Foot and Ankle

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Ankle and Foot
Tiffany, Brian, Marc
Tibiofibular Ligaments
Anterior Tibiofibular Ligament
Attaches the Anterior Distal Tibia to
the anterior Distal Fibula
Posterior Tibiofibular Ligament
Attaches posterior tibia
to the posterior fibula
Extensor Retinacula
Goes across the ankle and
attaches medially to the
tibia and laterally to the
fibula.
Plantar Ligaments
Long Plantar Ligament
 Goes from calcaneus to 24 metatarsels
Short Plantar
 Goes off the side of the
long plantar ligament
Plantar Aponeurosis

Goes over the long and
short plantar ligaments
Interrosseous ligament

Runs between the tibia
and the fibula
Plantaris




O-Posterior lateral
condyle of femur
I-Posterior calcaneus
A-Weak assist in knee flex;
ankle plantar flexion
IN-Tibial nerve, popliteal
artery
Tibialis Anterior
O-Lateral tibia and
interosseous membrane
I-1st Cuneiform and
metatarsal
A-Ankle inversion and
dorsiflexion
IN-Deep peroneal
nerve; Anterior tibial
artery
Tibialis Posterior
O-Interosseous membrane;
adjacent tibia and fibula
I-Navicular and most tarsels
and metatarsels
A-Ankle inversion; assists in
plantarflexion
IN-Tibial nerve ; Fibular
artery
Peroneus Longus




O-Lateral proximal fibula
and interosseous
membrane
I-Plantar surface of 1st
cuneiform and metatarsal
A-Ankle eversion; assists in
ankle plantarflexion
IN-Superficial peroneal
nerve; fibular artery
The Foot and Ankle
Bones: Tibia & Fibula
TIBIA
FIBULA
medial malleolus
fibular notch
head
lateral malleolus
Bones: Tarsals
Calcaneus
 Navicular
 Cuneiforms
 Talus
 Cuboid

Bones: Metatarsals & Phalangeals
Plantar Fasciitis
•The plantar fascia (or plantar aponeurosis) is the thick
connective tissue which supports the arch of the foot.
•It runs from the tuberosity of the calcaneus forward to
the heads of the metatarsal bones. It is the source of
plantar fasciitis.
•The plantar fascia supports the arch of the foot by
acting as a tie-rod, where it undergoes
tension when the foot bears weight.
•When tension becomes too much, small tears are made
in the fascia. Repeatitive tearing and stretching create
an inflamed and painful area.
•Most people complain of symptoms in the morning, or
after exercising like jogging of playing tennis.
Causes of Plantar Fasciitis
•Physical activity
•Arthritis
•Improper shoes
•Heredity
•Diabetes
Prevention




Maintain healthy weight
Stay away from those old beat-up
tennis shoes
Begin any sport activity slowly
Stretch in the morning and
throughout the day
Treatments




Night splints – helps keep fascia from
contracting during the night.
Orthotics – may help distribute weight
more evenly on the feet.
Physical therapy – instruction for
strength training exercises for LE.
Corticosteroids – provide temporary
relief.
Surface Anatomy
•Calcaneal tendon also
known as the Achilles
tendon.
•Lateral malleolus
•Medial malleolus
Surface Anatomy
•Extensor digitorum
longus tendon
•Extensor Hallucis longus
tendon
•Tibialis anterior tendon
•Extensor hallucis brevis
tendon
•Fibularis longus tendon
(Peroneus longus)
Surface Anatomy
Great Saphenous
Vein originates
from where the
dorsal vein of the
large toe merges
with the dorsal
venous arch of the
foot.
Surface Anatomy
Site of Dorsalis Pedis


The dorsal pedis pulse can be palpated
laterally to the extensor hallucis longus
tendon on the top surface of the foot.
Doctors use this site to determine if a
patient has peripheral vascular disease.
Flexor Hallucis Longus





O: Posterior fibula and
intersseous membrane
I: Distal phalanx of big toe
A: Flexes big toe;
inversion & plantar flexion of ankle
I: Tibial nerve
V: Fibular artery
Peroneus Brevis
O: Lateral distal fibula
 I: Base of 5th metatarsal
 A: Ankle eversion;
assists in plantar flexion
 I: Superficial peroneal
 V: fibular artery

Flexor Digitorum Longus



O: Posterior tibia
I: Distal phalanx of the four lesser toes
A: Flexes four lesser toes; assists in ankle inversion
plantar flexion of ankle
I: Tibial nerve
V: Posterior tibial artery
Peroneus Tertius
O: Distal medial fibula
 I: Base of 5th metatarsal
 A: Assists in ankle eversion
and dorsiflexion
 I: Deep peroneal nerve
 V: Anterior tibial artery

Gastrocnemius
O: Medial and lateral condyles of the femur
 I: Posterior calcaneus
 A: Knee flexion, ankle plantar flexion
 I: Tibial nerve
 V: Popliteal artery

Extensor Digitorum Longus
O: Fibula, interosseous membrance, tibia
 I: Distal phalanx of the four lesser toes
 A: Extends the four lesser toes, assists in ankle
dosiflexion
 I: Deep peroneal nerve
 V: Anterior tibial artery

Soleus
O: Posterior tibia and fibula
 I: Posterior calcaneus
 A: Ankle plantar flexion
 I: Tibial nerve
 V: Posterior tibial artery

Extensor Hallucis Longus
O: Fibula and interosseus membrane
 I: Distal phalanx of great toe
 A: Extends first toe; assists in ankle inversion
and dorsiflexion
 I: Deep peroneal nerve
 V: Anterior tibial artery

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