Bones of the Lower Leg

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bones of the foot and ankle

Name the 7 bones of the foot (not counting the phalanges)

Calcaneus, Talus, Navicular Medial Cuneiform, Intermediate Cuneiform, Lateral Cuneiform and Cuboid

What 3 bones make up the Ankle Joint

Tibia, Fibula and Talus

What is the largest and strongest bone of the foot?

Calcaneus

What is the most posterior-inferior part of the Calcaneus called?

process called the tuberosity

What process is on the lateral portion of the calcaneus?

peroneal trochlea or trochlear process

What structure is located medially on the calcaneous?

sustentaculum tali

What two bones articulate with the calcaneus and where are they located (direction)

calcaneous articulates anteriorly with the cuboid
calcaneous articulates superiorly with the talus

The articulation of what 2 bones makes up the subtalar joint?

the articulation of the talus and the calcaneus make up the subtalar joint

What is the opening in the middle of the subtalar joint called?

sinus tarsi

What is the second largest tarsal bone?

Talus

Where is the Navicular bone located?

On the medial side of the foot between the talus and the 3 cuneiforms.

What 4 bones does the navicular articulate with and what direction are they located?

Navicular articulates
1) posteriorly with the talus
2/3/4) anteriorly with the 3 cuneiforms (medial, intermediate and lateral cuneiforms)

Another name for the 1st digit on the foot, or big toe is?

Hallux

How many phalanges are on one foot?

14

How many metatarsals are on one foot?

5

How many tarsals are on one foot?

7

Where is the most common break on the foot located?

Proximal base of the 5th metatarsal (little toe side), on a rough tuberosity

Name the joint between between the bones of the foot. (5 kinds)

1) IP (interphalangeal joint) joint between the proximal and distal phalanges of 1st digit (big toe)
2) PIP (proximal interphalangeal) joints is between the middle and proximal phalanges.
3) DIP (distal interpahlangeal) joints is between the middle and distal phalanges
4) Between metatarsal and phalanges is the MTP (metatarsal phalangeal) joint
5) Between tarsals and the metatarsals is the TMT (tarsalmetatarsal) joint

Where are sesamoids almost always found on the foot?

plantar surface at the head of the 1st metatarsal (big toe)

What 4 bones does the talus articulate with and where are they located?

Talus articulates
1/2) Superiorly the tibia and fibula
3) Inferiorly with the calcaneous
4) anteriorly with the navicular

What 4 bones does the medial (first) cuneiform articulate with and what direction?

Medial cuneiform articulates with the
1) navicular proximally,
2/3) first and second metatarsals distally and the
4) intermediate cuneiform laterally.

What 4 bones does the intermediate (second) cuneiform articulate with and what direction?

Intermediate cuneiform articulates with the
1) navicular proximately
2) the second metatarsal distally
3) the medial cuneiform medially and
4) the lateral cuneiform laterally

What is the smallest of the tarsals and what direction?

The intermediate cuneiform is the smallest of the tarsals.

What 6 bones does the lateral (third) cuneiform articulate with and what direction?

The lateral cuneiform articulates with
1) the navicular proximally
2/3/4) the second, third and forth metatarsals distally
5) the intermediate cuneiform medially and
6) the cuboid laterally

What bone does all three cuneiform bones articulate with proximally?

The naviculcar

What side of the foot is the cuboid located on?

Cuboid is on lateral side of foot

What 4 bones does the cuboid articulate and what direction?

Cuboid articulates with
1) the calcaneus proximally
2) the lateral cuneiform medially and
3/4) the fourth and fifth metatarsals distally

Name the 2 arches of the foot.

Longitudinal arch and the transverse arch

Where is the transverse arch located?

transverse arch is located at the TMT joints (TarsalMetatarsal Joint)

Where is the longitudinal arch located and what does it do?

Longitudinal arch runs front to back, is both medial and lateral, most of the arch is on the medial side. It provides shock-absorbing support for the body weight.

What is located at the distal end of the fibula?

lateral malleolus

What is located at the distal end of the tibia?

medial malleolus

The inferior portions of what 2 bones form a deep socket?
What is the name of the deep socket?
What fits in the deep socket?

Tibia and Fibula for deep socket
Deep socket is called the ankle mortise
the talus fits into the ankle mortise

Which malleolus (lateral or medial) is more distal and posterior and by how much?

the lateral malleolus is more distal and posterior than the medial malleolus by about 1/2 inch or 1 cm.

What is the Anterior tubercle and where is it located and on what bone?

it is a process at the distal anterior and lateral tibia

What is the tibial plafond and where is it located?

it is the tibial joint surface or ceiling of the ankle mortise

What is the weight bearing bone of the lower leg?

Tibia

What makes up the medial and lateral portions of the proximal tibia?

the medial and lateral condyles of the tibia

Describe the intercondylar eminence and where it is located.

It is located on the superior surface of the tibia (below the femor), between the two condyles. It has two pointed prominences called the medial and lateral intercondylar tubercls.

What does the upper articular surface of the tibia have and what is it/they called. What bone does it articulate with. What is the degree of slope and what direction does it slope?

Upper articular surface of tibia has 2 concaved surfaces or articular facets that make up the tibial plateau that articulates with the femur. The tibial plateau slopes posteriorly from 10° to 20°.

Where is the tibial tuberosity located?

On the proximal anterior surface of the tibia just distal to the condyles.

the anterior portion of the tibial shaft (the sharp ridge) is called what?

Anterior crest or border ) aka, Shin bone

What is the fibular notch and what bone is it located on and where?

Fibular notch is located on the distal tibia, it is where the distal fibula articulates with the distal tibia.

What process is located on the distal tibia?

the medial malleolus

Where is the head of the fibula located and what does it articulate with?

Fibular head is proximal and articulates with the lateral condyle of the tibia

What is another name for the proximal pointed area on the head of the fibular styloid process?

The apex of the head

Where is the fibular neck located?

Proximal end of fibula, just under the apex and the head.

Where is the lateral malleolus located?

It is located on the distal lateral side of the fibula

What bone is the longest and strongest in the entire body?

the Femur

What is the largest sesamoid bone in the body and where is it located?

the Patella is the largest sesamoid bone. Located anteriorly on the distal femur, proximal to the knee joint by 1/2 inch.

Describe the patellar surface (also known as the intercondyler surface or trochlear groove) and what it does when the leg is extended and flexed.

The pateller surface is the distal portion of the anterior femur. When the leg is extended, the patella is superior to the patellar surface. When leg is flexed, the patella moves downward.

Describe the distal femur.

Has 2 large condlyles, the medial and lateral condyles. The medial condyle extends more distally.
These are separated by the intercondylar fossa or notch.
Just proximal to the condyles are medial and lateral epicondyles.
On the posteriolateral aspect of the medial condyle is the adductor tubercle.
The popliteal surface is located on the posterior side, just proximal to the intercondylar fossa.

What must you do for a lateral knee x-ray and why?

The tube must be angled 5-7° cephalic to superimpose the 2 condyles of the femur.

Where is the apex of the patella located?

The apex is inferior to the base of the patella, which is superior

What is the anterior surface of the the patella like?

It is convex and rough.

What is the posterior surface of the patella like?

It is smooth.

What joint if the largest and most complex joint in the body?

Knee joint

Name 2 articulations of the knee joint.

1) between the condyles of the femur and the condyles of the tibia
2) between the patella and the anterior surface of the distal femur

Name 2 collateral ligaments that prevent adduction and abduction at the knee joint. Best modality to view these?

1) LCL (fibular lateral collateral ligament)
2) MCL (tibial medial collateral ligament)
MRI

Name 2 cruciate ligaments that prevent anterior or posterior movement at the knee joint.Best modality to view these?

1) ACL (anteriaor curciate ligament)
2) PCL (posterior curciate ligament)
MRI

What kind of joint is the knee classified as?

Synovial joint

Name 2 knee bursa and what separates them.

1) Supraoatellar bursa
2) Infrapatellar bursa
separated by the infrapatellar fat pad.

What are manisci made of, what do they do and where are they located.

Menisci are disks made of fibrocartilage
They absorb shock
They are located between the articular facets of the tibial plateau and the femoral condyls

What kind of joint is the distal tibiofibular joint classified as? What kind of movement does it have? Are there any other joints in the lower extremities that are this same kind of joint?

Classification: Fiberous (sydesmosis type) joint
Movement: ampithorodial (only slightly moveable under certain situations)
No, it is the only one of this kind in the legs, all others are classified synovial (have bursa) and diarthodial mobility(freely moveable)

List the 8 types of joints in the lower extremities and their movement types.

Feet
1) IP joints: ginglymus hinge
2) MTP joints: ellipsodial condyloid
3) TMT joints: plane, gliding
4) Intertarsal: plane, fliding
5)Ankle: sellar saddle
Knee
6) Femotibial: bicondylar
7) Patellofemoral: sellar saddle
8) Proximal tib/fib: plane, gliding

What is the top or anterior surface of the foot called?

Dorsum

What is the bottom or posterior or the foot called?

Plantar

Describe an AP and PA projection of the foot.

AP: dorsoplantar projection
PA: plantardorsal projection

Describe dorsiflex, plantar flexion, inversion (varus) and eversion (valgus)

dorsiflex: toes go up
plantar flexion: point toes
inversion (varus): toes go toward the median
eversion (valgus): toes to toward the lateral

What are 2 exposure factors for the lower extremities?

Low to medium kV (50 to 70)
small focal spot

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