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MD1 Metabolism > Tibiofibular and Ankle Joints > Flashcards

Tibiofibular and Ankle Joints Flashcards

1
Q

Where does the patellar tendon insert into the tibia?

A

Tibial tuberosity

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2
Q

What is Osgood-Schlatter disease?

A

Inflammation and irritation of the patellar tendon at the tibial tuberosity during adolescence

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3
Q

What is the general shape of the tibia?

A

Essentially triangular, until distal end

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4
Q

What are the three borders of the tibia?

A

Anterior border
Interosseus/lateral border
Medial border

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5
Q

Which border of the tibia is subcutaneous?

A

Medial border

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6
Q

What is the hook-like process at the end of the tibia?

A

Medial malleolus

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7
Q

What projects down from the end of the fibula?

A

Lateral malleolus

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8
Q

What forms the socket for the ankle joint?

A

Medial and lateral malleoli

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9
Q

What are the grooves on the malleolus and posterior tibia for?

A

Flexor tendons

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10
Q

Which leg bone is weight bearing?

A

Tibia

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11
Q

Which leg bone is solely for muscle attachment, and bears no weight?

A

Fibula

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12
Q

What connects the tibia and the fibula?

A

Interosseus membrane

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13
Q

What does the interosseus membrane do?

A

Hold tibia and fibula together

Transmit forces

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14
Q

How many muscles attach to the fibula?

A

9

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15
Q

What is the only muscle that inserts into the fibula, and where does it insert?

A

Biceps femoris at head of fibula

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16
Q

What is the course of the fibularis longus tendon?

A

Goes across sole of foot and attaches to base of first metatarsal

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17
Q

What does the fibularis longus tendon do?

A

Hold big toe down in locomotion

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18
Q

How far does fibularis brevis extend across the sole of the foot?

A

Only goes to base of fifth metatarsal

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19
Q

What can happen to the fifth metatarsal in inversion sprains?

A

Avulsion fracture - bone becomes detached because of traction force applied by tendon

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20
Q

Which part of the tibia is most commonly injured?

A

Junction of middle and inferior thirds

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21
Q

Why is the junction of the middle and inferior thirds of the tibia most susceptible to injury?

A

Narrowest here

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22
Q

Why is bony repair at the junction of the middle and inferior thirds of the tibia impeded?

A

Relative lack of vascularity because site of anastomosis of anterior tibial and fibularis arteries

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23
Q

What holds the tibia and fibula together?

A

2 joints
- Superior
- Inferior
Interosseus membrane

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24
Q

What are the three functions of the interosseus membrane?

A

Hold tibia and fibula together
Transmits force from fibula to tibia
Site of attachment for muscles

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25
Q

What type of joint is the superior tibiofibular joint?

A

Synovial

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26
Q

What is the range and type of movement at the superior tibiofibular joint?

A

Not much movement

Gliding movement associated with movement at ankle and knee joint

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27
Q

What reinforces the superior tibiofibular joint?

A

Anterior and posterior tibiofibular ligaments

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28
Q

What type of joint is the inferior tibiofibular joint?

A

Syndesmosis

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29
Q

What is a syndesmosis?

A

Joint held together by fibrous tissue

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30
Q

What does the syndesmosis of the inferior tibiofibular joint do?

A

Keep distal ends of two bones together in movements at ankle joint
Prevents separation during weight bearing movements

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31
Q

What reinforces the inferior tibiofibular joint?

A

Anterior and posterior interosseus ligaments

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32
Q

When can the inferior tibiofibular joint sustain injury?

A

Landing from height
Diastasis = separation of two bones and splitting of interosseus membrane
Quite rare generally

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33
Q

What are the tarsal bones?

A 
Calcaneus
Talus
Navicular
Cuneiform
- Medial
- Middle
- Lateral
Cuboid
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34
Q

With which structures does each tarsal make contact?

A

Each tarsal makes contact with other adjacent to it

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35
Q

What joins adjacent tarsals?

A

Ligamentous bands

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36
Q

For which tendon does the calcaneus provide a significant lever for attachment?

A

Achilles’ tendon

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37
Q

What is the Achilles’ tendon?

A

Combined insertion of gastrocnemius and soleus

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38
Q

Which bone in the foot is the key bone in terms of articulation?

A

Talus

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39
Q

What does the Achilles’ tendon do?

A

Plantar flexor of ankle joint

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40
Q

Where on the calcaneus does the Achilles’ tendon attach?

A

Calcaneus tuberosity

41
Q

What is the size of the first metatarsal relative to the others?

A

Much bigger and thicker

42
Q

What is halux valgus?

A

Lateral displacement of first metatarsal

43
Q

What is the size of the second metatarsal relative to the others?

A

Most slender

44
Q

Why is the second metatarsal much more immobile than the others?

A

Base wedged in by medial and lateral cuneiforms

45
Q

What can cause a march fracture in the second metatarsal?

A

Lots of running on hard surfaces

Prolonged marching like in the armed forces

46
Q

How many phalanges are in the big toe?

A

2

47
Q

How many phalanges are in toes two to five?

A

3

48
Q

What creates the tunnel at the head of the first metatarsal on the undersurface?

A

Two sesamoid bones

49
Q

What passes through the tunnel at the head of the first metatarsal on the undersurface?

A

Tendon

Neurovascular structures supplying distal aspect of tes

50
Q

How is weight bearing transmitted through the bones of the foot?

A

Transmitted down onto calcaneus

Passes forward to talus and remaining bones

51
Q

When is the calcaneus especially susceptible to fracture?

A

Landing from height

52
Q

What often gets fractured along with the calcaneus when it’s because of landing from a height, and why?

A

Lower vertebrae because force transmitted up entire lower limb

53
Q

Why are parts of the talus relatively avascular?

A

No muscle attachments

54
Q

Which joint is above the talus?

A

Ankle joint

55
Q

Which joint is below the talus?

A

Subtalar joint

56
Q

Which joint is in front of the talus?

A

Midtarsal joints

57
Q

What are the midtarsal joints?

A

Talocalcaneonavicular joint

Calcaneocuboid joint

58
Q

What is the space between the tibial and fibular malleolus called, to form the ankle joint?

A

Mortice

59
Q

What fits into the mortice to form the ankle joint?

A

Body of talus

60
Q

What deepens the mortice posteriorly?

A

Inferior transverse ligament

61
Q

Which malleolus projects further distally?

A

Fibular

62
Q

Why is the axis of rotation at the ankle joint not horizontal?

A

Because fibular malleolus extends further distally than tibial

63
Q

Which movements are associated with plantar flexion?

A

Inversion

Slight adduction

64
Q

What are the general movements at the ankle joint?

A

Plantar and dorsi-flexion

65
Q

Why do ankle sprains have swelling in front of the line of the distal tibia?

A

Because capsule of joint projects further forwards to neck of talus

66
Q

Where do the collateral ligaments of the ankle joint attach?

A

Tips of malleoli

Go down

67
Q

Which of the collateral ligaments of the ankle joint is stronger?

A

Medial

68
Q

Which bone does the medial collateral ligament of the ankle joint incorporate?

A

Calcaneus

69
Q

How many bands make up the lateral collateral ligament of the ankle joint?

A

3

  • Anterior talofibular
  • Posterior talofibular
  • Calcaneofibular
70
Q

Which collateral ligament of the ankle joint is most often injured, and in what type of injury?

A

Lateral collateral ligament, particularly in sprains where foot goes into plantar flexion, inversion, and adduction

71
Q

Which band of the lateral collateral ligament of the ankle joint is most commonly injured?

A

Anterior

72
Q

What do the ligaments connecting the bones of the foot carry?

A

Blood vessels to individual bones

73
Q

What separates the anterior and posterior surfaces of the calcaneus, underneath the subtalar joint?

A

Groove - sinus tarsi

74
Q

What does the sinus tarsi house?

A

Talocalcaneal ligament

75
Q

What does the talocalcaneal ligament do?

A

Very strong

Resists inversion and eversion

76
Q

What does the subtalar joint do?

A

Keep talus and calcaneus in contact

77
Q

What are the movements at the subtalar joint?

A

Most of

  • Inversion = 20 degrees
  • Eversion = 10 degrees
78
Q

What is a clubbed foot?

A

Abnormal tarsal bone development

Causes inversion, where toes touch ground but heal doesn’t

79
Q

What bones articulate at the talocalcaneonavicular joint?

A

Talus
Calcaneus
Navicular

80
Q

What bones articulate at the calcaneocuboid joint?

A

Calcaneus

Cuboid

81
Q

How does the foot pronate?

A

Subtalar joint everts

Midtarsal joints abduct

82
Q

How does the foot supinate?

A

Subtalar joint inverts

Midtarsal joints adduct

83
Q

What is the pattern of pronation and supination in gait?

A

Supination in landing during gait
Pronation to bear weight after supinating
Re-supinates to take off into next stage of gait

84
Q

What is the spring ligament’s other name?

A

Plantar calcaneonavicular ligament

85
Q

What type of joint is the metatarsophalangeal joint?

A

Condyloid

86
Q

What are the movements at the metatarsophalangeal joint?

A

Flexion and extension

Adduction and abduction

87
Q

What type of joint is the interphalangeal joint?

A

Hinge

88
Q

What are the movements at the interphalangeal joint?

A

Flexion and extension

89
Q

What are the ligamentous supports of the metatarsophalangeal and interphalangeal joints?

A

Collateral ligaments

90
Q

What are the plantar and dorsal plates around the metatarsophalangeal and interphalangeal joints made of?

A

Fibrocartilage

91
Q

Where is the plantar aponeurosis?

A

Immediately deep to skin

Between calcaneus and and metarsal heads

92
Q

What does the plantar aponeurosis do?

A

Binds skin of foot for grip and protection
Maintains longitudinal arches of foot - especially when on balls of feet
Binds calcaneus and metatarsals together

93
Q

What can happen to the calcaneus in plantar fasciitis and why?

A

Bony spur forms because of traction of inflamed plantar aponeurosis

94
Q

Where are the arches of the foot?

A

Between 3 weight bearing points

  • Calcaneal tuberosity
  • Head of metatarsal 1
  • Head of metarsal 5
95
Q

What do the arches of the foot do?

A

Provide stable base in standing

Dynamic springs in locomotion

96
Q

What are the arches of the foot?

A

2 longitudinal arches
- Medial
- Lateral
1 transverse arch - hemi-arch on each foot

97
Q

What is the type of support of the arches during static activity?

A

Ligamentous

98
Q

What is the type of support of the arches during dynamic activity?

A

Muscular

MD1 Metabolism (18 decks)

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