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MSK > anatomy of the foot and ankle > Flashcards

anatomy of the foot and ankle Flashcards

1
Q

what are the three divisions of the bones in the foot

A

tarsal bones- 7 irregularly shaped bones situated proximally in the foot
metatarsals- 5 bones that connect the phalanges to the tarsal bones
phalanges- bones of the toe. each doe has 3 phalanges except the big toe which has only 2.

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2
Q

what bones are in the hindfoot

A

talus

calcaneus

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3
Q

what bones are in the mid foot

A

navicular
cuboid
cuneiforms

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4
Q

what bones are in the forefoot

A

metatarsals

phalanges

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5
Q

function of talus

A

to transmit forces from tibia to the calcaneus

the trochlear of the talus is the part that articulates with the tibia and fibula. its wider anteriorly than posteriorly

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6
Q

why is there a high risk of avascular necrosis if the talus is fractured

A
  • lack of muscle attachments on talus

- retrograde blood supply- the arteries enter the bone at its vital end

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7
Q

what type of joint is the ankle joint and what movement does it allow

A

synovial joint
hinge joint
permits dorsiflexion and plantar flexion of the foot

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8
Q

explain position of talus in dorsi and plantar flexion

A

the distal tibiofibular joint forms a bracket shaped socket known as a mortise. the trochlea of the talus cuts into the ankle mortise (aka malleolar fossa). in dorsiflexion the anterior part of the trochlear of the talus is held in mortise and joint is more stable. in plantar flexion posterior part of trochlea is held in the mortise and the joint is less stable.

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9
Q

what muscles allow plantarflexion od the ankle

A

gastrocnemius
soleus
plantaris
tibialis posterior

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10
Q

what muscles allow dorsiflexion of the ankle

A

tibialis anterior
extensor hallucis longus
extensor digitorium longus
peroneus tertius

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11
Q

what are the lateral ligaments in the ankle joint and what do they do

A

anterior talofibular ligament- between the lateral malleolus and neck of the talus
posterior talofibular ligament- between the malleolar fossa and the lateral tubercle of the talus.
calcaneofibular ligament- between the tip of the lateral malleolus sand the lateral surface of the calcaneus.

they resist inversion of the foot

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12
Q

what does the medial ligament in the ankle joint do

A

Aka deltoid ligament
resists excessive eversion of the foot
its fibres fan out from the medial mallelous to attach to the talus, calcaneus and navicular.

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13
Q

at what joints do eversion and inversion of the foot occur

A

subtalar, calcaneocuboid and the talocalcaneonavicular joints of the mid foot.

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14
Q

what muscles bring about eversion of the foot

A

lateral compartment of leg: peroneus longus and peroneus brevis
anterior compartment : peroneus tertius

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15
Q

what muscles bring about inversion of the foot

A 
tibialis anterior 
tibialis posterior (deep posterior compartment) muscles.
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16
Q

how can power of tibialis anterior be tested

A

ask patient to stand on their heels with their forefeet raised not the ground.

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17
Q

tibialis anterior:origin, insertion, action, innervation

A

originates from lateral surface of tibia and inserts onto medial cuneiform and the base of the first metatarsal.
-dorsiflexion and inversion of the foot
supplied by deep pernoneal(fibular) nerve

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18
Q

extensor digitorum longus: origin, insertion, action, innervation

A

originates from lateral condyle of the tibia, medial surface of fibula and interosseous membrane. fibres merge into a single tendon into the ankle where it divides into 4 tendons on dorsal of the foot.
actions: extension of the lateral 4 toes and assist in dorsiflexion of the foot
innervation : deep fibular nerve

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19
Q

extensor hallucis longus:origin, insertion, action, innervation

A

originates from medial surface of the fibular shaft attaches to the base of the distal phalanx of the great toe
action: extension great toe and dorsiflexion of the foot
innervation - deep fibular nerve.

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20
Q

peroneus (fibularis) tertius :origin, insertion, action, innervation

A

not present in everyone.
originates from medial surface of the fibula and descends with the EDL then diverges from it and inserts onto the base of the fifth metatarsal.
action : eversion and assist in dorsiflexion of the foot
innervation: deep fibular nerve.

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21
Q

what muscles are in lateral compartment of the leg

A

fibularis longus

fibularis brevis

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22
Q

fibulas longus :origin, insertion, action, innervation

A

orginates from upper lateral surface of the fibula and the lateral tibial condyle and inserts onto the plantar surface of the medial cuneiform and base of the first metatarsal.
action : peroneus longus everts and assists in plantar flexion of the foot. also support the medial and transverse arches of the foot.
innervation : superficial fibular nerve

23
Q

fibularis brevis:origin, insertion, action, innervation

A

originates from inferolateral surface of the fibular shaft and insert onto a tubercle on the base of the fifth metatarsal.
actions : eversion of the foot and supports lateral longitudinal arch
innervation : superficial fibular nerve

24
Q

what are the muscles in the superficial posterior compartment of the leg

A

gastrocnemius
plantaris
soleus

25
Q

what is the nurse associated with the calcaneal tendon and what is its role

A

subcutaneous calcaneal bursa- between the skin and the calcaneal tendon
deep calcaneal bursa -between calcaneal tendon and the calcaneus
to reduce friction during movement

26
Q

gastrocnemius:origin, insertion, action, innervation

A

has two heads
originates from the lateral femoral condyle, and medial head from the medial femoral condyle.
fibres converge and form a single tendon with the soleus and planataris to form the calcaneal tendon which inserts into the calcaneal tuberosity
Actions: It plantarflexes at the ankle joint
Innervation: Tibial nerve

27
Q

plantaris:origin, insertion , action , innervation

A

has a long thin tendon that can be mistaken for. nerve
originates from lateral supracondylar line of femur
action : very weak plantar flexor of foot and flexor of knee so is harvested by plastic surgeons
innervation : tibial nerve

28
Q

soleus:origin, insertion , action , innervation

A

originates from shell line of the tibia and proximal fibula and inserts onto calcaneal tuberosity.

actions: soleus plantar flexes the foot at the ankle joint
innervation: tibial nerve

29
Q

muscles in deep posterior compartment of leg

A

popliteus
tibialis posterior
flexor digitorum longus
flexor hallucis longus

30
Q

politeus:origin, insertion , action , innervation

A

originates from the tibial proximity to the solar line and inserts onto the lateral condyle of the femur and the posterior horn of the lateral meniscus.
actions: laterally rotates the femur on the tibia unlocking the knee joint so that flexion can occur.
innervation : tibial nerve

31
Q

tibialis posterior :origin, insertion , action , innervation

A

Originates from the interosseous membrane between the tibia and fibula and attaches to the plantar surfaces of the medial tarsal bones.
Actions: Inverts and plantarflexes the foot, maintains the medial arch of the foot.
Innervation: Tibial nerve.

32
Q

Flexor Digitorum Longus:origin, insertion , action , innervation

A

Attachments: Originates from the medial surface of the tibia, attaches to the plantar surfaces of the lateral four digits.
Actions: Flexes the lateral four toes.
Innervation: Tibial nerve.

33
Q

Flexor Hallucis Longus:origin, insertion , action , innervation

A

Attachments: Originates from the posterior surface of the fibula, attaches to the plantar surface of the phalanx of the great toe.
Actions: Flexes the great toe.
Innervation: Tibial nerve.

34
Q

what are the nerve roots of the tibial nerve

A

L4-S3

35
Q

what does the tibial nerve innervate

A

innervates skin of :posterolateral side of leg ,lateral foot ,sole of foot
provides motor innervation to :deep and superficial posterior compartments of leg.

36
Q

name the muscles the tibial nerve supplies

A

posterior thigh: long head of biceps femoris , semimembranosus, semitendinosus, hamstring compartment of adductor Magnus
superficial posterior compartment of leg: planters, soleus, gastrocnemius
deep posterior compartment of the leg: popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

37
Q

what are the sensory branches of the tibial nerve

A

medial sural cutaneous nerve
medial calcaneal branches
medial plantar nerve
lateral plantar nerve

38
Q

root values of common perineal (fibular nerve )

A

L4-S2

39
Q

muscles supplied by common perineal nerve

A

short head of biceps femoris

40
Q

the cutaneous supply of the common perineal nerve is :

A

skin of upper lateral leg

lateral sural cutaneous nerve

41
Q

what muscles are supplied by the superficial peroneal nerve

A

peroneus (fibularis) longus

peroneus (fibularis) brevis

42
Q

where is the cutaneous supply of the superficial fibular nerve to ?

A

dorsum of the foot excluding dorsum of the first webspace and the medial and lateral borders of the foot.

43
Q

which compartment of the leg is innervated by the deep perineal nerve

A

anterior compartment

44
Q

which muscles are supplied by the deep peroneal nerve

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
fibularis tertius

45
Q

where is the cutaneous innervation of the deep fibular nerve to?

A

dorsum of the first webspace

46
Q

where does the superficial femoral artery become the popliteal artery

A

when it passes through the adductor hiatus

47
Q

what does the popliteal artery divide into at the inferior border of the popliteus muscle

A

anterior tibial artery and tibioperoneal trunk. tibioperoneal trunk becomes posterior tibial and the fibular arteries

48
Q

what does the anterior tibial artery become when it passes into the dorsum of the foot

A

dorsalis pedis artery

49
Q

arrangement behind the medial mallelosu

A 
tibialis posterior tendon 
flexor digitorum longus tendon 
posterior tibial artery 
posterior tibial vein 
tibial nerve 
flexor hallucis longus
50
Q

what artery supply the foot

A

dorsalis pedis

posterior tibial

51
Q

the pulses of the lower limb

A

femoral pulse
popliteal artery
dorsalis pedis
posterior tibial

52
Q

borders of the popliteal fossa

A

superomedial border: semimembranosus
superolateral border: biceps femoris
inferomedial border : medial head of the gastrocnemius
ininferolateral border: lateral head of the gastrocnemius and plantaris

53
Q

what forms the floor and roof of the popliteal fossa

A

The floor of the popliteal fossa is formed by the posterior surface of the knee joint capsule, popliteus muscle and posterior femur. The roof is made of up two layers: popliteal fascia and skin.

MSK (12 decks)

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