anatomy of the ankle joint

Name the 7 tarsal bones

1)medial cuneiform 2) intermediate cuneiform 3)navicular 4)talus 5)lateral cuneiform 6)cuboid 7)calcaneus

structure passing Superficial to the extensor retinacula:

1. Great saphenous vein and saphenous nerve in front of the medial malleolus 2. Superficial peroneal nerve (medial and lateral branches) in front of the middle of the ankle joint

mention the parts of the deltoid ligament

1. Posterior tibiotalar ligament. 2. Tibiocalcanean ligament 3. Tibionavicular ligament 4. Anterior tibiotalar ligament

structures passing directly behind the ankle

1. Tendo-calcaneus. 2. Plantaris tendon.

mention the parts of the lateral ligament

1. The anterior talofibular ligament (weakest part) 2. The calcaneofibular ligament: (second weakest part) 3. The posterior talofibular ligament

How many phalanges are there?

14

how many retinacula around the ankle ?

5

How many tarsal bones are there?

7

structures passing Behind the lateral malleolus

A. Superficial to the superior peroneal retinaculum: 1. Small saphenous vein. 2. Sural nerve. B. Deep to the superior peroneal retinaculum: 1. Tendon of peroneus longus. 2. Tendon of peroneus brevis. 3. Common peroneal synovial sheath.

What are the Ottawa ankle rules?

Ankle: Pain at medial malleolus Pain at distal fibula Inability to bear weight Foot: Pain at mid-foot and 5th MT Pain at navicular bone Inability to bear weight for 4 steps point tenderness at posterior edge (of distal 6 cm) or tip lateral malleolus. point tenderness at posterior edge (of distal 6 cm) or tip medial malleolus. inability to weight bear (four steps) immediately after the injury and in emergency department.

structures passing Deep to or through the extensor retinacula:

Arranged from medial to lateral. 1. Tibialis anterior tendon and its synovial sheath. 2. Extensor hallucis longus tendon and its synovial sheath. 3. Anterior tibial vessels and dorsalis pedis vessels. 4. Deep peroneal nerve and its terminal branches. 5. Extensor digitorum longus tendon (EDL). 6. Peroneus tertius tendon (PT). Common synovial sheath surrounding EDL and PT tendons

Testing of nerves related to ankle

Ask for presence of parasthesia (tingling sensation) and Test for loss of sensation on lateral side of the foot (sural nerve distribution) and adjacent sides of the big and second toes (deep peroneal nerve distribution).

structures passing Behind the medial malleolus

Deep to the flexor retinaculum: Arranged from medial to lateral. 1. Tibialis posterior tendon and its synovial sheath. 2. Flexor digitorum longus tendon and its synovial sheath. 3. Posterior tibial vessels. 4. Tibial nerve. 5. Flexor hallucis longus tendon and its synovial sheath.

damage of the ligaments can be seen through

MRI through x ray y taking shots of the ankle from different angles(stress views)

Anterior Drawer Test

Put the foot in about 10 ̊ to 20 ̊ plantarflexion Hold the leg (tibia) steady by one hand and Pull the heel anteriorly by the other hand. Result: Excessive anterior movement of the foot means injury of The anterior talofibular ligament

Treatment of ankle injuries:

R: Rest, I: Ice, C: compression, E: Elevation.

Talar Tilt Test

Testing the integrity of calcaneofibular ligament. Hold the leg (tibia) steady by one hand and try to twist the foot medially (inversion) by the other hand. Result: Excessive medial displacement of the foot means injury of the calcaneofibular ligament.

Palpation of arteries related to ankle

The dorsalis pedis artery pulsations can be palpated on the dorsum of the foot The posterior tibial artery pulsations can be palpated on the medial side of the ankle

the talus articulates below with the ...

calcaneus (heel bone)

the lower surface of the tibia articulates with the lower surface of the fibula makeing up the ..

distal tibiofibular joint

acute ankle sprains are usually caused by ..

excessive inversion and planter flexion of the lateral ankle

to which type of joints does the ankle belong ?

hinge synovial joints (movement around one axis)

describe the articulating surfaces that make up the ankle joint

in the proximal aspect of the ankle: 1. Lower surface of the lower end of the tibia 2. Articular surface of the medial malleolus 3. Articular surface of the lateral malleolus along with the transverse part of the posterior tibiofibular ligament that deepens the joint cavity creating a socket known as (malleoular\ankle mortise) . Distal (lower) articular surface: It is formed by the upper part of the body of the talus (Lateral, Upper, and medial surfaces)

describe the movement of the ankle joint:

plantarflexion (It is performed by muscles of the posterior and lateral compartments of the leg) dorsiflexion(It is performed by muscles of the anterior compartment of the leg)

what are the 3 factors that affect a joint stability ?

shape of bones strength of ligaments strength of tendons and surrounding retnicula

what is the type of the distal tibiofibular joint and what are the ligaments that stabilize it ?

syndesmosis (fibrous joint) it is stabilized by 3 ligs anterior tibiofibular lig posterior tibiofibular lig interosseous tibiofibular lig

the ankle joint is also known as ..

talocrural joint

what are the bones the make up the foot?

tarsals metatarsals phalanges

the calcaneus articulates anteriorly with..

the cuboid bone

what are the two ligaments that stabilize the ankle joint

the deltoid ligament ( medial ligament ) (the strongest ) the lateral ligament

the talus articulates anteriorly with ..

the navicular bone

what are the two bones that make up the leg?

tibia and fibula