The foot and ankle Flashcards Preview

Anatomy term 2 > The foot and ankle > Flashcards

Flashcards in The foot and ankle Deck (59):

How is the ankle joint formed?

articulation between the distal tibia and fibula with the talus


What 2 movements does the synovial hinge joint allow?




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


What is the stability of the ankle joint like?

it is stable


What makes the ankle joint stable?

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

2. involves strong ligaments


What ligaments make the ankle joint stable?

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


Where is the trochlea wider?

wider anteriorly than posteriorly


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


What is the most stable position of the ankle?



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

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


What is the weakest ligament of the ankle joint?

Calcaneofibular ligament


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


What is the medial ligament also called?

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


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

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


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


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


Where does inversion and eversion usually occur?

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


Where does the subtler joint lie?

between the talus and underlying calcaneus


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

inversion injuries

with twisting of the plantar-flexed foot


What ligament is usually injured in an ankle sprain?

lateral ligament


How quickly do ligaments heal in ankle sprains and why?

they heal slowly

as ligaments are relatively avascular


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


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


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

the lateral ligament

particularly the anterior talofibular part


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

1. even joint space all the way


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


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


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

1. anterior dislocation of the distal talus of the tibia


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


How common are eversion injuries?

not very common


Where does the force come from in an eversion injury?

on medial aspect of the ankle


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


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

the force generated would be large


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


What is the osteology of the foot?

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


What are the joints of the foot?

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


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


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

Reduce space in interphalangeal joint


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

metarsophalangeal joints and interphalangeal joints affected


What is the medical term for a bunion?

Halux valgus


How the arches of the foot contribute to stability/what is their role? distribute weight acting as shock absorbers

2.increase flexibility of the foot

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


What are the 3 arches of the foot?

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


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

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


In the medial longitudinal arch where is weight transmitted?

Through the talus to the calcaneus and metatarsal heads


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

medial longitudinal arch


What bones make up the lateral longitudinal arch?

1. calcaneous
2. cuboid
3. lateral 2 metatarsals


What bones make up the transverse arch?

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


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

would flatten the arches


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


What is pes planus?

Flat foot

can be asymptomatic


What age groups is pes planus seen in?

adults and adolescents


What are the 2 types of pes planus?

1. flexible
2. rigid - fusion of tarsal bones


What is flexible pes planus?

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


What is pes planus caused by?

loose or degenerating ligaments


What can exacerbate pes planus?

gaining weight

spending a long time standing


What is the treatment for pes planus?

orthotics - specilaised insoles


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


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


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