![]() ![]() 9 speculated that a stretched CFL lifted both tendons during ankle inversion. With this point of view, Shinohara et al. Therefore, a hardened CFL, which indicates some mechanical interactions between the ligament and tendons, is highly possible. Benjamin and Ralphs 10 mentioned that when tendons and ligaments are subject to compression, they are frequently fibrocartilaginous. ![]() An interesting finding is that histological examinations reveal fibrocartilaginous changes on the contact surface of the CFL with the peroneal tendons 9. Regardless of the morphological variety, the CFL always closely crosses under the deep side of the peroneus longus tendon (PLT) and peroneus brevis tendon (PBT) (Fig. They described that direction of the mid-substance changed solely with the ankle joint position, and the CFL running angle variation could be interpreted as the different directions of the mid-substance in the various ankle position. 8 categorized the CFL structure into the mid-substance and fibular attachment. 7 noted that the running angles of the CFL vary during the ankle movements because the CFL becomes horizontal in plantar flexion and vertical in dorsi flexion. Among the parameters, the running angle of the CFL ranges from 0° to 90°, as reported by Ruth 5, and the angle shows a difference in tensing behavior, as noted in a simulation study by Edama et al. Several cadaveric studies have revealed structural variations in the CFL regarding length, width, running angle, or size of the attachment area 3, 4. However, a precise understanding of the ligament has not been fully achieved. Injuries involving the CFL are usually severe 1 after treatment, patients continue to complain of symptoms like pain and instability 2. The calcaneofibular ligament (CFL), which is a part of the lateral ligament complex, attaches the lateral malleolus to the calcaneus and stabilizes the ankle joint together with the anterior talofibular ligament (ATFL) and posterior talofibular ligament (PTFL). This phenomenon contributes to postural control, especially in regaining balance on uneven terrain, and provides a new perspective for the exercise methods or understanding the ankle joint instability due to sprains. These results strongly suggest that a tensed CFL can lift the peroneal tendons and may act as a “tensioner” for the effective transmission of muscle contraction. The actual lift amount reached 2.0 ± 0.8 mm for the PLT and 1.9 ± 1.0 mm for the PBT. ![]() Interestingly, with increased tension of the CFL, the tendons significantly moved toward the lateral direction ( P < 0.001), compared with their position when the CFL was detached. Eighteen cadaveric specimens were included in the study. To investigate the functional relationship between the peroneal longus tendon (PLT), brevis tendon (PBT), and CFL, we quantitatively analyzed the positional changes of the tendons by using a contactless three-dimensional optical scan system. In human bipedal locomotion, the peroneal muscles maintain mediolateral stability and prevent involuntary ankle inversion. Here, we propose a novel function of the calcaneofibular ligament (CFL), which stabilizes the ankle joint. Therefore, the options ‘a’, ‘b’, ‘c’, and ‘e’ are incorrect.The ligaments are believed to have a role in stabilizing joints and regulating joint motion. Each level of organ system builds off of the less complex levels to function. The body will not function correctly if the structural organization is not in the correct order of complexity. Thus, the correct answer is option (d) 1 (chemical level) 4 (cellular) 2 (tissue) 3 (organ) 6 (systemic) and 5(organismal). The most complex of systems is the organismal level which is composed of all systems functioning together to keep the human body alive. (5) Organs working together form organ systems, which makes the systemic level even more complex than its predecessors. At this level, tissue systems work together to form complex functions. ![]() (4) The next most complex level of organization is the organ level. (3) Tissues consist of groups of cells that function together in the body and form the third most complex level of organization. These cells are classified as the second most complex level of organization. (2) These molecules form together into cells, the smallest units of all living things. It is classified as first level of organization. (1) The chemical level is composed of atoms that react to form molecules. Structural organization starts with the simplest of level called chemical level. ![]()
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