The AnkleThe Ankle

1) IN WHICH PLANE DOES INVERSION AND EVERSION OF THE 1) IN WHICH PLANE DOES INVERSION AND EVERSION OF THE ANKLE JOINT TAKE PLACE?ANKLE JOINT TAKE PLACE?

Frontal or coronal Frontal or coronal planeplane

2) 2) NAME THE LIGAMENTS THAT WOULD BE INJURED IN AN NAME THE LIGAMENTS THAT WOULD BE INJURED IN AN INVERSION INJURY OF THE ANKLEINVERSION INJURY OF THE ANKLE

When an ankle is injured from twisting in towards the other foot, When an ankle is injured from twisting in towards the other foot, called an inversion injury, most commonly the Anterior Talofibular called an inversion injury, most commonly the Anterior Talofibular ligament is stretched.ligament is stretched.

Calcaneofibular (CFL) is the second most common ligament injured Calcaneofibular (CFL) is the second most common ligament injured after the anterior talofibular ligament (ATFL).after the anterior talofibular ligament (ATFL).

3) THE ARTICULATION OF 3) THE ARTICULATION OF WHICHWHICH BONES FORM THE ANKLE JOINT? BONES FORM THE ANKLE JOINT?

The Ankle joint is made up of the Talus, the distal Tibia, and the distal The Ankle joint is made up of the Talus, the distal Tibia, and the distal FibulaFibula

The articulation between the Tibia and the Talus bears more weight.The articulation between the Tibia and the Talus bears more weight.

4) ENUMERATE THE MOVEMENTS POSSIBLE IN THE ANKLE JOINT.4) ENUMERATE THE MOVEMENTS POSSIBLE IN THE ANKLE JOINT.

DORSIFLEXION (Flexion): dorsal flexion; movement of the top of DORSIFLEXION (Flexion): dorsal flexion; movement of the top of the ankle and foot toward the anterior tibia bone.the ankle and foot toward the anterior tibia bone.

PLANTAR FLEXION (extension): movement of the ankle and foot PLANTAR FLEXION (extension): movement of the ankle and foot away from the tibia.away from the tibia.

EVERSION: turning the ankle and foot outward; abduction, away EVERSION: turning the ankle and foot outward; abduction, away from the midline; weight is on the medial edge of the foot.from the midline; weight is on the medial edge of the foot.

INVERSION: turning the ankle and foot inward; adduction, toward INVERSION: turning the ankle and foot inward; adduction, toward the midline; weight is on the lateral edge of the footthe midline; weight is on the lateral edge of the foot

TOE FLEXION: movement of the toes toward the plantar surface of TOE FLEXION: movement of the toes toward the plantar surface of the footthe foot

TOE EXTENSION: movement of the toes away from the plantar TOE EXTENSION: movement of the toes away from the plantar surface of the foot.surface of the foot.

PRONATION: a combination of ankle dorsiflexion, subtalar PRONATION: a combination of ankle dorsiflexion, subtalar eversion, and forefoot abduction (toe-out)eversion, and forefoot abduction (toe-out)

SUPINATION: a combination of ankle plantar flexion, subtalar SUPINATION: a combination of ankle plantar flexion, subtalar inversion, and forefoot adduction (to-in).inversion, and forefoot adduction (to-in).

5) NAME THE MUSCLE WHICH CONTRACTS CAUSING 5) NAME THE MUSCLE WHICH CONTRACTS CAUSING DORSIFLEXION OF ANKLE JOINTDORSIFLEXION OF ANKLE JOINT

Tibialis anteriorTibialis anterior

6) WHAT IS THE DISTAL MEDIAL END OF TIBIA CALLED?6) WHAT IS THE DISTAL MEDIAL END OF TIBIA CALLED?

The predominant structure at the distal end of the tibia is the The predominant structure at the distal end of the tibia is the medial malleolusmedial malleolus

7) WHERE DOES THE TIBIA CONNECT TO THE FIBULA 7) WHERE DOES THE TIBIA CONNECT TO THE FIBULA MEDIALLY?MEDIALLY?

The fibula is placed on the lateral side of the tibia, with which it is The fibula is placed on the lateral side of the tibia, with which it is connected superiorly and inferiorly by the Superior tibiofibular connected superiorly and inferiorly by the Superior tibiofibular joint and the Inferior tibiofibular joint.joint and the Inferior tibiofibular joint.

8) WHAT IS THE FUNCTION OF GASTROCNEMIUS MUSCLE?8) WHAT IS THE FUNCTION OF GASTROCNEMIUS MUSCLE?

The function of the gastrocnemius muscle is ankle plantar flexion and The function of the gastrocnemius muscle is ankle plantar flexion and knee flexionknee flexion

9) 9) WHERE IS THE INSERTION OF THE TIBIALIS POSTERIOR WHERE IS THE INSERTION OF THE TIBIALIS POSTERIOR MUSCLE?MUSCLE?

The tibialis posterior has multiple The tibialis posterior has multiple insertions on the lower inner surfaces of insertions on the lower inner surfaces of the navicular, cuneiform, and second the navicular, cuneiform, and second through fifth metatarsal bases.through fifth metatarsal bases.

10) Where can you palpate the 10) Where can you palpate the tibialistibialis anterior muscle? anterior muscle?

It is the first It is the first muscle to the lateral muscle to the lateral side of the anterior side of the anterior tibial bordertibial border

11) Which nerve 11) Which nerve suppliessupplies the gastronemius muscle? the gastronemius muscle?

Tibial nerve: S1, S2Tibial nerve: S1, S2

12) The eversion of the ankle joint is governed by which muscles?12) The eversion of the ankle joint is governed by which muscles?

peroneus longus, peroneus peroneus longus, peroneus brevisbrevis

13.13. What is the function of flexor digiti minimi?What is the function of flexor digiti minimi?

Abduction of the proximal Abduction of the proximal phalanx of the fifth phalangephalanx of the fifth phalange

14) 14) LocateLocate the following parts of the ankle and foot on a subject the following parts of the ankle and foot on a subject

a- Lateral malleolusa- Lateral malleolusb- Medial malleolusb- Medial malleolusc- Phalangesc- Phalangesd- Metatarsal boned- Metatarsal bone

15) 15) Demonstrate the following movements.Demonstrate the following movements.a- Plantar flexiona- Plantar flexionb- Dorsal flexionb- Dorsal flexionc- Inversionc- Inversiond- Eversiond- Eversione- Flexion of toese- Flexion of toes

16) List the plane in 16) List the plane in whichwhich the following movement takes place. the following movement takes place.

a- Plantar flexiona- Plantar flexionb- Flexion of toe b- Flexion of toe Both take place in the sagittal Both take place in the sagittal plane.plane.

17.17. If a If a personperson injures his lateral planter nerve then which injures his lateral planter nerve then which movement is likely to get affected?movement is likely to get affected?

Flexion of the 3rd, 4th, 5th Flexion of the 3rd, 4th, 5th phalangesphalanges

18) 18) WhereWhere is the insertion of the Adductor hallucis muscle, and what is the insertion of the Adductor hallucis muscle, and what is its function?is its function?

Insertion is on the lateral Insertion is on the lateral aspect on the base of the 1st aspect on the base of the 1st proximal phalanx.proximal phalanx.

Function is adduction of the Function is adduction of the great toe and assists the great toe and assists the flexor hallucis brevis in flexing flexor hallucis brevis in flexing the great toes at the the great toes at the metatarsophalangeal joint.metatarsophalangeal joint.

19) Which movement helps a person to walk in terrain plain?19) Which movement helps a person to walk in terrain plain?

Per Dr. Ray’s instructions, omit this Per Dr. Ray’s instructions, omit this question.question.

20) What are the functions of the flexor hallucis longus muscle?20) What are the functions of the flexor hallucis longus muscle?

Flexion of the great Flexion of the great toe at the toe at the metatarsophalangemetatarsophalangeal joint (MTP) and al joint (MTP) and interphalangeal interphalangeal jointjointInversion of the Inversion of the footfootPlantar flexion of Plantar flexion of the anklethe ankle

21) Name the nerve supplying the following muscles21) Name the nerve supplying the following muscles

a.a. Extensor Digitorum LongusExtensor Digitorum Longus deep peroneal nervedeep peroneal nerve

b. b. Peroneus brevis Peroneus brevis superficial peroneal nervesuperficial peroneal nerve

c. c. SoleusSoleus tibial nervetibial nerve

d. d. LumbricalsLumbricals medial and lateral plantar medial and lateral plantar nervesnerves

e. e. Plantar interosseiPlantar interossei lateral plantar nervelateral plantar nerve

22)22) How can you strengthen your gastrocnemius?How can you strengthen your gastrocnemius?

Running, jumping, Running, jumping, hopping, and hopping, and skipping exercises.skipping exercises.

Heel-raising Heel-raising exercises with the exercises with the knees in full knees in full extension and the extension and the toes on a raised toes on a raised surface.surface.

23) During the concentric contraction of the soleus and gastrocnemius, 23) During the concentric contraction of the soleus and gastrocnemius, what type of contraction will take place in the tibialis anterior?what type of contraction will take place in the tibialis anterior?

Concentric contraction is Concentric contraction is defined as a contraction in defined as a contraction in which there is shortening of which there is shortening of the muscle the causes motion the muscle the causes motion to occur.to occur.

Because the tibialis anterior is Because the tibialis anterior is on the opposite side of the on the opposite side of the lower leg from the soleus and lower leg from the soleus and gastrocnemius it will be gastrocnemius it will be performing the opposite performing the opposite action, So if the action, So if the gastrocnemius and the soleus gastrocnemius and the soleus are concentrically contracted are concentrically contracted the tibialis anterior will be the tibialis anterior will be eccentrically contracted.eccentrically contracted.

24) What is the action of the peroneous brevis?24) What is the action of the peroneous brevis?

Plantar flexion of Plantar flexion of the anklethe ankle

Eversion of the footEversion of the foot

25) Complete the table25) Complete the table

Muscle Origin Insertion Action Innervation

Tibialis Anterior upper 2/3 of the lateral surface of the tibia

medial cuneiform and first metatarsal bone of the foot

dorsiflexion and inversion of the foot

deep peroneal nerve

Lumbricals tendons of flexor digitorum longus

dorsal surface of 2nd, 3rd, 4th, and 5th proximal phalanxes

MTP joint flexion of 2nd, 3rd, 4th, and 5th phalanges

1st lumbrical: medial plantar nerve

2nd, 3rd, and 4th:lateral plantar nerve

Soleus posterior surface of the proximal fibula and proximal 2/3 of the posterior tibial surface

posterior surface of the calcaneus

(Achilles tendon)

plantar flexion tibial nerve

Plantar interossei bases and medial shafts of the 3rd, 4th, and 5th metatarsals

medial aspects of bases of 3rd, 4th and 5th proximal phalanxes

MTP adduction and flexion of 3rd, 4th, and 5th phalanges

lateral plantar nerve

Abductor hallucis tuberosity of calcaneus, flexor retinaculum, and plantar aponeurosis

medial aspect of base of 1st proximal phalanx

MTP flexion and abduction of 1st phalanx

medial plantar nerve

Gastrocnemius medial head: posterior surface of the medial femoral condylelateral head: posterior surface of the lateral femoral condyle

posterior surface of the calcaneus (Achilles tendon)

plantar flexion and flexion of the knee

tibial nerve