IFS-2 Comprehensive Exam: Foot and Ankle Joints

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Questions and Answers

Which artery supplies the majority of blood to the forefoot?

  • Lateral Plantar artery
  • Fibular artery
  • Dorsalis Pedis artery (correct)
  • Anterior Tibial artery

What muscle group is primarily supplied by the Obturator artery?

  • Muscles of the Medial Compartment (correct)
  • Hamstrings
  • Gluteal muscles
  • Anterior Tibial muscles

Which artery contributes to the blood supply of the pelvic diaphragm?

  • Perforating artery
  • Popliteal artery
  • Inferior Gluteal artery (correct)
  • Superior Gluteal artery

Which artery primarily supplies the lateral compartment of the leg?

<p>Fibular (Peroneal) artery (B)</p> Signup and view all the answers

Which artery is responsible for supplying the muscles of the anterior compartment of the lower leg?

<p>Anterior Tibial artery (C)</p> Signup and view all the answers

What type of movement occurs when the pelvis and lumbar spine move in the same direction?

<p>Ipsidirectional (A)</p> Signup and view all the answers

Which muscles are primarily involved in producing a posterior pelvic tilt?

<p>Hip extensors and rectus abdominis (D)</p> Signup and view all the answers

What is the normal Q-angle measurement in degrees?

<p>10° - 15° valgus (A)</p> Signup and view all the answers

Which muscle is innervated by the inferior gluteal nerve?

<p>Gluteus Maximus (B)</p> Signup and view all the answers

Which of the following statements about the Q-angle is true?

<p>An abnormal Q-angle is greater than 20°. (B)</p> Signup and view all the answers

What happens during contradirectional movement of the pelvis and lumbar spine?

<p>The pelvis rotates anteriorly while the lumbar spine maintains lordosis. (B)</p> Signup and view all the answers

Which muscle primarily assists in hip hiking?

<p>Quadratus Lumborum (A)</p> Signup and view all the answers

What is the effect of a larger Q-angle on the knee joint?

<p>It increases the risk of patellofemoral joint pathologies. (A)</p> Signup and view all the answers

Which joint is involved in dorsiflexion and plantarflexion?

<p>Talocrural joint (C)</p> Signup and view all the answers

What is the primary function of the Transverse Tarsal joint?

<p>Stabilize the foot on uneven terrain (B)</p> Signup and view all the answers

Which joints are involved in inversion and eversion of the foot?

<p>Calcaneocuboid and Talonavicular joints (B)</p> Signup and view all the answers

Which joint of the foot is known as the 'Mortise' joint?

<p>Talocrural joint (B)</p> Signup and view all the answers

What is the primary function of the Rectus Femoris muscle?

<p>Extend leg at the knee and flex thigh at the hip (A)</p> Signup and view all the answers

The rearfoot pronation and forefoot supination occurs at which joint?

<p>Transverse Tarsal joint (A)</p> Signup and view all the answers

Which of the following muscles is responsible for flexing the leg at the knee and medially rotating it?

<p>Semitendinosus (C)</p> Signup and view all the answers

Which of the following joints is involved in decreased mobility for foot stability during push-off?

<p>Tarsometatarsal joint (D)</p> Signup and view all the answers

Which of the following statements about the subtalar joint is correct?

<p>It allows for movement in the frontal plane. (A)</p> Signup and view all the answers

What action does the Gastrocnemius perform when the leg is extended?

<p>Plantarflex the ankle (A)</p> Signup and view all the answers

Which muscle is part of the deep layer of the posterior lower leg and assists in flexing the great toe?

<p>Flexor Hallucis Longus (B)</p> Signup and view all the answers

What type of joint is the Intermetatarsal joint?

<p>Plane joint (A)</p> Signup and view all the answers

The Calcaneonavicular joint is formed by which two bones?

<p>Calcaneus and Navicular (D)</p> Signup and view all the answers

What is the main action of the Adductor Longus muscle?

<p>Adduct the thigh (B)</p> Signup and view all the answers

Which term describes the mechanism providing stability in the foot?

<p>Screw-home mechanism (D)</p> Signup and view all the answers

Which artery provides the primary blood supply to the femoral head?

<p>Medial Femoral Circumflex Artery (A)</p> Signup and view all the answers

What action is performed by the Tibialis Anterior?

<p>Dorsiflexes the ankle and inverts the foot (C)</p> Signup and view all the answers

Which muscle is responsible for laterally rotating the thigh and steadying the head of the femur?

<p>Obturator Externus (A)</p> Signup and view all the answers

What is the role of the Popliteus muscle?

<p>Unlocks the knee by rotating the femur (B)</p> Signup and view all the answers

Which muscle assists in weakly flexing the leg at the knee and is part of the superficial layer of the posterior lower leg?

<p>Plantaris (A)</p> Signup and view all the answers

Which of the following ligaments is primarily injured during ankle inversion?

<p>Anterior Talofibular Ligament (D)</p> Signup and view all the answers

What is the primary action of the Tibialis Anterior muscle at the ankle?

<p>Dorsiflexion (D)</p> Signup and view all the answers

In an open chain environment, which movement components are involved in pronation?

<p>Dorsiflexion, Eversion, Abduction (C)</p> Signup and view all the answers

Which ligament is responsible for supporting the medial longitudinal arch of the foot?

<p>Plantar Calcaneonavicular Ligament (A)</p> Signup and view all the answers

Which nerve is responsible for weakness in toe flexion and plantarflexion?

<p>Tibial Nerve (A)</p> Signup and view all the answers

During supination in closed chain kinematics, which describes the movement of the talus and calcaneus?

<p>Talus moves laterally, Calcaneus moves medially (B)</p> Signup and view all the answers

What motion occurs at the subtalar joint when inversion is performed?

<p>Adduction (D)</p> Signup and view all the answers

Which muscle primarily assists in the eversion of the foot?

<p>Fibularis Brevis (D)</p> Signup and view all the answers

Which artery descends anteromedially to the first interosseous space and divides into plantar and arcuate arteries?

<p>Anterior Tibial Artery (B)</p> Signup and view all the answers

Which of the following describes the open-packed position of Chopart's joint?

<p>Midway between supination and pronation (A)</p> Signup and view all the answers

What are the two arteries that the posterior tibial artery divides into?

<p>Medial and Lateral Plantar Arteries (C)</p> Signup and view all the answers

What is the primary role of Plantar calcaneocuboid ligament?

<p>Support Lateral Longitudinal Arch (A)</p> Signup and view all the answers

Which nerve descends through the popliteal fossa and runs inferiorly on Tibialis Posterior?

<p>Tibial Nerve (A)</p> Signup and view all the answers

What are the actions of the Gastrocnemius muscle at the ankle and knee?

<p>Plantarflex ankle when the leg is extended, flex knee (A)</p> Signup and view all the answers

Where does the superficial fibular nerve arise from?

<p>Between fibularis longus and neck of fibula (A)</p> Signup and view all the answers

What does full supination of the subtalar joint create?

<p>Rigidity for propulsion forward (B)</p> Signup and view all the answers

Which artery originates from the posterior tibial artery and descends in the posterior compartment?

<p>Fibular Artery (B)</p> Signup and view all the answers

What is the main function of the medial plantar nerve?

<p>Divides into muscular and cutaneous branches (C)</p> Signup and view all the answers

Which nerve branches from the tibial nerve and passes inferior to the lateral malleolus?

<p>Sural Nerve (B)</p> Signup and view all the answers

What artery is important for palpation after a hip replacement or popliteal bypass?

<p>Dorsalis Pedis Artery (D)</p> Signup and view all the answers

Flashcards

Dorsalis Pedis Artery

The Dorsalis Pedis Artery is a vital part of the foot's arterial circulation. It is a branch of the Anterior Tibial Artery and helps provide blood flow to the foot.

Medial Plantar Nerve

Situated in the foot, the Medial Plantar Nerve is a vital branch of the Tibial Nerve, crucial for controlling muscles and sensations in this area.

Posterior Tibial Artery

A main artery supplying the foot, the Posterior Tibial Artery runs through the posterior compartment of the leg. It branches into the Medial and Lateral Plantar Arteries.

Lateral Plantar Nerve

The Lateral Plantar Nerve branches from the Tibial Nerve and heads towards the outside of your foot, taking responsibility for controlling certain muscles and sensations there.

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Sural Nerve

This nerve is involved in providing sensation to the outer part of the foot. It branches off from the Tibial Nerve, and its path goes beneath the outer ankle bone.

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Deep Fibular Nerve

The Deep Fibular Nerve, coming from the common fibular nerve, controls muscles involved in foot movement and sensation. It travels along the shin bone (tibia) then reaches your foot's top side.

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Superficial Fibular Nerve

The Superficial Fibular Nerve controls muscles that aid in foot motions. It begins near the outer ankle bone (fibula), then becomes located beneath the skin.

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Tibial Nerve

This nerve starts near the shin bone (tibia), supplying signals to muscles involved in foot motion. It descends down until it reaches your foot's inner part.

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Talocrural Joint

The joint formed between the tibia, fibula, and talus.

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Subtalar Joint

The joint between the talus and calcaneus, responsible for inversion and eversion movements of the foot.

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Transverse Tarsal Joint (Chopart's Joint)

A complex joint formed by the talonavicular and calcaneocuboid joints, acting as a primary stabilizer for uneven terrain.

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Talonavicular Joint

The joint between the talus and navicular bones, contributing to inversion and eversion.

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Calcaneocuboid Joint

The joint between the calcaneus and cuboid bones, playing a role in inversion and eversion.

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Calcaneonavicular Joint

The joint between the navicular and calcaneus bones.

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Cuneonavicular Joint

The joint formed between the cuneiform bones (1-3) and the navicular bone.

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Tarsometatarsal Joint (Lisfranc's Joint)

The joint between the cuneiform bones (1-3) and metatarsals 1-3, or the cuboid and metatarsals 4-5, providing stability for push-off during walking.

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Intermetatarsal Joint

Joints formed between the bases of metatarsals 1/2, 2/3, 3/4, and 4/5.

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Metatarsophalangeal Joint

The joint between the distal end of the metatarsals and the proximal phalanges of the toes, allowing for flexion and extension of the toes.

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Lateral Collateral Ligament of the Ankle

A ligament in the ankle that helps to stabilize the joint during inversion, or turning the foot inwards. It is the most commonly injured ligament in the ankle.

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Anterior Talofibular Ligament

A ligament in the ankle that helps to stabilize the joint during inversion and helps prevent the ankle from rolling inward. If there is a severe enough injury the fibula may be pulled off.

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Calcaneofibular Ligament

A ligament in the ankle that helps to stabilize the joint during inversion, but it is less commonly injured than the Anterior Talofibular Ligament.

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Posterior Talofibular Ligament

A ligament in the ankle that helps to stabilize the joint during inversion and is least commonly injured during an inversion sprain.

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Medial Collateral Ligament of the Ankle

A ligament group in the ankle that helps to stabilize the joint during eversion, or turning the foot outwards.

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Anterior Tibiotalar Ligament

A ligament within the medial ankle that helps to stabilize the joint during eversion, or turning the foot outwards.

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Posterior Tibiotalar Ligament

A ligament within the medial ankle that helps to stabilize the joint during eversion, or turning the foot outwards.

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Tibionavicular Ligament

A ligament within the medial ankle that helps to stabilize the joint during eversion, or turning the foot outwards.

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Tibiocalcaneal Ligament

A ligament within the medial ankle that helps to stabilize the joint during eversion, or turning the foot outwards.

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Long Plantar Ligament

A ligament on the bottom of the foot that helps to support the lateral longitudinal arch of the foot.

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Plantar Calcaneocuboid Ligament

A ligament in the foot that helps to support the lateral longitudinal arch on the bottom of the foot.

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Plantar Calcaneonavicular Ligament

A ligament in the foot that helps to support the medial longitudinal arch, or the arch on the inside of the foot.

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Pronation

A movement of the ankle that involves dorsiflexion, eversion, and abduction. It occurs in an open chain movement meaning the foot is not fixed on the ground.

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Supination

A movement of the ankle that involves plantarflexion, inversion, and adduction. It occurs in an open chain movement meaning the foot is not fixed on the ground.

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Valgus

A movement of the ankle that involves the distal segment moving away from the midline of the body. In the ankle, it is synonymous with eversion.

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Varus

A movement of the ankle that involves the distal segment moving towards the midline of the body. In the ankle, it is synonymous with inversion.

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Pelvic Posterior Tilt

The glutes and hamstrings work together to pull the pelvis backward, like a hinge.

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Ipsidirectional Movement

When the pelvis and lumbar spine move in the same direction, increasing the overall range of motion of the trunk, as when bending down.

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Contradirectional Movement

When the pelvis and lumbar spine move in opposite directions, maintaining stability while the pelvis rotates over the femur and the lumbar spine keeps its curve.

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Anterior Pelvic Tilt

A position of the pelvis where the front tilts forward, usually caused by tight hip flexors and spinal erectors.

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Posterior Pelvic Tilt

A position of the pelvis where the front moves backward towards the rib cage, often caused by strong hip extensors and abdominal muscles.

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Hip Hike

A movement that lifts one side of the pelvis up, usually caused by the contralateral gluteus medius for stability and ipsilateral quadratus lumborum for lifting.

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Q Angle

The angle between the femur (thigh bone) and the patellar ligament (knee cap). A larger angle can lead to knee problems.

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Valgus Deformity

A condition where the knees bend inwards, often due to weak muscles or flat feet.

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What is the Profunda Femoris Artery known for supplying?

The Profunda Femoris Artery is a major branch of the femoral artery that primarily supplies the adductor muscles in the thigh.

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What do the Perforating Arteries supply?

The Perforating Arteries are branches of the Profunda Femoris Artery that supply blood to the hamstrings and adductor muscles.

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What is the Popliteal Artery and where is it located?

The Popliteal Artery is the continuation of the femoral artery in the popliteal fossa (behind the knee). It's crucial for supplying blood to the knee joint and surrounds it.

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What does the Anterior Tibial Artery supply?

The Anterior Tibial Artery is a major branch of the Popliteal Artery that supplies the muscles of the anterior (front) compartment of the leg, which are responsible for dorsiflexion of the foot.

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What is the main purpose of the Dorsalis Pedis Artery?

The Dorsalis Pedis Artery is a branch of the Anterior Tibial Artery that supplies the majority of the blood to the forefoot. It's easily palpable (felt) on the top of the foot.

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What is the action of the Rectus Femoris muscle?

The Rectus Femoris muscle is responsible for extending the leg at the knee joint and flexing the thigh at the hip joint. It also plays a role in stabilizing the joint.

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What is the function of the Vastus Lateralis muscle?

The Vastus Lateralis muscle is a powerful extensor of the knee joint, working to straighten the leg.

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What is the action of the Vastus Medialis muscle?

The Vastus Medialis muscle aids in extending the leg at the knee joint, focusing on the medial or inner side of the thigh.

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What is the function of the Vastus Intermedius muscle?

The Vastus Intermedius muscle is located deep within the thigh. It is responsible for extending the leg at the knee joint.

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What is the function of the Semitendinosus muscle?

The Semitendinosus muscle aids in extending the thigh, flexing the leg, and rotating the leg inwards. It is located on the back of the thigh.

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What is the function of the Semimembranosus muscle?

The Semimembranosus muscle aids in extending the thigh, flexing the leg, and rotating the leg inwards. It is located on the back of the thigh.

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What is the function of the Biceps Femoris muscle?

The Biceps Femoris muscle is a two-headed muscle located on the back of the thigh. Both heads extend the thigh and flex the leg. The long head also rotates the leg outwards, while the short head helps in lateral rotation.

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What is the action of the Adductor Longus muscle?

The Adductor Longus muscle adducts the thigh, which means it draws the leg towards the midline of the body.

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What is the function of the Adductor Brevis muscle?

The Adductor Brevis muscle adducts the thigh, bringing the leg closer to the midline of the body.

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What is the function of the Adductor Magnus muscle?

The Adductor Magnus muscle has two parts: an adductor part and a hamstring part. The adductor part flexes the thigh, while the hamstring part extends the thigh. The adductor part also adducts the thigh.

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Study Notes

Study Guide for IFS-2 Comprehensive Exam

  • Exam Structure: The exam covers units 1-7, with units 6-7 comprising 40-50% of the IFS-2 portion. Students should not underestimate the importance of any unit, even those with fewer items. Mastery of biomechanics, neuroanatomy, gross anatomy, and physiology are essential for upper-level courses.

Foot and Ankle Joints (Units 6-7)

  • Joint Overview: This section focuses on the joints of the foot and ankle, including the talocrural, subtalar, transverse tarsal, metatarsophalangeal (MTP), and calcaneocuboid joints. Understanding their locations and functions is crucial for the exam.

  • Joint Structure: Examining the joints in detail from proximal to distal:

    • Talocrural joint: Formed by the tibia, fibula, and talus, it enables dorsiflexion and plantarflexion.
    • Subtalar joint: Located between the talus and calcaneus, supporting inversion and eversion of the foot.
    • Transverse tarsal joint (Chopart's joint): A primary stabilizer for uneven terrain, with talonavicular and calcaneocuboid joints.
      • Closed Chain Movement: Rearfoot pronation/Forefoot supination.
    • Distal intertarsal joints: Include important joints like the cuneonavicular joint and others.
    • Forefoot joints: Covering tarsometatarsal joints (supporting foot stability, especially for push-off), intermetatarsal joints, metatarsophalangeal joints, and interphalangeal joints.

Innervation of the Leg (Unit 3)

  • Nerve Pathways: Review and understand the pathways of the obturator nerve, sciatic nerve branches (common fibular and tibial nerves), and their role in innervating muscles throughout the lower limb; this includes cutaneous innervation to the foot.

  • Muscle Compartments: Focus on the specific nerves innervating muscles within each compartment of the lower limb.

Biomechanics and Arthrokinematics (Unit 4)

  • Ankle/Foot Movements: Understanding the planes and axes of dorsiflexion, plantarflexion, inversion, and eversion is essential, along with their open-chain and close-chain kinematics.

  • Ligaments: Be sure to review the function of the ligaments, including their role in static and dynamic stability of the joints.

    • Ankle: Anterior Talofibular, Calcaneofibular, Posterior Talofibular, and Deltoid Ligament.
    • Foot: Long plantar ligament, plantar calcaneocuboid and plantar calcaneonavicular (spring) ligament, supporting the medial longitudinal arch.

Other Important Aspects

  • Muscle Actions: Thorough knowledge of the muscles in the lower leg and their actions (flexion, extension, adduction, abduction, and rotation) is vital for understanding the movement of the foot and ankle. Be aware of which nerves control each muscle group.
  • Nervous System Involvement: Review how the autonomic nervous system (sympathetic and parasympathetic) and spinal nerves influence the foot and ankle.
  • Blood Supply: A crucial area of study; familiarize yourself with the arteries (anterior and posterior tibial, dorsalis pedis, lateral and medial plantar) and their roles in blood flow to the lower extremities.
  • Additional Areas: Important considerations are the basics of ECGs and the blood supply to the heart.

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