Foot Anatomy

Bone Anatomy

• Tarsal Bones– Calcaneus– Cuboid– Navicular– 3 Cuneiforms– 5 metatarsals– 14 phalanges

(proximal, middle, distal)

• Exception

Mnemonic for Learning Tarsal Bones:

Medialcuneiform (1)

Intermediatecuneiform (2)

Lateralcuneiform (3)

NavicularA boatIt sails on the Cs

Talus

Calcaneus Cuboid

Tiger Cubs Need M I L C

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Division of the Foot

• Rearfoot• Midfoot• Forefoot

Hindfoot (Rearfoot)

• Subtalor Joint– Talus and calcaneus

articulation• Calcaneus• Inferior Talus

Midfoot

• Composed of – Navicular – 3 cuneiforms– cuboid

Forefoot

• 5 MT’s – Proximally 1-3

articulate with cuneiforms

– Proximally 4-5 articulate with cuboid

– Bases articulate with:• Phalanges

Articulations and Ligamentous Support

• Subtalor Joint– Three facets– Motions of the

Subtalor Joint• Inversion• Eversion

Hindfoot Articulations and Ligamentous Support

• Subtalor Joint– Ligamentous SupportMedial

Deltoid LigamentLateral

ATF CF PTF• Intra-articular Ligaments

– Interosseous Talocalcaneal

– Medial Talocalcaneal– Lateral Talocalcaneal

Midfoot Articulations and Ligamentous Support

• Six Joints– Talocalcaneonavicular – Calcaneocuboid– Cuboideonavicular– Intercuneiform– Cuneocuboid– Cuneonavicular

Midfoot Articulations and Ligamentous Support

• Ligamentous Support– Talocalcaneonavicular Joint

• Plantar Calcaneonavicular (Spring Ligament)

• Talonavicular• Bifurcate

– Calcaneonavicular– Calcaneocuboid

– Calcaneocuboid Joint• Bifurcate Ligament

– Calcaneocuboid portion• Plantar Calcaneocuboid• Long Plantar Ligament

Midfoot Articulations and Ligamentous Support

• Ligamentous Support– Talocalcaneonacicular Joint

• Plantar Calcaneonavicular (Spring Ligament)

• Talonavicular• Bifurcate

– Calcaneonavicular– Calcaneocuboid

– Calcaneocuboid Joint• Bifurcate Ligament

– Calcaneocuboid portion• Plantar Calcaneocuboid• Long Plantar Ligament

Midfoot Articulations and Ligamentous Support

• Ligamentous Support– Intercuneiform Joints

• Dorsal and Plantar Intercuneifrom Ligaments

– Cuneocuboid• Plantar and Dorsal

Cuneocuboid Ligaments

– Cuneonavicular Joints• Plantar and Dorsal

Cuneonavicular Ligaments

Midfoot Articulations and Ligamentous Support

• Ligamentous Support– Intercuneiform Joints

• Dorsal and Plantar Intercuneifrom Ligaments

– Cuneocuboid• Plantar and Dorsal

Cuneocuboid Ligaments

– Cuneonavicular Joints• Plantar and Dorsal

Cuneonavicular Ligaments

Forefoot Articulations

and Ligamentous Support

• Tarsometatarsal Joint (Lisfranc’s Joint)

• Intermetatarsal Joint• Metatarsalphalangeal

Joint (MTP)• Interphalangeal Joint

– PIP– DIP

Forefoot Articulations and Ligamentous Support

• Ligamentous Support– Intermetatarsal Joint

• Plantar Metatarsal Lig• Dorsal Metatarsal Lig

– MTP Joints• Plantar Fascia• Plantar Ligament• MCL and LCL

– Interphalangeal Joints• Plantar and dorsal joint

capsule• MCL and LCL

Arches• Ligaments in foot &

ankle maintain arches• Two longitudinal arches

– Medial longitudinal arch - extends from calcaneus bone to talus, navicular, 3 cuneiforms, and proximal ends of 3 medial metatarsals

– Lateral longitudinal arch - extends from calcaneus to cuboid and proximal ends of 4th & 5th metatarsals

• Transverse arch– extends across foot from

1st metatarsal to the 5th metatarsal

Arches of the Foot

• Medial Longitudinal Arch– Calcaneus– Talus– Navicular– 1-3 cuneiforms– 1-3 MT’s

Arches of the Foot

• Medial Longitudinal Arch continued– Ligament Support

• Plantar Calcaneonavicular

• Long Plantar Lig• Deltoid• Plantar fascia

Arches of the Foot

• Medial Longitudinal Arch continued– Ligament Support

• Plantar Calcaneonavicular

• Long Plantar Lig• Deltoid• Plantar fascia

Arches of the Foot

• Medial Longitudinal Arch continued– Ligament Support

• Plantar Calcaneonavicular

• Long Plantar Lig• Deltoid• Plantar fascia

Arches of the Foot

• Medial Longitudinal Arch continued– Ligament Support

• Plantar Calcaneonavicular

• Long Plantar Lig• Deltoid• Plantar fascia

Arches of the Foot

• Medial Longitudinal Arch continued– Muscular Support

• Intrinsic– Abductor Hallucis– Flexor Hallucis Brevis

• Extrinsic – Tibialis Posterior– Flexor Hallucis Longus– Flexor Digitorum

Longus

Arches of the Foot

• Medial Longitudinal Arch continued– Muscular Support

• Intrinsic– Abductor Hallucis– Flexor Hallucis Brevis

• Extrinsic – Tibialis Posterior– Flexor Hallucis Longus– Flexor Digitorum

Longus

Arches of the Foot

• Lateral Longitudinal Arch– Composed of

• Calcaneus• Cuboid• 4-5th MT’s

– Ligament Support• Long & Short Plantar• Plantar Fascia

Arches of the Foot

• Lateral Longitudinal Arch continued– Muscle Support

• Intrinsic– Abductor Digiti

Minimi– Flexor Digitorum

Brevis• Extrinisic

– Peroneus Longus, Brevis & Tertius

Arches of the Foot

• Transverse Arch– Formed By:– Ligament Support

• Intermetatarsal Ligaments• Plantar Fascia

– Muscle Support• All intrinsic muscles• Extrinisic

– Tibialis Posterior– Tibialis Anterior– Peroneus Longus

Once the skin of the sole of the foot has been removed, there is a very dense organized layer of deep fascia that runs down the middle of the sole; this is the plantar aponeurosis.

The plantar aponeurosis is thought to help maintain the medial longitudinal arch of the foot.

Plantar Fascia

Foot Muscles – Plantar Surface

• Superficial Layer– Abductor Hallucis– Abductor Digiti

Minimi– Flexor Digitorum

Brevis

Foot Muscles – Plantar Surface

• Middle Layer– Quadratus Plantae– Lumbricales

Foot Muscles – Plantar Surface

• Deep Layer– Flexor Hallucis Brevis– Adductor Hallucis

• Transverse and Oblique Heads

– Flexor Digiti Minimi

Foot Muscles – Plantar Surface

• Interosseus Layer– Plantar Interossei– Dorsal Interossei

Foot Muscles – Dorsal Surface

• Extensor Digitorum Brevis

• Extensor Hallucis Brevis