Tibiofibular and Ankle Joints

Question 1

Where does the patellar tendon insert into the tibia?

Answer 1

Tibial tuberosity

Question 2

What is Osgood-Schlatter disease?

Answer 2

Inflammation and irritation of the patellar tendon at the tibial tuberosity during adolescence

Question 3

What is the general shape of the tibia?

Answer 3

Essentially triangular, until distal end

Question 4

What are the three borders of the tibia?

Answer 4

Anterior border
Interosseus/lateral border
Medial border

Question 5

Which border of the tibia is subcutaneous?

Answer 5

Medial border

Question 6

What is the hook-like process at the end of the tibia?

Answer 6

Medial malleolus

Question 7

What projects down from the end of the fibula?

Answer 7

Lateral malleolus

Question 8

What forms the socket for the ankle joint?

Answer 8

Medial and lateral malleoli

Question 9

What are the grooves on the malleolus and posterior tibia for?

Answer 9

Flexor tendons

Question 10

Which leg bone is weight bearing?

Answer 10

Tibia

Question 11

Which leg bone is solely for muscle attachment, and bears no weight?

Answer 11

Fibula

Question 12

What connects the tibia and the fibula?

Answer 12

Interosseus membrane

Question 13

What does the interosseus membrane do?

Answer 13

Hold tibia and fibula together

Transmit forces

Question 14

How many muscles attach to the fibula?

Answer 14

9

Question 15

What is the only muscle that inserts into the fibula, and where does it insert?

Answer 15

Biceps femoris at head of fibula

Question 16

What is the course of the fibularis longus tendon?

Answer 16

Goes across sole of foot and attaches to base of first metatarsal

Question 17

What does the fibularis longus tendon do?

Answer 17

Hold big toe down in locomotion

Question 18

How far does fibularis brevis extend across the sole of the foot?

Answer 18

Only goes to base of fifth metatarsal

Question 19

What can happen to the fifth metatarsal in inversion sprains?

Answer 19

Avulsion fracture - bone becomes detached because of traction force applied by tendon

Question 20

Which part of the tibia is most commonly injured?

Answer 20

Junction of middle and inferior thirds

Question 21

Why is the junction of the middle and inferior thirds of the tibia most susceptible to injury?

Answer 21

Narrowest here

Question 22

Why is bony repair at the junction of the middle and inferior thirds of the tibia impeded?

Answer 22

Relative lack of vascularity because site of anastomosis of anterior tibial and fibularis arteries

Question 23

What holds the tibia and fibula together?

Answer 23

2 joints
- Superior
- Inferior
Interosseus membrane

Question 24

What are the three functions of the interosseus membrane?

Answer 24

Hold tibia and fibula together
Transmits force from fibula to tibia
Site of attachment for muscles

Question 25

What type of joint is the superior tibiofibular joint?

Answer 25

Synovial

Question 26

What is the range and type of movement at the superior tibiofibular joint?

Answer 26

Not much movement | Gliding movement associated with movement at ankle and knee joint

Question 27

What reinforces the superior tibiofibular joint?

Answer 27

Anterior and posterior tibiofibular ligaments

Question 28

What type of joint is the inferior tibiofibular joint?

Answer 28

Syndesmosis

Question 29

What is a syndesmosis?

Answer 29

Joint held together by fibrous tissue

Question 30

What does the syndesmosis of the inferior tibiofibular joint do?

Answer 30

Keep distal ends of two bones together in movements at ankle joint Prevents separation during weight bearing movements

Question 31

What reinforces the inferior tibiofibular joint?

Answer 31

Anterior and posterior interosseus ligaments

Question 32

When can the inferior tibiofibular joint sustain injury?

Answer 32

Landing from height Diastasis = separation of two bones and splitting of interosseus membrane Quite rare generally

Question 33

What are the tarsal bones?

Answer 33

``` Calcaneus Talus Navicular Cuneiform - Medial - Middle - Lateral Cuboid ```

Question 34

With which structures does each tarsal make contact?

Answer 34

Each tarsal makes contact with other adjacent to it

Question 35

What joins adjacent tarsals?

Answer 35

Ligamentous bands

Question 36

For which tendon does the calcaneus provide a significant lever for attachment?

Answer 36

Achilles' tendon

Question 37

What is the Achilles' tendon?

Answer 37

Combined insertion of gastrocnemius and soleus

Question 38

Which bone in the foot is the key bone in terms of articulation?

Answer 38

Talus

Question 39

What does the Achilles' tendon do?

Answer 39

Plantar flexor of ankle joint

Question 40

Where on the calcaneus does the Achilles' tendon attach?

Answer 40

Calcaneus tuberosity

Question 41

What is the size of the first metatarsal relative to the others?

Answer 41

Much bigger and thicker

Question 42

What is halux valgus?

Answer 42

Lateral displacement of first metatarsal

Question 43

What is the size of the second metatarsal relative to the others?

Answer 43

Most slender

Question 44

Why is the second metatarsal much more immobile than the others?

Answer 44

Base wedged in by medial and lateral cuneiforms

Question 45

What can cause a march fracture in the second metatarsal?

Answer 45

Lots of running on hard surfaces | Prolonged marching like in the armed forces

Question 46

How many phalanges are in the big toe?

Answer 46

2

Question 47

How many phalanges are in toes two to five?

Answer 47

3

Question 48

What creates the tunnel at the head of the first metatarsal on the undersurface?

Answer 48

Two sesamoid bones

Question 49

What passes through the tunnel at the head of the first metatarsal on the undersurface?

Answer 49

Tendon | Neurovascular structures supplying distal aspect of tes

Question 50

How is weight bearing transmitted through the bones of the foot?

Answer 50

Transmitted down onto calcaneus | Passes forward to talus and remaining bones

Question 51

When is the calcaneus especially susceptible to fracture?

Answer 51

Landing from height

Question 52

What often gets fractured along with the calcaneus when it's because of landing from a height, and why?

Answer 52

Lower vertebrae because force transmitted up entire lower limb

Question 53

Why are parts of the talus relatively avascular?

Answer 53

No muscle attachments

Question 54

Which joint is above the talus?

Answer 54

Ankle joint

Question 55

Which joint is below the talus?

Answer 55

Subtalar joint

Question 56

Which joint is in front of the talus?

Answer 56

Midtarsal joints

Question 57

What are the midtarsal joints?

Answer 57

Talocalcaneonavicular joint | Calcaneocuboid joint

Question 58

What is the space between the tibial and fibular malleolus called, to form the ankle joint?

Answer 58

Mortice

Question 59

What fits into the mortice to form the ankle joint?

Answer 59

Body of talus

Question 60

What deepens the mortice posteriorly?

Answer 60

Inferior transverse ligament

Question 61

Which malleolus projects further distally?

Answer 61

Fibular

Question 62

Why is the axis of rotation at the ankle joint not horizontal?

Answer 62

Because fibular malleolus extends further distally than tibial

Question 63

Which movements are associated with plantar flexion?

Answer 63

Inversion | Slight adduction

Question 64

What are the general movements at the ankle joint?

Answer 64

Plantar and dorsi-flexion

Question 65

Why do ankle sprains have swelling in front of the line of the distal tibia?

Answer 65

Because capsule of joint projects further forwards to neck of talus

Question 66

Where do the collateral ligaments of the ankle joint attach?

Answer 66

Tips of malleoli | Go down

Question 67

Which of the collateral ligaments of the ankle joint is stronger?

Answer 67

Medial

Question 68

Which bone does the medial collateral ligament of the ankle joint incorporate?

Answer 68

Calcaneus

Question 69

How many bands make up the lateral collateral ligament of the ankle joint?

Answer 69

3 - Anterior talofibular - Posterior talofibular - Calcaneofibular

Question 70

Which collateral ligament of the ankle joint is most often injured, and in what type of injury?

Answer 70

Lateral collateral ligament, particularly in sprains where foot goes into plantar flexion, inversion, and adduction

Question 71

Which band of the lateral collateral ligament of the ankle joint is most commonly injured?

Answer 71

Anterior

Question 72

What do the ligaments connecting the bones of the foot carry?

Answer 72

Blood vessels to individual bones

Question 73

What separates the anterior and posterior surfaces of the calcaneus, underneath the subtalar joint?

Answer 73

Groove - sinus tarsi

Question 74

What does the sinus tarsi house?

Answer 74

Talocalcaneal ligament

Question 75

What does the talocalcaneal ligament do?

Answer 75

Very strong | Resists inversion and eversion

Question 76

What does the subtalar joint do?

Answer 76

Keep talus and calcaneus in contact

Question 77

What are the movements at the subtalar joint?

Answer 77

Most of - Inversion = 20 degrees - Eversion = 10 degrees

Question 78

What is a clubbed foot?

Answer 78

Abnormal tarsal bone development | Causes inversion, where toes touch ground but heal doesn't

Question 79

What bones articulate at the talocalcaneonavicular joint?

Answer 79

Talus Calcaneus Navicular

Question 80

What bones articulate at the calcaneocuboid joint?

Answer 80

Calcaneus | Cuboid

Question 81

How does the foot pronate?

Answer 81

Subtalar joint everts | Midtarsal joints abduct

Question 82

How does the foot supinate?

Answer 82

Subtalar joint inverts | Midtarsal joints adduct

Question 83

What is the pattern of pronation and supination in gait?

Answer 83

Supination in landing during gait Pronation to bear weight after supinating Re-supinates to take off into next stage of gait

Question 84

What is the spring ligament's other name?

Answer 84

Plantar calcaneonavicular ligament

Question 85

What type of joint is the metatarsophalangeal joint?

Answer 85

Condyloid

Question 86

What are the movements at the metatarsophalangeal joint?

Answer 86

Flexion and extension | Adduction and abduction

Question 87

What type of joint is the interphalangeal joint?

Answer 87

Hinge

Question 88

What are the movements at the interphalangeal joint?

Answer 88

Flexion and extension

Question 89

What are the ligamentous supports of the metatarsophalangeal and interphalangeal joints?

Answer 89

Collateral ligaments

Question 90

What are the plantar and dorsal plates around the metatarsophalangeal and interphalangeal joints made of?

Answer 90

Fibrocartilage

Question 91

Where is the plantar aponeurosis?

Answer 91

Immediately deep to skin | Between calcaneus and and metarsal heads

Question 92

What does the plantar aponeurosis do?

Answer 92

Binds skin of foot for grip and protection Maintains longitudinal arches of foot - especially when on balls of feet Binds calcaneus and metatarsals together

Question 93

What can happen to the calcaneus in plantar fasciitis and why?

Answer 93

Bony spur forms because of traction of inflamed plantar aponeurosis

Question 94

Where are the arches of the foot?

Answer 94

Between 3 weight bearing points - Calcaneal tuberosity - Head of metatarsal 1 - Head of metarsal 5

Question 95

What do the arches of the foot do?

Answer 95

Provide stable base in standing | Dynamic springs in locomotion

Question 96

What are the arches of the foot?

Answer 96

2 longitudinal arches - Medial - Lateral 1 transverse arch - hemi-arch on each foot

Question 97

What is the type of support of the arches during static activity?

Answer 97

Ligamentous

Question 98

What is the type of support of the arches during dynamic activity?

Answer 98

Muscular