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Lower Limb > Intertarsal Joints and Great Tarsal Joint > Flashcards

Intertarsal Joints and Great Tarsal Joint Flashcards

1
Q

Talocalcaneal joint

A

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
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2
Q

5 ligaments of talocalcaneal joint

A
  • Medial talocalcaneal
  • Posterior talocalcaneal
  • Lateral talocalcaneal
  • Interosseous talocalcaneal
  • Anterior talocalcaneal
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3
Q

Medial talocalcaneal ligament

A
  • 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)
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4
Q

Posterior talocalcaneal ligament

A
  • 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
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5
Q

Lateral talocalcaneal ligament

A

Attaches to lateral surface of talus (beneath fibular facet) and lateral surface of calcaneus (anterior and superior to attachment of calcaneofibular ligament)

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6
Q

Interosseous talocalcaneal ligament

A
  • 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
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7
Q

Anterior talocalcaneal ligament

A
  • AKA “cervical” ligament (b/c attaches to neck of talus)

- Strong ligament that controls over-inversion

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8
Q

Talocalcaneonavicular joint

A
  • 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
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9
Q

4 ligaments of talocalcaneonavicular joint

A
  • Interosseous talocalcaneal
  • Dorsal talonavicular
  • Calcaneonavicular part of bifurcated ligament
  • Spring ligament (plantar calcaneonavicular ligament)
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10
Q

Interosseous talocalcaneal ligament

A
  • 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
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11
Q

Dorsal talonavicular ligament

A
  • AKA talonavicular ligament
  • Broad, thin band located dorsally
  • Between neck of talus and dorsal surface of navicular
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12
Q

Calcaneonavicular part of bifurcated ligament

A
  • 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
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13
Q

Plantar calcaneonavicular ligament

A
  • 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
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14
Q

Calcaneocuboid joint

A
  • Saddle-type synovial joint
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15
Q

5 ligaments of calcaneocuboid joint

A
  • Dorsal calcaneocuboid ligament
  • Lateral calcaneocuboid ligament
  • Calcaneocuboid part of bifurcated ligament
  • Long plantar ligament
  • Short plantar ligament
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16
Q

Dorsal calcaneocuboid ligament

A
  • Articular capsule of calcaneocuboid joint is thickened dorsally as dorsal calcaneocuboid ligament
17
Q

Lateral calcaneocuboid ligament

A
  • Articular capsule of calcaneocuboid joint is thickened laterally as lateral calcaneocuboid ligament
18
Q

Calcaneocuboid part of bifurcated ligament

A
  • Part of calcaneocuboid articulation

- Courses anterolaterally to medial surface of cuboid

19
Q

Long plantar ligament

A
  • 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
20
Q

Short plantar ligament

A
  • 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

21
Q

Great tarsal joint

A

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

22
Q

Bones included in the great tarsal joint

A

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

23
Q

12 articulations in the great tarsal joint

A

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

24
Q

Three classes of joints in the great tarsal joint

A
  • Intertarsal
  • Tarsometatarsal
  • Intermetatarsal
25
Q

Two variations in the great tarsal joint

A

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

26
Q

Ligaments of the great tarsal joint

A

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

27
Q

Ligaments for bones that articulate at proximal-distal surfaces

A

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

28
Q

Ligaments for bones that articulate at medial-lateral surfaces

A

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)
29
Q

Intertarsal articulation groupings

A 
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

30
Q

4 ANATOMICAL intertarsal joints

A 
-	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
31
Q

2 FUNCTIONAL intertarsal joints

A

Functionally, there are only 2 intertarsal joints (separate joint capsules, but function as a unit)

  • Functional subtalar joint
  • Transverse tarsal joint
32
Q

Functional subtalar joint

A

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

33
Q

Movement of functional subtalar joint

A
  • Eversion and inversion

- Supination (plantar flexion, inversion, adduction) and pronation (dorsiflexion, eversion, abduction)

34
Q

Transverse tarsal joint

A

AKA midtarsal joint, links midfoot to rearfoot

Composed of:

  • Talonavicular portion of talocalcaneonavicular joint
  • Calcaneocuboid joint
35
Q

Movement of transverse tarsal joint

A
  • Augments action of subtalar joint

- Functional joint - eversion and inversion

36
Q

Which functional joint does the great tarsal joint participate in?

A

NOTE: the great tarsal joint does NOT participate in EITHER functional joint
- Summary of anatomical and functional joints

37
Q

Summarize the functional intertarsal joints

A

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

Lower Limb (24 decks)

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