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Anatomy

Lower Limb

Question 63 of 180

While performing an examination of a 40 year old male patient who complains of pain in his foot, you notice an abnormality. His foot is displaced laterally and everted, and the head of the talus is no longer supported. A image of his foot is shown below. Which of the following ligaments is most likely to be stretched in this patient:

By Drvgaikwad (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

(Image by Drvgaikwad (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0), via Wikimedia Commons)

Answer:

Flat foot is characterised by the disappearance of the medial longitudinal arch. The spring ligament supports the head of the talus and the medial longitudinal arch. The long and short plantar ligaments support the lateral medial longitudinal arch. The anterior talofibular and calcaneofibular ligaments support the ankle joint laterally.

Spring Ligament

Anatomy / Lower Limb / Ankle and Foot Joints

Last Updated: 25th January 2019

The spring ligament (plantar calcaneonavicular ligament) is a broad thick ligament that extends from the calcaneus to the navicular bone. It supports the head of the talus, stabilises the talocalcaneonavicular joint and resists depression of the medial arch of the foot. The spring ligament takes the weight of the body from the talus and transmits it to the forefoot.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Spring Ligament. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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