Download MBBS Anatomy PPT 82 Ankle Joint Gk Notes

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Contents of the anterior compartment

o Muscles:
1. Tibialis anterior
2. Extensor digitorum

longus

3. Extensor hal ucis longus
4. Peroneus tertius

o Anterior tibial artery
o Deep peroneal nerve.

Muscles of the anterior compartment


Retinacula

Deep fascia is thickened to form

bands.

Retain tendons in place.

?Superior Extensor Retinaculum

? Inferior Extensor Retinaculum

?Superior Peroneal Retinaculum

? Inferior Peroneal Retinaculum

Muscles of the back


Muscles of lateral side


ANKLE or TALO-CRURAL JOINT

Uni-axial synovial joint

Modified hinge joint

Tibio-fibular mortise




Trochlea tali

Ligaments

?Capsule

?Synovial membrane

?The ankle joint is bound medially by the strong

Deltoid ligament

? Three lateral ligaments

?Anterior talofibular ligament

? Posterior talofibular ligament

? Calcaneofibular ligament


Deltoid ligament or Medial ligament

Superficial part:

? Anterior part or Tibio - navicular part

? Intermediate part or Tibio - calcanean

part

? Posterior part or Posterior

tibio - talar part

Deep part/Anterior Tibiotalar


Attachments & parts of deltoid

ligament

Medial mal eolus

of Tibia

Anterior Tibiotalar

Tibiotalar

Talus

Tibionavicular

Tibiocalcanean

Sustanticulum

Tali


Lateral ligaments

Anterior Talofibular

Lateral mal eolus of

Fibula

Neck of Talus

Posterior

Talofibular

Calcaneofibular ligament crossed by

tendons of Peroneus longus & Brevis


Movements of ankle joint

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


Movements

Plantar Flexion: S1, S2

Gastrocnemius

Soleus

Assisted by

Tibialis posterior,

Flexor Digitorum longus,

Flexor Hal ucis longus,

Peroneus longus and brevis in extreme plantar

flexion

Dorsiflexion: L4, L5

Tibialis anterior
Extensor Digitorum longus,
Extensor Hallucis longus,
Peroneus tertius



Arterial supply

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

NERVE SUPPLY

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


Interphalangeal joints

Typical hinge joint

Permit plantar flexion and

dorsiflexion

Metatarso - phalangeal joints

El ipsoidal type of synovial joint.
Ligaments:
? Capsule.
? Collateral ligaments.
? Deep metatarsal ligaments.
Movements:
? Dorsi & plantar flexion.
? Adduction & abduction.


Tarso-metatarsal joints

Plane synovial joints

Gliding movements

Intertarsal joints

SIX synovial cavities between tarsus and metatarsus :

a) Sub-talar

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

c) Calcaneo-cuboid tarsal

d) A joint cavity comprising cuneo

-navicular, intercuneiform,

cuneo-cuboid and intermediate

and lateral cuneiform with

bases of 2nd and 3rd metatarsal

bone.

e) Between medial cuneiform and

base of 1st metarcarpal.

f) Between cuboid and 4th and 5th

metacarpal


SUBTALAR JOINT /Posterior talo-calcanean joint

Ligaments

Capsule

Medial and lateral talo-calcanean ligaments

Interosseous talo-calcaneanligament

Cervical ligament

Interosseous talo-calcanean

ligament

Cervical ligament


Midtarsal or transverse tarsal joints

TRANSVERSE TARSAL

JOINT

(MIDTARSAL JOINT)

TALONAVICULAR JOINT

CALCANEO-CUBOID
JOINT



Midtarsal or transverse tarsal joint

? Talonavicular joint

? Calcaneocuboid joint

Medial view of foot


Talo-calcaneo-navicular joint

Restricted bal and socket type of joint

Ligaments

Talo-navicular ligament

Plantar calcaneo-navicular

Calcaneo-navicular part of bifurcated

ligaments

The bifurcated ligament

Y-shaped band.

Its stem attached proximal y to

the anterior part of the upper

calcaneal surface

Distal y it divides into 2 limbs - calcaneocuboid and

calcaneonavicular parts.

The calcaneocuboid ligament extends to the dorsomedial aspect of

the cuboid

The calcaneonavicular ligament is attached to the dorsolateral

aspect of the navicular


Midtarsal or transverse tarsal joints

?Talonavicular joint


?Calcaneocuboid joint

Lateral view of foot

CALCANEOCUBOID JOINT

Saddle or sellar joint.


Between anterior surface of calcaneus & posterior

surface of cuboid

CALCANEOCUBOID JOINT
Ligaments

? Capsule

? Calcaneocuboid part of bifurcate ligament

? Long plantar ligament

? Short plantar or Plantar calcaneocuboid ligament

BIFURCATE LIGAMENT

DORSAL CALCANEOCUBOID

LIGAMENT

CALCANEOCUBOID JOINT


SHORT PLANTAR

LIGAMENT

(Plantar

LONG

calcaneocuboid

PLANTAR

ligament)

LIGAMENT

PLANTAR VIEW

Medial

Lateral

? The longest ligament associated with the

tarsus.

? From Plantar surface of the calcaneus to

plantar surface of the cuboid


? The deep fibres are attached to the

cuboid and more superficial fibres to the

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

sometimes fifth, metatarsals.

Long plantar

ligament




Plantar calcaneocuboid ligament

? Is deeper than the long plantar ligament

? From the anterior calcaneal tubercle to

the cuboid

Movements

INVERSION

EVERSION


Inversion & Eversion

These movements are essential to adjust the foot while

walking on uneven surface.

Inversion

Sole is directed downwards & medially.

Associated with plantar flexion


Eversion

Sole is directed downwards & laterally.

Associated with dorsiflexion

Joints on which it occurs

Lateral view

? Subtalar joint

? Transverse tarsal joint.

Medial view

? Talo-calcaneo-navicular joint


Axis of movement

Passes obliquely upwards, forward & medial y

from the heel end of calcaneus through sinus tarsi

to dorso-medial surface of neck of Talus

Muscles causing Inversion

Tibialis Anterior

Tibialis Posterior
Muscles causing Eversion

Peroneus longus

Peroneus brevis

Peroneus tertius

EVERSION LIMITED BY

DELTOID LIGAMENT

TIBIALIS ANTERIOR

TIBIALIS POSTERIOR

Medial view of the skeleton of foot
INVERSION LIMITED BY

LATERAL TALO-

CALCANEAL

LIGAMENT

CERVICAL LIGAMENT

CALCANEOFIBULAR

LIGAMENT

PERONEUS LONGUS

PERONEUS BREVIS

Lateral view of the skeleton of foot

APPLIED ANATOMY

Ankle sprains :


Lateral Ankle Sprains caused by Over inversion of

foot, which is common causes anterior talo-

fibular & calcaneo - fibular ligaments to tear.

a/k/a Low Ankle sprain

Medial Ankle Sprains When foot is forcibly

everted fibres of deltoid ligament are torn.