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Study Guide: Anatomy and Biomechanics of the Ankle Joint

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Anatomy and Biomechanics of the Ankle Joint Study Guide

Anatomy and Terminology of the Ankle Region

The anatomical designation for the ankle region is the talocrural region, with an informal appellation being the 'jumping bone'.

Answer: True

Explanation: The ankle is anatomically referred to as the talocrural region and is informally known as the jumping bone.

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In precise medical terminology, the term 'ankle' may strictly denote only the talocrural joint, distinct from the broader anatomical region.

Answer: True

Explanation: While common usage often refers to the entire region, medical terminology can specifically denote the talocrural joint itself when using the term 'ankle'.

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The ankle region is anatomically composed of three distinct articulations: the talocrural, subtalar, and inferior tibiofibular joints.

Answer: True

Explanation: The ankle region is composed of three distinct joints: the talocrural joint, the subtalar joint, and the inferior tibiofibular joint.

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The principal osseous components forming the ankle region are the talus, situated within the foot, and the tibia and fibula, the bones of the lower leg.

Answer: True

Explanation: The primary bones forming the ankle region are the talus (part of the foot) and the tibia and fibula (bones of the lower leg).

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The tibial plafond, a term derived from French meaning 'ceiling,' refers to the superior articular surface of the distal tibia, not a prominence on the fibula.

Answer: True

Explanation: The tibial plafond, a French word for 'ceiling,' refers to the superior articular surface of the distal tibia that articulates with the talus.

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The lateral malleolus is the bony projection located on the distal end of the fibula, not the tibia.

Answer: True

Explanation: The lateral malleolus is the bony projection located on the distal end of the fibula, forming the lateral part of the ankle mortise.

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Some anatomical texts designate the talocrural joint as the 'upper ankle joint,' distinguishing it from the subtalar joint, which significantly influences foot positioning and is sometimes termed the 'lower ankle joint'.

Answer: True

Explanation: Some anatomical texts refer to the talocrural joint as the 'upper ankle joint' and the subtalar joint, which influences foot positioning, as the 'lower ankle joint'.

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A ball-and-socket ankle joint is a rare anatomical variation that resembles the configuration of the hip or shoulder joint.

Answer: True

Explanation: A ball-and-socket ankle joint is an uncommon anatomical variation where the joint resembles the hip or shoulder joint.

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What is the anatomical designation for the ankle region, colloquially known as the 'jumping bone'?

Answer: Talocrural region

Explanation: The anatomical term for the ankle region, often informally called the 'jumping bone', is the talocrural region.

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Which of the following articulations is NOT considered one of the three primary joints comprising the ankle region?

Answer: Proximal tibiofibular joint

Explanation: The three distinct joints composing the ankle region are the talocrural, subtalar, and inferior tibiofibular joints. The proximal tibiofibular joint is part of the leg, not the ankle complex.

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The osseous prominence on the distal tibia that contributes significantly to ankle stability is termed the:

Answer: Medial malleolus

Explanation: The medial malleolus is the bony prominence on the distal end of the tibia that forms the medial boundary of the ankle mortise and contributes to stability.

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Some anatomical texts differentiate the talocrural joint as the 'upper ankle joint,' designating the joint that significantly influences foot positioning as the:

Answer: Subtalar joint

Explanation: The subtalar joint is often referred to as the 'lower ankle joint' due to its significant influence on foot positioning, in contrast to the talocrural joint ('upper ankle joint').

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Which rare anatomical variation presents an ankle joint with a configuration analogous to that of the hip or shoulder joint?

Answer: Ball-and-socket ankle joint

Explanation: A ball-and-socket ankle joint is a rare anatomical variation resembling the hip or shoulder joint.

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Talocrural Joint: Structure and Function

The talocrural joint is characterized as a synovial hinge joint, not a pivot joint, and its primary movements are not rotational.

Answer: True

Explanation: The talocrural joint is classified as a synovial hinge joint, and its primary movements are dorsiflexion and plantarflexion, not significant rotation.

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The articulation between the fibula and the talus bears a lesser proportion of the body's weight compared to the tibia-talus articulation.

Answer: True

Explanation: The articulation between the tibia and the talus bears a greater amount of weight compared to the articulation between the fibula and the talus.

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The talocrural joint is uniquely described in human anatomy using the woodworking terminology of 'mortise and tenon'.

Answer: True

Explanation: The talocrural joint is the only mortise and tenon joint found in the human body, a description derived from woodworking joints.

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Dorsiflexion and plantarflexion constitute the principal movements occurring at the talocrural ankle joint.

Answer: True

Explanation: Dorsiflexion and plantarflexion are the primary movements associated with the talocrural ankle joint.

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The talar mortise is formed by the tibial plafond and the medial and lateral malleoli, not the shafts of the tibia and fibula.

Answer: True

Explanation: The talar mortise is formed by the tibial plafond and the medial and lateral malleoli, creating a socket for the talus.

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The bony architecture of the ankle joint provides maximal stability when the foot is positioned in dorsiflexion, not plantarflexion.

Answer: True

Explanation: The ankle joint's bony structure is most stable when the foot is positioned in dorsiflexion because the talus is more securely seated within the mortise.

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The talocrural joint, articulating the distal tibia and fibula with the talus, is classified as which type of synovial joint?

Answer: Synovial hinge joint

Explanation: The talocrural joint is classified as a synovial hinge joint, enabling dorsiflexion and plantarflexion.

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Within the ankle region, which articulation bears the predominant portion of the body's weight transmitted to the foot?

Answer: Tibia-talus articulation

Explanation: The articulation between the tibia and the talus bears the majority of the weight transmitted through the ankle to the foot.

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What unique structural classification, originating from woodworking terminology, is used to describe the talocrural joint?

Answer: Mortise and tenon

Explanation: The talocrural joint is uniquely described using the woodworking terms 'mortise and tenon' due to its interlocking structure.

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Which pair of movements are considered the primary actions produced at the talocrural joint?

Answer: Dorsiflexion and Plantarflexion

Explanation: Dorsiflexion and plantarflexion are the primary movements associated with the talocrural ankle joint.

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The 'talar mortise,' also known as the 'ankle mortise,' is primarily formed by the tibial plafond and which other osseous structures?

Answer: Medial and lateral malleoli

Explanation: The talar mortise is formed by the tibial plafond and the medial and lateral malleoli, which cradle the talus.

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The osseous architecture of the ankle joint provides maximal stability when the foot is positioned in which orientation?

Answer: Dorsiflexion

Explanation: The bony architecture of the ankle joint is most stable when the foot is in a position of dorsiflexion.

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Ankle Ligaments and Soft Tissues

The deltoid ligament is situated on the medial aspect of the ankle and functions to prevent excessive eversion.

Answer: True

Explanation: The deltoid ligament is located on the medial side of the ankle and functions to prevent excessive eversion (outward turning) of the foot.

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The calcaneofibular ligament is one of the three primary ligaments contributing to the stability of the lateral aspect of the ankle.

Answer: True

Explanation: The calcaneofibular ligament is one of the three key ligaments stabilizing the lateral aspect of the ankle.

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Retinacula are connective tissue structures that primarily serve to secure tendons in place across the ankle, rather than transmitting muscle force directly.

Answer: True

Explanation: Retinacula are bands of connective tissue that hold tendons securely in place during movement, ensuring efficient force transmission from muscles to bones.

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The superior extensor retinaculum is anatomically situated in proximity to the distal extremities of the tibia and fibula.

Answer: True

Explanation: The superior extensor retinaculum is located near the distal ends of the tibia and fibula, acting to hold the extensor tendons in place.

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The flexor retinaculum extends from the medial malleolus to the calcaneus and encloses structures including the tibial nerve.

Answer: True

Explanation: The flexor retinaculum extends from the medial malleolus to the calcaneus and contains the tendons of the flexor muscles, posterior tibial artery and vein, and the tibial nerve.

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Mechanoreceptors within the ankle are principally engaged in proprioception, the sensory modality responsible for sensing the body's position and kinesthetic movement.

Answer: True

Explanation: Mechanoreceptors in the ankle are primarily involved in proprioception, sensing the body's position and movement.

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A 2011 functional magnetic resonance imaging (fMRI) study provided evidence demonstrating a correlation between the central nervous system's processing of ankle proprioception and overall balance performance.

Answer: True

Explanation: A 2011 fMRI study demonstrated a link between ankle proprioception processing and balance performance.

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Which robust ligament is situated on the medial aspect of the ankle and functions to prevent excessive outward turning (eversion) of the foot?

Answer: Deltoid ligament

Explanation: The deltoid ligament is located on the medial side of the ankle and functions to prevent excessive eversion.

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The lateral aspect of the ankle is stabilized by three principal ligaments, including the anterior talofibular, posterior talofibular, and which additional ligament?

Answer: Calcaneofibular ligament

Explanation: The lateral side of the ankle is stabilized by the anterior talofibular, posterior talofibular, and calcaneofibular ligaments.

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What is the principal function of retinacula within the ankle region?

Answer: To hold tendons securely in place during movement

Explanation: Retinacula are structures that hold tendons securely in place across the ankle, ensuring efficient muscle action.

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Which of the following anatomical structures is situated within the flexor retinaculum, extending between the medial malleolus and the calcaneus?

Answer: Tibial nerve

Explanation: The flexor retinaculum contains the tibial nerve, posterior tibial artery and vein, and the tendons of the flexor hallucis longus and flexor digitorum longus muscles.

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Mechanoreceptors within the ankle are critically important for which sensory function?

Answer: Proprioception (sensing position and movement)

Explanation: Mechanoreceptors in the ankle are primarily involved in proprioception, sensing the body's position and movement.

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Which of the following anatomical structures is contained within the superior extensor retinaculum?

Answer: Tendons of the extensor hallucis longus and extensor digitorum longus

Explanation: The superior extensor retinaculum contains the tendons of the extensor hallucis longus and extensor digitorum longus muscles, among other structures.

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Ankle Injuries and Fractures

An isolated injury to the syndesmotic ligament, which stabilizes the distal tibiofibular articulation, is commonly designated as a high ankle sprain.

Answer: True

Explanation: An isolated injury to the syndesmotic ligament is commonly referred to as a high ankle sprain.

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The ankle is the most commonly injured major joint in the human body.

Answer: True

Explanation: Among all major joints in the body, the ankle is the most commonly injured, largely due to its role in weight-bearing and locomotion.

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Characteristic symptoms of an ankle fracture encompass pronounced pain, edema (swelling), ecchymosis (bruising), and impaired weight-bearing capacity.

Answer: True

Explanation: Common symptoms of an ankle fracture include significant pain, swelling, bruising, and the inability to bear weight.

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Potential complications arising from ankle fractures include malunion, compartment syndrome, and post-traumatic arthritis.

Answer: True

Explanation: Potential complications of ankle fractures include malunion, compartment syndrome, and post-traumatic arthritis.

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A trimalleolar fracture involves fractures of the medial malleolus, lateral malleolus, and posterior malleolus, not solely the medial and lateral malleoli.

Answer: True

Explanation: A trimalleolar fracture involves fractures of the medial malleolus, lateral malleolus, and posterior malleolus.

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The Ottawa ankle rule is a clinical decision tool utilized to guide the necessity of radiography for suspected ankle injuries, rather than directly assessing ligament damage severity.

Answer: True

Explanation: The Ottawa ankle rule is a diagnostic tool used to assess the need for X-rays in ankle injuries, not to determine the severity of ligament damage.

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The X-ray image identified as a 'bimalleolar fracture legend' illustrates fractures of the medial and lateral malleoli, not all three malleoli.

Answer: True

Explanation: A bimalleolar fracture legend illustrates fractures involving the medial and lateral malleoli, not a trimalleolar fracture.

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An injury specifically affecting the syndesmotic ligament, which stabilizes the distal tibiofibular articulation, is commonly designated as a(n):

Answer: High ankle sprain

Explanation: An isolated injury to the syndesmotic ligament is commonly referred to as a high ankle sprain.

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The ankle is frequently cited as the most commonly injured major joint in the human body, primarily owing to its critical role in:

Answer: Weight-bearing, movement, and balance

Explanation: The ankle is the most commonly injured major joint due to its crucial role in weight-bearing, locomotion, and maintaining balance.

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Which of the following clinical manifestations is commonly indicative of an ankle fracture?

Answer: Noticeable swelling and bruising

Explanation: Common symptoms of an ankle fracture include significant pain, swelling, bruising, and the inability to bear weight.

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A fracture encompassing the medial malleolus, lateral malleolus, and posterior malleolus is classified as a(n):

Answer: Trimalleolar fracture

Explanation: A fracture involving fractures of the medial malleolus, lateral malleolus, and posterior malleolus is classified as a trimalleolar fracture.

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The Ottawa ankle rule functions as a clinical guideline intended to:

Answer: Guide the need for radiography (X-ray) in ankle injuries

Explanation: The Ottawa ankle rule is a clinical guideline used to help determine whether an X-ray is necessary for a patient with an ankle injury.

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The radiographic image identified as a 'bimalleolar fracture legend' specifically depicts fractures involving which components of the ankle?

Answer: The medial and lateral malleoli

Explanation: A bimalleolar fracture involves fractures of the medial and lateral malleoli.

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Which of the following is NOT enumerated as a potential complication of an ankle fracture within the provided source material?

Answer: Osteoporosis

Explanation: Potential complications listed include malunion, compartment syndrome, and post-traumatic arthritis. Osteoporosis is a condition that can weaken bones, but it is not listed as a direct complication of an ankle fracture itself in this context.

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Radiographic Assessment and Clinical Conditions

In a healthy ankle, the average distance between the talus and the lateral malleolus is approximately 2.13 mm, not the medial malleolus.

Answer: True

Explanation: In a healthy ankle, the average distance between the talus and the lateral malleolus is approximately 2.13 mm, while the distance to the medial malleolus is approximately 1.70 mm.

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A reduction in the joint space width within the ankle articulation is a potential indicator of osteoarthritis.

Answer: True

Explanation: A decrease in the joint space width within the ankle can be an indicator of osteoarthritis, a degenerative joint disease.

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Projectional radiography, commonly known as X-ray, typically serves as the initial imaging modality for evaluating suspected ankle pathologies.

Answer: True

Explanation: Projectional radiography (X-ray) is usually the first imaging method used to evaluate suspected ankle pathologies.

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Talipes equinovarus, commonly designated as clubfoot, is a congenital condition characterized by equinus (plantarflexion) and varus (inward rotation) deformities, not valgus.

Answer: True

Explanation: Talipes equinovarus, or clubfoot, is characterized by equinus (downward ankle deflection) and varus (inward foot rotation) deformity.

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In adult contexts, 'ankle joint equinus' denotes a limitation in the range of motion, specifically restricting dorsiflexion.

Answer: True

Explanation: In adults, 'ankle joint equinus' refers to a restriction limiting the range of motion in dorsiflexion.

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The Tibiotalar surface angle (TTS) is a radiographic measurement employed to quantify varus or valgus deformities of the ankle, not the distance between the talus and malleoli.

Answer: True

Explanation: The Tibiotalar surface angle (TTS) is used to measure varus or valgus deformities, not the distance between the talus and malleoli.

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The medial clear space measurement is utilized to assess the integrity of the medial collateral ligament complex, whereas the tibiofibular clear space assesses the tibiofibular syndesmosis.

Answer: True

Explanation: The medial clear space measurement assesses the medial collateral ligament complex, while the tibiofibular clear space measurement assesses the integrity of the tibiofibular syndesmosis.

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A reduction in the joint space width between the talus and adjacent osseous structures, such as the tibial plafond, may indicate which pathological condition?

Answer: Osteoarthritis

Explanation: A decrease in the joint space width within the ankle can be an indicator of osteoarthritis.

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While projectional radiography (X-ray) is typically the initial imaging technique for ankle injuries, which advanced modalities may be employed for more detailed evaluation of subtle fractures or ligamentous injuries?

Answer: MRI and CT scans

Explanation: While X-rays are typically the first imaging method, MRI and CT scans may be used for more detailed evaluation of subtle fractures or ligamentous injuries.

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The Tibiofibular clear space measurement, derived from radiographic imaging, is utilized to assess the integrity of which specific ankle structure?

Answer: Tibiofibular syndesmosis

Explanation: The Tibiofibular clear space measurement on an X-ray is used to assess the integrity of the tibiofibular syndesmosis.

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Talipes equinovarus, commonly designated as clubfoot, is a congenital condition characterized by which specific combination of deformities?

Answer: Equinus and Varus

Explanation: Talipes equinovarus, or clubfoot, is characterized by equinus (downward ankle deflection) and varus (inward foot rotation) deformity.

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What is the clinical definition of 'ankle joint equinus' in adult patients?

Answer: A restriction limiting dorsiflexion

Explanation: In adults, 'ankle joint equinus' refers to a restriction limiting the range of motion in dorsiflexion.

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The Tibiotalar surface angle (TTS) is a radiographic measurement employed to quantify which specific type of ankle deformity?

Answer: Varus or Valgus deformities

Explanation: The Tibiotalar surface angle (TTS) is a radiographic measurement used to quantify varus or valgus deformities of the ankle.

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Historical and Evolutionary Perspectives

Historical figures such as Aristotle and Leonardo da Vinci did indeed discuss the function of the ankle in locomotion.

Answer: True

Explanation: The role of the ankle in locomotion has been a subject of historical discussion, with figures like Aristotle and Leonardo da Vinci examining its function.

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The etymological derivation of the word 'ankle' suggests a connection to ancient terms signifying 'bent'.

Answer: True

Explanation: The word 'ankle' is etymologically linked to ancient words meaning 'bent'.

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An evolutionary hypothesis proposes a transition towards enhanced voluntary control of the ankle joint during human evolutionary development.

Answer: True

Explanation: An evolutionary suggestion posits a shift towards more precise voluntary control of the ankle joint during human evolution.

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The etymological origin of the term 'ankle' is theorized to be associated with ancient words signifying:

Answer: Bent

Explanation: The word 'ankle' is etymologically linked to ancient words meaning 'bent'.

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What evolutionary hypothesis has been proposed concerning the development of foot and ankle control?

Answer: Development of more precise voluntary control of the ankle joint

Explanation: An evolutionary suggestion posits a shift towards more precise voluntary control of the ankle joint during human evolution.

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