion, anterior trochlea moves between malleoli
»spreads tibia and fibula slightly
»increases their grip on talus.

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11
Q

What is the most stable position of the ankle joint?

A

Dorsiflexion.

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12
Q

What are the lateral ligaments of the ankle? (3)

A
  • Posterior talofibular ligament
  • Anterior talofibular ligament
  • Calcaneofibular ligament
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13
Q

Which anterior ligament tends to be weaker and what are the consequences?

A

Anterior talofibular ligament tends to be weaker.

|&raquo_space; sprains

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14
Q

How many medial ligaments are there at the ankle?

A

One.

-several parts

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15
Q

What are the attachments of the medial ligament?

A

Attached to the medial malleolus, then fans out&raquo_space; talus, navicular and calcaneus.

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16
Q

What is the medial ligament also called?

A

Deltoid ligament.

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17
Q

What other structures help to stabilise the ankle? (2)

A
  • Distal interosseous membrane

- Anterior & posterior tibiofibular ligaments

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18
Q

What movements are possible at the ankle? (4)

A
  • Dorsiflexion
  • Plantar flexion
  • Inversion
  • Eversion
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19
Q

What angle does dorsiflexion occur to?

A

45*.

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20
Q

What muscles are involved in dorsiflexion?

A

Anterior compartment of the leg.

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21
Q

Which nerve supplies the anterior compartment of the leg?

A

Deep fibular (peroneal) nerve.

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22
Q

Which artery supplies the anterior compartment of the leg?

A

Anterior tibial artery.

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23
Q

What angle does plantar flexion occur to?

A

20*.

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24
Q

What muscles are involved in plantar flexion?

A

Posterior compartment of the leg.

-except popliteus

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25
Q

Which nerve supplies the posterior compartment of the leg?

A

Tibial nerve.

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26
Q

Which artery supplies the posterior compartment of the leg?

A

Posterior tibial artery.

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27
Q

What is inversion?

A

Pointing sole of foot medially.

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28
Q

Which joints are involved in inversion?

A

Primarily subtalar joint (not ankle).

-some movement in tranverse tarsal joint

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29
Q

Which nerve roots are involved in inversion?

A

L4 & L5.

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30
Q

What angle does inversion occur to?

A

30*.

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31
Q

What is eversion?

A

Pointing sole of foot laterally (outwards).

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32
Q

Which joints are involved in inversion?

A

SAME AS INVERSION:
Primarily subtalar joint (not ankle).
-some movement in tranverse tarsal joint

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33
Q

Which nerve roots are involved in eversion?

A

L5 & S1.

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34
Q

What angle does eversion occur to?

A

20*.

35
Q

What is the subtalar joint?

A

Articulation between talus and calcaneus.

36
Q

What type of injury causes most ankle sprains?

A 
Inversion injuries (sole >> medially).
-twisting of a plantar-flexed foot
37
Q

What area of the foot is strained in an inversion injury?

A

Strain on lateral foot.

-especially anterior talofibular ligament

38
Q

Why do ligaments heal relatively slowly?

A

They are fairly avascular.

39
Q

What happens when ligaments detach from bone during ankle sprains?

A

Fibres do not grow back as extensively&raquo_space; healed ligament usually weaker.

40
Q

What do torn ligaments increase the likeliness of?

A

Ankle dislocation.

-destabilise the joint

41
Q

Which ankle ligament is weaker; lateral or medial?

A

Lateral ligament is weaker.

-especially anterior talofibular part

42
Q

How should the joint space appear on a normal ankle x-ray?

A

The joint space should be an even depth all the way round.

43
Q

Give an example of a condition that can decrease the joint space at the ankle.

A

Osteoarthritis.

44
Q

What is a common ankle fracture?

A

Lateral malleolar fracture (distal fibula).

  • ankle stretched laterally
  • inversion injury
45
Q

What is more common; inversion or eversion injuries?

A

Inversion injuries.

46
Q

Which ligament is most likely to be damaged by an eversion injury?

A

Medial (deltoid) ligament.

-medial ankle strained

47
Q

What structures can be damaged in an eversion injury?

A

Eversion injuries pull the medial ligament&raquo_space; tearing of medial malleolus.
» talus rotates laterally
» fracture of fibula

48
Q

What are the main functions of the foot? (3)

A
  • Support body weight
  • Lever to propel body
  • Shock absorber
49
Q

What are the main group of bones in the foot? (3)

A
  • Tarsal bones
  • Metatarsal bones
  • Phalanges
50
Q

Which bones makes up the tarsal bones?

A
  • PROXIMAL (talus & calcaneus)
  • INTERMEDIATE (navicular)
  • DISTAL (cubid & cuneiforms)
51
Q

What are the proximal tarsal bones? (2)

A
  • Talus

- Calcaneus

52
Q

What is the intermediate tarsal bone?

A

Navicular.

53
Q

What are the distal tarsal bones?

A
  • Cuboid

- Cuneiforms

54
Q

How many cuneiform bones are there?

A

THREE:

  • medial
  • intermediate
  • lateral
55
Q

How many metatarsal bones are there?

A

Five.

56
Q

How many phalanges are there?

A

2 on great toe (I).
3 on other toes (II-V).
-prox/mid/dist

57
Q

What are the main joints in the foot?

A

PROX&raquo_space; DIST:

  • transverse tarsal joint
  • naviculo-cuneiform joint
  • tarsometatarsal joint
  • metatarso-phalangeal joint
  • interphalangeal joints
58
Q

What 2 joints make up the transverse tarsal joint?

A
  • Talonavicular joint

- Calcaneocuboid joint

59
Q

Which bones are involved in the transverse tarsal joint? (4)

A
  • Talus & navicular

- Calcaneus & cuboid

60
Q

What helps to stabilise the foot?

A

Arches.

61
Q

How do arches help to stabilise the foot?

A
  • Distribute weight

- Increase flexibility

62
Q

What are the arches in the foot? (3)

A
  • Medial longitudinal arch
  • Lateral longitudinal arch
  • Transverse arch
63
Q

What bones does the medial longitudinal arch consist of? (5)

A
  • Calcaneus
  • Talus
  • Navicular
  • 3 Cuneiforms
  • Medial 3 metatarsals
64
Q

Where is weight transmitted in the medial longitudinal arch?

A

Through the talus to the calcaneus and metatarsal heads.

65
Q

What bones does the lateral longitudinal arch consist of? (3)

A
  • Calcaneus
  • Cuboid
  • Lateral 2 metatarsals
66
Q

Which arch is higher/more important; lateral or medial longitudinal?

A

Medial longitudinal arch.

67
Q

What bones does the transverse arch consist of? (3)

A
  • Cuboid
  • 3 Cuneiforms
  • Bases of 5 metatarsals
68
Q

Which 2 mechanism support the arches of the foot?

A
  • Passive

- Dynamic

69
Q

What is involved in passive support of the arches?

A

Ligaments and the shape of the bones.

70
Q

What is involved in active support of the arches?

A

Intrinsic and extrinsic muscles.

71
Q

What is pes planus?

A

Flat foot.

-flat longitudinal arch

72
Q

What are the 2 types of pes planus?

A
  • Flexible (arch is present when not weight bearing)

- Rigid (i.e. fusion of tarsal bones)

73
Q

Which type of pes planus is more common?

A

Flexible.

74
Q

What usually cause flexible pes planus?

A

Loose/degenerating ligaments.

75
Q

What can make pes planus worse?

A
  • Gaining weight

- Standing for a long time

76
Q

What can pes planus lead to?

A

Displacement of talus (inf/med)
» misalignment of knee
» pain and decreased shock absorption
» lower back pain

77
Q

How is pes planus treated?

A

Specialised insoles (orthotics)&raquo_space; support arches.

78
Q

What movements are possible in the foot?

A
  • Flexion/extension

- Abduction/adduction (limited)

79
Q

Which joints does flexion/extension of the foot involve?

A
  • Metatarsophalangeal joints

- Interphalangeal joints (prox/dist)

80
Q

Which joints does abduction/adduction of the foot involve?

A

Metatarsophalangeal joints.

81
Q

What is gout and which joint does it typically affect?

A 
Inflammatory arthritis (crystal deposits).
-typically affects 1st MTP joint
82
Q

What effect does arthritis have on joint space?

A

Decreases joint space.

83
Q

What is a Lisfranc injury?

A

Injury of foot where 1+ metatarsal bones are displaced.

  • often requires surgery
  • often misdiagnosed

Yr 2 Movement - term 2 and 3 (13 decks)

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