Sem 2 - N - Joints of the foot - Arches, weight distrubtion, Subtalar/midtarsal/tarsometatarsal joints/ligaments, inversion/eversion Flashcards
What were the bones of the hindfoot, midfoot and forefoot?
- Hindfoot - talus and calcaenus
- Midfoot - navicular, 3 cuneiforms and cuboid
- Forefoot - metatarsals and phalanges
- What does the talus articulate with?
- What does the calcaenus articulate with?
- What does the navicular articulate with?
- What does the cuboid bone articulate with?
- * Talus articulates with the distal end of tibia and innner surface of lateral and medial malleolus (collectively known as malleolar mortise) as well as the calcaneus and navicular bone
- * The calcaneus articulates with the talus and cuboid bone
- * The navicular articulates with the talus. all 3 cuneiforms and cuboid
- * The cuboid bone articulates with the calcaenous, lateral cuneiform, 4th/5th metatarsals and navicular
What is the groove on the inferior aspect of the cuboid bone for?
The groove on the inferior aspect of the cuboid bone is present due to the peroneus longus tendon running under the foot to attach to the base of the 1st metatarsal and medial cuneiform
The foot has longitudinal and transverse arches What is the function of the arches of the foot?
The shape of the arches of the foot allowes the foot to act as a spring board.
The arches are able to deform slightly allowing for the distribution of weight and can help acts as shock absorbers during locomotion
What forms the transverse arch of the foot?
The transverse arch of the foot is formed by the 3 cuneiform bones (medial, intermediate and lateral) and the cuboid bone as well as the bases of the 5 metatarsals
Which structures help to strengthen the transverse arch of the foot?
- The tendon of the tibialis posterior
- The tendon of the peroneus longus
- The transverse head of the adductor hallucis (running along the plantar ligament of the metatarsalphalyngeal joints)
- The deep transverse metatarsal ligament
The transverse arch of the foot can be divided into the tarsal arch, metatarsal arch and anterior arch
Which structures are specific to supporting each of these arches?
- Tarsal arch - supported by the tendons of tibialis posterior and the peroneus longus
- Metatarsal arch - supported by the transverse head of the adductor hallucis (runs on the plantar ligament of the MTP joints)
- Anterior arch - supported by the deep transverse mtatarsal ligament
There is both a medial and lateral longitduinal arch
Which bones form the lateral longitudinal arch?
The lateral longitudinal arch is formed by the calcaneus, cuboid and 4th/5th metatarsal bones
What forms the medial longitudinal arch?
Medial longitudinal arch is formed by the calcaenus, talus, navicular, 3 cuneiforms (medial, intermediate and lateral) and metatarsals 1-3
Which arch is more important between medial and lateral logntiduinal arches? Which will flatten when standing?
The medial longitudinal arch is both more important and high than the lateral longituinal arch
The lateral longitudinal arch is flatter and will rest on the ground when standing
The longitduinal arches of the foot have a dynamic and a passive support
What forms the dynamic support of the longitudinal arches?
The dynamic support of the longitduinal arches is provided by All the intrinsic muscles of the foot
- * Flexor digitorum longus
- * Flexor hallucis longus
- * (Tibialis anterior attaches to medial and inferior aspect of mecdial cuneiform and 1st metatarsal and therefore can help pull the arch when it contracts)
What provides passive support to the longitudinal arches of the foot?
- Plantar calcaneonavicular ligament (spring ligament)
- Short plantar ligament (plantar calcaneocuboid ligament)
- Long plantar ligament 4. Plantar aponeurosis
Passive support of the longitudinal arches provided by
- * Spring ligament
- * Short plantar ligament
- * Long plantar ligament
- * Plantar aponeurosis
Describe the attachment of these ligaments Which ligament also supports the head of the talus due to it slinging underneath the head?
- (plantar calcaneonavicular) Spring ligament - from calcaneus to navicular (helps to support head of talus as well)
- (plantar calcaneocuboid) Short plantar ligament - from calcaneus to cuboid
- Long plantar ligament - fibres attach from calcaenus to cuboid and some fibres to metatarsals
- Plantar aponeurosis
State the strucutres providing dynamic and passive support to the transverse and longitudinal arches of the foot
- Transverse arch of the foot
- * Tendons of tibialis posterior and peroneus longus
- * Transverse head of adductor hallucis
- * Deep transverse metatarsal ligament
- Longitudinal arches of foot
- Dynamic support - Intrinsic foot muscles, flexor digitorum and hallucis longus (tibialis anterior)
- Passive support - Plantar calcaneonavicular (spring) ligament, short plantar (plantar calcaneocuboid) ligament, long plantar ligament and plantar aponeurosis
A canal is formed for the passage of the peroneus longus muscle in the sole of the foot due to the ligamentous arrangement What ligament helps to form this peroneal canal?
The long plantar ligament converts the groove on the under surface of the cuboid into a canal for the passage of the peroneus longus Long plantar ligament attaches between calcaenus, cuboid and more superficial fibres to the metatarsals
How is the weight distributed throughout the bones of the foot?
Weight is distributed equally throughout the foot between the heads of the metatarsals and the calcaenus Bony fibres run anteriorly to metatarsal heads and inferiorly to calcaenus
Which metatarsal heads take the most weight?
The sesamoid bones at the 1st metatarsal head and 2nd metatarsal head form a large pressure area
- The joints of the foot can be very complicated
- * Subtalar
- * Talonavicular+ talocalcaneal = talocacaneonavicular
- * Calcaneocuboid
- * Cuneonavicular
- * Tarsometatarsal
- * Intermetatarsal
- * Metatarsophalangeal
- * Interphalangeal First we discuss subtalar.
What type of joint and what are the two types?
Subtalar joint is a synovial plane joint
- We have the anatomical subtalar joint which anatomists use
- Clinicians refer to the subtalar joint as including the talocalacaneal joint is both joints move together
Describe the articulating surface in the anatomical subtalar joint and state the type of joint
Anatomical subtalar joint - synovial plane joint
Articulation between the slightly concave posterior articular surface of the talus for the calcaneus And the slightly convex posterior articulating facet of the calcaneus for the talus
As the subtalar joint is a synovial joint it will indeed have a joint capsule and this weak capsule is supports by ligaments
What are the names of the ligaments supporting the anatomical subtalar joint? Which ligament is the strongest supporter?
Medial, lateral, posterior and interosseous talocacaneal ligaments support the anatomical subtalar joint
The interosseous talocalcaneal ligament is the strongest ligament of the anatomical subtalar joint
What joints form the transverse midtarsal joint?
The transverse midtarsal joint is formed by the talonavicular part of the talocalcaneonavicular joint and the calcaneocuboidal joint
(Talonavicualar + talocalcaneal = talocalcaneonavicular)
The transverse midtarsal joint is formed by the talonavicular part of the talocacaneonavicular joint and calcaneocuboid joint
What type of joint is the talonavicular, talocalcaneal and calcaneocuboid joint?
Talocalcaneonavicular joint
- Talocalcaneal joint - synovial plane joint
- Talonavicular joint - synovial ball and socket joint
- Calcaneocuboid joint - synovial plane joint
What are the articulating surfaces in the talocalcaneal joint and the talonavicular joint?
Which part of the talocalcaneovaciular joint does the talonavicular joint form?
Talocalcaneal - synovial plane - articulation between the head of the talus articulating with the sustentaculum tali of the calcaneus
Talonavicular - ant. part of talocalcaneonavicular joint- synovial ball and socket - convex head of talus articulates with concave navicular bone
There are 5 different ligaments associated with the transverse midtarsal joint What are these ligaments?
- Bifurcate ligament
- Dorsal calcaneocuboid ligament
- Long plantar ligament
- Short plantar (plantar calcaneocuboid) ligament
- Spring (plantar calcaneonavicular) ligament
- Bifurcate ligament
- Dorsal calcaneocuboid ligament
- Long plantar ligament
- Short plantar (plantar calcaneocuboid) ligament
- Spring ligament (plantar calcaneonavicular ligament)
What are the attachments of each of these ligaments?
- Bifurcate - calcaneus to navicular and cuboid
- Dorsal calcaneocuboid - calcaneus to cuboid bone
- Long plantar - calcaneus to cuboid and metatarsals
- Short plantar (plantar calcaneocuboid) - calcaneus to cuboid
- Spring (plantar calcaneonavicular)- calcaneus to navicular
Where do the long plantar, short plantar and spring ligaments lie in relation to one another?
Spring ligament is the most medial followed by short plantar ligament followed by long plantar ligament
We have discussed the subtalar, talocalcaneonavicular (talocalcaneal and talonavicular) and calcaneocuboidal joints
Lets discuss the movements occurring at these joint
- What movements occur at the subtalar and talocalcaneal part of the talocalcaneonavicular joint?
- What movements occur at the transverse midtarsal joint?
At the subtalar and talocalcaneal joint - inversion/eversion of the foot occurs
At the transverse midtarsal joint (talonavicular + calcaneocuboid joint) - augmentation of inversion/eversion of the foot occurs - movement of this joints needs to occur before inversion/eversion of the foot can occur
Describe how inversion/eversion of the foot will occur - need to known about forefoot, midfoot, hindfoot and movements around which joint
CLUE - must be an initial movement at midtarsal joint as this allows for inversion/eversion to occur at the clinical subtalar joint (anatomical subtalar + talocalcaneal)
Muscles attach on the forefoot and midfoot
- For the beginning of inversion/eversion, the forefoot and midfoot must rotate on the hindfoot at transverse midtarsal joint
Ligaments tighten & force is transferred to calcaneus
- The forefoot, midfoot and calcaenous then must rotate under the talus at the (clincial) subtalar joint for inversion/eversion of the foot to occur
What type of joint is the cuneonavicular joint?
This is a synovial plane joint
What are the tarsometatarsal joints also known as? What are the articulating bones? What type of joint is it?
Tarsometatarsal joints are also kown as LisFranc’s joints (separates midfoot and forefoot)
- The anterior tarsal bones (cuboid and cuneiforms) articulate with the bases of the metatarsals
- ALL SYNOVIAL PLANE JOINTS
Which anterior tarsal bones articulate to which metatarsal bases
- Cuboid bone articulates with the base of metatarsal 4 and 5
- Medial cuneiform articulates with the base of the 1st metatarsal
- Intermediate cuneiform articulates with the base of the 2nd metatarsal
- Lateral cuneiform articulates with the base of the 3rd metatarsal
What are the ligaments involved in the tarsometarsal joints?
Dorsal, plantar and interosseous tarsometatarsal ligaments help to bind the joints
What type of joints are the intermetarsal joints?
The intermetatarsal joints are all synovial plane joints
What type of joints are the metatarsophalangeal joints and what movement is permitted here? What type of joints are the interphalyngeal joints and what movement is permitted here?
All MTP joints are synovial condyloid joints allowing for flexion, extension adduction and abduction
The interphealnygeal joints are synovial hinge joints and allow for flexion/ extension
- * Subtalar
- * Talonavicular+ talocalcaneal = talocacaneonavicular
- * Calcaneocuboid
- * Cuneonavicular
- * Tarsometatarsal
- * Intermetatarsal
- * Metatarsophalangeal
- * Interphalangeal
State what type of joint each of these joints are
- * Subtalar joint - synovial plane joint
- * Talonavicular joint - synovial ball and socket joint
- * Talocalcaneal joint - synovial plane joint
- * Calcaneocuboid joint - synovial plane joint
- * Cuneonavicular joint - synovial plane joint
- * Tarsometatarsal joint - synovial plane joint
- * Intermetatarsal joint - synovial plane joint
- * Metatarsophalangeal joint -synovial condyloid joint
- * Interphalnygeal joint - synovial hinge joint
