Mock4 - Foot and ankle

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1. Name the tarsal bones

2. Articulation
   The talus articulates:

Superiorly

with tibia and fibula

Anteriorly

with navicular bone

Inferiorly

with calcaneus

The navicular articulates:

Anteriorly

with the three cuneiforms

Posteriorly

with talus

The cuboid articulates:

Posteriorly

with calcaneus

Anteriorly

with lateral two metatarsals

The cuneiforms articulate:

Anteriorly

with medial three metatarsals

Posteriorly

with navicular bone

The calcaneus articulates:

Superiorly

with talus

Anteriorly

with cuboid

Name Muscle inserted at Tuberosity of base of fifth metatarsal

Peroneus brevis

What will happen in case of fracture at mid talus bone?

Avascular necrosis

The blood supply of talus

-Posterior tibial artery supplies the body of the talus via:
Artery of tarsal canal (supplies most of talar body, dominant blood supply)
Deltoid branch supplies the medial portion of talar body
-Anterior tibial artery supplies head and neck of talus
-Peroneal artery supplies head and neck of talus via artery of tarsal sinus

In case of displaced talar neck fracture, which could lead to disruption of artery of tarsal canal, most of talar body will lose its blood supply (except medial portion which is supplied by the deltoid branch) and that will lead eventually to AVN

In case of injury of extensor retinaculum, what is the artery we will be worried about?

Anterior tibial artery

In case of injury of Achilles tendon, what will happen?

Loss of plantar flexion

Arches? Components of each?

Medial longitudinal arch
• Calcaneus, Talus, Navicular• 3 cuneiforms• 3 medial metatarsals
Lateral longitudinal arch
• Calcaneus• Cuboid• 2 lateral metatarsals
Transverse arch
• Cuboid, 3 cuneiforms• Bases of metatarsals

Structures under the extensor retinaculum

Mnemonic: Tom Has Very Nice Dogs & Pigs
Tibialis anterior
Extensor Hallucis longus
Anterior tibial vessels,
Anterior tibial nerve
Digitorum longus (Extensor)
Peroneus tertius

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Structures behind medial malleolus?

Mnemonic: Tom Does Very Nice Hats
Tibialis posterior tendon
Flexor Digitorum longus
posterior tibial Vessels
posterior tibial Nerve
Hallucis longus (Flexor)

Identify structure number 12 on the XR:

Sustentaculum tali

What is the component of ankle joint?

Tibia
Fibula
Talus

What is the type of this joint?

Synovial hinge joint

Movements of this joint?

Plantarflexion
Dorsiflexion

At which movement is it more stable? Why?

Ankle joint is most stable in dorsiflexion, because the talus is wider anteriorly and narrower posteriorly.
(Note: In dorsiflexion, the wider anterior part of the talar trochlea wedges tightly into the mortise formed by the tibia and fibula.)

Components of subtalar joint?

Talus and calcaneus

What are the movements at the joint?

Inversion and eversion of foot

Identify the Deltoid ligament, calcaneofibular ligament, posterior talofibular ligament:

Spoiler

Deltoid ligament (6)
Calcaneofibular ligament (3)
Posterior talofibular ligament (19)

Demonstrate pulses of the foot?

The dorsalis pedis pulse is found between the first two metatarsal bones.
The posterior tibial pulse is found 2cm-3cm below and behind the medial malleolus.

What does the midtarsal joint do?

The midtarsal joint, consisting of the talonavicular and the calcaneocuboid joints, is presumed to be responsible for the foot being both flexible and rigid during different parts of the stance phase of gait.