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Ortho > Foot & Ankle > Flashcards

Foot & Ankle Flashcards

(61 cards)

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1
Q

What nerve is at risk during fibula ORIF?

A

Superficial peroneal nerve

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2
Q

Where does the SPN cross the fibula?

A

3-12cm proximal to the distal fibula

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3
Q

In which direction does the superficial peroneal nerve cross the fibula

A

Posterior to anterior

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4
Q

What nerve is at risk with open Achilles’ tendon repair?

A

Sural nerve

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5
Q

Where does the sural nerve cross the Achilles’ tendon?

A

10cm proximal to its insertion into the calcaneus

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6
Q

What tendon is directly medial to the Achilles’ tendon?

A

The plantaris tendon- can look like nerve intra-op

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7
Q

What happens to the ankle mortise as the ankle goes from plantarflexion to dorsiflexion?

A

Mortise widens

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8
Q

Which ligaments make up the syndesmosis?

A

AITFL, PITFL, IOL, Transverse tibiofibular ligament, inferior transverse ligament

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9
Q

In which direction is the syndesmosis most unstable?

A

Anterior to Posterior

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10
Q

Which bones does the spring ligament connect?

A

Calcaneus and navicular

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11
Q

What are the primary ligaments of the medial ankle?

A

Deltoid ligament, calcaneonavicular (spring) ligament

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12
Q

What are the layers of the deltoid ligament?

A

Superficial- attaches to the anterior colliculus of the tibia and spans the tibiotalar and subtalar joints
Deep- originated from the posterior colliculus of the tibia and only spans the tibiotalar joint

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13
Q

What are the primary ligaments of the lateral ankle?

A

ATFL, PTFL, CFL, LTCL

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14
Q

Which ankle ligament is the weakest and most likely to be Injured?

A

ATFL (Always Tears First)

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15
Q

Which lateral ankle ligament is the strongest?

A

PTFL

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16
Q

Which lateral ankle ligament is the primary restraint to inversion while the foot is in plantarflexion?

A

ATFL

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17
Q

Which lateral ankle ligament is the primary restraint to inversion while the foot is in neutral or dorsiflexion?

A

CFL

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18
Q

Where does the posterior tibialis tendon insert?

A

Navicular and medial cuneiform

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19
Q

What is the function of the posterior tibialis tendon?

A

Inversion and plantarflexion of the foot

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20
Q

What is the major antagonist to the posterior tibialis tendon?

A

Peroneus brevis

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21
Q

Where does the tibialis anterior tendon insert?

A

Medial cuneiform and 1st metatarsal

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22
Q

What is the function of tibialis anterior

A

Dorsiflexion and inversion

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23
Q

Where does peroneus longus insert?

A

1st metatarsal and medial cuneiform

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24
Q

What is the function of peroneus longus?

A

Plantarflexion and eversion

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25
Where does peroneus brevis insert?
5th metatarsal base
26
What is the function of peroneus brevis?
Plantarflexion and eversion
27
How are the peroneal tendons orientated at the level of the ankle joint?
Peroneus brevis is anterior and longus posterior | Remember Brevis is closer to Bone (fibula)
28
What is the name of the recesses on the distal tibia where the fibula sits?
Inicisura fibularis
29
How many muscles or tendons attach to the talus?
0
30
What percentage of the talus is covered with cartilage?
70%
31
What is the blood supply of the talus?
Artery of the tarsal canal (from PT artery) Anterior tibial artery Artery of the tarsal sinus (from the anterior tibial and peroneal arteries)
32
What is the main blood supply to the talus?
Posterior tibial artery
33
Which branch of the artery of the tarsal canal supplies the medial talar body?
Deltoid artery
34
What structure runs between the medial and lateral tubercles of the posterior process of the talus?
FHL
35
What is the primary motion of the subtalar joint?
Inversion and eversion
36
What are the three facets of the subtalar joint?
Anterior, middle, posterior
37
Which facet of the calcaneus is the largest?
Posterior
38
With the extensile lateral approach to the calcaneus, which structures are at risk?
Sural nerve, lateral calcaneal branch of the peroneal artery
39
What are the 2 most common approaches to the calcaneus?
Extensile lateral and sinus tarsi
40
What inserts into the base of the 5th metatarsal?
Peroneus brevis | Lateral band of the plantar fascia
41
What is the origin of the plantar fascia?
Medial calcaneal tuberosity
42
Which joints are referred to as the Chopart’s joints?
Calcaneocuboid and talonavicular joints
43
The lis franc ligament connects which 2 bones?
Medial cuneiform and 2nd metatarsal
44
Which bones make up the medial column of the foot?
1st metatarsal, medial cuneiform and navicular
45
Which bones make up the middle column of the foot?
2nd and 3rd metatarsals, middle and lateral cuneiforms
46
Which bones make up the lateral column of the foot?
4th and 5th metatarsals, cuboid
47
Which column of the foot is most rigid?
Middle
48
Which column of the foot is most flexible?
Lateral
49
Which column of the foot should not be fused?
Lateral column
50
Why should the lateral column of the foot not be fused?
Allows for functional motion
51
Which column of the foot carries the most load in weightbearing?
Medial column
52
What muscles and nerve roots are tested during neurovascular exam of the foot?
Tibialis anterior- ankle dorsiflexion- L4 EHL- great toe extension- L5 Gastrocnemius/ soleus complex- ankle plantarflexion S1
53
What are the 5 sensory nerves to the foot?
``` Saphenous nerve- medial foot DPN- 1st web space SPN- Dorsum of the foot Sural- lateral foot Tibial- sole of foot ```
54
Which 3 vessels supply the foot?
Posterior tibial Anterior tibial Peroneal arteries
55
How many compartments are in the foot?
9- Medial, lateral, 4 interosseus, 3 central
56
What is the non-union rate for talus fractures?
5%
57
What is the most common complication of talar neck fractures?
Subtalar arthritis
58
What is the rate of arthritis in talar neck fractures?
50-100%
59
What is the rate of tibiotalar (ankle joint) arthritis following talar neck fracture?
33%
60
If AVN occurs post talar neck fracture, where abouts does it occur?
The talar body
61
What is the only remaining blood supply to the talus with displaced talar neck fractures?
The deltoid branch of the artery of the tarsal canal from the posterior tibial artery

Ortho (12 decks)

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