Podcast
Questions and Answers
Which ligament is most likely injured in the case of an ankle sprain resulting from twisting the ankle?
Which ligament is most likely injured in the case of an ankle sprain resulting from twisting the ankle?
- Anterior talofibular ligament (correct)
- Posterior talofibular ligament
- Spring ligament
- Deltoid ligament
What is the common clinical presentation indicating a lateral ankle ligament injury?
What is the common clinical presentation indicating a lateral ankle ligament injury?
- Bruising and swelling on the medial aspect
- Pain that radiates down the foot
- Tenderness over the lateral malleolus with swelling (correct)
- Instability of the knee joint
What imaging result is typically observed in patients with lateral ankle injuries where ligaments are compromised but bones are intact?
What imaging result is typically observed in patients with lateral ankle injuries where ligaments are compromised but bones are intact?
- Dislocations in the ankle joints
- Fractures of the fibula
- Soft tissue calcifications
- No fractures visible on X-rays (correct)
Which ligament is least likely involved in a typical inversion ankle injury?
Which ligament is least likely involved in a typical inversion ankle injury?
Which of the following is NOT a common risk factor for lateral ankle sprains?
Which of the following is NOT a common risk factor for lateral ankle sprains?
What type of joint is the Ankle Joint classified as?
What type of joint is the Ankle Joint classified as?
Which structure forms the roof of the ankle joint socket?
Which structure forms the roof of the ankle joint socket?
Which of the following ligaments is NOT associated with the ankle joint?
Which of the following ligaments is NOT associated with the ankle joint?
Which movement is primarily associated with the ankle joint?
Which movement is primarily associated with the ankle joint?
What is the primary characteristic of the tibio-fibular joints?
What is the primary characteristic of the tibio-fibular joints?
Which part of the foot's anatomy is NOT mentioned as an area of focus for the small joints?
Which part of the foot's anatomy is NOT mentioned as an area of focus for the small joints?
Which structure forms the lateral side of the ankle joint socket?
Which structure forms the lateral side of the ankle joint socket?
What is the function of the deltoid ligament in the ankle joint?
What is the function of the deltoid ligament in the ankle joint?
What is the significance of the medial (deltoid) ligament?
What is the significance of the medial (deltoid) ligament?
Which part of the deltoid ligament is attached to the navicular bone?
Which part of the deltoid ligament is attached to the navicular bone?
What does the lateral ligament primarily resist?
What does the lateral ligament primarily resist?
Which of the following is NOT a component of the lateral ligament?
Which of the following is NOT a component of the lateral ligament?
What nerve supplies the muscles responsible for dorsiflexion at the ankle joint?
What nerve supplies the muscles responsible for dorsiflexion at the ankle joint?
What is one of the primary roles of the medial (deltoid) ligament?
What is one of the primary roles of the medial (deltoid) ligament?
Which muscle is NOT involved in dorsiflexion of the foot?
Which muscle is NOT involved in dorsiflexion of the foot?
Which part of the medial ligament is attached to the calcaneus bone?
Which part of the medial ligament is attached to the calcaneus bone?
Which nerve is primarily responsible for the innervation of the Peroneus (Fibularis) Longus?
Which nerve is primarily responsible for the innervation of the Peroneus (Fibularis) Longus?
What is the primary action of the Gastrocnemius muscle?
What is the primary action of the Gastrocnemius muscle?
Acute sprains of the lateral ankle are primarily caused by what type of foot movement?
Acute sprains of the lateral ankle are primarily caused by what type of foot movement?
Which ligament is commonly involved in lateral ankle sprains?
Which ligament is commonly involved in lateral ankle sprains?
Which muscle is part of the deep posterior compartment of the leg?
Which muscle is part of the deep posterior compartment of the leg?
What is the less common type of acute ankle sprain?
What is the less common type of acute ankle sprain?
Which muscle is NOT associated with plantarflexion?
Which muscle is NOT associated with plantarflexion?
What type of joint primarily allows for the movement of the ankle and small joints of the foot?
What type of joint primarily allows for the movement of the ankle and small joints of the foot?
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Study Notes
Tibio-Fibular Joints
- Proximal Tibio-Fibular Joint:
- Articular Surfaces: Head of fibula and lateral condyle of tibia
- Type: Synovial – Plane
- Ligaments: Anterior and posterior ligaments, and interosseous membrane
- Distal Tibio-Fibular Joint:
- Articular Surfaces: Lateral malleolus of fibula and distal end of tibia
- Type: Syndesmosis – Fibrous
- Ligaments: Anterior and posterior inferior tibiofibular ligaments, interosseous membrane
Ankle Joint
- Type: Synovial – Hinge
- Articular Surfaces:
- Socket is formed by tibia and fibula bones.
- Roof: Inferior surface of distal end of tibia
- Medial side: Medial malleolus of tibia
- Lateral side: Lateral malleolus of fibula
- Supporting Ligaments:
- Medial (Deltoid) ligament: Prevents over-eversion of the foot and maintains the medial longitudinal arch
- Lateral Ligament: Composed of three separate ligaments (anterior talo-fibular ligament, posterior talo-fibular ligament, and calcaneo-fibular ligament), helps to resist inversion of the foot
- Movements: Dorsiflexion and plantarflexion
- Stability: Relatively stable due to strong ligaments
Movements of the Ankle Joint (Foot)
- Dorsiflexion (Extension)
- Muscles: Tibialis anterior, Extensor Digitorum Longus, Extensor Hallucis Longus, Peroneus (Fibularis) Tertius
- Nerve Supply: Anterior Tibial (Deep peroneal) Nerve
- Plantarflexion (Flexion)
- Muscles: Peroneus (Fibularis) Longus, Peroneus (Fibularis) Brevis, Gastrocnemius, Soleus, Plantaris, Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus
- Nerve Supply: Musculocutaneous (Superficial peroneal) Nerve, Posterior Tibial Nerve
Small Joints of Foot
- Intertarsal joints:
- Talocalcaneonavicular joint
- Calcaneocuboid joint
- Talocalcaneal joint
- Tarsometatarsal Joints (Lisfranc’s Joint):
- Articulation between the distal row of tarsal bones and the metatarsals.
- Important for weight-bearing and transferring force to the forefoot
- Intermetatarsal joints:
- Articulations between the metatarsals
- Allow for limited motion
- Metatarsophalangeal joints:
- Articulations between the metatarsals and the phalanges
- Allow for flexion, extension, adduction, and abduction
- Interphalangeal joints:
- Articulations between the phalanges
- Allow for flexion and extension
Arches of the Foot
- The foot is shaped like an arch, which helps to absorb shock, provide stability, and propel the body forward.
- Medial Longitudinal Arch: Formed by talus, navicular, three cuneiform bones, and medial 3 metatarsals
- Lateral Longitudinal Arch: Formed by calcaneus, cuboid, and lateral 2 metatarsals
- Transverse Arch: Extends across the foot and provides additional support, formed by the cuboid, cuneiforms and metatarsals
Clinical Correlation
- Acute Sprains of the "Medial Ankle": Less common, caused by excessive eversion, pulling off the tip of the medial malleolus.
- Acute Sprains of the "Lateral Ankle": More common, caused by excessive inversion of the foot with plantar flexion of the ankle. The anterior talofibular ligament and calcaneofibular ligament are partially torn, resulting in pain and swelling.
Case Scenario
- A 28-year-old male presents with ankle pain and swelling after twisting his ankle while playing soccer. The patient has tenderness over the lateral malleolus with swelling and bruising.
- The most likely injured ligament: Anterior talofibular ligament
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