The foot and ankle Flashcards Preview

Anatomy term 2 > The foot and ankle > Flashcards

Flashcards in The foot and ankle Deck (59):
1

How is the ankle joint formed?

articulation between the distal tibia and fibula with the talus

2

What 2 movements does the synovial hinge joint allow?

dorsiflexion

plantarflexion

3

What is the osteoology of the ankle?

1. tibia
2. fibula
3. medial malleolus - distal tibia
4. talus
5. lateral malleolus - distal fibula
6. calcaneus - heal bone
7. fibular trochlear
8. cuboid
9. groove
10. navicular
11. cuneiforms

4

What is the stability of the ankle joint like?

it is stable

5

What makes the ankle joint stable?

1. good congruity between malleolar mortice and trochlea - the malleoli grip the talus

2. involves strong ligaments

6

What ligaments make the ankle joint stable?

1. distal part - interosseous membrane
2. anterior and posterior tibiofibular ligaments

7

Where is the trochlea wider?

wider anteriorly than posteriorly

8

What is the movement of the trochlea during dorsiflexion and what does this movement do to the tibia and fibula?

the anterior part of the trochlea moves between the malleoli

spreads the tibia and fibula slightly increasing their grip on the talus

9

What is the most stable position of the ankle?

dorsiflexion

10

What are the lateral ligaments of the ankle joint that contribute to stability?

1. posterior talofibular ligament
2. anterior talofibular ligament
3. calcaneofibular ligament

11

What is the weakest ligament of the ankle joint?

Calcaneofibular ligament

12

What is the medial ligament attached to and where does it fan out to?

- attaches to the medial malleolus

- fans out to attach to talus, navicular and calcaneus

13

What is the medial ligament also called?

deltoid ligament due to it's resemblance to the greek letter delta

14

What are the movements of the ankle joint? (4)

1. dorsiflexion
2. plantarflexion
3. inversion
4. eversion

15

What muscles does dorsiflexion involve and what nerve and artery are these muscles supplied by?

muscles of the anterior compartment of the leg

deep fibular (perineal) nerve

anterior tibial artery

16

What muscles does plantar flexion involve and what nerve and artery are these muscles supplied by?

muscles of the posterior compartment of the leg - except popliteus

supplied by the tibial nerve

posterior tibial artery

17

Where does inversion and eversion usually occur?

- at subtler joint - with some movement in the transverse tarsal joint

18

Where does the subtler joint lie?

between the talus and underlying calcaneus

19

What type of injuries are most ankle sprains? (inversion or eversion?)

inversion injuries

with twisting of the plantar-flexed foot

20

What ligament is usually injured in an ankle sprain?

lateral ligament

21

How quickly do ligaments heal in ankle sprains and why?

they heal slowly

as ligaments are relatively avascular

22

What happens to the growth and strength of a ligament when it is detached from bone?

fibres don't grow back into the bone as extensively

healed ligament is usually weaker

23

What do torn ligaments predispose the ankle joint to and why?

They predispose the ankle joint to dislocation

As the ankle joint is less stable

24

Which ligament is weaker - the lateral or medial ligament and which part in particularly?

the lateral ligament

particularly the anterior talofibular part

25

What do you look for in a normal ankle joint x ray?

1. even joint space all the way

26

What can been seen on a x ray of a patient with osteoarthritis?

loss of joint space

loss of cartilage space

contour of talus is gone

27

What types of fractures can you have at the ankle joint?

1. fracture at distal fibula - lateral malleolar fracture
2. left ankle bimalleolar fracture
3. open fracture of lateral side of leg
4. fracture of fibula

28

What type of dislocation can you have at the ankle joint?

1. anterior dislocation of the distal talus of the tibia

29

What ligament can an eversion injury pull on and avulse and how can this fracture the fibula?

pull on strong medial ligament

causes avulsion of medial malleolus

fracture of fibula - lateral rotation of the talus

30

How common are eversion injuries?

not very common

31

Where does the force come from in an eversion injury?

on medial aspect of the ankle

32

What is the role of the foot? (3)

1. support and transmit body weight
2. act as a lever to propel body weight
3. act as a resilient spring to absorb shock

33

What would happen to the about of force generated with impact on ground if the foot was rigid?

the force generated would be large

34

What makes the foot able to deform to absorb shock and adapt to uneven surfaces?

the fact that it is a series of small bones and ligaments

35

What is the osteology of the foot?

1. calcaneus
2. talus
3. navicular
4. cuneiforms
5. metacarpals
6. phalanges

36

What are the joints of the foot?

1. naviculo-cuneiform joints
2. tarsometatarsal joints
3. metatarsophalangeal joints
4. interphalangeal joints

37

On an x ray what would you see on a patient with gout?

build up of uric acid on the first big toe

1st metatarsal phalangeal joint

38

What would you see on an x ray of the foot on a patient with gout?

Reduce space in interphalangeal joint

39

What would you see in a patient with rheumatoid arthritis on an X ray?

metarsophalangeal joints and interphalangeal joints affected

40

What is the medical term for a bunion?

Halux valgus

41

How the arches of the foot contribute to stability/what is their role?

1.help distribute weight acting as shock absorbers

2.increase flexibility of the foot

3. act as springboards for propulsion during walking, running and jumping

42

What are the 3 arches of the foot?

1. medial longitudinal - MLA
2. lateral longitudinal - LLA
3. transverse - TA

43

What bones does the medial longitudinal arch compromise of? (5)

1.calcaneus
2. talus
3. navicular
4. 3 cuneiforms
5. 3 medial metatarsals

44

In the medial longitudinal arch where is weight transmitted?

Through the talus to the calcaneus and metatarsal heads

45

Which arch is higher and more important the lateral longitudinal arch or medial longitudinal arch?

medial longitudinal arch

46

What bones make up the lateral longitudinal arch?

1. calcaneous
2. cuboid
3. lateral 2 metatarsals

47

What bones make up the transverse arch?

1. cuboid
2. 3 cuneiforms
3. bases of the 5 metatarsals

48

What would the weight of the body do to the arches if they were not supported?

would flatten the arches

49

How is the stability of the arches maintained? (2)

1. passive - includes ligaments and shape of the bones
2. dynamic- intrinsic and extrinsic muscles of the foot

50

What is pes planus?

Flat foot

can be asymptomatic

51

What age groups is pes planus seen in?

adults and adolescents

52

What are the 2 types of pes planus?

1. flexible
2. rigid - fusion of tarsal bones

53

What is flexible pes planus?

1. more common
2. arch is present when not weight bearing and absent when standing

54

What is pes planus caused by?

loose or degenerating ligaments

55

What can exacerbate pes planus?

gaining weight

spending a long time standing

56

What is the treatment for pes planus?

orthotics - specilaised insoles

57

What problems can pes planus cause?

1. displacement of the talus infer-medially
2. misalignment of ankle and knees causing pain in these areas
3. can decrease shock absorption by the foot leading to lower back pain

58

What are the movements of the toes of the foot and what joints do they occur at?

1. flexion - metatarsophalangeal joints and proximal and distal interphalangeal joints
2. extension - metatarsophalangeal joints and proximal and distal interphalangeal joints
3. abduction - limited - at metatarsophalangeal joints
4. adduction - relaxed position - limited - metattarsopahlangeal joints

59

What injuries can occur to the foot?

1. dislocated toes
2. communitive fracture
3. oblique fractures
4. stress fractures - running
5. fracture at bases of metatarsophalangeal joints
6. lisfranc injury - disruption of mid foot when foot is thrown forwards like in horse riding and is easy to miss on x rays
7. fracture of calcaneus - jumping or falling from a height