Week 13 Anatomy - Ankle and Foot Flashcards
What bones form the ankle joint?
Tibia
Fibula
Talus
What is the collective name for the group of medial ligaments of ankle?
Deltoid ligament - attachments from tibia to talus, navicular, calcaneus
What are the major ligaments of the lateral aspect of ankle joint?
Anterior talofibular ligament (most commonly injured)
Posterior talofibular ligament
Calcaneofibular ligament
Does the ankle joint participate in inversion/eversion?
No! This occurs at the MTP joints of the forefoot
What structures pass anterior to medial malleolus?
Saphenous vein
Saphenous nerve
What structures pass posterior to medial malleolus (and therefore deep to flexor retinaculum)?
“Tom, Dick, and Very Naughty Harry”
Tibialis posterior
Flexor digitorum longus
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Flexor hallucis longus
What structures pass underneath the extensor retinaculum?
“Timothy Has A Very Nasty Disease, Fungal Toe”
Tibialis anterior tendon
extensor Hallucis longus
tibial Anterior Artery
tibial anterior Vein
deep fibular Nerve
extensor Digitorium longus
Fibularis tertius
What bones form the posterior-most aspect of the foot?
Calcaneus
Talus
Navicular (anterior to talus)
What are the names of the row of 4 bones in the mid foot, medial to lateral?
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
Cuboid
What bones form the medial longitudinal arch?
Calcaneus, Talus, Navicular, 3 cuneiforms and 3 metatarsals
What bones form the lateral longitudinal arch?
Calcaneus, cuboid, lateral two metatarsals
What bones forms the transverse arch of the foot?
Cuboid, cuneiforms, and bases of metatarsals
What is the major ligamentous support of the medial arch?
Spring ligament/plantar calcaneonavicular
What is the major ligamentous support of the lateral longitudinal arch?
Long plantar ligament
What structures bear the greatest strength and therefore most important for maintaining arch?
Plantar ligaments and plantar aponeurosis
What are the passive factors which contribute to arch stability?
Bones and ligaments
What are the active factors which contribute to arch stability?
Intrinsic muscles and long tendons of FHL and FDL
What is the general arterial supply to the dorsum of the foot?
Dorsalis pedis: it’s a direct continuation of anterior tibial artery, until it passes under extensor retinaculum
What is the general arterial supply of the plantar aspect of the foot?
Posterior tibial artery divides deep to flexor retinaculum into medial and lateral plantar arteries.
Medial plantar artery = deep branch which supplies muscles of great toe, medial sole
Lateral plantar artery = runs lateral and anteriorly, to form the deep plantar arch, which supply the lateral digits via the metatarsal arteries it gives off
What two veins does the venous blood from the foot mainly drain into?
Great and Small Saphenous veins
(From dorsal venous arch, to medial marginal vein of foot to great saphenous vein on medial aspect)
(From lateral marginal vein of foot to small saphenous vein on lateral aspect)
What nerve supplies majority of dorsum of foot, except for interdigital space of toes 1+2?
What nerve does the interdigital space?
Superficial fibular nerve = most
Deep fibular = interdigital space
What is the majority of the foot sole innervated by?
Medial aspect = medial plantar nerve (medial terminal branch of tibial nerve)
Lateral aspect = lateral plantar nerve (lateral terminal branch of tibial nerve)
What nerve/s innervate lateral aspect of foot and heel?
Sural nerve/calcaneal branches (originating from both tibial and common fibular nerve)
How many layers make up the sole of the foot?
Four
What muscles make up the first layer of the sole of the foot?
Abductor hallucis (from calcaneal tuberosity to proximal phalanx)
Flexor digitorum brevis (from calcaneal tuberosity to middle phalanges of lateral 4 digits - split tendon to allow FDL tendons to pass through)
Abductor digiti minimi - from tubercle of calcaneus to lateral base of proximal 5th phalanx)
What muscles make up the second layer of the foot?
Hint, there are two muscles in 2nd layer
Quadratus plantae - from plantar surface of calcaneus to tendon of FDL, has a synergistic effect with FDL
Lumbricals - “worm like” - from tendons of FDL to medial aspect of lateral 4 digits - flex proximal phalanges, extend middle and distal phalanges of lateral 4 digits
What muscles make up the 3rd layer of the sole?
Hint, 3 muscles in layer 3
Flexor hallucis brevis - from cuboid and lateral cuneiform to base of proximal phalanx
Adductor hallucis, has two heads: oblique and transverse
- Oblique from bases of metatarsals 2-4
- Transverse from plantar ligament of MTP from 5th MT
Flexor digiti minimi brevis - from base of 5th MT to base of 5th proximal phalanx
What muscles make up 4th layer of the sole?
Plantar (unipennate) and dorsal (bipennate) interossei muscles
PAD and DAB
