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RAD141 - Chap 7A

RAD141 - Chap 7A - foot, ankle

What are the 4 main groups of bones in the lower limb? foot, leg, femur, hip
How many bones in the foot? What are the groups? 26 bones in each foot -> 14 phalanges, 5 metatarsals (instep), 7 tarsals
How are the phalanges numbered? 1-5, starting on the medial side of the foot; distal, middle, and proximal phalanx on all but the 1st digit, which only has proximal & distal
How do the phalanges of the foot differ from those of the hand? the phalanges of the foot are smaller and have more limited movement
What is difficult with the distal phalanges of the 2nd - 5th toes? they are very small and may be difficult to identify as separate bones on a radiograph
What are the metatarsals? the 5 bones of the instep; numbered 1-5 from medial side; each consists of 3 parts -> distal -> head; central -> body (shaft); proximal -> base
What is a landmark on the 5th metatarsal? the base is expanded laterally into a prominent rought tuberosity which provides for the attachment of a tendon; it is readily visible on radiographs and is a common trauma site for the foot
What are the joints of the phalanges? each joint of the foot has a name derived from the 2 bones on either side of that joint; interphalangeal (IP) joint of the 1st digit, distal IP (DIP) and proximal IP (PIP) of the 2nd - 5th phalanges
What are the joints of the metatarsals? each of the joints at the head of the metatarsal is a metatarsophalangeal (MTP) joint; each of the joints at the base of the metatarsal is a tarsometarsal (TMT) joint
What is the important metatarsal joint? the base of the 3rd metatarsal (3rd tarsometarsal joint) -> this is the centering point (CR location) for an AP and oblique foot
What are sesamoid bones? What is special about sesamoid bones in the feet? small detatched bones, embedded in tendons; sesamoid bones tend to be larger and more significant radiographically in the lower limbs as they can be fractured, and because of their plantar location, can be very painful
Where are sesamoid bones commonly found in the foot? sesamoid bones are almost always present on the plantar surface at the head of 1st metatarsal near the 1st MTP joint; may also be found near other joints of the foot
What are the tarsal bones named? calcaneus, talus, cuboid, navicular, and 1st, 2nd, 3rd cuneiforms (Come To Colorado (the) Next 3 Christmases
What are alternative names for the calcaneus, talus, and navicular bones? calcaneus -> os calcis; talus -> astragalus; navicular -> scaphoid
How do the tarsals compare to the carpals? only 7 tarsals (8 carpals), tarsals are larger, less mobile (provides a basis of support for the boid in an erect position)
Which is the only tarsal bone involved in the ankle joint? the talus
What is the largest and strongest bone of the foot? Second largest? largest, strongest ->the calcaneus; the posterior portion is often called the heel bone; 2nd largest -> talus
What tuberosity processes are found on the calcaneus? thetuberosity is on the most posterior-inferior part -> large tendons attach here; at its widest points has 2 small rounded, processes -> larger = lateral process, smaller = medial process
What other processes are on the calcaneous, unrelated to the tuberosity? the peroneal trochlea, aka the trochlear process is visualized laterally on an axial projection; on the medial proximal aspect is a larger more prominent bony process called the sustentaculum tali
What are the articulations of the calcaneus? anteriorly w/the cuboid and superiorly w/the talus; the superior articulation w/the talus forms the subtalar (talocalcaneal) joint
What 3 facets appear at the subtalar joint? the larger posterior articular facet and the smaller anterior and middle articular facets
What is the calcaneal sulcus? the sinus tarsi? calcaneal sulcus -> the deep depression between the posterior and middle articular facets; sinus tarsi (aka tarsal sinus) -> opening in the middle of the subtalar joint for passing of ligaments (combo of calcaneal sulcus & depression in the talus)
Describe the talus It is the 2nd largest tarsal bone and is located between the lower leg and the calcaneus; the weight of the body is transmitted by this bone thru the ankle & talocalcaneal joints
What 4 bones does the talus articulate with? superiorly w/the tibia and fibula, inferiorly with the calcaneus, and anteriorly with the navicular
Describe the navicular a flattened, oval-shaped bone located on the medial side of the foot between the talus and the 3 cuneiforms
What 4 bones does the navicular articular articulate with? posteriorly with the talus and anteriorly with the 3 cuneiforms
Describe the 3 cuneiforms cuneiform means wedge-shaped; located on the medial & midaspects of the foot between the 1st 3 metatarsals distally & the navicular proximally; largest is the medial (first) cuneiform; the intermediate (2nd) cuneiform is the smallest cuneiform
What 4 bones does the medial cuneiform articulate with? the 1st cuneiform articulates with the navicular proximally, the 1st and 2nd (3rd?) metatarsals distally, and the intermediate cuneiform laterally
What 4 bones does the intermediate cuneiform articulate with? the 2nd cuneiform articulates with the navicular proximally, the 2nd metatarsal distally, and the medial & lateral cuneiforms on each side
What 6 bones does the lateral cuneiform articulate with? the 3rd cuneiform articulates with the navicular proximally, the 2nd, 3rd, and 4th metatarsals distally, the intermediate cuneiform medially, and the cuboid laterally
Describe the location of the cuboid located on the lateral aspect of the foot, distal to the calcaneus, proximal to the 4th and 5th metatarsals
Which 4 bones does the cuboid articulate with? the calcaneus proximally, the lateral cuneiform medially, and the 4th and 5th metatarsals distally; occasionally, it will also articulate with the navicular
What are the 2 arches that the bones of the foot are arranged? What is their function? the longitudinal and transverse arches -> provide a strong, shock-absobin support for the weight of the body
Describe the longitudinal arch it is springy and comprises a medial and lateral component, with most of the march on the medial and midaspects of the foot
Describe the transverse arch located primarily along the plantar surface of the distal tarsals & the tarsometatarsal joints; made up of the cuneiforms, especially the smaller 2nd & third cuneiforms in combo w/the larger 1st cuneiform & the cuboid
Which 3 bones form the ankle joint? tibia, fibula, and the talus
How is the mortise of the ankle formed? What is the mortise? from the lateral malleolus of the fibula, the medial malleolus of the tibia, & the inferior portions of the tibia (tibial plafond) & fibula; it is a 3-sided opening into which the upper talus fits
How can the entire 3-part joint space of the aknkle mortise be viewed? not on a true frontal view (AP projection) because of overlapping of portions of the distal fibula & tibia by the talus; a 15 deg internally rotated AP projection (mortise position) is required
What is the anterior tubercle? an expanded process at the distal enterior and lateral tibia, articulates with the superolateral talus & partially overlaps the fibula anteriorly
What is the tibial plafond? plafond = ceiling; the distal tibial joint surface forms the roof of the ankle mortise joint; certain types of fractures of the ankle in children and youth involve the distal tibial epiphysis & tibial plafond
How can a true lateral ankle view be verified? the lateral malleolus should be about 0.5 inches posterior to the medial malleolus; the lateral malleolus should also extend about 0.5 inches more distally than the medial malleolus
What type of joint is the ankle joint? synovial joint of the ginglymus (hinge) type, with flexion & extension (i.e. dorsiflexion and plantar flexion) movements only
What prevents the ankle from moving laterally? strong collateral ligaments extending from the medial and lateral malleoli to the calcaneus and talus
What happens if the ankle is subject to lateral stress? a "sprained" ankle, with stretched or torn collateral ligaments and torn muscle tendons resulting in an increase in parts of the mortise joint space
What type of joint are the interphalangeal joints? hinge type
What type of joints are the metatarsotarsal joints? condylar
What type of joints are the intertarsal and tarsometatarsal joints? gliding joints
What is the ankle joint? What type? the ankle joint is the articulation of the talus with the tibia and fibula; it is a hinge type joint
Created by: debmurph