Week 13 Anatomy - Ankle and Foot

Question 1

What bones form the ankle joint?

Answer 1

Tibia
Fibula
Talus

Question 2

What is the collective name for the group of medial ligaments of ankle?

Answer 2

Deltoid ligament - attachments from tibia to talus, navicular, calcaneus

Question 3

What are the major ligaments of the lateral aspect of ankle joint?

Answer 3

Anterior talofibular ligament (most commonly injured)
Posterior talofibular ligament
Calcaneofibular ligament

Question 4

Does the ankle joint participate in inversion/eversion?

Answer 4

No! This occurs at the MTP joints of the forefoot

Question 5

What structures pass anterior to medial malleolus?

Answer 5

Saphenous vein
Saphenous nerve

Question 6

What structures pass posterior to medial malleolus (and therefore deep to flexor retinaculum)?

“Tom, Dick, and Very Naughty Harry”

Answer 6

Tibialis posterior
Flexor digitorum longus
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Flexor hallucis longus

Question 7

What structures pass underneath the extensor retinaculum?

“Timothy Has A Very Nasty Disease, Fungal Toe”

Answer 7

Tibialis anterior tendon
extensor Hallucis longus
tibial Anterior Artery
tibial anterior Vein
deep fibular Nerve
extensor Digitorium longus
Fibularis tertius

Question 8

What bones form the posterior-most aspect of the foot?

Answer 8

Calcaneus
Talus
Navicular (anterior to talus)

Question 9

What are the names of the row of 4 bones in the mid foot, medial to lateral?

Answer 9

Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
Cuboid

Question 10

What bones form the medial longitudinal arch?

Answer 10

Calcaneus, Talus, Navicular, 3 cuneiforms and 3 metatarsals

Question 11

What bones form the lateral longitudinal arch?

Answer 11

Calcaneus, cuboid, lateral two metatarsals

Question 12

What bones forms the transverse arch of the foot?

Answer 12

Cuboid, cuneiforms, and bases of metatarsals

Question 13

What is the major ligamentous support of the medial arch?

Answer 13

Spring ligament/plantar calcaneonavicular

Question 14

What is the major ligamentous support of the lateral longitudinal arch?

Answer 14

Long plantar ligament

Question 15

What structures bear the greatest strength and therefore most important for maintaining arch?

Answer 15

Plantar ligaments and plantar aponeurosis

Question 16

What are the passive factors which contribute to arch stability?

Answer 16

Bones and ligaments

Question 17

What are the active factors which contribute to arch stability?

Answer 17

Intrinsic muscles and long tendons of FHL and FDL

Question 18

What is the general arterial supply to the dorsum of the foot?

Answer 18

Dorsalis pedis: it’s a direct continuation of anterior tibial artery, until it passes under extensor retinaculum

Question 19

What is the general arterial supply of the plantar aspect of the foot?

Answer 19

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

Question 20

What two veins does the venous blood from the foot mainly drain into?

Answer 20

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)

Question 21

What nerve supplies majority of dorsum of foot, except for interdigital space of toes 1+2?

What nerve does the interdigital space?

Answer 21

Superficial fibular nerve = most

Deep fibular = interdigital space

Question 22

What is the majority of the foot sole innervated by?

Answer 22

Medial aspect = medial plantar nerve (medial terminal branch of tibial nerve)
Lateral aspect = lateral plantar nerve (lateral terminal branch of tibial nerve)

Question 23

What nerve/s innervate lateral aspect of foot and heel?

Answer 23

Sural nerve/calcaneal branches (originating from both tibial and common fibular nerve)

Question 24

How many layers make up the sole of the foot?

Answer 24

Four

Question 25

What muscles make up the first layer of the sole of the foot?

Answer 25

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)

Question 26

What muscles make up the second layer of the foot?

Hint, there are two muscles in 2nd layer

Answer 26

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

Question 27

What muscles make up the 3rd layer of the sole?

Hint, 3 muscles in layer 3

Answer 27

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

Question 28

What muscles make up 4th layer of the sole?

Answer 28

Plantar (unipennate) and dorsal (bipennate) interossei muscles

PAD and DAB