Ankle Joint and Foot Medical Presentation

Ankle Joint Foot PowerPoint Presentation

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Published on : Dec 12, 2017 | Views : 2419 | Downloads : 4

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Slide 1-

Ankle Joint & foot Prepared by Dr Syed Imam
Slide 2-

Type: Hinge synovial joint Articular surfaces: Superiorly the tibia and fibula, inferiorly the trochlea of the talus Articular capsule: Encloses the joint and is attached to bones near their articular margins. Synovial membrane: Lines the capsule Trochlea of talus ankle joint
Slide 3-

Ligaments : Medial (deltoid) ligament: Extends from the medial malleolus to the navicular bone , calcaneus and talus. Prevents overeversion and maintains the medial longitudinal arch. 2. Lateral ligament: Weaker than the medial ligament. Consists of anterior talofibular, posterior talofibular and calcaneofibular ligaments. Resists inversion of foot. May be torn during an ankle sprain
Slide 4-

Nerve supply: Deep peroneal nerve Tibial nerve Movements: Dorsiflexion (Muscles of Anterior compartment of leg) Plantar flexion (Muscles of posterior compartment of leg) Inversion and eversion of the foot take place at the subtalar & intertarsal joint Muscles producing Inversion Tibialis anterior, tibialis posterior, flexor hallucis longus Muscles producing the eversion Peroneus longus, peroneus brevis and peroneus tertius Tibial nerve
Slide 5-

dorsiflexion plantar flexion at the ankle joint eversion inversion at the subtalar/intertarsal joints Movements at the ankle/foot
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Sole of the foot Skin Is thick and hairless Firmly bound to the underlying deep fascia Cutaneous nerves: Medial planter nerve: Innervates the medial 2/3 of the sole Lateral planter nerve Innervates the lateral 1/3 of the sole Medial calcaneal branch of tibial nerve Innervates the heel
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Plantar aponeurosis Thickened deep fascia. Attachments: posteriorly to calcaneus. anteriorly divides into 5 slips one for each toe. Functions: protects underlying structures gives firm attachment to overlying skin Maintains longitudinal arches of the foot Plantar aponeurosis
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Layers of the sole 1st layer 2 abductors with one flexor inbetween. Muscles of the sole arranged in 4 layers from superficial to deep Abductor hallucis Flexor digitorum brevis Abductor digiti minimi
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2nd layer → 2 tendons with two muscle groups. Quadratus plantae (Flexor digitorum accessorius) Lumbricals (4 muscles) Flexor digitorum longus tendon Flexor hallucis longus tendon
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3rd layer → 2 flexors with one adductor in between. Flexor hallucis brevis Adductor hallucis Flexor digiti minimi brevis
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4th layer → 2 tendons with two muscle groups. Plantar interossei (3 muscles) PAD Dorsal interossei (4 muscles) DAP Peroneus longus tendon Tibialis posterior tendon
Slide 12-

Medial and lateral plantar nerves Neurovascular plane is between 1st & 2nd layers while deep branches are between 3rd & 4th layers. All muscles of the sole are supplied by lateral plantar nerve except 4 muscles (Abd. hallucis, Flex. dig. brevis, Flex. hallucis brevis & 1st lumbrical) which are supplied by medial plantar n. Medial plantar n. supplies skin of medial 2/3 of the sole + plantar surface of medial 3 ½ toes. Lateral plantar n. supplies skin of lateral 1/3 of the sole + plantar surface of lateral 1 ½ toes.
Slide 13-

Plantar arch of the lateral plantar a. + deep branch of lateral plantar nerve pass between 3rd & fourth layers of the sole.
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Consist of: Medial longitudinal arch Lateral longitudinal arch Transverse arch Factors maintaining arches of foot Shape of bones Strength of ligaments Tone of muscles Function : Support the body in the erect position Act as spring in locomotion Absorbs and distributes downward forces from the body during standing and moving. Minimize pressure on nerves and vessels C Arches of the foot
Slide 15-

Medial longitudinal arch: The highest and most important arch in the foot. Formed by talus (key stone), calcaneus, navicular, cuneiform bones, and three medial metatarsal bones Supported by: Spring and deltoid ligaments, planter aponeurosis Tendons of the flexor hallucis longus, flexor digitorum longus, tibialis anterior and tibialis posterior
Slide 16-

Lateral longitudinal arch: More flat and lower Formed by calcaneus , cuboid, the lateral two metatarsal bone The key stone is cuboid bone Supported by : Planter aponeurosis. Peroneus longus tendon, short muscles of little toe
Slide 17-

Transverse arch Formed by Heads of the five metatarsal bones Cuboid, three cuneiforms (incomplete arch) Supported by 1. Deep transverse ligament 2. Transverse head of the adductor hallucis 3. Peroneus longus tendon.
Slide 18-

Pes planus (flat foot) Def.: Depression of the medial longitudinal arch. Causes: (congenital and acquired) 1- Abnormal shape of bones. 2- Weakness of muscles or ligaments of sole. 3- Overstretch of spring & plantar ligaments. 4- Rapid increase in body weight. Symptoms: Pain in the foot due to stretched ligaments + pressure on nerves of the sole.
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Thanks