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Anatomy

Lower Limb

Question 3 of 180

Which of the following structures primarily supports the medial longitudinal arch rather than the lateral longitudinal arch of the foot:

Answer:

The medial longitudinal arch is supported by the spring ligament, the deltoid ligament, the plantar aponeurosis, the small muscles in the sole of the foot and the tendons of the tibialis anterior, tibialis posterior and flexor hallucis longus muscles which provide passive and dynamic support. The lateral longitudinal arch is supported by the the long and short plantar ligament and the fibularis longus tendon together with the extensor tendons and the short muscles of the little toe.

The bones of the foot form longitudinal and transverse arches (relative to the ground) which absorb and distribute weight bearing forces during standing and moving.

The longitudinal arch is formed between the posterior end of the calcaneus and the heads of the metatarsals and has a medial and lateral part.

Table: Constituent Bones and Prime Supporting Factors of the Longitudinal Foot Arches

Arch Constituent Tarsal Bones Prime Supporting Factors
Medial longitudinal arch Calcaneus, talus, navicular, three cuneiforms and medial three metatarsal bones Spring ligament, deltoid ligament, plantar aponeurosis and tendons of the tibialis anterior and tibialis posterior muscles
Lateral longitudinal arch Calcaneus, cuboid and lateral two metatarsal bones Plantar aponeurosis, fibularis longus tendon, long and short plantar ligament

Medial Longitudinal Arch

The higher medial longitudinal arch is formed and maintained by the interlocking of the calcaneus, the talus, the navicular, the three cuneiforms and the medial three metatarsal bones. The medial longitudinal arch is supported by the spring ligament, the deltoid ligament, the plantar aponeurosis, the small muscles in the sole of the foot and the tendons of the tibialis anterior, tibialis posterior and flexor hallucis longus muscles which provide passive and dynamic support.

Lateral Longitudinal Arch

The lateral longitudinal arch is formed from the calcaneus, the cuboid and the lateral two metatarsal bones. The lateral longitudinal arch is flatter than the medial part and rests on the ground during standing. The lateral longitudinal arch is supported by the the long and short plantar ligament and the fibularis longus tendon together with the extensor tendons and the short muscles of the little toe.

By OpenStax College [CC BY 3.0 , via Wikimedia Commons

Arches of the Foot: Medial and Lateral Views. (Image by OpenStax College [CC BY 3.0 , 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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