L10- Ankle

Question 1

what are the three divisions of the foot, and what are in them?

Answer 1

• hindfoot: talus; calcaneus
• midfoot: navicular, cuboid, cuneiforms
• forefoot: metatarsals, phalanges

Question 2

describe the superior tibiofibular joint

Answer 2

synovial plane joint with a capsule

Question 3

describe the inferior tibiofibular joint

Answer 3

syndesmosis:

• posterior tibiofibular ligament
• anterior tibiofibular ligament
• crural tibiofibular interosseous ligament

Question 4

what is the talotibial (talocrural) joint?

Answer 4

the ankle joint

Question 5

describe it

Answer 5

• most congruent joint in the body
• ## synovial hinge joint

Question 6

describe the mortise and tenon joint

Answer 6

• mortise:
  = fibular malleolus
  = tibial malleolus
  = distal end of tibia
• tenon: head of talus

Question 7

describe its axis

Answer 7

• toe out stance (= normal tibial torsion)

- pathological: external/ internal tibial torsion

Question 8

describe the movements of the talotibial joint

Answer 8

• dorsiflexion = increased toe out
• plantarflexion = decreased toe out
• mostly occur in sagittal plane

Question 9

describe the medial collateral

Answer 9

its an ankle ligament

• aka: deltoid

Question 10

what are the components of the medial collateral

Answer 10

• tibionavicular
• tibiocalcanean
• anterior tibiotalar
• posterior tibiotalar

Question 11

describe the lateral collateral and its components

Answer 11

weakest of the collaterals

components:

• anterior talofibular
• posterior talofibular
• calcaneofibular

Question 12

describe the talocalcaneal joint

Answer 12

aka: subtalar joint

very stable
uniaxial, triplanar

Question 13

how many surfaces does it have? describe them

Answer 13

3
- posterior: concave facet on talus with convex facet on calcaneus

• anterior: convex facets on body and neck of talus; concave facets on calcaneus

Question 14

describe the tarsal tunnel

Answer 14

• nonsynovial

- ligament = talocalcaneal ligament

Question 15

what are the movements of the talocalcaneal joint?

Answer 15

(inversion)

• adduction (vertical axis)
• supination (longitudinal axis)
• plantarflexion (coronal axis)

(eversion)
- opposite of inversion

Question 16

what are the ligaments of the talocalcaneal joint?

Answer 16

• interosseous talocalcaneal

- posterior and lateral talocalcaneal ligaments

Question 17

describe the talocalcaneonavicular joint

Answer 17

• composite joint: talocalcaneal jt + talonavicular jt

movements: inversion (closed packed); eversion

Question 18

describe the calcaneonavicular (spring) joint

Answer 18

• from sustentaculum tali to inferior navicular
• continuous medially with deltoid ligament
• continuous laterally with medial band of bifurcate ligament
• helps to maintain medial longitudinal arch

Question 19

describe the calcaneocuboid joint: articulating bones, movements, and ligaments

Answer 19

• calcaneus + cuboid
• triplanar
• plantar calcaneocuboid (short plantar); long plantar (most important)*

Question 20

describe the transverse tarsal joint

Answer 20

composite joint: talonavicular + calcaneocuboid

Question 21

function of transverse tarsal joint

Answer 21

• traditional link btwn hindfoot and forefoot
• adds to inversion/ eversion range
• compensates forefoot for hindfoot eversion
• keeps distal foot inverted with lateral surface in contact with ground while hindfoot is everted
• compensation between hindfoot and forefoot not possible when hindfoot is inverted

Question 22

what 3 retinacula exist on ankle?

Answer 22

• superior/inferior extensor retinacula
• flexor retinaculum
• peroneal (fibular) retinaculum

Question 23

superior/ inferior extensor retinacula

Answer 23

• localized thickenings of anterior crural fascia

Question 24

what do they bind down?

Answer 24

tendons of:

• tibialis anteior
• extensor hallucis longus
• extensor digitorum longus
• peroneus tertius

Question 25

what does it cover/

Answer 25

- deep peroneal nerve | - anterior tibial artery

Question 26

describe the flexor retinaculum

Answer 26

- localized medial thickening of crural fascia

Question 27

what does it bind down?

Answer 27

- flexor hallucis longus - flexor digitorum longus - tibialis posterior

Question 28

what does it cover?

Answer 28

tibial nerve posterior tibial artery

Question 29

describe the peroneal retinaculum

Answer 29

- localized medial thickening of lateral deep fascia | - binds down tendons of: peroneus longus and brevis

Question 30

describe the plantar arches

Answer 30

- longitudinal: medial + lateral | - pathologies: pes cavus + pes planus

Question 31

what are the support ligaments of the plantar arches

Answer 31

- plantar calcaneonavicular (spring): primary support for medial longitudinal arch - long plantar: primary support for lateral longitudinal arch

Question 32

what are other support ligaments?

Answer 32

- plantar aponeurosis - plantar calcaneocuboid (short plantar) - marginal abductors

Question 33

arch support structures

Answer 33

- shapes of bones | - peroneus longus