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Musculoskeletal Module > Lecture 14 > Flashcards

Lecture 14 Flashcards

1
Q

What are the essential features of the talus?

A 
Lines up under Tibia and Fibula
-Tight and stable joint
Top of talus = Dome shaped
Smooth - Articular Cartilage
for when you move feet Up and Down (Dorsiflexion and Plantar flexion)
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2
Q

What are the 3x bones of the Ankle Joint Propa?

A
  1. Tibia
  2. Talus
  3. Fibula
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3
Q

What is the Heel bone?

A

Calcaneus
=Heel bone/Hindfoot
Posterior part of calcaneus = where Achilles Tendon attaches (Calcaneal Tendon)
Sustentaculum Tali = portion of Calcaneus (heel bone/hind foot) Under the Talus bone - Supports Talus

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4
Q

What is the Sustentaculum Tali?

A

Portion of the Calcaneus located underneath the Talus

Supports Talus

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5
Q

What is anothe word for hind foot?

A

Calcaneus

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6
Q

What are the two other words for Calcaneus?

A

Hind foot/Heel bone

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7
Q

What is the function of the sustentaculum tali?

A

Support Talus, as is part of the calcaneus bone located underneath the calcaneus

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8
Q

Where is the Navicular located?

A

Medial and superior aspect of foot
directly Inferior to the 3x Cuneiforms
“little boat” /kayak/paddle board side on

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9
Q

What is the name of the bone that is directly Inferior to the 3x cuneiforms on the foot and is boat shaped?

A

Navicular

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10
Q

Where is the cuboid located?

A

Lateral superior aspect of foot

Lateral to 3x cuneiforms and navicular

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11
Q

What is the name of the bone that is directly lateral to the 3x cuneiforms on the foot?

A

cuboid

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12
Q

What are the 3x names of the 3x Cuneiforms?

A
  1. Medial
  2. Intermediate
  3. Lateral
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13
Q

What are the names of the Toes Proper?

A

Phalanges

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14
Q

What are the phalanges?

A

bones of the toes Proper

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15
Q

How many planes is the Ankle Joint Propa in?

A

1x plane

just up and down / Dorsiflex and Plantar flex

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16
Q

What is the difference between the anterior and posterior portion of the talar bone?

A

Anterior wider than > Posterior
Dorsiflexed foot = Anterior part of dome engaged = fills space b/w tibia and fibula really tightly = ankle joint is MOST stable (during dorsiflexion) -standing flat
vs
Plantarflexion = Talar dome rotated anteirorly foot pointing down = Less wide dome = Joint is less engaged and more space between Talus - Tibia and Fibula = Less strong and More likely to get injured (during Plantarflexion) - running, wearing high heels

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17
Q

Are you more likely to get injured when your foot is dorsiflexed or plantar flexed?

A

Plantar flexed
-running
-high heels
due to - posterior dome being smaller - more space b/w joint - less engaged - less stable/strong - more likely to be injured

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18
Q

What is the relative complexity between the Subtalar Joint and the Ankle Joint Proper?

A 
Subtalar joint (between talus Calcaneus) = More complex
=allows inversion and eversion
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19
Q

What is the difference between the planes of movement between the Ankle Joint Propa or the Subtalar joint?

A

Ankle Joint = up and down dorsiflexion and plantarflexion

Subtalar joint = more complex = inversion and eversion

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20
Q

What is a consistency of the size of the space around the talus?

A

Size of joint space around the talus should be symetrical

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21
Q

What is an example of a syndesmosis joint located in the foot?

A

Tibiofibular joint

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22
Q

What are the names of the 4x joints located in the foot?

A
  1. Ankle Joint Proper
  2. Subtalar Joint
  3. Talocalceonavicular joint
  4. tibiofibular joint
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23
Q

Talocalceonavicular joint?

A

B/w Talus, sustentaculum Tali (part of the calcaneus which is underneath supporting the talus) and Navicular
-Pronation and Supernation

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24
Q

What joint is composed of the talus, calcaneus and navicular?

A

Talocalceonavicular Joint
-allows for pronation and supernation
+ a little inversion and eversion

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25
Q

What are the 3x out of the 4 joints in the foot that allow for movement?

A
  1. Ankle joint Propa: up and down dorsiflexion and plantarflexion
  2. Subtalar joint = Inversion and Eversion
  3. Talocaleonavicular Joint = Supernation and pronation and a little bit of inversion and eversion
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26
Q

What plane(s) of movement of the foot are enabled by the subtalar joint?

A

inversion and eversion

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27
Q

What plane(s) of movement of the foot are enabled by the ankle joint proper?

A

up and down dorsiflexion and plantarflexion

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28
Q

What plane(s) of movement of the foot are enabled by the talocaleonavicular joint?

A

Supernation and pronation and a little bit of inversion and eversion

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29
Q

What 3x ligaments come off the Fibula?

A 
Lateral ligaments
(as Littler Lateral FibuLa)
1. Anterior Talofibular lig
2. Posterior Talofibular lig.
3. Calcaneofibular 
2x ligaments between fibula and talus 
2x ligament between fibula and calcaneous
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30
Q

What are the ligaments coming off the Tibia?

A

Medial Ligaments
(as Tibia is medial)
Tougher and stronger(matching larger tibia)
Deltoid ligament = 4x components. Fused together, causing Fan shaped
Fans out to attach 2x onto Talus (anteriorly and posteriorly) + Sustentaculum tali (of calcaneus) + navicular

31
Q

Where do the 4x branches of the deltoid ligament on the Medial side of the foot attach to?

A

2x to Talus
1. Anterior Talus 2. Posterior Talus
+ Sustentaculum Tali (of calcaneus)
+ Navicular

32
Q

What 3x things is the distal tibiofibular joint stabilised by?

A
  1. Anterior Tibiofibular ligaments
  2. Posterior Tibiofibular ligaments
  3. Interosseus membrane
33
Q

What 2x collective thing stabilise the ankle joint itself?

A

Medial and lateral ligament complexes
Medial = 4x ligaments off the Tibia
Lateral = 3x ligaments off the Fibula

34
Q

What are 2x words which describes the deltoid ligament?

A

Wide and strong

35
Q

What is the lateral ligament complex composed of?

A

Fibula = Little Lateral FibuLa

  1. Ant. Talofibular Ligament
  2. Post. Talofibular ligament
  3. Calcanofibular ligament
36
Q

What could be an indication for an abnormal foot xray?

A

Uneven.unsymetrcal size of joint space
fractured fibula
everything has moved laterallly
break in lateral malleolus

37
Q

What are the 3x categories of the foot?

A
  1. tarsal bones (5x)
  2. metatarsals (5x)
  3. phalanges -3x per toe (except big toe has 2x)
38
Q

What are the 5x Tarsal bones?

A
  1. Talus
  2. Calcaneus
  3. Navicular
  4. Cuboid
  5. Cuneiforms
39
Q

What is the mortise component of you foot joint?

A

TIbia and Fibula

40
Q

What is the Tenon component of your foot joint?

A

Talus - protruding piece that fits into the cut out

41
Q

What are the essential features of the Mortise and Tenon joint of the ankle?

A

Mortise = Tibia and Fibula
Tenon = Talus - protruding piece that fits into the cut out
- Once fit in is pretty stable
- is a corresponding hole/fit so doesnt fall out
-allows ankle joint to work as ONE UNIT
-ligaments help unify the 3x separate bones

42
Q

What is the most important ligament in the ankle joint?

A

Tibiofibular joint

43
Q

What are the essential features of the tibiofibular joint?

A

Dense Fascia (similar to fescia lata/ITB)
Thickening of the interosseus membrane distally (distal thickening)
Syndesmosis
Tight joint -allowing for only very small amount of movement
-also allows talus to fit nice and neatly into ankle joint
-avoids excess wiggle room
Extramovement
=damage via articular cartilage, early onset arthiritis and pain
Stabilised by 2x Anterior and Posterior Tibiofibular ligaments + Interosseus membrane

44
Q

What would happen is the tibiofibular ligament didnt hold the tibia and fibula close together?

A

Woudl allow for more room/looser fit between the talus(tenon) and tibia and fibula(mortise) joint
Extramovement
=damage to articular cartilage, early onset arthiritis, pain

45
Q

What would a Syndesmotic Injury look like?

A

When you can see both the tibia and fibula CLEARLY from one view (not overlapping like they should be)
or Unsymetrical joint space between the 3x bones of the ankle joint proper
tibiofibular ligament torn
Need to repair tibiofibular ligament to avoid ongoing injury

46
Q

What is a fair assumption of you could see both the tibia and fibula clearly in one view (of an xray)?

A

Syndesmotic Injury
The tibiofibular ligament (syndesmosis) is torn
more wiggle room for talus
lead to more potential injuries due to Excess movement (articular cartilage, early onset arthritis, pain)
THEREFORE
would be unsymmetrical joint space
-need to repair the ligament to avoid further injury

47
Q

What is the relationship between the Dorsalis Pedis Artery and the Posterior Tibial Artery of the foot?

A

The dorsalis pedis artery comes over the top of the foot and Anastomoses/fuses with the Posterior Tibial Artery from the plantar surface
-allows the foot to have a good bloody supply, coming from the top and bottom, and meeting the middle

48
Q

What structural features allow the foot to have a good bloody supply?

A

Dorsalis Pedis artery Anastomoses with the Posterior Tibial Artery
- good blood supply in the foot, coming from the top and bottom, and meeting in the middle

49
Q

From what directions does the foot receive a good bloody supply?

A

Top has Dorsalis Pedis Artery, Bottom as Posterior Tibial artery, and two anastomose in the middle
-ensuring and backing up one another to have a good blood supply in the foot

50
Q

What is the relationship between the Posterior Tibial artery and the Tibial Nerve?

A

Run together through the foot
- Both havent split in the Medial Foot,(from posterior compartment –> foot)
then They both split together once theyre into the foot(Medial and Lateral Planter Nerve) and (Medial and Lateral Planter Artery)
Run together
Spread out to supply the Plantar aspects of the foot

51
Q

What are the terminal branches of the tibial nerve?

A

-once they enter the foot
Medial Plantar Nerve
Lateral Plantar Nerve
-branches and runs with the Posterior Tibial artery and is relative branches

52
Q

What are the terminal branches of the Posterior Tibial Artery?

A

-once they enter the foot
Medial Plantar Artery
Lateral Plantar Artery
-branches and runs with the Tibial nerve and its relative branches

53
Q

What are the 3x terminal branches off the Popliteal Artery?

A
  1. Anterior Tibial Artery
  2. Posterior Tibial Artery
  3. Peroneal Artery
54
Q

What is the path of the Posterior Tibial Artery?

A

Runs in Posterior compartment
passes Posterior to the Medial Malleolus in the Tarsal Tunnel’-good place to take a pulse
-same pathway/runs with the Tibial Nerve

55
Q

In what portion of the Posterior Tibial Artery is it a good location to take a pulse?

A

When the Posterior Tibial artery runs Posteiror to the Medial Malleolus in the tarsal tunnel
-same pathway as/runs with the Tibial Nerve

56
Q

What is the relationship between the Posterior Tibial artery and the Medial Malleolus?

A

path of Posterior Tibial artery:
Runs through posterior compartment, runs Posterior to Medial Malleolus in the tarsal tunnel
-same pathway as/ runs with the Tibial Nerve

57
Q

What is the path of the Tibial Nerve?

A

Largest branch from sciatic nerve
Runs down Posterior compartment, Then runs Posterior to Medial Malleolus in the Tarsal Tunnel
-same path as the Posterior Tibial Artery
Branches into Medial and Lateral Planter Nerves once entering the foot
-after entering medially with the Posterior Tibial Nerve

58
Q

What is the location of the tibial Nerve and Posterior Tibial Artery in the tarsal tunnel?

A

Both run together Posterior to the Medial Malleolus, prior to entering and branching medially into respective Medial and Lateral Plantar branches (medial and lateral Plantar Artery) and (Medial and Lateral Plantar Nerve)

59
Q

What does the Lateral Plantar Nerve go off to innervate?

A 
Cutaneous
Smaller
Laterally
Lateral border of sole
and Lateral 1 and 1/2 toes
60
Q

What does the Medial Plantar Nerve go off to innervate?

A

Cutaneous
Larger
Medially
Majority of the skin on the sole f the foot
Digital branches of medial toes 1-4 (I-IV)

61
Q

What are the 2x categories of the Longitudinal Arch of the foot?

A

Medial Arch and Lateral Arch

62
Q

What are the essential features and 9x of the Medial arch part of the Longitudinal Arch

A

Medial Arch:
Higher
More important
9x parts: Calcaneus, Talus, Navicular, 3x Cuneiforms, 3x MEtatarsals
Talar= Keystone to the Medial Arch
-helping to Mainting the arch are 3x muscles: Tibialis Anterior, Posterior and Peroneus Longus

63
Q

What is the Keystone of the Medial Arch of the foot?

A

Talus

64
Q

What is the role of the talus in the medial arch of the longitudinal arch of the foot?

A

Talus in the Keystone of the medial arch

65
Q

Which component of the Longitudinal arch is higher and more important?

A

MEdial Arch

arch is maintained by Tibialis Anterior, Tibialis Posterior and Peroneus Longus

66
Q

What are the essential features and 4x of the Lateral arch part of the Longitudinal Arch?

A

Flatter (rests on ground when standing)

Calcaneous, Cuboid and 2x MEtatarsals

67
Q

What are the 2x opposing arches of the foot?

A 
Longitundinal arch (Medial and lateral arch)
Transverse Arch
68
Q

What are the essential features of the Transverse Arch?

A

Side to side
Cuneiforms, cuboid, and bases of metatarsals (5x)
Peroneus Longus important in mainting this arch

69
Q

Which muscles help maintain the Medial Arch components of the Longitudinal arch?

A
  1. Tibialis Anterior
  2. Tibialis Posterior
  3. Peroneus Longus
70
Q

Which muscles help maintain the Transverse arch?

A

Peroneus Longus

71
Q

What are the main features regarding Muscle Layers in the foot?

A

4x muscle layers
Plantar surface
numbered 1-4 Superficial –> Deep

72
Q

What are the essential features of the second layer of the foot muscles?

A
  • Tendons from Posterior compartment
  • Neurovascular Bundle
  • important if there is a penetrating injury + bleeding = needs to be able to find neurovascular bundle to stop
73
Q

In what layer of the foot do the Tendons from the Posterior compartments enter?

A

2nd Layer
-Neurovascular Bundle also enters at this level (makes sense as Posterior Tibial Artery and Tibial Nerve Run and branch off together in the foot side by side)

74
Q

What is the importance of knowing that the Neurovascular Bundle is located in the second muscular layer of the foot?

A

If there is penetrating injury
then = blood
=need to know where the neurovascular bundle is to be able to locate and stop the bleedin

Musculoskeletal Module (27 decks)

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