Ankle Joint Plan

Question 1

Classify the talocrural (ankle) joint

Answer 1

It is a hinge joint

Question 2

What are the bones / articulation of the ankle joint?

Answer 2

Mortise (tibia and fibula) and tenon (talus)

Question 3

Name the retinaculum of the ankle joint

Answer 3

The retinaculum is a band of thick deep fascia that holds the long tendons of your ankle (those that cross the ankle) in place.

1. Flexor retinaculum
2. Peroneal retinaculum
3. Superior extensor retinaculum
4. Inferior extensor retinaculum

Question 4

Describe where the flexor retinaculum runs to and from

Answer 4

Passes from the back of the medial malleolous to the medial tubercle of the calcaneus

Question 5

Describe where the peroneal retinaculum runs to and from

Answer 5

Split into 2 parts

1. Superior retinaculum - attaches to the lateral side of the calcaneus passing over the tendons of fibularis longus and brevis to the posterior border of the lateral malleolus
2. Inferior retinaculum - binds the 2 peroneal tendons to the lateral side of the calcaneus

Question 6

Describe where the superior extensor retinaculum runs to and from

Answer 6

Runs horizontally across all extensor tendons between the tibia and fibula just above the ankle joint.

Question 7

Describe where the inferior extensor retinaculum runs to and from

Answer 7

Is a Y-shaped thickening on the dorsum of the foot.

Question 8

Describe the joint capsule of the ankle joint

Answer 8

• A Fibrous capsule completely surrounds the ankle joint
• Thin & weak anteriorly and posteriorly to accommodate plantar and dorsi flexion
• Strengthened laterally & medially by collateral ligaments
• Posteriorly it is attached to the posterior tibiofibular ligament

Question 9

Describe the synovial membrane of the ankle joint

Answer 9

• Lines the capsule

- Produces synovial fluid which nourishes cartilage, removes waste and reduces friction

Question 10

Name the medial ligaments of the ankle

Answer 10

Deltoid ligaments:
Deep:
1. Posterior tibiotalor ligament 
2. Anterior tibiotalor ligament
Superior: Continuous attachment from navicular to sustentaculum tali of the calcaneus 
1. Tibiocalcaneal ligament 
2. Tibionavicular ligament

Question 11

Name the lateral ligaments of the ankle

Answer 11

Lateral ligaments are not as strong as the deltoid ligaments

1. Anterior and posterior talofibular (ATFL and PTFL)
2. Calcaneofibular (CFL) laterally

Question 12

How many degrees of freedom is at the ankle?

Answer 12

1 degrees of freedom

Question 13

What are the permitted movements at the foot and ankle joint?

Answer 13

1. Plantar and dorsi flexion
2. Inversion and eversion
3. Toe flexion +/- adduction and extension +/- abduction

Question 14

What arteries supply the ankle?

Answer 14

Anterior and posterior tibial arteries

Question 15

What nerves supply the ankle?

Answer 15

Branches of the deep peroneal nerve and tibial nerve

Question 16

What muscles perform plantarflexion?

Answer 16

Deep: (Tom, Dick and Harry)

1. Tibialis posterior
2. Flexor digitorum longus
3. Flexor hallucis

Superifical:

1. Gastrocnemius
2. Soleus
3. Plantaris

Question 17

What muscles perform dorsiflexion?

Answer 17

1. Tibialis anterior
2. Extensor hallucis longus
3. Extensor digitorum longus

Question 18

Gastrocnemius

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 18

1. Medial head: medial condyle of femur 
Lateral head: lateral condyle of femur
2. Posterior calcaneus via calcaneal tendon
3. Plantar flexes foot 
Flexes the leg at the knee
4. Tibial nerve (S1,S2)

Question 19

Soleus

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 19

1. Proximal half of posterior surface of tibia along soleal line and proximal 1/3 of posterior fibula
2. Posterior calcaneus via calcaneal tendon
3. Plantar flexes foot
4. Tibial nerve (S1,S2)

Question 20

Tibialis Anterior

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 20

1. Upper two-thirds of the lateral surface of the tibia and interosseous membrane
2. Medial and plantar side of medial cuneiform
   Base of 1st metatarsal
3. Dorsi flexes foot
   Inverts foot at ankle
4. Deep peroneal nerve (L4,L5,S1)

Question 21

Tibialis Posterior

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 21

1. Upper lateral aspect of posterior surface of the tibia. Interosseous membrane. Posterior surface of the fibular
2. Navicular tuberosity, plantar surface of the medial cuneiform
3. Plantar flexes foot
   Inverts foot
4. Tibial nerve (L5, S1)

Question 22

Plantaris

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 22

1. Lateral supracondylar ridge of femur above lateral head of gastrocnemius
2. Posterior calcaneus via calcaneal tendon
3. Plantar flexes foot
   Flexes leg at the knee
4. Tibial nerve (L4, L5, S1)

Question 23

Flexor Digitorum Longus

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 23

1. Medial half of middle posterior surface of tibia
2. Base of distal phalanges of lateral four toes
3. Flexes distal phalanges of lateral four toes. Plantar flexes foot
4. Tibial nerve (L5, S1)

Question 24

Flexor Hallucis Longus

1. Origin
2. Insertion
3. Action
4. Innervation

Answer 24

1. Distal 2/3 of posterior surface of fibula. Adjacent interosseous membrane
2. Base of distal phalanx of big toe
3. Flexes distal phalanx of big toe. Plantar flexes foot
4. Tibial nerve (L5, S1, S2)

Question 25

Extensor Digitorum Longus 1. Origin 2. Insertion 3. Action 4. Innervation

Answer 25

1. Upper two thirds of anterior shaft of fibula, interosseous membrane 2. Middle & distal phalanges of digits 2-5 3. Extends toes 2-5 Dorsi flexes foot at ankle 4. Deep peroneal nerve (L4,L5,S1)

Question 26

Extensor Hallucis Longus 1. Origin 2. Insertion 3. Action 4. Innervation

Answer 26

1. Middle half of anterior shaft of fibula 2. Base of distal phalanx of great toe 3. Extends big toe Dorsi flexes foot. Inverts foot 4. Deep peroneal nerve (L4,L5,S1)