Foot, Ankle, & Lower Leg

Anatomical Structures

Bones

• 28 bones in the foot

• Toes = phalanges (14 bones)

• Sesamoids

• Metatarsals (5 bones)

• Cuboid, Navicular, Cuneiforms (3)

• Talus, Calcaneus

• Bones• Talus• Calcaneus• Cuboid• Cuneiform

Intermediate• Cuneiform Lateral• Cuneiform Medial • NavicularNavicular• Metatarsals• ProximalPhalanges• Middle Phalanges• Distal Phalanges• Sesamoid

JointsDistalInter – Phalangeal Joint

ProximalInter- Phalangeal Joint

Metatarso-Phalangeal Joint

Dot labeling

• DP• MP• PP• Mt• MC• IC

• LC

• Cu• Nav• Tal• Cal• MM• LM

Medial Side

• Metatarsals– 1st-4th : Top of the

foot from the MP joint (last “knuckle”) until you feel the next “bump”

•Distal Phalanges – tips of your toes•Proximal Phalanges – the start of your toes

Medial• NavicularNavicular -- the

prominent structure on the medial side of the foot.

Cuneiform Medial: Between the proximal end of the 1st metatarsal and the navicular tuberosity

Medial MalleolusBone sticking out on the inside

Anterior• Proximal

Phalanges – the start of your toes

• Middle Phalanges – middle part of your toes

• Distal Phalanges – tips of your toes

•Metatarsals•1st-4th : Top of the foot from the MP joint (last

“knuckle”) until you feel the next “bump”

•Cuneiform Intermediate and Lateral – after the “bump” (the proximal end of the metatarsals) of the 2nd and 3rd toes, you will be on the Intermediate (2nd met) and Lateral (3rd met) Cuneiforms

Lateral

• 5th Metatarsal: lateral side of the foot, the proximal end is the most prominent point on the lateral side.

•Cuboid: Palpate the styloid process of the 5th metatarsal, then move promixmally and note a groove

• Lateral Malleolus - Bone sticking out on the lateral side

•Talus - The divot anterior and inferior to lateral malleolus

Calcaneus - Your heelCalcaneus - Your heelPeroneal Tubercle: Peroneal Tubercle: This tubercle is the This tubercle is the most prominent most prominent landmark on the landmark on the calcaneous located calcaneous located inferior and anterior inferior and anterior to the lateral to the lateral malleolusmalleolus

Bones of

Lower Leg

Arches of the Foot

• Longitudinal Arch– Runs from Calcaneus to the Metatarsal Heads– Acts as a shock absorber– Proximal end of the Feet are very important!

• Transverse Arch– Across the metatarsal heads

Longitudinal Arch

Ligaments

• What does a ligament do?

• What is the name for the injury to a ligament?

Lateral Ligaments

• Anterior Talo-fibular Ligament (ATF)

• Calcaneofibular Ligament (CF)

• Posterior Talo-fibular Ligament (PTF)

-Anterior Tibio-Fibular Ligament (Anterior Tib-Fib)-Posterior Tibio-Fibular Ligament(Posterior Tib-Fib)

Deltoid LigamentDeltoid Ligament

- Made up of 4 ligaments in one!

Muscles of lower leg, ankle, & foot

• Gastrocnemius– O: Medial and Lateral

Condyle of the Femur– I: Calcaneus– A: Flex knee, pf ankle

• Soleus (Achilles Tendon)– O: Proximal fibula,

middle tibia– I: Calcaneus– A: pf ankle

Gastrocnemius

Soleus

Muscles of Lower Leg

• Flexor Hallucis Longus– O: Middle posterior fibula– I: Distal Phalenx of great toe– A: Pf and inv of ankle, flex great toe

Muscles of Lower Leg

• Flexor Digitorum Longus– O:Posterior Tibia– I: Distal phalanges of toes 2-5– A: pf and inverson of ankle, flex toes 2-5

Muscles of Lower Leg

• Tibialis Posterior– O: Middle posterior tibia and

fibula– I: Navicular, medial

cuneiform, and metatarsals 2-5

– A: pf and inversion of ankle

Muscles of Lower Leg• Peroneus Longus

– O: lateral tibia and proximal fibula– I: Proximal end of 1st metatarsal

(plantar side)– A: Eversion/ PF

• Peroneus Brevis– O: middle fibula– I: 5th metatarsal – A: Eversion/ PF

Muscles of Lower Leg

• Tibialis Anterior– O: lateral proximal tibia– I: medial cuneiform and

Proximal end of 1st metatarsal– A: Dorsiflexion/ inversion

Muscles of Lower Leg

• Extensor Digitorum Longus– O: Lateral tibia/ proximal fibula– I: phalanges of 2-5– A: DF, Eversion, Extension 2-5

• Extensor Hallucis Longus– O: Middle fibula– I: distal phalanx great toe– A: DF, Inversion, Extension

great toe

Muscles of Lower Leg Structures

Muscles of Lower Leg

What muscles

• Invert the foot

• Evert the foot

• Plantarflex

• Dorsiflex