Ankle and Foot Flashcards
Ankle and Foot Function
When standing
* Weightbearing
* Stability
* Adaptability to surface
* Maintain centre of gravity over
base of support
Ankle and foot function
When moving
* Produce force - propulsion
* Absorb force – deceleration
* Adaptability to surface
* Adaptability to direction
* Move centre of gravity as base of support changes
Structure
Relatively long lower leg
* Shortened but
more adaptable foot
* 33 joints
* Large extrinsic muscles
for power
* Short intrinsic muscles
for control
Ankle and foot movements
- Dorsiflexion / Plantarflexion
- Inversion / Eversion
- Toe Flexion / Extension
- Toe Abduction / Adduction
Mostly multi-joint movements
with muscles acting over
multiple joints
Talocrural joint
- Synovial hinge joint
- Dorsiflexion and plantarflexion
- Mortice and tenon
- 3 articular surfaces
- Trochlea / medial / lateral
Why not just have one fixed shin
bone?
movement of fibula allows greater adaptability whilst keeping stability.
superior tibiofibular joint- synovial plate joint
inferior tibiofibular joint- syndesmosis
Joints of the foot
Foot arthrology covered in Nick’s
recorded lecture
* Generally joint name descries
the joint position
* Useful to think of foot in sections
* Hindfoot
* Midfoot
* Forefoot
Foot arthrology
title
foot functions
base of support
adapt to uneven surfaces
shock absorber
propulsion
arches of the foot
part 1
3 arches
medial arch
lateral arch
anterior transverse arch
supports plantar vault- supported by 3 arches where the weight is distributed through the 3 points
medial arch
highest arch
no contact with the ground
very flexible
made of 5 bones-
calcaneus
talus
navicular
medial cuneiform
metatarsal 1
lateral arch
flatter than medial arch
in contact with the ground
more rigid than medial arch
made of 3 bones-
calcaneus
cuboid
metatarsal 5
anterior transverse arch
relatively flat
contacts ground
formed by head of 5 metatarsals
arch stabilisation
bones form like the curve of a bridge with a keystone in the middle
arches supported by-
shape of bones
short ligaments connecting adjacent bones- staples
long soft tissues spanning length of foot- tie beam
muscles pulling up on an arch- sling
tie beam of medial and lateral arches
plantar fascia- strong layer of thick, fibrous tissue that spans length of foot
walking
how the foot moves and adapts during walking
process
heel strike- weight going through calcaneus
arches are raised
stance phase- vault is flattened- shock absorption
muscles contract to stop further flattening- plantar tightness
heel off- plantar tightness contracts further
foot now a rigid lever- caught between two forces
toe off- as big toe extends plantar fascia tightens reinforcing medial arch- windlass mechanism
movements of the foot
foot can move on and off the floor
foot off the floor
tri planar movements
inversion-
plantarflexion
adduction
supination
eversion-
dorsiflexion
abduction
pronation
foot on the floor
tri planar motion-
weight transfers medially- pronation
weight transfers laterally- supination
eversion- hindfoot and forefoot move in same direction
inversion- hindfoot and forefoot move in opposite directions
supination
medial arch rises
forefoot-
adducts
pronates
planatarflexes
hindfoot-
abducts
supinates
dorsiflexes
pronation
medial arch flattens
forefoot-
abducts
supinates
dorsiflexes
hindfoot
adducts
pronates
plantarflexes
summary
foot movements primarily occur at-
subtalar joint (hindfoot movement)
midtarsal joint (forefoot movement)
can be likened to movements of a boat
occur in combination to produce
inversion and eversion
pronation and supernation
lower leg anterior compartment muscles
tibialis anterior
extensor digitorum longus
extensor hallucis longus
peroneus/ fibularis tertius
tibialis anterior
Origin: Lateral condyle and proximal half of lateral surface of tibia, adjacent interosseous membrane of leg.
Insertion: Inferomedial aspect of medial cuneiform bone and base of first metatarsal bone.
Action: Dorsiflexes foot at ankle joint; inverts foot at subtalar and transverse tarsal joints.
Innervation: Deep fibular nerve
extensor Digitorum longus
Origin: Lateral condyle of tibia, proximal three quarters of fibula, and adjacent interosseous membrane of leg.
Insertion: Dorsal aspects of bases of both the middle and distal phalanges of the second, third, fourth, and little toes.
Action: Extends second, third, fourth, and little toes; dorsiflexes foot at ankle joint.
Innervation: Deep fibular nerve
extensor Hallucis Longus
Origin: Medial surface of fibula and adjacent interosseous membrane of leg.
Insertion: Dorsal aspect of base of distal phalanx of great toe.
Action: Extends great toe; dorsiflexes foot at ankle joint.
Innervation: Deep fibular nerve
Peroneus / Fibularis tertius
Origin: Medial surface of fibula and adjacent interosseous membrane of leg.
Insertion: Dorsal aspect of base and body of fifth metatarsal bone.
Action: Dorsiflexes foot at ankle joint; assists in eversion of foot at subtalar and transverse tarsal joints.
Innervation: Deep fibular nerve (L5-S1).
lower leg posterior compartment muscle
Superficial: Gastrocnemius, soleus & plantaris (Triceps surae collectively)
Deep: Popliteus, Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus
gastrocnemius
Origin: Lateral and medial condyles of femur, lateral supracondylar line, and popliteal surface of femur.
Insertion: Posterior surface of calcaneus, via calcaneal tendon.
Action: Plantarflexes foot at ankle joint; flexes leg at knee joint.
Innervation: Tibial nerve (S1-S2).
soleus
Origin: Head of fibula, posterior surface of fibula, soleal line, and medial border of tibia.
Insertion: Posterior surface of calcaneus, via calcaneal tendon.
Action: Plantarflexes foot at ankle joint.
Innervation: Tibial nerve (S1-S2)
plantaris
Origin: Lateral supracondylar line of femur.
Insertion: Posterior surface of calcaneus.
Action: Assists in plantarflexion of foot at ankle joint; assists in flexion of leg at knee joint.
Innervation: Tibial nerve (S1-S2)
popliteus
Origin: Groove for popliteus muscle.
Insertion: Posterior surface of tibia, superior to soleal line.
Action: Medially rotates leg at knee joint; “unlocks” knee joint at beginning of knee flexion.
Innervation: Tibial nerve (L4-S1).
tibialis posterior
Origin: Posterior surface of tibia, inferior to soleal line, posterior surface of fibula, and adjacent interosseous membrane of leg.
Insertion: Tuberosity of navicular bone, plantar aspects of medial, intermediate, and lateral cuneiform bones, and plantar aspects of bases of second to fourth metatarsal bones.
Action: Inverts foot at subtalar and transverse tarsal joints; plantarflexes foot at ankle joint.
Innervation: Tibial nerve (L4-L5).
flexor digitorum longus
Origin: Posterior surface of tibia, inferior to soleal line.
Insertion: Plantar aspects of bases of the distal phalanges of the second, third, fourth, and little toes
Action: Flexes second, third, fourth, and little toes; plantarflexes foot at ankle joint.
Innervation: Tibial nerve (L5-S2).
flexor hallucis longus
Origin: Distal two thirds of posterior surface of fibula and adjacent interosseous membrane of leg.
Insertion: Plantar aspect of base of distal phalanx of great toe.
Action: Flexes great toe; plantarflexes foot at ankle joint.
Innervation: Tibial nerve (L5-S2).
lower leg lateral compartment muscles
Peroneus / Fibularis Longus
Peroneus / Fibularis Brevis
Peroneus / Fibularis Longus
Origin: Head and lateral surface of fibula, adjacent intermuscular septa.
Insertion: Plantar surface of medial cuneiform bone and base of first metatarsal bone.
Action: Everts foot at subtalar and transverse tarsal joints; assists in plantarflexion of foot at ankle joint.
Innervation: Superficial fibular nerve (L5-S1).
Peroneus / Fibularis Brevis
Origin: Lateral surface of fibula and adjacent intermuscular septa.
Insertion: Tuberosity of fifth metatarsal bone.
Action: Everts foot at subtalar and transverse tarsal joints; assists in plantarflexion of foot at ankle joint.
Innervation: Superficial fibular nerve (L5-S1)
dorsal intrinsic foot muscles
Extensor digitorum brevis,
Extensor hallucis brevis,
Dorsal interossei
Extensor digitorum brevis
Origin: Dorsolateral aspect of calcaneus, inferior extensor retinaculum of foot, and talocalcaneal interosseous ligament.
Insertion: Extensor expansions of second to fourth toes.
Action: Extends second to fourth toes.
Innervation: Deep fibular nerve (L5-S1).
Extensor hallucis brevis,
Origin: Dorsolateral aspect of calcaneus, inferior extensor retinaculum of foot, and talocalcaneal interosseous ligament.
Insertion: Dorsal aspect of base of proximal phalanx of great toe.
Action: Extends great toe.
Innervation: Deep fibular nerve (L5-S1)
Dorsal interossei
second dorsal
Origin: Lateral aspect of body of second metatarsal bone and medial aspect of body of third metatarsal bone.
Insertion: Lateral aspect of base of proximal phalanx of second toe and extensor expansion of second toe.
Action: Laterally abducts second toe at its metatarsophalangeal joint; simultaneously flexes metatarsophalangeal joint and extends interphalangeal joints of second toe.
Innervation: Deep branch of lateral plantar nerve (S2-S3).
plantar intrinsic foot muscles
First layer: Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
Second layer: Quadratus plantae, lumbricals
Third layer: Flexor hallucis brevis, adductor hallucis, Flexor digitorum minimi
Fourth layer: Plantar interossei
abductor hallucis
Origin: Medial process of calcaneal tuberosity, flexor retinaculum of foot, and plantar aponeurosis.
Insertion: Medial aspect of base of proximal phalanx of great toe.
Action: Abducts great toe at its metatarsophalangeal joint.
Innervation: Medial plantar nerve (S1-S3)
flexor digtorum brevis
Origin: Medial process of calcaneal tuberosity and plantar aponeurosis.
Insertion: Plantar aspects of bodies of middle phalanges of the second, third, fourth and little toes.
Action: Flexes second, third, fourth, and little toes.
Innervation: Medial plantar nerve (S1-S3).
abductor digiti minimi
Origin: Medial and lateral processes of calcaneal tuberosity and plantar aponeurosis.
Insertion: Lateral aspect of base of proximal phalanx of little toe.
Action: Abducts and flexes little toe at its metatarsophalangeal joint.
Innervation: Lateral plantar nerve (S2-S3)
quadratus plantae
Origin: Medial and lateral aspects of plantar surface of calcaneus.
Insertion: Tendon of flexor digitorum longus muscle.
Action: Assists in flexion of second, third, fourth, and little toes.
Innervation: Lateral plantar nerve (S1-S3).
lumbricals
first-
Origin: Tendon of flexor digitorum longus that travels to the second toe.
Insertion: Medial aspect of extensor expansion of second toe.
Action: Simultaneously flexes metatarsophalangeal joint and extends interphalangeal joints of second toe.
Innervation: Medial plantar nerve (S2-S3).
flexor hallucis brevis
Origin: Plantar surfaces of cuboid and lateral cuneiform bones; tendon of tibialis posterior.
Insertion: Medial and lateral aspects of base of proximal phalanx of great toe.
Action: Flexes great toe.
Innervation: Medial plantar nerve (S1-S3).
adductor hallucis
Origin: Plantar aspects of bases of second to fourth metatarsal bones, tendon of fibularis longus muscle, plantar ligaments of metatarsophalangeal joints, and deep transverse metatarsal ligament.
Insertion: Lateral aspect of base of proximal phalanx of great toe.
Action: Adducts great toe at its metatarsophalangeal joint.
Innervation: Deep branch of lateral plantar nerve (S2-S3)
flexor digitorum minimi
Origin: Posterior surface of tibia, inferior to soleal line.
Insertion: Plantar aspects of bases of the distal phalanges of the second, third, fourth, and little toes
Action: Flexes second, third, fourth, and little toes; plantarflexes foot at ankle joint.
Innervation: Tibial nerve (L5-S2).
plantar interossei
first
Origin: Medial aspects of base and body of third metatarsal bone.
Insertion: Medial aspect of base of proximal phalanx of third toe and extensor expansion of third toe.
Action: Adducts third toe at its metatarsophalangeal joint; simultaneously flexes metatarsophalangeal joint and extends interphalangeal joints of third toe.
Innervation: Deep branch of lateral plantar nerve (S2-S3).
