Leg and Foot Flashcards
What bones make up the proximal group of the tarsal bones?
Talus and Calcaneus
What does the head of talus articulate with?
Navicular
Which part of the talus articulates with the calcaneus?
Anterior and middle facet on the inferior side of the domed articular surface
Which bone is the intermediate tarsal bone?
Navicular
What bones make up the distal group of tarsal bones?
Cuboid, Cuneiforms (Lateral, Intermediate and Medial)
Which bone articulates posteriorly with the cuboid?
Calcaneus
Which bone articulates medially with the cuboid?
Lateral cuneiform
What bones articulate anteriorly with the cuboid?
Bases of lateral 2 metatarsals
What bone articulates posteriorly with the cuneiforms?
Navicular
What bones articulate anteriorly with the cuneiforms?
Bases of medial 3 metatarsals
What are the 3 arches of the foot?
Medial longitudinal, Lateral longitudinal and Transverse arches
What are the functions of the arches of the foot?
Dampen impact for weight bearing,
Dampen superimposed rotational motions,
Adapt to changes in supporting surface,
Protect neurovasculature from compression
What is the function of the interosseous membrane?
Provides an increased surface area for muscle attachment
What are the articulating surfaces that form the distal tibiofibular joint
fibular notch of the distal tibia and the fibula.
What is the classification of the distal tibiofibular joint?
Fibrous syndesmosis joint (Amphiarthrotic)
What ligaments hold the distal tibiofibular joint together?
Anterior tibiofibular ligament, Posterior tibiofibular ligament and interosseous membrane
What is the functional classification of the ankle joint?
Synovial Hinge joint
What joints form the ankle joint?
Distal tibiofibular joint
Talocrural joint
What connective tissue is the articular surface covered with?
Hyaline Cartilage
In which position is the ankle joint more stable?
Dorsiflexion
Why is the ankle joint more stable in that position?
The articular surface of talus is much wider anteriorly than posteriorly and this bones fit tighter when the foot is dorsiflexed.
What movements occur at the subtalar/talocalcaneal joint?
Gliding and rotation
Whaat ligaments stabilise the subtalar/talocalcaneal joint?
Lateral, medial, posterior and interosseous talocalcaneal ligaments
What joints make up the transverse tarsal joint?
Talocalcaneonavicular and calcaneocuboid joints
What is the classification of the TCN joint?
‘Constrained ball and socket’
What ligaments support the TCN joint?
Dorsal Calcaneonavicular ligament
Spring ligament
What movements occur at the Talocalcaneonavicular joint?
Gliding and rotation
What is the functional classification of the calcaneocuboid joint?
Synovial saddle joint
What movements occur at the calcaneocuboid joint?
Gliding and rotation
What is the function of the transverse tarsal joint?
Allows forefoot to maintain contact with ground while rearfoot pronates-supinates in response to terrain or movement of leg
What are the intertarsal joints in the foot?
Calcaneocuboid, Cubonavicular, Cuneonavicular
What is the function of the Calcaneocuboid joint?
Stability to the longitudinal column of the foot
What is the classification of the cubonavicular joint?
Fibrous syndesmosis
What is the classification of the cuneonavicular joint?
Synovial plane joint
What is the functional classification of the tarsometatarsal joint?
Synovial plane joint
What is the functional classification of the metatarsophalangeal joint?
Synovial ellipsoid
What movements can occur in the metatarsophalangeal joint?
Flexion, Extension, abduction, adduction, rotation, circumduction
What is the function of the metatarsal break?
Allows weight to be distributed across the 2nd-5th metatarsal heads
What is the functional classification of the interphalangeal joint
Synovial Hinge joint
What are the lateral ligaments of the ankle?
Anterior Talofibular ligament, Posterior talofibular ligament and Calcaneofibular ligament
What is the overall function of the lateral ligaments?
Resists inversion
What is the function of the Anterior talofibular ligament?
Excessive inversion combined with plantar flexion
What is the function of the Calcaneofibular ligament?
Resists inversion especially during dorsiflexion
What is the function of the Posterior talofibular (lateral) ligament?
Stabilise talus within the mortise
Limits excessive abduction of talus during dorsiflexion
What are the medial ligaments (deltoid ligament) of the ankle?
Tibionavicular part, tibiocalcaneal part, posterior tibiotalar part and anterior tibiotalar part
What does the tibionavicular part connect?
Navicular bone to sustentaculum tali of calcaneus bone
What does the tibiocalcaneal part attach to?
Sustenentaculum tail of calcaneus bone
What does the posterior tibiotalar part attach to?
Medial side and medial tubercle of talus
What does the anterior tibiotalar (medial) part attach to?
Medial surface of talus
What is the capsule of talocalcaneonavicular joint reinforced by?
Interosseous talocalcaneonavicular ligament (posterior), Talonavicular ligament (Superior), Spring ligament (Inferior)
Where does the plantar fascia/aponeurosis insert into?
Plantar plates of MTP joints
What is the function of the plantar aponeurosis?
Holds foot rigid for push off and provides major support for foot arches alongside spring ligament, short and long plantar ligament
What is the function of the deltoid ligament?
Resists eversion across the talocrural, subtler and talonavicular joints
What movements at the ankle joint contribute to pronation?
Calcaneal eversion
Talar Plantarflexion and Adduction
Tibial internal rotation
Describe the active subsystem of the Plantar intrinsic foot muscles
control the rate & extent of deformation of the arch
local stabilisers provide a stable base for the large extrinsic muscles,
with greater PCSA & moment arms, to produce gross motion or to resist large external moments during late stance & push-off phases
What structures provide passive support at the foot?
Plantar fascia
Plantar calcaneonavicular ligament (spring ligament)
Plantar calcaneocuboid (short plantar) ligament
Long plantar ligament
What structures provide active support of the foot
extrinsic and plantar intrinsic foot muscles
What leg muscles support the medial longitudinal arch and the 1st ray?
Tibialis Anterior
Tibialis Posterior
Fibularis Longus
Which muscles are Dorsiflexors of the foot?
Tibialis Anterior
Extensor Digitoum Longus
Extensor Hallucis Longus
Fibularis Tertius
What are the Plantarflexors of the foo
Gastrocnemius soleus FHL tibialis posterior FDL FL FB
What are the invertors of the foot?
Tibialis Posterior Tibialis Anterior Gastrocnemius Soleus FDL FHL EHL
What are the evertors of the foot?
FL
FB
FT
EDL
What muscles flex the toes?
FDL
FHL
What muscles extend the toes?
EDL
EHL
Compare and contrast the bone & joint structure and function of the ankle and the wrist.
Ankle is a synovial hinge joint; wrist is a synovial ellipsoid joint
In the ankle, 1 tarsal bone (talus) articulates with both long bones of the leg (tibia + fibula); in the wrist, 2 carpal bones (scaphoid + lunate) articulate with one long bone of the arm (distal radius)
Compare and contrast the bone and joint structure and function of the foot and hand.
Metatarsals are larger than Metacarpals as they need to be able to support the body’s weight
There are 8 carpal bones in the hand but 7 tarsal bones in the foot.
The intertarsal joints compose of various articulations with different joint classifications:
Calcaneocuboid- Synovial saddle
Cubonavicular- Fibrous syndesmosis
Cuneonavicular- Synovial plane
whereas the intercarpal joints are synovial plane joints
Phalanges in hands are longer than phalanges in feet = length of fingers assists in dexterity and fine control for interaction with the environment, feet have weight-bearing role
1st CMC is a synovial saddle joint + pollex is out of plane to the other digits = allowing opposition of thumb against other digits; in feet, 1st TMT is a synovial gliding joint + in the same plane as other digits = less mobile, weight-bearing role
What are the joints in the foot?
Distal tibiofibular Talocrural Joint Subtalar joint TCN joint Calcaneocuboid DIT TMT MTP IP
What is the classification of the TCN joint?
‘Constrained ball and socket’
What ligaments support the TCN joint?
Dorsal Calcaneonavicular ligament
Spring ligament
Describe the Dynamic Foot control
During gait the foot moves between the supinated & pronated positions and the arches of the foot must be controlled. Dynamic foot control relies on the interaction between multiple active and passive structures.
Passive support is obtained from the:
o Plantar fascia
o Plantar calcaneonavicular ligament (spring ligament)
o Plantar calcaneocuboid (short plantar) ligament
o Long plantar ligament
Active support is obtained from the extrinsic and plantar intrinsic foot muscles. If the support obtained from the passive structures is insufficient, excessive activity may be required from the muscles which may result in injury. Alternatively, if weakness or fatigue occurs in the muscles, increased load will be placed on the passive system.
