foot and ankle Flashcards
anatomical regions of foot
- The hind-foot : talus; calcaneus
- The mid-foot: navicular; cuboid; 3 cuneiform
- The fore-foot : metatarsals; phalanges
how many bones and what are they divided into
26 and divided into tarsals, metatarsals and phalanges
tarsals
divisions
make up the hindfoot and midfoot - a set of seven irregularly shaped bones situated proximally
metatarsals
divisions
long bones of the forefoot, forming the arch and connecting the tarsals to the phalanges. Numbered 1 through 5 starting from the medial side
phalanges
divisions
part of the forefoot, the bones of the toes
what do bones of foot provide
- mechanical support for the soft tissues
- helping the foot withstand the weight of the body whilst standing and in motion.
what is the tarsus
proximal region of the foot and consists of seven tarsal bones
organised into 3 rows:
prox- talus(overlap calcaneus)/ calcaneus (tall one)
intermediate- navicular (under talus)
distal- cuboid (articulate w 4&5 toe)/ three cuneiforms (articulate w 1,2&3 toe)
acryonym: the cock never comes tidially
talus
- Most proximal bone of the foot
- 70% is covered with hyaline cartilage as it articulates with other bones
- Connects to the calcaneus on the underside through the subtalar or talocalcaneal joint
- Connects distally to the navicular through the talonavicular joint
- Relatively poor blood supply – injuries take greater time to heal
- Has three parts: body, head, and neck
- body is roughly square and topped by the dome which connects the talus to the lower leg at the ankle joint
- Talar neck is not covered with cartilage and is the entry point for blood supply
calcaneus
- known as the heel bone
- largest bone in the foot, and along with the talus, it makes up the hind-foot
- The anterior, middle, and posterior facets on the superior surface of the calcaneus allow the talus to sit on top of the calcaneus, forming thesubtalar joint
- connects to thecuboid boneto form thecalcaneal-cuboid joint
what are the tarsal bones
Navicular:
* Distal to the talus and connects with it at the talonavicular joint
* Distal aspect connects to the cuneiforms
* Poor blood supply
* Medially the navicular tuberosity is the main attachment site for the posterior tibial tendon
Cuboid:
* Square shaped bone on the lateral aspect of the foot
* Distal aspect of the calcaneus articulates with the cuboid at the calcaneocuboid joint
Cuneiforms:
* Three cuneiform bones: medial, intermediate, and lateral cuneiforms
* Provide stability
* Plantar and dorsal ligaments connect to the cuneiforms
what are metatarsals
- five long bones of the forefoot, between the tarsals and phalanges.
- theyare numbered 1-5 (medial to lateral
- Each metatarsal has a similar structure: convex dorsally and consist of a head, shaft, and base (distal to proximal)
- has 3/4 articulations:
1. proximally- tarsometatarsal joints (between the metatarsal bases and thetarsal bones)
2. laterally– intermetatarsal joint(s) – between the metatarsal and the adjacent metatarsals
3. distally– metatarsophalangeal joint – between the metatarsal head and the proximal phalanx
phalanges
- 14 phalangesare the bones of the toes
- second to fifth toes all have proximal, middle and distal phalanges whilst the great toe has only 2: proximal and distal phalanges
- are similar in structure to the metatarsals, each phalanx consists of a base, body and head
joints of the foot and ankle
that allow for movement, stability, and weight-bearing
- Talocrural – tibiotalar/ankle joint - formed by the tibia, fibula, talus- main joint of the ankle
- Talonavicular joint– articulation between the head of the talus and posterior navicular
- Naviculocuneiform joint– compound joint, articulations between the navicular and 3 cuneiforms
- Tarsometatarsal joint – Lisfranc joint – between the tarsal and metatarsal bones
- Metatarsalphalangeal joints – connects the metatarsals and proximal phalanges
- Calcaneocuboid joint – formed by distal surface of the calcaneus with the proximal cuboid
- Subtalar joint – (talocalcaneal joint) between the talus and calcaneus
articulation of the ankle joint
- Talocrural joint is a complex synovial hinge joint
- Distal tibia and fibula form a structure called the MORTISE and the talus sits within it
- The inferior tibiofibular joint stabilises the talocrural joint by tightly securing the tibia and fibula together
- the joint is reinforced by strong ligaments
main ligaments of the ankle
can be divided to medial and lateral
MEDIAL:
* called the deltoid ligament;
- resists eversion
D - posterior tibiotalar ligament
D - anterior tibiotalar ligament
S - talonavicular
S - talocalcaneal ligament
LATERAL:
* are located on the fibula side of the ankle
* PTFL (The Posterior Talofibular Ligament) connects posterior talus to the fibula
* ATFL (The Anterior Talofibular Ligament) connects the anterior talus to the fibula
* CTFL (The Calcaneofibular Ligament) connects the calcaneus to the fibula
* resists inversion
ankle stability
**Foot arches and ankle ligaments work together to provide stability, balance, and efficient movement
- Foot arches absorb shock, distribute weight, support balance, and enable efficient propulsion, adjusting dynamically to various terrains
- Ankle ligaments limit excessive motion, maintain joint alignment, provide proprioceptive feedback for balance, and distribute loads across the joint, reducing stress and preventing injury
- they ensure smooth and stable movement while protecting the foot and ankle from impact and misalignment
arches of the foot
- formed by the tarsal and metatarsal bones
- strengthened by ligaments and tendons
- allow the foot to support the weight of the body in the erect posture with the least weight
3 arches of the foot
Medial Longitudinal Arch:
* Higher of the two longitudinal arches
* formed by the calcaneus, talus, navicular, cuneiforms, and first three metatarsals.
* Supported by muscles, ligaments, and plantar aponeurosis
Lateral Longitudinal Arch:
* Flatter of the two arches, formed by the calcaneus, cuboid and 4th and 5th metatarsal bones.
* Supported by muscles and ligaments and the plantar aponeurosis
Transverse Arch:
* Formed by the metatarsal bases, cuboid and cuneiforms.
* Supported by muscles, ligaments and plantar aponeurosis
major nerves of the foot and ankle
- Tibial nerve (branch of the sciatic nerve) divides into medial and lateral plantar nerves
- Common peroneal nerve (branch of the sciatic nerve) splits into superficial and deep peroneal
- Sural nerve (formed from tibial and common peroneal nerve) innervates the posterior and lateral aspects of the lower leg
- Saphenous nerve (branch of the femoral nerve) innervates the medial foot and ankle
main arteries in the foot and ankle
primarily provided by the arches of the foot that branch from larger systemic vessels higher up
femoral artery
popliteal (knee and lower leg)
split into anterior tibial artery (run down front) and continues as dorsalis pedis artery
also split into posterior tibial artery (run down back) and
gives rise to medial/lateral plantar artery to form plantar arch
also give rise to fibular/ peroneal artery
main veins of foot and ankle
S: long saphenous vein: run along medial side/ drains back into femoral vein
s: short saphenous: run along lateral/ drain into popliteal
S: dorsal venous network: drain dorsal aspect
D: accompany arteries
D: anterior/ posterior tibial vein + fibular vein: drain blood back to popliteal -> femoral -> IVC
tibia
- larger medial weight-bearing bone of the leg
- articulates proximally with the femur and fibula
- articulates distally with fibula and talus
- proximally has a medial and lateral condyle
- distally the medial end forms the medial malleolus
- Is the most frequently fractured long bone
fibula
- parallel and lateral to the tibia but smaller
- does not articulate with the femur proximally
- helps stabilise the ankle joint distally
- lateral malleolus articulates with the talus distally
hallux valgus
injuries
the bunion
fractures
injuries
dislocation
injuries
heel spur
injuries
ankle sprain
injuries
