Download MBBS Anatomy PPT 82 Ankle Joint Gk Notes

Contents of the anterior compartment

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o Muscles:
1. Tibialis anterior
2. Extensor digitorum

longus

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3. Extensor hal ucis longus
4. Peroneus tertius

o Anterior tibial artery

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o Deep peroneal nerve.

Muscles of the anterior compartment

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Retinacula

Deep fascia is thickened to form

bands.

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Retain tendons in place.

?Superior Extensor Retinaculum

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? Inferior Extensor Retinaculum

?Superior Peroneal Retinaculum

? Inferior Peroneal Retinaculum

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Muscles of the back


Muscles of lateral side

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ANKLE or TALO-CRURAL JOINT

Uni-axial synovial joint

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Modified hinge joint

Tibio-fibular mortise

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Trochlea tali

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Ligaments

?Capsule

?Synovial membrane

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?The ankle joint is bound medially by the strong

Deltoid ligament

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? Three lateral ligaments

?Anterior talofibular ligament

? Posterior talofibular ligament

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? Calcaneofibular ligament


Deltoid ligament or Medial ligament

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Superficial part:

? Anterior part or Tibio - navicular part

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? Intermediate part or Tibio - calcanean

part

? Posterior part or Posterior

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tibio - talar part

Deep part/Anterior Tibiotalar

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Attachments & parts of deltoid

ligament

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Medial mal eolus

of Tibia

Anterior Tibiotalar

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Tibiotalar

Talus

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Tibionavicular

Tibiocalcanean

Sustanticulum

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Tali


Lateral ligaments

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Anterior Talofibular

Lateral mal eolus of

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Fibula

Neck of Talus

Posterior

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Talofibular

Calcaneofibular ligament crossed by

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tendons of Peroneus longus & Brevis


Movements of ankle joint

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Dorsiflexion:
Close packed state. Position more stable.
Plantar flexion:
Loosely packed state of joint. Joint is less stable.

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Movements

Plantar Flexion: S1, S2

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Gastrocnemius

Soleus

Assisted by

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Tibialis posterior,

Flexor Digitorum longus,

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Flexor Hal ucis longus,

Peroneus longus and brevis in extreme plantar

flexion

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Dorsiflexion: L4, L5

Tibialis anterior
Extensor Digitorum longus,

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Extensor Hallucis longus,
Peroneus tertius

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Arterial supply

? Mal eolar branches of Anterior Tibial Artery.
? Mal eolar branches of Peroneal Artery.

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NERVE SUPPLY

? Branches from Deep Peroneal Nerve.
? Branches from Tibial Nerve.

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Interphalangeal joints

Typical hinge joint

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Permit plantar flexion and

dorsiflexion

Metatarso - phalangeal joints

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El ipsoidal type of synovial joint.
Ligaments:
? Capsule.
? Collateral ligaments.

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? Deep metatarsal ligaments.
Movements:
? Dorsi & plantar flexion.
? Adduction & abduction.

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Tarso-metatarsal joints

Plane synovial joints

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Gliding movements

Intertarsal joints

SIX synovial cavities between tarsus and metatarsus :

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a) Sub-talar

b) Talo-calcano-navicular Mid-tarsal / Transverse

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c) Calcaneo-cuboid tarsal

d) A joint cavity comprising cuneo

-navicular, intercuneiform,

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cuneo-cuboid and intermediate

and lateral cuneiform with

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bases of 2nd and 3rd metatarsal

bone.

e) Between medial cuneiform and

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base of 1st metarcarpal.

f) Between cuboid and 4th and 5th

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metacarpal


SUBTALAR JOINT /Posterior talo-calcanean joint

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Ligaments

Capsule

Medial and lateral talo-calcanean ligaments

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Interosseous talo-calcaneanligament

Cervical ligament

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Interosseous talo-calcanean

ligament

Cervical ligament

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Midtarsal or transverse tarsal joints

TRANSVERSE TARSAL

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JOINT

(MIDTARSAL JOINT)

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TALONAVICULAR JOINT

CALCANEO-CUBOID
JOINT

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Midtarsal or transverse tarsal joint

? Talonavicular joint

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? Calcaneocuboid joint

Medial view of foot

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Talo-calcaneo-navicular joint

Restricted bal and socket type of joint

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Ligaments

Talo-navicular ligament

Plantar calcaneo-navicular

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Calcaneo-navicular part of bifurcated

ligaments

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The bifurcated ligament

Y-shaped band.

Its stem attached proximal y to

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the anterior part of the upper

calcaneal surface

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Distal y it divides into 2 limbs - calcaneocuboid and

calcaneonavicular parts.

The calcaneocuboid ligament extends to the dorsomedial aspect of

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the cuboid

The calcaneonavicular ligament is attached to the dorsolateral

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aspect of the navicular


Midtarsal or transverse tarsal joints

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?Talonavicular joint


?Calcaneocuboid joint

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Lateral view of foot

CALCANEOCUBOID JOINT

Saddle or sellar joint.

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Between anterior surface of calcaneus & posterior

surface of cuboid

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CALCANEOCUBOID JOINT
Ligaments

? Capsule

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? Calcaneocuboid part of bifurcate ligament

? Long plantar ligament

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? Short plantar or Plantar calcaneocuboid ligament

BIFURCATE LIGAMENT

DORSAL CALCANEOCUBOID

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LIGAMENT

CALCANEOCUBOID JOINT

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SHORT PLANTAR

LIGAMENT

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(Plantar

LONG

calcaneocuboid

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PLANTAR

ligament)

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LIGAMENT

PLANTAR VIEW

Medial

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Lateral

? The longest ligament associated with the

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tarsus.

? From Plantar surface of the calcaneus to

plantar surface of the cuboid

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? The deep fibres are attached to the

cuboid and more superficial fibres to the

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bases of the 2nd, 3rd and 4th and

sometimes fifth, metatarsals.

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Long plantar

ligament

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Plantar calcaneocuboid ligament

? Is deeper than the long plantar ligament

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? From the anterior calcaneal tubercle to

the cuboid

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Movements

INVERSION

EVERSION

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Inversion & Eversion

These movements are essential to adjust the foot while

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walking on uneven surface.

Inversion

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Sole is directed downwards & medially.

Associated with plantar flexion

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Eversion

Sole is directed downwards & laterally.

Associated with dorsiflexion

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Joints on which it occurs

Lateral view

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? Subtalar joint

? Transverse tarsal joint.

Medial view

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? Talo-calcaneo-navicular joint


Axis of movement

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Passes obliquely upwards, forward & medial y

from the heel end of calcaneus through sinus tarsi

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to dorso-medial surface of neck of Talus

Muscles causing Inversion

Tibialis Anterior

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Tibialis Posterior
Muscles causing Eversion

Peroneus longus

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Peroneus brevis

Peroneus tertius

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EVERSION LIMITED BY

DELTOID LIGAMENT

TIBIALIS ANTERIOR

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TIBIALIS POSTERIOR

Medial view of the skeleton of foot
INVERSION LIMITED BY

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LATERAL TALO-

CALCANEAL

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LIGAMENT

CERVICAL LIGAMENT

CALCANEOFIBULAR

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LIGAMENT

PERONEUS LONGUS

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PERONEUS BREVIS

Lateral view of the skeleton of foot

APPLIED ANATOMY

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Ankle sprains :


Lateral Ankle Sprains caused by Over inversion of

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foot, which is common causes anterior talo-

fibular & calcaneo - fibular ligaments to tear.

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a/k/a Low Ankle sprain

Medial Ankle Sprains When foot is forcibly

everted fibres of deltoid ligament are torn.

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