The foot and ankle

Question 1

ankle joint = what bones?

Answer 1

tibia and fibula with the talus

Question 2

movement at the ankle joint? what type of joint?

Answer 2

synovial hinge allows dorsiflexion and plantar flexion

Question 3

factors for stability of ankle

Answer 3

1. good congruity between malleolar mortice and trochlear - malleoli grip talus
2. very strong ligaments = distal part of interosseus + ant. + post. tibiofibular ligaments

Question 4

is the trochlea of the talus wider ant. or post?

Answer 4

ant.

Question 5

movements of trochlear and malleoli in dorsiflexion

Answer 5

the ant. part of trochlea moves between the malleoli

this spreads the tibia and fibula increasing their grip

dorsiflexion is most stable position

Question 6

lateral ligaments of ankle joint

Answer 6

posterior talofibular
ant. talofibular
calcaneofibular ligament

Question 7

medial ligaments

Answer 7

post. tibiotalar
tibiocalcaneal
tibionavicular
ant. tibiotalar

Question 8

dorsiflexion

Answer 8

ant. compartment of the leg

supplied by deep fibular (peroneal) nerve

Anterior tibial artery

Question 9

plantarflexion

Answer 9

post. compartment of leg (except popliteus)

tibial nerve
posterior tibial artery

Question 10

which joint allows inversion and eversion?

Answer 10

subtalar joint

Question 11

inversion uses what cranial roots?

Answer 11

L4 L5

Question 12

eversion uses what cranial roots?

Answer 12

L5 S1

Question 13

where is the subtalar joint?

Answer 13

between the talus and underlying calcaneus

Question 14

most common ankle sprains caused by

Answer 14

twisting of plantar flexed foot

Question 15

why do ankle sprains take a long time to heal?

Answer 15

relatively avascular

Question 16

long term problems with ankle sprain

Answer 16

if ligament detaches from bone fibres do not grow back into bone cortex as extensively so usually weaker

weak ligaments destabilise = predisposition to dislocation

Question 17

which ankle ligament is weaker than the other?

Answer 17

lateral ligament of ankle is weaker than medial - esp. the ant. talofibular part

Question 18

an eversion injury

Answer 18

pull the strong medial ligament causing avulsion of the medial malleolus

the talus rotates laterally fracturing the fibula

Question 19

joints of the foot

Answer 19

transverse tarsal joint - 2
naviculo-cuneiform
tarsometatarsal
metatarso-phalangeal
interphalangeal

Question 20

types of transverse tarsal joint

Answer 20

talonavicular joint

calcaneocuboid joint

Question 21

three arches of the foot

Answer 21

medial longitudinal
lateral longitudinal
transverse

Question 22

medial longitudinal arch

Answer 22

comprises - calcaneus, talus, navicular, 3 cuneiforms and 3 medial metatarsals

weight through the talus to the calcaneus and metatarsal heads

medial is higher and more important than lateral

Question 23

lateral longitudinal arch

Answer 23

calcaneus, cuboid and lateral 2 metatarsals

Question 24

transverse arch

Answer 24

cuboid, 3 cuneiforms and bases of the 5 metatarsals

Question 25

2 mechanisms to support foot arches

Answer 25

passive - ligaments and bone shapes

dynamic - intrinsic and extrinsic muscles of the foot

Question 26

pes planus

Answer 26

flexible or rigid
usually caused by loose or degenerating ligaments
exacerbated by gaining weights or spending a lot of time standing

Question 27

pes planus treatment

Answer 27

can be asymptomatic can cause infero-medial talus dislocation

can cause misalignment of ankle and knee and cause pain

problems with shock absorption = back pain

treated with insoles

Question 28

lisfranc injury

Answer 28

cuneiform to metatarsal injury by pressing down on like a stilleto shaped foot