Download The Ankle and Foot Joints

The Ankle and Foot Joints
Function of the foot
• Provide a stable platform
• Generate propulsion
• Absorb shock
Bones
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Ankle + foot = 28 bones
foot = 26 bones
Leg: tibia, fibula
Foot:
– Tarsals (7): talus, calcaneus, navicular, cuboid, and cuneiforms (3)
– Metatarsals (5)
– Phalanges (14)
Joints
• Tibiofibular:
– articulation between tibia and fibula
• amphiarthrodial joint
• Ankle joint
– Talocrural
• articulation between talus and tibia; talus and fibula
• classified as a ginglymus
Joints
• Subtalar joint
– articulation between talus and calcaneus
– classified as arthrodial (gliding) joint
• Transverse tarsal joint
– articulation between talus, navicular, calcaneus
and cuboid bones
– classified as arthrodial joint
Joints
• Tarsometatarsal
– tarsal bones and metatarsal
– classified as arthrodial (gliding) joints
• Metatarsophalangeal
– metatarsals and phalanges
– classified as condyloid
• Interphalangeal joints (proximal and distal)
– phalangeal bones
– ginglymus
Arches of the foot
• Medial longitudinal arch
– calcaneus, talus, navicular, cuneiforms (3), and
medial metatarsals (3).
• Lateral longitudinal arch
– calcanueus, cuboid, lateral metatarsals (4 & 5)
• Transverse arch
– across metatarsals
Classifying Arch Type
• Pes Planus: Flat foot
• Pes Cavus: High Arch
• Normal
Movements
• Ankle joint
– dorsiflexion: “raising the toes”
– plantarflexion: “point the toes”
• Subtalar & Transverse tarsal joints
– Calcaneal inversion and eversion
• Interphalangeal joints
– flexion
– extension
Movements
• Supination
• inversion
• plantar flexion
• adduction
• Pronation
• eversion
• dorsiflexion
• abduction
Summary
• Bones of the foot:
– tarsals, metatarsals, phalanges
• Joints of the foot and ankle
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talocrural (ankle)
subtalar
transverse tarsal
metatarsalphalangeal
interphalangeal
• Movements
– dorsiflexion/plantarflexion (ankle joint)
– inversion/eversion (subtalar & transverse tarsal)
– flexion and extension of toes about the interphalangeal joints
Muscles
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Plantar flexors
Dorsi flexors
Evertors
Invertors
Plantar Flexors
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Gastrocnemius
Flexor digitorum longus
Peroneus longus
Plantaris
Soleus
Tibialis Posterior
Dorsiflexors
• Tibialis anterior
• Peroneus tertius
• Extensor digitorum longus
Invertors
• Tibialis anterior
• Tibialis posterior
• Flexor hallucis longus
Evertors
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Peroneus longus
Peroneus brevis
Peroneus tertius
Extensor digitorum longus
Extensor digitorum longus (p44)
• Origin
– lateral condyle of tibia
– upper 3/4 of anterior aspect of fibula
• Insertion
– superior aspect of foot, middle and distal
phalanges of four lesser toes
• Action
– Extension of four lesser toes
– dorsal flexion
– eversion
Extensor hallucis longus (p45)
• Origin
– fibula, middle aspect of anterior fibula
• Insertion
– superior aspect of foot, base of distal phalanx of
great toe
• Action
– dorsiflexion
– extension of great toe
Peroneus tertius (p46)
• Origin
– fibula, anterior-lateral surface of lower 1/3 of
fibula
• Insertion
– superior aspect of foot, base of fifth metatarsal
• Action
– Eversion
– Dorsal flexion
Tibialis anterior (p47)
• Origin
– Lateral condyle of tibia
– Upper two-thirds of anterior-lateral aspect of tibia
• Insertion
– plantar surface of 1st (medial) cuneiform and 1st
metatarsal
• Action
– Dorsal flexion
– inversion
Peroneus brevis (p48)
• Origin
– fibula, lower two-thirds, lateral aspect
• Insertion
– 5th metatarsal tuberosity
• Action
– eversion
Peroneus longus (p49)
• Origin
– lateral surface of tibia
– fibula, upper two-thirds of lateral aspect of fibula
• Insertion
– inferior aspect of foot, 1st cuneiform and 1st
metatarsal bones
• Action
– Eversion
– Plantar flexion
Flexor digitorum longus (p50)
• Origin
– tibia, middle third, posterior aspect
• Insertion
– plantar surface of foot, distal phalanx of each of
the four lesser toes (no big toe)
• Action
– ‘toe’ flexion
– plantar flexion
Flexor hallucis longus (p51)
• Origin
– fibula, lower two-thirds, posterior aspect
• Insertion
– plantar aspect of foot, base of distal phalanx of
big toe (‘hallucis’)
• Action
– ‘big toe flexion’
– inversion
Gastrocnemius (p52)
• Origin
– medial and lateral epicondyle of the femur
• Insertion
– posterior surface of calcaneus
• Action
– plantar flexion
– knee flexion
Soleus (p54)
• Origin
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upper 1/3 posterior shaft of fibula
posterior surface of head of fibula
popliteal line
middle 1/3 of medial border of tibia
• Insertion
– Posterior surface of the calcaneus
• Action
– Plantar flexion
Note
• Gastrocnemius and Soleus muscles have a
common tendon/insertion (calcaneal tendon
or Achilles tendon)
• Some texts refer to the combination of the
gastrocnemius and soleus as the triceps
surae (three headed muscle).
Plantaris (p53)
• Origin
– posterior surface of lateral epicondyle of femur
• Insertion
– posterior surface of calcaneus
• Action
– plantar flexion
Tibialis Posterior (p55)
• Origin
– middle 1/3 of posterior-lateral surface of tibia
– middle 1/3 of posterior-medial surface of fibula
• Insertion
– plantar surface of foot, lower inner surfaces of
navicular, cuneiforms, and 2nd & 3rd metatarsals
• Action
– plantar flexion
– inversion
Summary of muscles
• Plantar flexors
– gast., sol., flx digitorum long., per longus, tib post,
plantaris
• Dorsi flexors
– tib ant, per tertius, ext dig long
• Evertors
– per longus, brevis, tertius, ext dig longus
• Invertors
– tib ant & post, flx hallucis long