Foot Flashcards
3 groups of bone
seven tarsal bones
metatarsal I to V
phalanges (Each toe has 3 other than great toe - 2)
Tarsal
Proximal - talus, calcaneus
Intermediate - navicular
Distal - cuboid, 3 cuneiforms
Cuboid articulation
Posteriorly with calcaneus, medially with lateral cuneiform and anteriorly with bases of lateral 2 metatarsals. tendon of peroneus longus lies in prominent groove on the anterior plantar surface
Cuneiform articulation
with each other, posteriorly with navicular and anteriorly with base of medial three metatarsals
Ankle joint
Synovial, talus of foot and tibia and fibula of leg
Blood supply of talus
branches from dorsalis pedis - superior aspect of talar neck and dorsal portion of head and neck
branches from fibular artery - a small portion of lateral talus
Medial (deltoid) ligament
large, strong and triangular in shape.
Apex attached above to medial malleolus and broad base is attached below to line that extends from tuberosity of navicular in front to medial tubercle of talus behind
Parts of deltoid ligament
Tibionavicular
Tibiocalcaneal (most superficial)
Anterior and posterior tibiotalar. Anterior tibiotalar is deep to tibionavicular and tibiocalcaneal parts
Plantar calcaneonavicular ligament (spring ligament)
connects navicular bone to sustentaculum tali of calcaneus bone behind
Supports head of talus, takes part in talocalcaneonavicular joint and resists depression of medial arch of foot
Lateral ligament
3 separate ligaments
Anterior talofibular
Posterior talofibular
Calcaneofibular
Intertarsal joint
Synovial joints which mainly invert, evert, supinate and pronate the foot
Major joints of movements in intertarsal joints
subtalar, talocalcaneonavicular, calcaneocuboid,
Talocalcaneonavicular and calcaneocuboid forms the transverse tarsal joint
Between cuneiforms and cuneiform and navicular only allow limited movements
joint between cuboid and navicular (cubonavicular) normally fibrous
Ottawa ankle rule
Ankle x ray if there is ankle pain and any of:
- bone tenderness in distal 6cm of posterior tibia and medial malleolus
- bone tenderness in distal 6cm of posterior fibula and lateral malleolus
- unable to walk for 4 steps
Foot x ray if there is midfoot pain and any of:
- bone tenderness at base of fifth metatarsal bone
- bone tenderness at navicular bone
- unable to walk for 4 steps
Subtalar joint
between talus and calcaneus
allows inversion and eversion of foot
lateral, medial, posterior and interosseous talocalcaneal ligaments stabilize the joint
Talocalcaneonavicular joint
allows inversion and eversion of foot, also pronation and supination
reinforced by interosseous talocalcaneal ligament posteriorly, superiorly by talonavicular ligament and inferiorly by spring ligament
Calcaneocuboid joint
inversion and eversion of foot, pronation and supination of forefoot on hindfoot
Reinforced by bifurcate ligament and long plantar ligament and plantar calcaneocuboid ligament (short plantar ligament)
These ligaments resist depression of lateral arch of foot
MTP joint
reinforced by medial and lateral collateral ligaments and plantar ligaments
Allows flexion, extension and limited abduction, adduction, rotation and circumduction
Tarsometatarsal joint
plane joints, allow flexion, extension and rotation. Take part in pronation and supination of foot
interphalangeal joints
hinge joints allowing flexion and extension.
Reinforced by medial and lateral collateral ligaments and plantar ligaments
Tarsal tunnel borders
Posteromedial side of ankle Formed by medial malleolus of tibia medial and posterior surface of talus medial surface of calcaneus AND overlying flexor retinaculum
Contents of tarsal tunnel
Medial to lateral (tom dick and harry) Tibialis posterior FDL posterior tibial Artery tibial Nerve FHL
Extensor retinaculum
superior and inferior
Superior extensor retinaculum
superior to ankle joint and attached to anterior borders of fibula and tibia
Inferior extensor retinaculum
y-shaped, base - lateral side of upper surface of calcaneus, medial side of plantar aponeurosis
Top attached to medial malleolus
Structures passing under extensor retinaculum
Lateral to medial Peroneus tertius EDL Dorsalis pedis (anterior tibial artery initially in between EHL and tibialis anterior but crosses laterally underneath EHL to end up lateral to EHL) EHL TIbialis anterior
Ligaments supporting arch of foot
Plantar calcaneonavicular ligament
Long plantar ligament
Short plantar ligament
Plantar aponeurosis
Muscles supporting arch of foot
Tibialis anterior
tibialis posterior
Peroneus longus
Intrinsic muscles of foot
Dorsal aspect - EDB, EHB
Plantar side - 4 layers
All innervated by tibial nerve except EDB, EHB and first 2 dorsal interossei by deep peroneal nerve
First layer of sole of foot
Medial to lateral
abductor hallucis
FDB
abductor digiti minimi
2nd layer of sole of foot
tendons of FDL
quadratus plantae
four lumbrical muscles
3rd layer of sole of foot
medial to lateral
flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis
4th layer of sole of foot
4 dorsal interossei
3 plantar interossei
Blood supply to foot
branches of posterior tibial (medial and lateral plantar) and dorsalis pedis
