Foot And Ankle Anatomy

Question 1

Medial longitudinal arch of the foot, construction, function and factors that maintain it

Answer 1

Construction - calcaneus, talus and navicular. 3 cuneiforms and 3 medial metatarsals

Function - it’s a high arch that is concerned with elastic propulsion whilst walking

Factors maintaining - ligaments - interposes, plantar aponeurosis, long plantar ligament, deltoid and spring ligaments. Muscles - tib ant and tib post, short muscles of big toe and FHL.

Question 2

Lateral longitudinal arch of the foot: construction, function and factors maintaining

Answer 2

Construction - calcaneus, cuboid and 2 lateral metatarsals.

Function - low arch for bodyweight transmission

Factors maintaining - interposes Piaget, plantar aponeurosis, short plantar ligament. 3 Peronei muscles and short muscles of little toe

Question 3

Transverse arch of the foot: construct, function and factors maintaining

Answer 3

Construct: cuboid, cuneiforms and base of metatarsals

Function: both elastic propulsion and bodyweight transmission

Factors maintaining - interosseous ligaments, peroneus longus and adductor hallicus

Question 4

Spring ligament

Answer 4

Calcaneonavicular

Question 5

Deltoid ligament

Answer 5

Medial side. 4 parts. 3 anterior 1 posterior.

Anteriorly: from the anterior colliculus anteriortibiotalar attaches to the anteromedial surface of the talus; tibiobavicular to the navicular tuberosity and tibiocalcaneal to the suscentaculum tali on the calcaneus.

Posterior: posterior tibiotalar from posterior colliculus to the medial talus

Question 6

Lateral collateral ligament of the ankle

Answer 6

3 parts.

From the lateral maleoloud to the talus - anterior and posterior fibulotslar ligaments

From the lateral mal to the posterior calcareous - calcaneofilbular.

Question 7

Attachments of the deltoid ligament

Answer 7

Colliculi of the medial mal

Neck and body of the talus
Suscentaculum tali of calcaneus
Navicular tuberosity
Spring ligament

Question 8

Subdesmotic components

Answer 8

Anterior and posterior inferior tobiofibulsr ligaments
Inferior Transverse liagemt
Interosseous membrane

Anterior chaput tubercle. Posterior volkmann .

Question 9

Midtarsal joint of chopart

Answer 9

Transverse tarsal joint

calcaneocuboid saddle joint and talcalcenonavicular ball and socket

Question 10

What movements occur at the subtalar joint

Answer 10

Inversion and eversion

Question 11

Which muscles perform the movements at subtalar joint

Answer 11

Inversion: tin ant and tin post

Eversion; peroneus longus and brevis

Question 12

What type of joint is the subtalar joint

Answer 12

Synovial hinge

Question 13

What bones form the ankle

Answer 13

Tibia, fibula and talus (trochlear surface)

Question 14

Muscles involved in plantar flexing

Answer 14

Posterior compartments

Gastrocnemius, soleus, plantar is, tib post, flexible hallicus longus and flexor digitorum longus

Question 15

Muscles involved in dorsiflexiln

Answer 15

Anterior compartment

TiB ant

Peroneus tertius

EHL
EDL

Question 16

Why is the ankle most stable in dorsiflexikn

Answer 16

Because the talar surface is not uniform, it is widest anteriorly so is stabilised in dorsiflexilm.

In paltarflexion the narrower posterior part of the trochlea is articulating with the tibia which is less stable as it does not fill the space on the tibia and allows more movement

Question 17

What type of joint is the inferior tibiofibulsr

Answer 17

Syndesmosis

Question 18

Type of joint inferior tibiofibulsr

Answer 18

Syndesmosis

Question 19

Associated injury sundesmotic fracture

Answer 19

Lateral malleolus

Question 20

Muscles that make up the Achilles tendon

Answer 20

Gastroc, soleus, plantaris

Question 21

What makes up the Achilles tendon

Answer 21

Gastroc, soleus, plantar is

Question 22

Structures passing behind the medial malleolus

Answer 22

Tarsal tunnel

Tom Dick and Very Nervous Harry

Tibialis posterior, flexor digitorum longus, posterior tibial vessels, posterior tibial nerve and flexor hallicus longus

Question 23

Structures deep to the extensor retinculjm

Answer 23

Anterior

Tom has very nice dogs and pigs

Tib ant

EHL

Tib ant vessels

TiB ant nerve

EDL

Peroneus tertius

Question 24

Dorsalis pedis artery

Answer 24

Continuation of anterior tibial when it crosses the ankle joint

Passes anteriorly over the dorsal aspect of talus, navicular and cuneiforms then passes inferior as the deep plantar artery between the two heads of the first dorsal interposes muscles to join the deep plantar arch

Question 25

Medial and lateral plantar arteries

Answer 25

Supply the sole of the foot Branches of posterior tibial I’m the sole between 1st and second layers of muscle Lateral planter forms the deep plantar arch with the deep plantar artery from DP

Question 26

Where to palpate DP and TP arteries

Answer 26

Lateral to EHL tendon Halfway between posterior border medial mal and Achilles

Question 27

What movements does the extensor hallicus Longus perform?

Answer 27

Extension of the great toe Dorsiflexion of the foot Some assistance with inverson

Question 28

What movements does extensor Hallicus Longus perform?

Answer 28

Extension of the great toe Dorsiflexion of the foot Some assistance with inversion

Question 29

What vessels would you find deep to EHL?

Answer 29

Anterior tibial artery and vein

Question 30

What nerve lies deep to EHL?

Answer 30

Deep peroneal

Question 31

Where do you test sensation for s1

Answer 31

Lateral foot

Question 32

Where do you test L4

Answer 32

Medial malleolous

Question 33

Where do you test deep peroneal nerve

Answer 33

1st web space

Question 34

Where do you test superficial peroneal nerve

Answer 34

Dorsum of the foot

Question 35

Where do you test Sural nerve

Answer 35

lateral malleolus

Question 36

Leg reflex

Answer 36

Ankle s1 Knee L3/4

Question 37

How do you describe dorsiflexion

Answer 37

Movement of the foot, upwards, towards the leg

Question 38

At what joint does dorsiflexion occur

Answer 38

Tib fib talus

Question 39

What muscles are involved in dorsiflexion of the foot

Answer 39

Tibialis anterior Extensor hallicus longus Extensor digitorum longus Peroneal tertius = the anterior compartment

Question 40

How would you describe plantarfkexion

Answer 40

The downwards movement of the foot in relation to the leg

Question 41

What muscles are involved in plantar flex ion

Answer 41

Posterior compartments Gastroc, soleus, plantaris Tibialis posterior, flexor hallicus longus and brevis, popliteus

Question 42

What happens when tib ant and tib post contract together

Answer 42

Inversion of the foot

Question 43

What joint does inversion and evrsi9n occur at

Answer 43

Subtalar

Question 44

What muscles are responsible for ankle eversion

Answer 44

Lateral compartment Peroneal longus and brevis

Question 45

What motor and sensory function is lost with damage to the superficial peroneal nerve

Answer 45

Inability to evert the foot and loss of sensation over the dorsal aspect of the foot (except from 1st web space)

Question 46

Describe the Dermatome of the leg

Answer 46

L1 groin L2 thigh L3 knee L4 shin and big toe L5 muscle lower leg and 3 toes S1 lateral foot and heel S2 back of the leg S3 toilet seat area S4 and S5 perineum

Question 47

Myotomes leg

Answer 47

L1 and 2 hip flex ion L3 knee extension L4/5 ankle dorsiflexion L5 big toe extension S1 plantarflexion

Question 48

Findings L2 nerve root compression

Answer 48

Sensory loss anteromedial thigh Iliopsoas weak

Question 49

Findings L3 nerve root compression

Answer 49

Lower thigh and knee sensation loss Quads extension

Question 50

Findings L4 nerve root compression

Answer 50

Anteromedial lower leg numbness Loss of tib ant

Question 51

Findings L5 nerve root compression

Answer 51

Anteromedial lateral lower leg numbness and dorsum of foot Loss of EHL and gluteus medius

Question 52

Findings S1 nerve root compression

Answer 52

Numbness lateral foot and heel Gastrosoleus complex and gluteus maximus

Question 53

Findings S234 nerve root compression

Answer 53

Perinatal numbness Bowel/bladder dysfunction Cremasteric reflex