S5L1 - Functional Anatomy Of The Foot And Ankle Flashcards
What 3 groups can the bones of the foot be divided into?
- Tarsal bones
- Metatarsals
- Phalanges
What are the tarsal bones?
7 irregularly shaped bones, situated proximally in the foot
What are the metatarsals?
5 bones that connect the phalanges to the tarsal bones
What are the phalanges?
The bones of the toes. Each toe has 3 phalanges (proximal, middle and distal), except the big toe which only has 2 (proximal and distal)
What is the plantar and dorsal view of the foot?
Plantar view = from the sole
Dorsal = from above
What 3 regions can the foot bones be divided into?
- Hindfoot - talus and calcaneus
- Mid foot - navicular, cuboid and cuneiforms
- Forefoot - metatarsals and phalanges
Describe the talus bone
Most superior of the tarsal bones.
Function ; transmits weight of the body to the foot, from the tibia to the calcaneus bone
What articulations occur with the talus bone?
3 articulations:
- Superiorly - ankle joint, between the talus, tibia and fibula
- Inferiorly - subtalar joint, between the talus and calcaneus
- Anteriorly - talonavicular joint, between the talus and the navicular.
What is the trochlear of the talus
A groove that articulates with the tibia and fibula. The trochlear is wider anteriorly than posteriorly to give additional stability to the dorsiflexed ankle.
What muscles are attached to the talus?
None
Why is the blood supply to the talus described as retrograde?
The arteries enter the talus at its distal end.
Why is there a high risk of avascular necrosis if the talus is fractured?
- No muscle attachments (which would improve the vascularity)
- Retrograde blood supply.
What articulations does the calcaneus bone have?
- Superiorly ; subtalar (talocalcaneal) joint, between the calcaneus and the talus.
- Anteriorly : calcaneocuboid joint. Between the calcaneus and the cuboid.
What is the function of the calcaneus?
It protrudes posteriorly from the foot, taking the entire weight of the body when the heel contacts the ground when walking.
Where is the calcaneal tuberosity? What is its function?
On the posterior aspect of the calcaneus bone. Attachment site for the Achilles’ tendon.
What are the proximal row of tarsal bones?
The calcaneus and the talus.
What are the intermediate row of tarsal bones?
The navicular.
What is the navicular?
An intermediate tarsal bone, positioned medially. The navicular articulates with the talus posteriorly, all 3 cuneiform bones anteriorly, and the Cupid bone laterally. On the plantar surface of the navicular there is a tuberosity for the insertion for part of the tibialis posterior tendon.
What are the distal row of the tarsal bones?
4 different bones. the cuboid, the lateral, the intermediate and the medial cuneiforms.
What is the cuboid bone?
The furthest lateral, cuboidal distal row tarsal bone. Articulates proximally with the calcaneus and distally with the fourth and fifth metatarsals. The inferior surface of the cuboid is marked by a groove for the tendon of the peroneus longus
Describe the cuneiform bones
3 different bones, the medial, intermediate and lateral. Wedge shaped. Articulate proximally with the navicular bone. Articulate distally with the first, second and third metatarsals.
Tibialis anterior, tibialis posterior and peroneus all insert onto the medial cuneiform.
Describe the structure of the metatarsals.
Between the tarsal bones and the phalanges. Numbered 1 to 5 from medial to lateral. Convex dorsally and consists of a base, shaft, neck and head.
What are the tarsometatarsals?
The joints between the metatarsal bases and the tarsal bones.
Where are the intermetatarsal joint?
Joints between adjacent metatarsal bones
Where are the metatarsophalangeal joints?
The joints between the metatarsal head and the proximal phalanx
Describe the structure of the ankle joint
A synovial joint between the bones of the leg (tibia and fibula) the foot . Functionally, it is a hinge joint, permitting dorsiflexion and plantarflexion of the foot.
What is the mortise?
A bracket-shaped socket deformed from the tibiofibular ligaments at the distal tibiofibular joint.
When is the ankle joint most/ least stable?
Most stable during dorsiflexion as the anterior part (wider part) of the talus trochlear is held in the ankle mortise.
Least stable is in plantarflexion when the posterior part of the trochlear ( the narrow part) is held in the mortise.
What muscles are used to produce plantarflexion of the foot
Muscles in the posterior compartment of the leg: Gastrocnemius Soleus Plantaris Tibialis posterior
What muscles are used to produce dorsiflexion of the foot?
Muscles in the anterior compartment of the leg: Tibialis anterior Extensor hallucis longus Extensor digitorum longus Peroneus Tertius
How is the range of dorsiflexion limited?
By passive resistance form the muscle of the posterior compartment
What are the 3 parts of the lateral ligament of the ankle joint?
- The anterior talofibular ligament - between the lateral malleolus and the neck of the talus
- The posterior talofibular ligament - between the malleolus fossa/mortise and the lateral tubercle of the talus
- The calcaneofibular ligament between the tip of the lateral malleolus and the lateral surface of the calcaneous
What is the function of the lateral ligaments of the ankle?
To prevent inversion of the foot.
What is the function of the medial ligament?
To resist excessive eversion of the foot
Where does inversion and eversion of the foot occur?
Not at the ankle joint
At the subtalar, calcaneocuboid and the talocalcaneonavicular joints of the mid foot.
What is the functional significance of inversion and eversion of the foot?
For walking on uneven surfaces
Describe the subtalar joint
The articulation between the talus and the calcaneus.
Plane type of synovial joint.
The major joint for inversion and eversion of the foot as it is on an oblique axis.
No role in dorsiflexion or plantarflexion
What muscles are used to produce eversion of the foot?
Muscles of the lateral compartment of the leg (Peroneus longus and peroneus brevis)
And muscles from the anterior compartment of the leg ( peroneus tertius )
What muscles are used to produce inversion of the foot?
Anterior compartment = tibialis anterior
Deep posterior compartment = tibialis posterior
What are the main weight bearing bones during standing?
The calcaneus and the heads of the metatarsals
How are the tarsal and metatarsal bones traditionally described as being arranged? (Arches)
Medial longitudinal, lateral longitudinal and anterior transverse arches.
How are the 3 arches of the foot maintained?
- By the shape of the interlocking bones
- By the ligaments of the foot
- By the intrinsic muscles of the foot
- Pull of the long tendons of extrinsic muscles.
What is the transverse arch?
The anterior arch of the foot. A half arch that forms a complete arch when the feet are together
What is the medial longitudinal arch?
Formed by the calcaneus, talus, navicular, the three cuneiforms and the medial three metatarsals.
What maintains the integrity of the medial longitudinal arch?
The plantar aponeurosis and the spring ligament (plantar calcaneonavicular ligament), together with the tibialis anterior and the peroneus longus tendons.
Muscles supporting the medial longitudinal arch are the tibialis anterior, tibialis posterior, peroneus longus and flexor hallucis longus.
What forms the lateral longitudinal arch?
The calcaneus, cuboid and lateral two metatarsals.
What supports the lateral longitudinal arch?
Contraction of the peroneus brevis muscle
What four muscles are in the anterior compartment of the leg?
Tibialis anterior
Extensor digitorium longus
Extensor hallicus longus
Peroneus (fibularis) tertius