Anatomy

The Achilles tendon (tendo calcaneus) is primarily the common tendon of which muscles?

• Gastrocnemius and soleus

• Gastrocnemius and tibialis anterior

• Soleus and fibularis (peroneus) longus

• Tibialis posterior and flexor digitorum longus

Which tarsal bone articulates with the tibia and fibula to form the ankle joint?

• Calcaneus

• Cuboid

• Talus

• Navicular

The primary function of the anterior compartment muscles of the leg is?

• Plantarflexion of the foot

• Eversion of the foot

• Flexion of the toes

• Dorsiflexion of the foot

A 24-year-old athlete presents with pain at the posterior aspect of her heel. Physical examination suggests pain upon palpation and a positive Thompson test (where squeezing the calf does not cause foot plantarflexion). Which structure is most likely injured?

• Deltoid ligament

• Achilles tendon

• Plantar calcaneonavicular (spring) ligament

• Fibular retinaculum

A 36-year-old runner complains of numbness and tingling over the dorsum of her foot between the big toe and second toe. Which nerve is most likely involved?

• Saphenous nerve

• Tibial nerve

• Deep fibular (peroneal) nerve

• Superficial fibular (peroneal) nerve

A patient has difficulty everting the foot and weakness in plantarflexion of the ankle. Which compartment of the leg is most likely affected?

• Lateral

• Anterior

• Superficial posterior

• Medial

The tibialis posterior muscle plays a critical role in supporting the arch of the foot. Where does its primary tendon insert?

• Tuberosity of the 5th metatarsal

• Calcaneus tuberosity

• Navicular tuberosity (and expansions to other tarsals)

• Base of the 1st metatarsal

A 45-year-old patient comes in with pain beneath the medial malleolus that radiates into the sole of the foot. Examination reveals a positive Tinel’s sign when tapping behind the medial malleolus. Which structure is likely to be compressed?

• Deep fibular (peroneal) nerve

• Superficial fibular (peroneal) nerve

• Posterior tibial nerve (tibial nerve in the tarsal tunnel)

• Tibial nerve in the popliteal fossa

A 29-year-old long-distance runner has chronic pain along the medial aspect of the foot. Imaging shows subtle flattening of the medial longitudinal arch. On examination, active inversion against resistance is weak, and there is tenderness near the navicular tuberosity. Which structure is most likely dysfunctional?

• Tibialis anterior tendon

• Flexor hallucis longus tendon

• Tibialis posterior tendon

• Plantar calcaneonavicular (spring) ligament

An 18-year-old soccer player presents with foot drop (inability to dorsiflex the ankle). Which structure in the proximal leg is most likely injured?

• Common fibular (peroneal) nerve at the fibular neck

• Sural nerve near the lateral malleolus

• Tibial nerve in the popliteal fossa

• Deep fibular (peroneal) nerve at the dorsum of foot