ankle and foot anatomy

• provides a stability and mobility role

  Stability:

  • Stable base of support, helps with balance during motion
  • Acts as a rigid level during gait
  • Rigid structure for weight bearing

  Mobility:

  • Dampens rotation
  • Absorbs shock
  • Conforms to different terrain
  • Problems with foot can cause problems elsewhere
• the foot and ankle regions

  • 28 bones and 33 joints
  • Proximal and distal tibiofibular joints
  • Talocrural joint
  • Subtalar joint
  • Midtarsal (talocalcaneonavicular & calcaneocuboid joints)
  • 5 x TMT (tarsometatarsal joint)
  • 5 x MTP (metatarsophalangeal joint)
  • 9 x IP (interphalangeal joint)
• What type of joint is the distal (inferior) tibiofibular joint?

  It is a fibrous joint or a syndesmosis joint.
• What is the characteristic of fibrous joints?

  They are strong joints that do not permit movement.
• What holds the distal tibiofibular joint together?

  It is held together by fibrous (collagenous) connective tissue.
• What type of joint is the talocrural joint?

  It is a synovial joint.
• Which bones form the talocrural joint?

  The tibia, fibula, and talus form the talocrural joint.
• What type of movement does the talocrural joint permit?

  It permits dorsiflexion and plantarflexion.
• What is the degree of dorsiflexion allowed by the talocrural joint?

  30 degrees.
• What is the degree of plantarflexion allowed by the talocrural joint?

  50 degrees.
• What type of joint is the subtalar joint classed as structurally?

  It is classed as a synovial joint.
• What is the functional classification of the subtalar joint?

  It is functionally a plane synovial joint.
• Which two tarsal bones articulate at the subtalar joint?

  The talus and calcaneus articulate at the subtalar joint.
• What movements does the subtalar joint allow for?

  It allows for inversion and eversion of the foot.
• What is the degree of inversion allowed by the subtalar joint?

  30 degrees.
• What is the degree of eversion allowed by the subtalar joint?

  18 degrees.
• transverse (MID) tarsal joint

  • Also known as Chopart’s joint.
  • Combined Talocalcaneonavicular and Calcaneocuboid Joints.
  • Extends from side to side across the foot with talus and calcaneus behind and the navicular and cuboid in front.
  • Movements which occur at the subtalar and mid tarsal joint produce inversion and eversion of the foot
• What are the Tarsometatarsal (TMT) joints between?

  The four anterior tarsal bones and the bases of all 5 metatarsals
• What are the ligaments associated with the TMT joints?

  • Dorsal TMT ligaments
  • Plantar TMT ligaments
  • Interosseous TMT ligaments
• What type of joints are the Interphalangeal joints?

  Hinge joints
• What type of joints are the TMT joints classified as?

  Plane synovial joints
• What are the Metatarsophalangeal (MTP) joints?

  Synovial condyloid joints between the rounded head of the metatarsal and the cupped base of the proximal phalanx
• What ligaments are associated with the MTP joints?

  • Collateral ligaments
  • Plantar ligament
  • Deep transverse metatarsal ligament
• How do the Interphalangeal joints function?

  The head of the more proximal phalanx articulates with the base of the next distal phalanx
• How do sesamoids assist during walking and running?

  They provide leverage for push off
• What ligaments are associated with the Interphalangeal joints?

  • Collateral ligaments
  • Plantar ligaments
• What is the function of sesamoids in the foot?

  They act like pulleys, providing a smooth surface for tendons to slide over
• What are the three arches of the foot?

  • Medial longitudinal arch
  • Lateral longitudinal arch
  • Transverse arch
• What bones compose the Medial longitudinal arch?

  • Calcaneus
  • Talus
  • Navicular
  • All 3 cuneiforms
  • Medial first 3 metatarsals
• What bones compose the Transverse arch?

  • Cuboid
  • 3 cuneiforms
  • Bases of the 5 metatarsals
• What is a sesamoid bone?

  A bone embedded within a tendon or a muscle
• What bones compose the Lateral longitudinal arch?

  • Calcaneus
  • Cuboid
  • Lateral 2 metatarsals
• ankle ligaments

  Lateral ligament - 3 separate parts 

  1. Anterior talofibular ligament (ATFL)
  2. Posterior talofibular ligament (PTFL)
  3. Calcaneofibular ligament (CFL)

  • Not as strong as the medial collateral ligament (deltoid)
  • Most ankle sprains involve the lateral ligaments

  Deltoid ligament (medial aspect)

  • Roughly triangular in shape
  • Several bands of fibers fused together - deeper and superficial parts 
• muscles of the lower leg and ankle

  • Anterior
  • Tibialis anterior
  • EHL
  • EDL
  • Paroneous tertius
  • Lateral
  • Peroneus longus 
  • Peroneus brevis
  • Posterior
  • Deep:
  • FHL 
  • FDL
  • Tibialis posterior
  • Superficial:
  • Gastrocnemius 
  • Soleus
  • Plantaris
• muscles of the foot

  • Plantar view
  • Superficial:
  • Plantar aponeurosis
  • Abductor hallucis
  • Flexor digitorum brevis
  • Abductor digiti minimi
  • Intermediate:
  • Quadratus plantae
  • Lumbricals
  • Deep:
  • Flexor hallucis brevis
  • Flexor digiti minimi brevis

  Achilles tendon

  • Attaches the calf muscles to the calcaneus.
  • Thickest and strongest tendon in the body.
  • As the fibers pass downwards they spiral through 90 degrees

  Retinaculum

  • A retinaculum is a band of thickened deep fascia around tendons that hold them in place (prevents bowstringing).
  • Not part of any muscle
• the plantar fascia

  • The thick connective tissue (aponeurosis) which supports the arch on the plantar side of the foot.
  • Runs between the medial calcaneal tubercle and the proximal phalanges of the toes.
  • There are 3 bands (medial, central and lateral).
  • Important in the maintenance of the longitudinal arches of the foot
• blood and nerve supply

  • Talocrural Joint
  • Blood supply – anterior and posterior tibial and peroneal arteries
  • Nerve supply – deep peroneal, saphenous, sural and tibial nerves
  • Subtalar Joint
  • Blood supply – posterior tibial and peroneal arteries
  • Nerve supply – posterior tibial, medial plantar and sural nerves
  • Midtarsal Joint
  • Blood supply – posterior tibial and peroneal arteries
  • Nerve supply – posterior tibial, medial and lateral plantar nerves
• what is proprioception?

  • Proprioception is the sense of self-movement and body position
  • Proprioception allows humans to control our limbs without having to look directly at them
  • The proprioception system is made up of receptor nerves that are positioned in ligaments, tendons, muscles and joints
  • If there is an injury, there will be a decrease in the proprioception ability
• What is clubfoot also known as?

  Talipes equinovarus
• What is positional clubfoot caused by?

  It is caused when the foot has been held in an unusual position in utero