Intertarsal Joints and Great Tarsal Joint Flashcards
Talocalcaneal joint
AKA subtalar joint
- One of the 2 joints between the talus and calcaneus
- Gliding or plane-type synovial joint
- Posterior calcaneal facet of talus and posterior talar facet of calcaneus articulate in this joint
- The tarsal sinus lies anterior to the talocalcaneal joint, separating the talocalcaneal joint from the talocalcaneonavicular joint
- Has a fibrous capsule which forms the ligaments
5 ligaments of talocalcaneal joint
- Medial talocalcaneal
- Posterior talocalcaneal
- Lateral talocalcaneal
- Interosseous talocalcaneal
- Anterior talocalcaneal
Medial talocalcaneal ligament
- Attaches to medial tubercle of talus and medial surface of calcaneus (posterior to sustentaculum tali)
- Blends with deltoid (which is superficial)
- Blends with interosseous talocalcaneal (deep)
Posterior talocalcaneal ligament
- Attaches to lateral tubercle on posterior surface of talus and dorsal surface of calcaneus
- May attach to medial tubercle as well (Y-shape) and then medial band forms tunnel for FHL
Lateral talocalcaneal ligament
Attaches to lateral surface of talus (beneath fibular facet) and lateral surface of calcaneus (anterior and superior to attachment of calcaneofibular ligament)
Interosseous talocalcaneal ligament
- Broad, flat band that lies within tarsal canal
- Runs obliquely from sulcus tali to sulcus calcanei
- Lies between subtalar (posterior) and talocalcaneonavicular (anterior) joints
- Inside the tarsal sinus - closes off tunnel
Anterior talocalcaneal ligament
- AKA “cervical” ligament (b/c attaches to neck of talus)
- Strong ligament that controls over-inversion
Talocalcaneonavicular joint
- Complex joint with several articular surfaces
- Calcaneus NEVER articulates with navicular
- Talus articulates with 2 facets on calcaneus (ANTERIOR to tarsal canal)
- Anterior talar facet of calcaneus articulates with anterior calcaneal facet of talus
- Middle talar facet of calcaneus articulates with middle calcaneal facet of talus
- Talus articulates with navicular (head of talus articulates with proximal surface of navicular)
- Articular capsule is weak where not reinforced by ligaments
4 ligaments of talocalcaneonavicular joint
- Interosseous talocalcaneal
- Dorsal talonavicular
- Calcaneonavicular part of bifurcated ligament
- Spring ligament (plantar calcaneonavicular ligament)
Interosseous talocalcaneal ligament
- Same ligament as before… Part of both the subtalar joint and talocalcaneonavicular joint
- Broad, flat band that lies within tarsal canal
- Runs obliquely from sulcus tali to sulcus calcanei
- Lies between subtalar (posterior) and talocalcaneonavicular (anterior) joints
- Inside the tarsal sinus - closes off tunnel
Dorsal talonavicular ligament
- AKA talonavicular ligament
- Broad, thin band located dorsally
- Between neck of talus and dorsal surface of navicular
Calcaneonavicular part of bifurcated ligament
- Other part is calcaneocuboid part of bifurcate ligament (part of calcaneocuboid joint)
- Bifurcate ligament is a V or Y shape
- Stem of ligament blends with cervical ligament at tarsal sinus
- Passes anteromedially to dorsal surface of navicular
Plantar calcaneonavicular ligament
- AKA Spring ligament
- VERY STRONG… Supports head of talus and maintains medial longitudinal arch
- Forms articular surface of talocalcaneonavicular joint
- Contains numerous elastic fibers
- Attaches posteriorly to sustentaculum tali
- Attaches anteriorly to plantar surface of navicular and tuberosity of navicular
- Contacts 2 ligaments of deltoid: (medial to spring lig.)
- Tibionavicular ligament
- Tibiocalcaneal ligament
- Tibialis posterior is inferior and medial to spring ligament and supports spring ligament
Calcaneocuboid joint
- Saddle-type synovial joint
5 ligaments of calcaneocuboid joint
- Dorsal calcaneocuboid ligament
- Lateral calcaneocuboid ligament
- Calcaneocuboid part of bifurcated ligament
- Long plantar ligament
- Short plantar ligament
Dorsal calcaneocuboid ligament
- Articular capsule of calcaneocuboid joint is thickened dorsally as dorsal calcaneocuboid ligament
Lateral calcaneocuboid ligament
- Articular capsule of calcaneocuboid joint is thickened laterally as lateral calcaneocuboid ligament
Calcaneocuboid part of bifurcated ligament
- Part of calcaneocuboid articulation
- Courses anterolaterally to medial surface of cuboid
Long plantar ligament
- LONGEST ligament in the foot
- One of the stronger ligaments
- Attaches to calcaneus at medial and lateral processes and depression in between
- Courses distally, splits into superficial and deep
- Deep fibers attach to peroneal ridge of cuboid
- Superficial fibers make sheath over peroneus longus tendon and attach to bases of 2nd, 3rd, 4th and 5th metatarsals
Short plantar ligament
- AKA plantar calcaneocuboid ligament
- Wide, strong band that lies DEEP to long plantar
- Can see it on edges of long plantar since wider
- Attaches to anterior tubercle of calcaneus and cuboid (just posterior to peroneal ridge and beak of coronoid process)
NOTE: both long and short plantar ligaments support lateral longitudinal arch of foot
Great tarsal joint
o Unlike other joints, the great or general tarsal joint is not a single joint
o Contains numerous articular surfaces
o All surfaces share the same synovial membrane and same synovial fluid
o A single articular capsule surrounds ALL of the bones involved
Bones included in the great tarsal joint
o 5 of the 7 tarsal bones (all except talus and calcaneus)
o 3 metatarsals (2nd 3rd and 4th)
NO talus!
NO calcaneus!
Only the MIDDLE 3 metatarsals
12 articulations in the great tarsal joint
Navicular (3)
o Navicular – medial cuneiform
o Navicular – intermediate cuneiform
o Navicular – lateral cuneiform
Cuneiform (3)
o Medial cuneiform – intermediate cuneiform
o Intermediate cuneiform – lateral cuneiform
o Lateral cuneiform – cuboid
2nd metatarsal (3)
o Medial cuneiform – 2nd metatarsal
o Intermediate cuneiform – 2nd metatarsal
o Lateral cuneiform – 2nd metatarsal
Other metatarsal (3)
o Lateral cuneiform – 3rd metatarsal
o 2nd metatarsal – 3rd metatarsal
o 3rd metatarsal – 4th metatarsal
Three classes of joints in the great tarsal joint
- Intertarsal
- Tarsometatarsal
- Intermetatarsal
Two variations in the great tarsal joint
o Articulation between the 3rd and 4th mets are sometimes not part of great tarsal joint
o In some feet, the cuboid and navicular articulate within the great tarsal joint
- Normally, there is a fibrous (rather than synovial) joint between the cuboid and navicular
Ligaments of the great tarsal joint
o For a joint as complex as the great tarsal joint, it is advisable to learn the ligaments in groups rather than between each articular surface
Ligaments for bones that articulate at proximal-distal surfaces
For bones that articulate at proximal-distal surfaces, there are two ligaments for each articulation (dorsal and plantar)
- Plantar ligament is strong
- Dorsal ligament is weak
- Each ligament is named using either the word “dorsal” or “plantar” as adjectives followed by the names of the two bones
Example: dorsal medial cuneonavicular ligament
Ligaments for bones that articulate at medial-lateral surfaces
For bones that articulate at medial-lateral surfaces, there are three ligaments for each articulation (dorsal, plantar and interosseous)
- Interosseous ligament is the strongest
- Dorsal ligament is the weakest
- Each ligament is named with normal nomenclature (as described previously)
Intertarsal articulation groupings
o 1 - Talocalcaneal joint o 2 - Calcaneocuboid joint o 3 - Talocalcaneonavicular joint o 4 - Great tarsal joint o 5 - Lateral tarsometatarsal joint o 6 - Medial tarsometatarsal joint
NOTE: there are 4 intertarsal joints (1-4) and 3 tarsometatarsal joints (4-6)… The great tarsal joint is BOTH an intertarsal and a tarsometatarsal joint
4 ANATOMICAL intertarsal joints
- There are 4 anatomical joints, with each joint having its own articular capsule and synovial membrane. These joints are: o Talocalcaneal or subtalar joint o Talocalcaneonavicular joint o Calcaneocuboid joint o Great tarsal joint
2 FUNCTIONAL intertarsal joints
Functionally, there are only 2 intertarsal joints (separate joint capsules, but function as a unit)
- Functional subtalar joint
- Transverse tarsal joint
Functional subtalar joint
Composed of:
- (Anatomical) subtalar joint
- Talocalcaneal portion of the talocalcaneonavicular joint
NOTE: the functional subtalar joint is the combination of the two (anatomical) joints between the talus and calcaneus
Movement of functional subtalar joint
- Eversion and inversion
- Supination (plantar flexion, inversion, adduction) and pronation (dorsiflexion, eversion, abduction)
Transverse tarsal joint
AKA midtarsal joint, links midfoot to rearfoot
Composed of:
- Talonavicular portion of talocalcaneonavicular joint
- Calcaneocuboid joint
Movement of transverse tarsal joint
- Augments action of subtalar joint
- Functional joint - eversion and inversion
Which functional joint does the great tarsal joint participate in?
NOTE: the great tarsal joint does NOT participate in EITHER functional joint
- Summary of anatomical and functional joints
Summarize the functional intertarsal joints
o Talocalcaneonavicular joint participates in both functional joints
o Great tarsal joint does NOT participate in either functional joint
o Two bones anterior to transverse tarsal joint are the cuboid and navicular
o Two posterior located bones are talus and calcaneus
