Foot Boons

Question 1

Sections of the foot

Answer 1

SECTIONS
1. FOREFOOT; made up of the 5 toes (phalanges) & the 5 proximal long bones (metatarsals)
2. MIDFOOT; made up of 3 Cuneiform bones, Cuboid bone and Navicular bone
- these form central parts of the foot arches
3. HINDFOOT; (heel & ankle)-contains Talus bone (which supports leg) & the Calcaneus (heel) - I→ lura
✔ midfoot is connected to the hind- and fore-foot by muscles and by the plantar fascia.
-band of tissue (fascia) that connects your heel bone to the base of your toes. It supports the arch of the foot and absorbs shock when walking. Tension and stress on the fascia can cause small tears.
✔ midfoot and forefoot taken together exhibit ;
❖ dorsum (the area facing upwards while standing)
❖ planum (the area facing downwards while standing)

Question 2

❖ Midfoot + hindfoot =

Answer 2

Tarsus

Question 3

Metatarsus

Answer 3

metatarsus of the foot consists of five long bones, which are called the metatarsals (it is the regon)

Question 4

Achilles Tendon

Answer 4

connects heel to calf muscles- essential for running,
jumping & standing on toes

Question 5

instep

Answer 5

instep is the arched part of the top of the foot between the toes and the ankle.

https://i.shgcdn.com/3ca2cf79-b974-485d-b8ed-d3b14d36b016/-/format/auto/-/preview/3000x3000/-/quality/lighter/

Question 6

Arches

Answer 6

3 arches
Two longitudinal arches and a transverse arch, maintained by
✔ interlocking shapes of the foot bones
✔ strong ligaments
✔ pulling action of the muscles during activity
▪ The slight mobility of these arches when weight is applied to and removed from the foot, beware to small bons makes walking and running more energetically feasible sine more force

Question 7

Foot has two important functions;

Answer 7

✔ to support body weight
✔ to propel body forward in walking & running

Question 8

multiple bones allow foot to

Answer 8

✔ adapt to uneven surfaces
✔ assist the forward propulsive movements of gastrocnemius & soleus muscles; this would not be possible with single bone

A segmented structure such as the foot can only hold up weight if it is built in the form of an arch

Foot has three arches, present at birth- 2 longitudinal & 1 transvers

Question 9

two longitudinal arches

Answer 9

1. medial longitudinal arch
   ❖ curves above the ground
   ❖ stretches from the heel bone over the keystone talus to the three medial metatarsals.
2. lateral longitudinal arch is very low.
   Cuboid is its keystone,
   it stretches from the calcaneus to the distal ends of the fourth & fifth metatarsals.

The two longitudinal arches serve as pillars for the transverse arch

Question 10

lteral transvers longetudinal arch vs medial longitudinal arch

Answer 10

lteral transvers longetudinal arch vs medial longitudinal arch
key stone coboid talus
from calaneus calaneus
to 4 and 5 metatarsel tree metatarsals

Question 11

B. One transverse arch-

Answer 11

B. One transverse arch-
❖ runs obliquely across the tarsometatarsal joints.
❖ Keystone is the middle 1 (intermediate) cuneiform

https://www.ghoshyoga.org/uploads/1/3/2/4/13243244/arches-of-the-foot_orig.png

Question 12

MEDIAL vsLATERAL

Answer 12

❖ MEDIAL; big toe side - twards the midline
❖LATERAL; little toe side
- away from the midline

Question 13

PROXIMAL vs DISTAL

Answer 13

PROXIMAL: towards ankle - twards the joint
▪ DISTAL: towards toes
- away from the joint

Question 14

DORSAL vs PLANTAR

Answer 14

▪ DORSAL; upper surface of foot
▪ (dorsum)

PLANTAR; lower surface of foot
(planum)

Question 15

Applied or clinical anatomy

Answer 15

is the application of anatomical knowledge to the
diagnosis and treatment of disease.

Question 16

Varus deformity

Answer 16

is a term for the medial (inward) angulation of the distal segment of a bone or joint.

Question 17

Valgus deformity

Answer 17

A Valgus deformity is a term for the outward (lateral/left ) angulation of the distal segment of a bone or joint. (VALGUS)

a combined deformity with a malpositioning of the firstmetatarsophalangeal jointcaused by a lateral deviation of the great toe and a medial deviation of the first metatarsal bone.

https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRKgPAIkzhHdrjYRTriQA5VUHtcgiTgd1f78Q&usqp=CAU

Question 18

Equinus

Answer 18

condition in which the upward bending motion of the ankle joint is limited. Someone with equinus lacks the flexibility to bring the top of the foot toward the front of the leg- plantarflexion

https://cdn.shopify.com/s/files/1/0909/6780/files/02_22_2017_The_Equinus_Foot_dc04392b-3728-4646-95c7-1be950090e42.jpg?v=1488441692

Question 19

Bunion

Answer 19

A joint deformity causing a bony bump that forms on the joint at the base of the big toe, when there is a hallux valgus

The skin over the bunion might be red and sore

https://orthoinfo.aaos.org/globalassets/figures/a00155f03.jpg

Question 20

forefoot

Answer 20

Phalanges-distal, middle and proximal, numbered from medial to lateral.
❖ Each phalanx has
- a distal head;
- a shaft
- a proximal base
* multiple muscle attachments
* distal phalanges bear roughened tuberosity on plantar aspect for attachment to pulp of toe tip
Tubercle - A small, rounded prominence where connective tissues attach.
pulp - the fleshy mass of the plantar aspect of the distal part of the toe.
https://www.google.com/search?q=pulp+toe&client=ms-android-samsung-ss&hl=en&prmd=isvn&sxsrf=ALiCzsb3yd3TdhB1h0app_e0xJj4ZAhsMQ:1665939028956&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjC5qbAmuX6AhXdgv0HHdfABQwQ_AUIGigB&biw=384&bih=718&dpr=2.81#imgrc=EwDFajWpfW-frM

❖ Each toe has 3 phalanges except big toe (no. 1) which has only 2 (distal & proximal-no middle!)

Metatarsals- five of each numbered from medial to lateral
big toe no.1 small toe no.5
❖ Each bone, like the phalanges, has
o a distal head
o a shaft
o a proximal bas

Question 21

proximal phalanges

Answer 21

FIRST ROW OF THE PHALANGES

✔ are the largest phalanges in the foot
✔ are less thick and longer as compared to distal phalanges;
✔ shaft is convex superiorly and concave inferiorly
✔ shaft is compressed from sides.
✔ base is concave and head contains a trochlear surface for articulation with middle phalanx.

Question 22

middle phalanges

Answer 22

SECOND ROW OF THE PHALANGES (absent in 1st toe)
✔ The middle phalanges are short and thick
✔ They are broader as compared to those in first row but are reduced in length

Question 23

distal phalanges

Answer 23

THIRD ROW OF THE PHALANGES
✔ These are also known as the distal phalanges
✔ They are small when compared to the others
✔ They bear the nailbeds
❖ All the toes of feet contain one distal phalanx
❖ big toe lacks a middle phala

Question 24

1st. Metatarsal structure

Answer 24

1st. Metatarsal

Large & strong; important in bearing weight of body
▪ Head is grooved on its inferior aspect by medial &
lateral sesamoid bones in the tendons of FHB
▪ proximal articular surface (Base) is large and
kidney-shaped; articulates with the medial
cuneiform bone
✔ its circumference is grooved, for the tarsometatarsal
ligaments
✔ medially base gives insertion to part of the tendon of
the tibialis anterior
✔ laterally base gives insertion to part of the tendon of
the peroneus (fibularis) longus

Question 25

5th. Metatarsal

Answer 25

5th. Metatarsal curved longitudinally, so as to be concave below, slightly convex above; head articulates with the fifth proximal phalanx. The base articulates posteriorly, with the cuboid and medially, with the 4 th metatarsal. ▪ The fifth metatarsal has a prominent tubercle or tuberosity, on the lateral side of its base; gives insertion to peroneus (fibularis) brevis ▪ The plantar surface of the base is grooved for the tendon of the abductor digiti quinti. ▪ A strong band of the plantar aponeurosis connects the projecting part of the tuberosity with the lateral process of the tuberosity of the calcaneus

Question 26

plantar aponeuros

Answer 26

connects the projecting part of the tuberosity with the lateral process of the tuberosity of the calcaneus

Question 27

fractures of metatarsals 5th

Answer 27

base of 5th MT can be fractured during forced inversion of the foot, when the tendon of insertion of peroneus (fibularis) brevis pulls off the base of the metarsal (Avulsion fracture) A Jones fracture occurs at the base of the 5th MT Stress fractures of a MT bone are common in joggers & soldiers after long marches; occur most frequently in distal 1/3 of 2,3,4 MT minimal displacement occurs due to attachment of interosseus muscles

Question 28

A Jones fracture

Answer 28

e occurs at the base of the 5 th MT Stress fractures of a MT bone a

Question 29

(Avulsion fracture)

Answer 29

base of 5th MT can be fractured during forced inversion of the foot, when the tendon of insertion of peroneus (fibularis) brevis pulls off the base of the metarsal (Avulsion fracture

Question 30

Cuneiforms

Answer 30

3 small wedge-shaped bones articulate proximally with Navicular Articulate distally with 1-3 Metatarsals Lateral cuneiform articulates laterally with cuboid Wedge-shape contributes to formation & maintenance of transverse arch

Question 31

CUBOID

Answer 31

✔ Proximally; Calcaneum ✔ Distally; 4th & 5thMetatarsals ✔ Medially; Lateral cuneiform & navicular

Question 32

Tarsus

Answer 32

the Mid & Hind Foot Proximal bones ✔ Talus ✔ Calcaneus Intermediate bone ✔ Navicular Distal bones ✔ Cuneiform bones (M.I.L.) ✔ Cubo

Question 33

cuboid

Answer 33

Dorsal Surface; rough, for the attachment of ligaments. Plantar Surface; peroneal sulcus‐ anteriorly a deep groov for the peroneus (fibularis) longus Is bounded behind by a prominent ridge, to which the long plantar ligament is attached The ridge ends laterally in a tuberosity which presents an oval facet where the sesamoid bone or cartilage frequently found in the tendon of the peroneus (fibularis) longus frequently glides The surface of bone behind the peroneal sulcus is rough, for the attachment of the: plantar calcaneocuboid ligamen a few fibres of the flexor hallucis brevis fasciculus from the tendon of the tibialis posterior lateral surface - presents a deep notch formed by the bigining of the peroneal sulcus; also see the tuberosity posterior surface; - articulates with the anterior surface of the calcaneus – the calcaneocuboid joint. anterior surface - divided by a vertical ridge into two facets, forming the fourth (L) and fifth (M) tarsometatarsal joint medial surface- presents a facet, for articulation with the third (lateral) cuneiform; behind this (occasionally) a smaller facet, for articulation with the navicular bone. It is rough in the rest of its extent, for the attachment of strong interosseous ligament

Question 34

Navicular

Answer 34

located on the medial side of the foot, and articulates proximally with the talus, distally with the three cuneiform bones, and laterally with the cuboid resembles a small boat, due to strongly concave proximal articular surface (for talus). tuberosity of the navicular bone; situated on medial border of foot, in front of and below medial malleolus for insertion of tibialis posterior . ✔ Tibialis posterior is the only muuscle that attaches to the navicular bone

Question 35

CALCANEUM

Answer 35

✔Articulates above with the Talus and in front with the cuboid antirior surface ✔anterior; small & articulates with cuboid ✔superior surface; three articular facets for talus; anterior Middle & Post. Facets separated by groove (sulcus calcanei) ✔Posterior surface; forms prominence of heel and gives attachment to the Tendo Achilles ✔Inferior (plantar) surface: anterior tubercle →in the midline anteriorly and posteriorly →medial &lateral tubercles (processes) ✔Tuber calcanei (calcanean tuberosity) at the back Medial view ✔▪ medial surface; has large shelf-sustentaculum tali,which assists in support of talus ✔ Lateral surface; almost flat; anteriorly small elevation-peroneal tubercle (trochlea) which seperates tendons of peroneus (fibularis) longus & peroneus (fibularis) brevis

Question 36

avulsion fractur

Answer 36

occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone

Question 37

Calcaneal spur

Answer 37

(or heel spur) is a small osteophyte (bony spur) located on the calcaneus. Calcaneal spurs are typically detected by a radiological examination (X-ray). generally no effect However, repeated damage can cause these deposits causing a large calcaneal (or heel) spur - may be painful. ✔ Obese people, flatfooted people, and women who constantly wear high-heeled shoes are most susceptible to heel spurs.

Question 38

calcaneal sulcus

Answer 38

the deep groove separating the anterior and middle articular surfaces from the posterior articular surface calcaneal sulcus, together with the talar sulcus on the inferior surface of the talus, forms the tarsal canal, which widens laterally into the tarsal sinus.

Question 39

Talus

Answer 39

◆ Lots of ligaments are attached to the talus but no muscle attachments head; directed distally; convex for navicular tuberosity) ; inferiorly rests on ▪ sustentaculum tali behind and • calcaneonavicular ligament in front ❖ neck; lies behind head ✔ dorsal surface for ligament ✔ plantar surface The calcaneal sulcus, together with the talar sulcus on the inferior surface of the talus, forms the tarsal canal, which widens laterally into the tarsal sinus.for the strong interosseous talocalcaneal ligament. Sinus tarsi =(tunnel between calcaneus & talus ✔ formed by sulcus tali & sulcus calcanei ❖ body; cuboidal; ✔ superior (dorsal) surface presents, behind, a smooth trochlear surface for ticulation with the tibia. In front it is continuous with the upper surface of the neck of the bone. ✔ medial surface = facet for medial malleolus of tibia ✔ lateral surface = facet for lateral malleolus of fibula ✔inferior surface →is large and oval or oblong . It articulates with the corresponding facet on the upper surface of the calcaneus

Question 40

Fractures of the Talus

Answer 40

fractures occur at neck or body of the Talus Occur during violent dorsiflexion of the ankle joint when the neck is driven against anterior edge of distal end of tibia Body of talus can be fractured by jumping from a height, although the two malleoli prevent Displacement of the fragme

Question 41

TIBIA

Answer 41

✔ is slightly expanded and on its inferior aspect shows saddle-shaped articular surface for trochlea of Talus ✔ medial malleolus, -Bone prolonged downwards medially, lateral surface of which articulates with Talus. ✔ Lateral dipression-for articulation with Fibula

Question 42

fibula

Answer 42

lower end of fibula forms triangular lateral malleolus On medial surface of lateral malleolus is a facet for articulation with lateral aspect of Talus Below and behind articular facet is malleolar (digital) fossa malleolar (digital) fossa . _ gives attachment to the posterior talofibular ligament.