← Back to Session

Questions Answered: 180

Final Score 76%

137
43

Questions

  • Q1. X Incorrect
  • Q2. X Incorrect
  • Q3. Correct
  • Q4. Correct
  • Q5. Correct
  • Q6. X Incorrect
  • Q7. X Incorrect
  • Q8. Correct
  • Q9. Correct
  • Q10. Correct
  • Q11. X Incorrect
  • Q12. Correct
  • Q13. Correct
  • Q14. Correct
  • Q15. Correct
  • Q16. X Incorrect
  • Q17. Correct
  • Q18. Correct
  • Q19. Correct
  • Q20. Correct
  • Q21. Correct
  • Q22. Correct
  • Q23. X Incorrect
  • Q24. Correct
  • Q25. Correct
  • Q26. Correct
  • Q27. Correct
  • Q28. Correct
  • Q29. Correct
  • Q30. Correct
  • Q31. Correct
  • Q32. Correct
  • Q33. X Incorrect
  • Q34. Correct
  • Q35. Correct
  • Q36. Correct
  • Q37. Correct
  • Q38. Correct
  • Q39. Correct
  • Q40. Correct
  • Q41. Correct
  • Q42. X Incorrect
  • Q43. Correct
  • Q44. Correct
  • Q45. Correct
  • Q46. Correct
  • Q47. Correct
  • Q48. Correct
  • Q49. Correct
  • Q50. Correct
  • Q51. Correct
  • Q52. X Incorrect
  • Q53. Correct
  • Q54. X Incorrect
  • Q55. X Incorrect
  • Q56. Correct
  • Q57. Correct
  • Q58. X Incorrect
  • Q59. Correct
  • Q60. X Incorrect
  • Q61. X Incorrect
  • Q62. Correct
  • Q63. Correct
  • Q64. Correct
  • Q65. Correct
  • Q66. Correct
  • Q67. Correct
  • Q68. Correct
  • Q69. Correct
  • Q70. Correct
  • Q71. X Incorrect
  • Q72. Correct
  • Q73. Correct
  • Q74. Correct
  • Q75. Correct
  • Q76. Correct
  • Q77. X Incorrect
  • Q78. X Incorrect
  • Q79. X Incorrect
  • Q80. Correct
  • Q81. Correct
  • Q82. X Incorrect
  • Q83. X Incorrect
  • Q84. Correct
  • Q85. X Incorrect
  • Q86. Correct
  • Q87. Correct
  • Q88. Correct
  • Q89. Correct
  • Q90. X Incorrect
  • Q91. X Incorrect
  • Q92. Correct
  • Q93. X Incorrect
  • Q94. Correct
  • Q95. Correct
  • Q96. Correct
  • Q97. Correct
  • Q98. Correct
  • Q99. Correct
  • Q100. Correct
  • Q101. Correct
  • Q102. Correct
  • Q103. X Incorrect
  • Q104. Correct
  • Q105. Correct
  • Q106. X Incorrect
  • Q107. Correct
  • Q108. X Incorrect
  • Q109. Correct
  • Q110. Correct
  • Q111. Correct
  • Q112. Correct
  • Q113. Correct
  • Q114. X Incorrect
  • Q115. X Incorrect
  • Q116. Correct
  • Q117. Correct
  • Q118. Correct
  • Q119. Correct
  • Q120. Correct
  • Q121. X Incorrect
  • Q122. X Incorrect
  • Q123. Correct
  • Q124. Correct
  • Q125. Correct
  • Q126. Correct
  • Q127. X Incorrect
  • Q128. Correct
  • Q129. Correct
  • Q130. Correct
  • Q131. Correct
  • Q132. Correct
  • Q133. Correct
  • Q134. Correct
  • Q135. X Incorrect
  • Q136. Correct
  • Q137. Correct
  • Q138. Correct
  • Q139. Correct
  • Q140. Correct
  • Q141. Correct
  • Q142. Correct
  • Q143. X Incorrect
  • Q144. Correct
  • Q145. Correct
  • Q146. Correct
  • Q147. Correct
  • Q148. Correct
  • Q149. Correct
  • Q150. Correct
  • Q151. X Incorrect
  • Q152. Correct
  • Q153. Correct
  • Q154. Correct
  • Q155. Correct
  • Q156. X Incorrect
  • Q157. X Incorrect
  • Q158. Correct
  • Q159. Correct
  • Q160. Correct
  • Q161. Correct
  • Q162. Correct
  • Q163. Correct
  • Q164. Correct
  • Q165. X Incorrect
  • Q166. Correct
  • Q167. Correct
  • Q168. Correct
  • Q169. X Incorrect
  • Q170. X Incorrect
  • Q171. Correct
  • Q172. Correct
  • Q173. Correct
  • Q174. Correct
  • Q175. Correct
  • Q176. Correct
  • Q177. Correct
  • Q178. Correct
  • Q179. X Incorrect
  • Q180. X Incorrect

Anatomy

Lower Limb

Question 36 of 180

Which of the following nerves is most important for plantarflexion of the foot at the ankle joint:

Answer:

Plantarflexion of the foot at the ankle joint is primarily performed by muscles of the posterior compartment of the leg, innervated by the tibial nerve. The fibularis longus, innervated by the superficial fibular nerve assists in this action.

Table: Anatomical Overview of the Ankle Joint

Joint Ankle
Type Synovial hinge joint
Articulations Talus with the inferior tibia and talus with the medial malleolus of the tibia and the lateral malleolus of the fibula
Stabilising factors Shape of talus bone and articulations with malleoli; Medial and lateral collateral ligaments
Movements Flexion and extension

Joint articulations

The ankle joint is a hinge type synovial joint formed between the distal ends of the tibia and fibula, and the superior part of the talus.

The tibia and fibula are bound together by strong tibiofibular ligaments forming a deep bracket-shaped socket, which the talus bone then fits into. The talus bone articulates with the tibia in two places; the inferior surface of the tibia forms the roof of the socket and its medial malleolus articulates with the medial surface of the talus bone. The lateral malleolus of the fibula articulates with the lateral surface of the talus bone. The articulation of the talus with the inferior tibia forms the weightbearing surface and the articulations of the talus with the malleoli act to stabilise the joint.

The articular surface of the talus is much wider anteriorly than it is posteriorly, therefore the bone fits more tightly in the socket when the foot is dorsiflexed (and the wider surface of the talus moves into the ankle joint), making the joint more stable in dorsiflexion. Conversely the ankle joint is weakest during plantarflexion (when the narrower part of the talus is in the joint) and it is in this position that the majority of ankle injuries occur - usually as a result of the sudden inversion of the foot.

Ligaments

The ankle joint is supported on each side by the medial (deltoid) and lateral collateral ligaments.

The large strong deltoid ligament is triangular in shape, attached proximally to the medial malleolus at its apex and its broad base attached distally to a line that extends from the tuberosity of the navicular bone anteriorly to the medial tubercle of the talus posteriorly. The medial ligament is subdivided into four parts: the tibionavicular part, the tibiocalcaneal part, the posterior tibiotalar part and the anterior tibiotalar part. It acts to prevent overeversion of the foot and helps maintain the medial longitudinal arch.

The weaker lateral ligament is actually composed of three separate ligaments all originating from the lateral malleolus; the anterior talofibular ligament (attaching to the anterior talus), the posterior talofibular ligament (attaching to the posterior talus) and the calcaneofibular ligament (attaching to the calcaneus). It resists inversion of the foot and is frequently injured in ankle sprain inversion injuries. The most commonly affected ligament is the anterior talofibular ligament followed by the calcaneofibular ligament and then the posterior talofibular ligament.

By OpenStax College [CC BY 3.0 , via Wikimedia Commons

Ankle Joint. (Image by OpenStax College [CC BY 3.0 , via Wikimedia Commons)

Joint movements

The ankle joint allows dorsiflexion and plantarflexion of the foot.

Table: Movements of the Ankle Joint

Movement Main Muscles Involved Main Nerves Involved
Dorsiflexion Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus, Fibularis tertius Deep fibular nerve
Plantarflexion Gastrocnemius, Plantaris, Soleus, Flexor hallucis longus, Tibialis posterior, Fibularis longus Tibial nerve, Superficial fibular nerve

Report A Problem

Is there something wrong with this question? Let us know and we’ll fix it as soon as possible.

Loading Form...

Close
  • 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

Join our Newsletter

Stay updated with free revision resources and exclusive discounts

©2017 - 2024 MRCEM Success