Joints of the foot Flashcards
Ankle joint is formed by ?
- Malleolar fork or ankle mortice 2. Talar dome
Malleoar fork or ankle mortice is formed by?
- lateral surface of medial malleolus 2.inferior surface of distal extemity of tibia 3. medial surface of lateral malleolus
What is talar dome?
medial, superior and lateral surface of the body of talus
Movement at ankle joint is primarily——–due to major angulation to ———plane
dorsiflexion, sagittal
which ones are stronger? lateral ankle joint or medial ankle joints
medial ankle joints
what kind of ligament is anterior talofibular ligament ?
capsular ligament
where does the anterior talofibular ligament attach to?
anterior border of lateral malleolus and lateral surface of the body of talus
what type of ligament is calcaneofibular lig?
extracapuslar
where does the calcaneofibular lig attach to?
anterior border of the apex of lateral malleolus and and to the fibular spine on the lateral surface of the calcaneous
calcaneofibular lig is crossed superficially by what structure?
fibularis longus and fibularis brevis tendons
what type of ligament is posterior talofibular ?
capsular
where dies the posterior talofibular attach to?
inferior portion of the malleolar fossa and to the lateral tubercle on the posterior surface of the talus.
what is the weakest lateral ankle ligament?
anterior talofibular lig
what is the strongest and most deeply situated ligament of lateral ankle ligaments?
posterior talofibular ligament
medial ankle ligamnets are what type of ligament?
All are capsular lig
what are the superficial deltoid lig?
- tibionavicular 2. calcaneotibial 3.posterior talotibial
where does the tibionavicular lig attach to?
anterior colliculus and dorsomedial aspect of navicular
where does the calcaneotibial lig attach to?
anterior colliculus and sustentaculum tali
where does the posterior talotibial lig attach to?
anterior colliculus and medial tubercle on the posterior surface of the body of talus
what are the deep deltoid lig?
- anterior talotibial 2. deep posterior talotibial
anterior talotibial lig
attaches to anterior colliculus and intercollicular groove on the medial surface of the body of talus below the pear-shaped articular facet
deep posterior talotibial lig
attaches to the posterior colliculus ,and to the intercollicular groove adn to the medial tubercle on the posterior surface of the body of talus
what is the weakest component of deltoid lig?
tibionavicular lig
ankle sprain
twisting of the weightbearing foot usually in the inverted and plantarflexed position.damage usually includes anterior talofibular lig and calcaneofibular lig ( lateral ankle lig) posterior talofibular is rarely damaged due to its horizontal nature .
ankle fracture
weight bearing with foot in supinated or pronated position with a twisting of the ankle
in anterior ankle arthroscopy you want to avoid?
anterior tibial vessles and deep fibular nerve
in posterior ankle artroscopy you want to avoid?
posteior tibial vessles and tibial nerve
what are the structures that are viewed from anterior portal?
medial gutter, medial bend, sagittal groove, lateral bend, lateral gutter
functional joint is determined by?
motion about a joint axis
anatomical joint is determined by?
joint capsule
Name 2 functional joints of the intertarsal joints?
subtalar and midtarsal. subtalar joint is between talus and calcaneous .
Name the angulations of the functional subtaral joint
42 from transverse plane
48 from frontal plane
16 from sagittal plane
what is the major motion at the subtalar joint?
supination/pronation moslt in in the frontal and transverse plane
in OKC of subtalar joint the pronation consist of?
Eversion, Abduction , Dorsiflexion (PEABD)
in OKC of subtaltar joint the supination consists of?
Plantarflexion, inversion, adduction ( SPIN ADD)
in true OKC supination and pronation of subtalar joint what bone is remained stationary?
Talus but the ankle is plantarflexed and dorsiflexed resulting in tlus to plantarflexed and dorsiflexed
CKC supination of subtalar joint
- calcaneal inversion
- abduction and dorsiflexion of the talus-external rotaion of tibia
CKC pronation of subtalat joint consist of
- calcaneal eversion
- adduction and plantarflexion of the talus
- internal rotaion of tibia
Functional midtarsal joint is AKA?
transverse tarsal joint, chopart’s joint, cyma line
Functional midtarsal joint is formed by?
calcaneocuboid, Talonavicular
what are the 2 axes of midtarsal joint that motion occurs about?
longitudinal midtarsal joint axis
oblique midtarsal joint axis
longitudinal axis
is angulated 75 from the frontal plane
oblique angle
is angulated 57 from sagittal plane and 52 from transverse plane.
what is the motion about the longitudinal axis?
frontal lane so inversion and eversion while supination and pronation occurs
what is the motion about the oblique axis?
primarily adduction/abduction and plantarflexion/dorsiflexion while supination and pronation to occur.
what is motion about transverse plane?
abduction/adduction
what is motion about frontal plane?
inversion/eversion
what is motion about sagittal plane?
dosrsiflexion/plantarflexion
Anatomically the subtalar joint is divided into and ——–and ———-synovial cavity.
anterior and posterior
the posterior subtalar articular cavity involves
the posterior articular areas of the calcaneous and talus
the anterior subtalar articulation involves
middle and anterior articular areas of calcaneous and talus
ligaments of the posterior subtalar joint?
- posterior talocalcaneal capsular lig
- Anterior talocalcaneal lig ( cervical)
- posterior talocalcaneal lig
- lateral talocalcaneal lig
- medial talocalcaneal lig
- Interosseous talocalcaneal lig
posterior talocalcaneal capsular lig is reinforces anteriorly by?
interosseous talocalcaneal lig
Anterior talocalcaneal lig ( cervical)
attached to lateral surface of the neck of the talus and sinus tarsi of the calcaneous
posterior talocalcaneal lig
attaches to the lateral tubercle on the posterior surface of the body of talus and superior surface of the` calcaneous
lateral talocalcaneal lig
attaches to the lateral process on the lateral surface of body of talus and lateral surface of the calcaneous
medial talocalcaneal lig
attached to the medial tubercle on the posterior surface of the body of talus and and the posterior aspect of sustentaculum tali
Interosseous talocalcaneal lig
attaches to the sulcus tali and calcaneal sulcus..limiting factor in subtalar joint motion.
name a ligament that occupies tarsal canal
Interosseous talocalcaneal lig
talocalcaneonavicular joint anatomically includes
- anterior subtalar joint
- talonavucular joint
- atriculation between head of the talus and spring lig
ligaments of talocalcaneonavicular joint?
- talocalcaneonavicular capsular lig
- dorsal talonavicular lig
- bifurcate lig
- spirng or plantar calcaneonavicular lig
talocalcaneonavicular capsular lig
encloses the anterior subtalar joint, the talonavicular joint and the articulation of the head of talus and spring lig
dorsal talonavicular lig
capsular ligamnet attaches to the dorsal surface of the neck of talus and dorsum of navicular
bifurcate lig
attaches to sinus tarsi of the calcaneous and divides into 2 portions
- calcaneonavucular( medial): attaches to the dorsolateral aspect of navicular
- calcaneocuboid( lateral): attaches to the dorsomedial aspect of cuboid
spirng or plantar calcaneonavicular lig
attaches to the anterior margin of sustentaculum tali and the plantar surface of navicular
the soft tissue structures that occupy the sinus tarsi are collectively called?
Hoke’s tonsil
The only ligamnet of the foot with elastic fibers
spring lig
superior surface of he spring lig contains fibrocartilage for articulation with
head of talus
support the head of talus between sustentaculum tali and plantar surface of navicular
spring lig
spring lig forms a strong bond between
rear foot and midfoot
ligaments of calcaneocuboid joint
- calcaneocuboid capsular lig
- dorsal calcaneocuboid lig
- bifurcate lig
- short plantar lig ( plantar calcaneocuboid)
- long plantar lig(long calcaneocuboid lig)
encloses the articular surface of calcaneous and cuboid
calcaneocuboid capsular lig
capsular lig attaches to sinus tarsi of the calcaneous and dorsum of cuboid
dorsal calcaneocuboid
attaches to tuberce and transverse groove on the plantar surface of the calcaneous and plantar surface of the cuboid poseterior to fibular ridge
short plantar lig
one of the longest ans strongest ligaments of the foot
long plantar ligament
long plantar lig
attaches to the plantar surface of the calcaneous between tuberosity and tubercle and distally it divides into deep and superficial fibers
deep fibers
attach to fibular ridge and tuberosity of the cuboid
superficial fibers
attach to the base of 2nd, 3rd, 4th and 5th metatarsals
convert the fibular groove into a canal for passage of the tendons of Fibualaris longus
Superficial fibers of long plantar lig
form a strong bond between rearfoot and midfoot
- spring lig
- short plantar lig
- long pantar lig
ligaments of cuboidonavicular joint
- Dorsal cuboidonavicular lig
- interosseous cuboidonavicular lig
- Plantar cuboidonavicualr lig
when a joint is present the interosseous lig——-in size.
Decrease
How many cunonavicualr joints are there?
Three
ligaments of cunonavicular ligaments?
- Dorsal cunonavicular lig
2. plantar cunonavicular lig
how many intercuneiform joints?
two
ligaments of intercuneiform joints?
dorsal, plantar , interosseous
ligaments of cunocuboid joint?
dorsal, plantar, interosseous
Tarsometatarsal joints
joints that are formed by the cuneiforms and cuboid articulating with the base of metatarsals .
which of the tarsometatarsal joints have more motions?
the joint between the 1st cuneiform and first metatarsal base and the joint between cuboid and the 5th metatarsal base
ligaments of tarsometatarsal joints?
- Dorsal tarsometatarsal ligaments (8)
- Interosseous tarsometatarsal ligaments (3)
- plantar tarsometatarsal ligaments (9)
1st Interosseous tarsometatarsal ligament
attaches to the lateral surface of the 1st cuneiform and medial surface of the 2nd base. (Lisfranc’s ligament)
2nd Interosseous tarsometatarsal ligament
attaches to the medial surface of the 3rd cuneiform and lateral surface of 2nd metatarsal base
3rd Interosseous tarsometatarsal ligament
attaches to the lateral surface of 3rd cuneiform and medial surface of 4th metatarsal base (some fibers to the lateral surface of 3rd metatarsal base)
plantar tarsometatarsal ligaments
There is one ligamnet for rach of the 8 tarso metatarsal articulation plus one from the 1st cuneiform to the 3rd metatarsal base
intermetatarsal joint ligaments
- Dorsal intermetatarsal lig
- Plantar intermetatarsal lig
- interosseous intermetatarsal lig
heads of the metatarsals are interconnected at the plantar plate by?
deep transverse metatarsal ligament
the deep transverse metatarsal ligament in the 1st inter space is divided into
1.dorsal
2. plantar
which surround the conjointed tendon of adductor hallucis
superficial transverse metatarsal lig
band of tissue that interconnects superficial slips of the central portion of plantar aponeurosis and helps maintain the position of fat pad at the level of MTPs.
what motions are possible on lesser metatarsophalangeal joint?
dorsiflexion, plantarflexion about a transverse axis and anduction/adduction about vertical axis
ligaments of MTP joints
- metatarsopalangeal capsular lig
- metatarsophalangeal plantar plate
- collateral metatrsophalangeal (2)
- metatarsophalangeal suspensory or metatarsoglenoid (2)
metatarsopalangeal capsular lig
attaches to the anatomical neck of metatarsals and the edges of the base of proximal phalanx . it has a loose attachment to the metatarsal heads and allow dorsiflexion and plantarflexio
metatarsophalangeal plantar plate
capsular ligaments that is actually a fibrocartilaginous thickenning of the plantar portion of the capsule .It attaches loosely to the metatarsal head and firlmly to the base of the proximal phalanx. The firm attachment to the base of the proximal phalanx allows the plantar plate to stay in contact with the ground as the metatarsal head undergoes movement.
collateral metatrsophalangeal (2)
cord like capsular ligaments that attach to tubercles on either side of the head of the metatarsal and the tubercles on the base of proximal phalanx.
metatarsophalangeal suspensory or metatarsoglenoid (2)
triangular shaped capsular ligaments that attach to the tubercles on either side of the head of the metatarsal and the sides of the plantar plate.
the plantar plate is ———on its dorsal surface for articulation with the head of metatarsal and ———–on its plantar surface for tendons of _______and_________
smooth
grooved
FDL and FDB
sesamoids are embedded in
plantar plate
sesamoid apparatus is formed by
- tendon of flexor hallucis brevis
- tendon of abductor hallucis
- conjoined tendon of adductor hallucis
- sesamoids
- plantar plate ( which includes sasamoid ligaments)
what kind of motion is possible at the IPJ ?
dorsiflexion/plantarflexion about a transverse axis
major ligaments of IPJ
- interphalangeal capsular lig
- interphalangeal plantar plate
- collateral interpahalneagl lig
hw many synovial cavities are there in the foot?
9 interphalangeal
5 metatrsophalangeal
6 withing the intettarsal, tarsometatarsal and intermetatarsal articulations
how many synocial cavities in the forefoot
14
synovial cavities of the foot?
- posterior subtalar synocial cavity
- calcaneocuboid synovial cavity
- talocalcaneonavicular synovial cavity
- Greater lateral synovial cavity
- lateral tarsometatarsal synovial cavity
- medial tarsometatarsal synovial cavity
Medial tarso metatarsal
between the first cuneiform and the base of the first metatarsal
greater tarsal synpvial cavity
- cuboidonavicular
- cunonavicular
- intercuneiform
- cuneocuboid
- intermediate tarsometatarsal ( articulation between the cuneiforms and the second, third, and fourth metatarsal bases
- intermetatarsal ( articulation between the bases of second and third metatarsals and the bases of the third and forth metatarsals
strength and resiliency is imparted to the foot in the form of
arches
arches are formed by——and maintained by——
bones, ligaments and muscles
what is the posterior base of the longitudinal arch?
tuberosity of the calcaneous
what is the anterior base of the longitudinal arch?
metatarsal heads and sesamoids
body of longitudinal arch is formed by?
metatrsal and tarsal bones with the talus being the keystone
lateral part of the longitudinal arch
rigid and flatter and composed of calcaneous and cuboid, lateral 2 metatarsal and their phalanges
medial part of the longitudinal arch
more flexible and arched. composed of calcaneous, talus ,navicular, cuneiforms and medial 3 metatarsals and their phalanges.
ligaments of the longitudinal arch of the foot
- spring lig (medial side of the arch)
- short plantar lig ( lateral)
- long plantar lig ( lateral)
- central portion of plantar aponeurosis ( both side)
Muscular support of the longitudinal arch
- Tibialis posterior ( medial side of the arch)
- FHL(medial side of the arch)
- FDL (medial and lateral side of the arch)
Tom, Dick, Harry
transverse arch of the foot
formed by cuboid, cuneiforms and the bases of the metatarsals
The highest point of the transverse arch
second cuneiform and the base of second metatarsal.
ligaments of the transverse arch of the foot?
interosseous intercuneiform
cuneocuboid
tarsometatarsal
intermetatarsal ligaments
intrinsic muscular support of the transverse arch of the foot
ADDUCTOR HALLUCIS
Muscular support of the transverse arch of the foot
Fibularis longus
tibialis posterior
arches in babies is masked by
Fats
pes planus
flat foot
pes cavus
high arched
first ray is formed by
first cuneiform and first metatarsal and their associated joints ( cunonavicular and tarsometatarsal)
As the 1st ray dorsiflex
it inverts
As the 1st ray plantarflexes
it everts
normal first ray function depends on
normal MTP function of the hallux
2nd ray is formed by
2nd cuneiform and 2nd metatarsal
4th ray is formed by
4th metattarsal
2nd, 3rd and 4th rays exhibit what kind of motion?
sagittal plane motion about a transverse axis of motion
5th ray is formed by
5th metatarsal
movemnet at the 5th ray occurs in the direction of
supination and pronation about a triplane axis that courses in the same direction as the subtalar joint axis.