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Questions and Answers
What symptom is common in severe cases of weakness and atrophy of the intrinsic foot muscles?
What symptom is common in severe cases of weakness and atrophy of the intrinsic foot muscles?
- Symptoms improve at night
- Worsening symptoms with prolonged standing (correct)
- Radiating numbness with flexion
- Pain increases during rest
What does a positive Tinel sign indicate?
What does a positive Tinel sign indicate?
- Compression of the ankle joint
- Neuropathy associated with tapping the flexor retinaculum (correct)
- A fracture of the medial malleolus
- Weakness in the dorsal foot muscles
Which of the following conditions could potentially cause weakening of the intrinsic foot muscles?
Which of the following conditions could potentially cause weakening of the intrinsic foot muscles?
- Chronic plantar fasciitis
- Severe ankle sprain
- Peroneal nerve entrapment (correct)
- Metatarsal fractures
How is radiating paresthesia commonly triggered in the context of ankle retinacula issues?
How is radiating paresthesia commonly triggered in the context of ankle retinacula issues?
What activity is most likely to aggravate symptoms of intrinsic foot muscle weakness?
What activity is most likely to aggravate symptoms of intrinsic foot muscle weakness?
What is the primary function of the flexor retinaculum at the ankle?
What is the primary function of the flexor retinaculum at the ankle?
Which structure is NOT contained within the tarsal tunnel under the flexor retinaculum?
Which structure is NOT contained within the tarsal tunnel under the flexor retinaculum?
Where is the extensor retinaculum located?
Where is the extensor retinaculum located?
What type of structure is the flexor retinaculum categorized as?
What type of structure is the flexor retinaculum categorized as?
How many types of extensor retinaculum are identified?
How many types of extensor retinaculum are identified?
Which of the following tendons is NOT mentioned as part of the contents of the tarsal tunnel?
Which of the following tendons is NOT mentioned as part of the contents of the tarsal tunnel?
What is the specific shape of the inferior extensor retinaculum?
What is the specific shape of the inferior extensor retinaculum?
What is the pulse of which artery primarily located in the tarsal tunnel?
What is the pulse of which artery primarily located in the tarsal tunnel?
Which structure is located deep to the extensor retinaculum in the lower limb?
Which structure is located deep to the extensor retinaculum in the lower limb?
Which tendon is NOT found deep to the peroneal retinaculum?
Which tendon is NOT found deep to the peroneal retinaculum?
Which term describes the thickening of deep fascia that holds the tendons of the lateral compartment of the leg?
Which term describes the thickening of deep fascia that holds the tendons of the lateral compartment of the leg?
What is a common cause of tarsal tunnel syndrome?
What is a common cause of tarsal tunnel syndrome?
Which of the following symptoms is NOT typically associated with tarsal tunnel syndrome?
Which of the following symptoms is NOT typically associated with tarsal tunnel syndrome?
Which structure is found superficial to the extensor retinaculum?
Which structure is found superficial to the extensor retinaculum?
Which of the following structures is NOT located deep to the extensor retinaculum?
Which of the following structures is NOT located deep to the extensor retinaculum?
Which vein is located superficial to the peroneal retinaculum?
Which vein is located superficial to the peroneal retinaculum?
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Study Notes
Ankle Retinacula
- Thickening of deep fascia that holds tendons in position
- Located at the ankle joint
Flexor Retinaculum
- Thickening of deep fascia that holds long flexor tendons in position
- Located on the medial side of the ankle, behind the medial malleolus
- Converts the space behind the medial malleolus into an osteo-fascial tunnel, the tarsal tunnel
- Tarsal tunnel contains:
- Tibialis posterior tendon
- Flexor digitorum longus tendon
- Posterior tibial artery
- Posterior tibial nerve
- Flexor hallucis longus tendon
Extensor Retinaculum
- Thickening of deep fascia that holds long extensor tendons in position
- Located on the anterior side of the ankle
- Two types:
- Superior extensor retinaculum
- Inferior extensor retinaculum (Y-shaped)
- Structures deep to extensor retinaculum (medial to lateral):
- Tibialis anterior tendon
- Extensor hallucis longus tendon
- Dorsalis pedis artery
- Anterior tibial (deep peroneal) nerve
- Extensor digitorum longus tendons
- Fibularis tertius tendon
- Structures superficial to extensor retinaculum (medial to lateral):
- Great saphenous vein
- Saphenous nerve
Peroneal Retinaculum
- Thickening of deep fascia that holds tendons of the lateral compartment of the leg in position
- Located on the lateral side of the ankle, behind the lateral malleolus
- Structures deep to peroneal retinaculum (medial to lateral):
- Peroneus longus tendon
- Peroneus brevis tendon
- Structures superficial to peroneal retinaculum (medial to lateral):
- Small saphenous vein
- Sural nerve
Clinical Correlation
- Tarsal tunnel syndrome: an entrapment syndrome caused by pressure on contents within tarsal tunnel.
- Causes:
- Fracture of talus, calcaneus, and medial malleolus
- Rheumatoid arthritis
- Clinical picture:
- Neuropathic pain and paresthesia in the heel, sole of the foot, and first three toes
- Weakness and atrophy of intrinsic foot muscles (severe cases)
- Symptoms worsen with walking, prolonged standing, and at night
- Positive Tinel sign: radiating paresthesia triggered by tapping the flexor retinaculum posterior to the medial malleolus
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