Joints of Foot and Ankle Part 3 Flashcards
open kinetic chain
calcaneus and foot moving on talus
closed kinetic chain
talus moving, forefoot is fixed, calcaneus is mostly fixed
open kinetic chain pronation
Dorsiflexion
Abduction
Eversion
open kinetic chain supination
dorsiflexion (talus)
abduction (talus)
inversion (calcaneus)
tibia external rotation
closed kinetic chain pronation
plantar flexion (talus)
adduction (talus)
eversion (calcaneous)
tibia internal rotation
Open Kinetic Chain
roll and slide in opposite directions
Closed Kinetic Chain
roll and slide of mortise on the trochlea
Ankle joint innervation
- Deep fibular nerve
- Accessory deep fibular when present
- Tibial nerve
- Saphenous nerve
- Sural nerve
subtalar innervation
Tibial nerve Lateral dorsal cutaneous (sural) Medial plantar Deep fibular Accessory deep fibular when present
talocalcaneonavicular innervation
Medial plantar
Deep fibular
Calcaneocuboid innervation
Lateral plantar
Sural
Deep fibular
Accessory deep fibular when present
Cuneocuboid joint and cuboidonavicular innervation
Lateral plantar and deep fibular
innervation of 1st and 2nd Cuneonavicular, medial intercuneiform, cuneometatarsal 1-2
Deep fibular
Plantar side: Medial plantar
innervation of 3rd cuneonavicular, 3rd cuneometatatarsal, , lateral intercuneiform
Deep fibular and lateral plantar
innervation of Cuboid metatarsal 4,5
Sural
Superficial fibular
LPN
Intermetatarsal joint
innervation
-Dorsum: deep fibular
-Plantar:
deep branch of lateral plantar: between 2nd and 3rd and 3rd and 4th metatarsal bases
Superficial branch of LPN: between 4th and 5th metatarsal base
innervation of MTP joints and IP joints
Branches from the dorsal and plantar digital nerves that pass by the joint
2-4th MTP joints can also receive innervation from deep branch of LPN
PIP joints between
head of proximal phalanx and base of middle phalanx
DIP joints between
head of middle phalanx and base of distal phalanx
Interphalangeal Joints (IP Joints)
- Proximal and distal have similar structure
- Gingylmus (hinge), synovial joints; diarthrosis
- Joint capsule ataches to articular margin
- Movements: dorsiflexion/plantarflexion
Hallux only has an i
nterphalangeal joint (IP) Between head of proximal phalanx and base of distal phalanx
Medial and Lateral collateral ligaments of the __ interphalangeal joint
From the tubercles of the phalangeal head proximally to tubercles of phalangeal base distally
Plantar interphalangeal ligament of the __ interphalangeal joint
From the head of a phalanx proximally to base of phalanx distally
All the muscles, ligaments/capsule that attaches to the sesamoid bones
- Flexor hallucis brevis (medial and lateral)
- Abductor hallucis muscle (medial)
- Adductor hallucis muscle (lateral)
- Deep transverse metatarsal ligament (lateral)
- Sesamophalangeal ligaments (medial and lateral)
- Metatarsophalangeal suspensory ligament (medial and lateral)
- Intersesamoid ligament (medial and lateral)
- Plantar plate
Anatomic and functional unit formed by
- Proximal phalanx
- Collateral ligaments
- Plantar plate
Metatarsophalangeal Joints
Metatarsal head with base of proximal phalanx
metatarsophalangeal joints are __ joints
Ellipsoid, synovial joint; diarthrosis
Metatarsophalangeal Joints movements
abduction/adduction; flex/ext; circumduction
Metatarsophalangeal Joints capsule attaches
to articular margins, lined by synovium
Extensor expansion supports
dorsal capsule
Usually No ligaments between
1st and 2nd metatarsals, they usually do not articulate
Intermetatarsal joints are __ joints
planar, synovial, diarthrosis
Intermetatarsal joints between
2nd and 3rd (part of great tarsal joint)
3rd and 4th (part of great tarsal joint)
4th and 5th
Sesamophalangeal ligaments (phalangeosesamoid) medial
tibial (medial) sesamoid to medial tubercle of proximal phalanx base
Sesamophalangeal ligaments (phalangeosesamoid) lateral
fibular (lateral) sesamoid to lateral tubercle of proximal phalanx base
Intersesamoid ligament
Connects the medial and lateral sesamoids
Collateral ligaments of 1st MTP joint (Proper collateral ligaments or metatarsophalangeal ligament)medial
from medial tubercle of met head to medial tubercle of proximal phalanx base
Collateral ligaments of 1st MTP joint (Proper collateral ligaments or metatarsophalangeal ligament) lateral
from lateral tubercle of met head to lateral tubercle of proximal phalanx base
Metatarsophalangeal suspensory ligaments (metatarsoglenoid ligaments or metatarsosesamoid ligaments or Accessory collateral ligaments)
MEDIAL
from medial tubercle of met head to medial sesamoid & plantar plate
Metatarsophalangeal suspensory ligaments (metatarsoglenoid ligaments or metatarsosesamoid ligaments or Accessory collateral ligaments)
LATERAL
from lateral tubercle of met head to lateral sesamoid & plantar plate
plantar plate attaches to
sesmoids
Medial and lateral collateral ligaments of __ MTP joint or Proper collateral ligaments
Pass between tubercles of the met heads and proximal phalanx base
Medial and lateral metatarsophalangeal suspensory ligaments of ___MTP (Metatarsoglenoid ligaments or accessory collateral ligaments)
From medial and lateral tubercles of met head to plantar plate
Plantar Metatarsophalangeal Ligaments
Pass from plantar aspect of met head to plantar aspect of proximal phalanx
Plantar (volar) plate
Fibrocartilaginous disc like structure located on the plantar to metatarsal head
*type 1 cartilage
Plantar (volar) plate
Important in
MTP dorsoplantar joint stability; Shock absorption
Resists tensile and compressive forces
plantar plate Has attachment to:
deep transverse metatarsal ligament, sling of extensor expansion, flexor tendon sheath, plantar fascia, collateral ligaments and proximal phalanx
Ligament that connects adjacent metatarsal heads and plantar (volar) plates
Deep Transverse Metatarsal Ligament
Deep Transverse Metatarsal Ligament is an important stabalizer of
the MTP joints
Proximal edge of deep transverse metatarsal ligament is at the level of
the metatarsal condyles, distal doesn’t usually extend past met head
Anatomy is different between the 1st metatarsal space (between met heads of digit 1and 2
- Attaches to 2nd metatarsal head and plantar plate; splits into a dorsal and plantar slip
- Plantar slip attaches to lateral sesamoid bone of 1st MTP joint
- Dorsal slip attaches joint capsule of 1st MTP joint
- The tendon of the adductor hallucis passes between the 2 slips
