Ankle Joint and foot

I cannot believe I have a favorite tarsal bone...but if you even care its the navicular

28

28

Total bones of the foot including the fibula and tibia

7

How many tarsal bones are there?

toes to sky

Describe dorsiflexion

tippy toes

Describe plantarflexion

dorsiflexion, plantarflexion

What 2 movements of the foot occur at the talocrural?

dorsiflexion

extension in the hand is to _______ in the foot

plantarflexion

flexion in the hand is to _______ in the foot

eversion

pronation in the hand is to _______ in the foot

inversion

supination in the hand is to _______ in the foot

tibia, fibula, talus

What are the bones of the ankle?

talus

What bone of the foot has a trochlea with 3 facets and articulates with the inferior surface of the tibia and 2 malleoli

the connection between tib/fib is unmoveable

Why is the ankle joint super stable?

dorsiflexion because the wider part (trochlea of talus) is wedged into the box

Which position of the ankle is the strongest and why?

downstairs, its plantarflexed

Are you more likely to sprain your ankle walking up or downstairs, why?

deltoid ligament, lateral ligament

The articular capsule of the ankle joint is reinforced by the

talus, navicular, calcaneous

The deltoid ligament connects the medial malleolus to the

inversion, lateral ligaments

A patient presents to the ER after an ankle sprain, which type of sprain is most common and what ligament is most likely affected?

deltoid

Which ankle joint ligament is the strongest?

anterior talofibular, calcaneofibular, posterior talofibular (anterior to posterior)

In what order do you tend to tear lateral ligaments?

lateral ligament of ankle

The anterior talofibular, calcaneofibular, and posterior talofibular make up what ligament?

fibula

Which bone can fracture in an inversion sprain?

Anterior talofibular

What is the weakest part of the lateral ligament?

eversion

A patient presents to the ER for a foot injury. Xray shows an avulsion of the medial malleolus. What direction did the injury occur in?

dorsiflexors

Tendons that pass anterior to the ankle joint have what action on the ankle joint?

plantarflexion

Tendons that pass posterior to the ankle joint have what action

subtalar, talocalcaneonavicular, transverse tarsal

inversion and eversion occur at what joints in general?

subtalar joint

Inversion and eversion happen MOSTLY at the

between posterior calcaneous and talus

Where can you find the subtalar joint?

talocalcaneonavicular joint

The subtalar joint is a piece of the

transverse tarsal

Which joint helps extend inversion and eversion farther?

talonavicular (medial), calcaneocuboid (laterall)

The transverse tarsal joint is made up of the

inversion

Tendons on the medially aspect of the foot, such as tibialis anterior and posterior, act in what way on the foot?

eversion

Muscles that insert on the lateral or medial foot act in

plantar aponeruosis

Acts as a thick elastic band and includes the vertical septa

2nd toe

What is the plane of movement for the feet

abductor hallucis, flexor digitorum brevis, abductor digiti minimi

Muscles of the 1st layer

1st layer (aponeurosis)

What layer of the foot helps maintain arches

flexor digitorum longus, flexor hallucis longus, lumbricals, quadratus plantae

Muscles of the second layer

lumbricals

Found in the sole of the foot, arise from the tendon for the flexor digitorum longus, insert on metarsals 2-5, flex and extend toes

quadratus plantae

Which second layer of muscle has no homolog in the hand?

flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis

muscles in the 3rd layer of the foot

intrinsic (live and die in the foot)

The muscle of the 3rd layer of the foot are considered

relieve pressure

What are the function does the sesmoid bones

bring the big toe back toward the 2nd toe

Action of the adductor hallucis

interossei plantar (3), dorsal (4)

Muscles of the 4th layer of the foot

2nd toe cannot adduct

Why are there only 3 planter interossei muscles

adduct

planter interossei action

abduct

dorsal interossei

extensor digitorum brevis, extensor hallucis brevis

Muscles of the dorsum (top) of the foot

deep fibular nerve

Muscles of the dorsum of the foot are innervated by the

superficial fibular nerve

Which nerve does sensory innervation of the top foot with the exception of the dorsal skin between first 2 toes

deep fibular nerve

Which nerve does the sensory innervation for dorsal skin between first 2 toes

medial and lateral plantar nerve

Tibial nerve divides into the

1st lumbrical, abductor hallucis, flexor digitorum brevis, flexor hallucis brevis

Medial plantar nerve innervates the

Lateral plantar

The “rest” of the muscles of the plantar foot (abductor digiti minimi, quadratus plantae, 2,3,4th lumbricals, adductor hallucis, flexor digiti minimi brevis, plantar and dorsal interossei) are innervated by

medial plantar nerve

Which nerve does more skin than muscle in the plantar foot

dorsalis pedis

The dorsum of the foot is supplied via the ___________ a branch of the anterior tibial artery

arculate artery, deep plantar artery

The dorsalis pedis artery divides into the

dorsal metatarsal artery

The arculate artery gives off the

dorsal digital artery

the dorsal metatarsal artery becomes the

deep plantar, lateral plantar

What arteries form the deep plantar arch?

medial plantar, lateral plantar

The sole of the foot is supplied by the _________ a branch from the posterior tibial artery

medial plantar

supplies the medial surface of great toe

plantar metatarsal and common digital

The deep plantar arch gives off the

shape of bones, ligaments, plantar aponeurosis, muscle tone and tendons

Factors that help us maintain foot arches

distribute weight between calcaneus and metatarsal heads

Function of arches

2 longitudinal and transverse

How many arches are there

medial and lateral

parts of the longitudinal arch

calcaneus, talus, navicular, 3 cuniforms, medial 3 metatarsals

the medial arch consist of

medial

Which part of the longitudinal arch is “higher”

lateral

Which part of the longitudinal arch is less mobile and resitant?

talus

Keystone of medial part of longitudinal arch

calcaneus, cuboid, lateral 2 metatarsals

The lateral component of the longitudinal arch consists of

cuboid

What is the keystone of the lateral arch

metatarsal heads anterior, cuneiform and cuboid posterior

The transverse arch is made up of the

tibialis posterior/anterior, fibularis longus

The transverse arch of the foot is supported by the

plantar aponeurosis

resist depression of medial longitudinal arch on weight bearing; flexible, elastic spring board

Spring ligament (plantarcalcaneonavicular)

What is the major ligament holding up the medial longitudinal arch

talus falls, you get flat feet

What happens if the spring ligament weakens?

sustentaculum tali

What structure is under the spring ligament that helps maintain the medial longitudinal arch?

tibialis posterior

What muscle is important in holding up the medial longitudinal arch