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OA 11.4

OA 11.4. Chapter 18 ( pp 487-496). Injuries to the Foot & Ankle. O bjectives. Identify… The bones of the foot & ankle The ligaments of the foot & ankle The muscles of the foot & ankle The tendons of the foot & ankle The blood vessels & nerves of the foot & ankle Other structures.

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OA 11.4

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  1. OA 11.4

  2. Chapter 18 (pp 487-496) Injuries to the Foot & Ankle

  3. Objectives Identify… • The bones of the foot & ankle • The ligaments of the foot & ankle • The muscles of the foot & ankle • The tendons of the foot & ankle • The blood vessels & nerves of the foot & ankle • Other structures

  4. The bones • The foot contains 28 bones • Phalanges (16) • Proximal (1-5) • Intermediate (2-5) • Distal (1-5) • Sesamoids (1)

  5. The bones • The foot contains 28 bones • Metatarsals (5) • Tarsal bones (7) • Cuneiforms • Medial • Intermediate • Lateral • Cuboid • Navicular • Talus • Calcaneous • Tibia • Fibula

  6. The bones • Tibia • Fibula

  7. Phalanges • There are 14 total phalanges • Great toe = 2 • All other toes = 3 • Each toe has a proximal, intermediate, & distal phalange (except Great toe)

  8. Phalanges • Great toe has 2 sesamoid bones • Act like “mini patella” to increase leverage and protect the joint

  9. metatarsals • Each toe has a corresponding metatarsal (MT) • Important areas: • Head of the 1st MT • Base of the 5th MT • In-between the 2-3 MT heads

  10. Tarsal bones • The tarsal bones make up the mid- & rear-foot • Cuneiforms (E, F, G) • Medial (G) • Intermediate (F) • Lateral (E) • Cuboid (C) • Navicular (D) • Talus (B) • Calcaneous (A)

  11. Bones of the leg • Tibia and fibula extend past the talus bone • Distal end is referred to as the malleolus • Medial = tibial • Lateral = fibular

  12. Bones of the leg • Tibia • Larger of the two bones • Primary weight bearing bone

  13. Bones of the leg • Fibula • Smaller bone, extends more distally • Provides for muscle attachments • ≤ 10% weight bearing

  14. the ligaments • Important ligaments in the foot: • Calcaneonavicular ligament (spring ligament)

  15. The ligaments • Medial ankle: • Deltoid ligament

  16. The ligaments • Lateral ankle: • Anterior talofibular (ATF) • Calcaneofibular(CF) • Posterior talofibular(PTF) • Not shown

  17. The ligaments • Lower leg: • Distal anterior tibiofibular ligament • Distal posterior tibiofibular ligament • Interosseous membrane

  18. OA 11.5 • Identify the bones: • A • D • E • C

  19. articulations • Interphalangeal (IP, PIP, DIP) • Metatarsophalangeal (MP or MTP) joints • Intermetatarsal joints • Tarsometatarsal (TMT) joints • Subtalar joint • Talocrural joint

  20. Subtalar joint • Articulation of the talus & calcaneus

  21. Talocrural joint • Tibia, fibula, talus • Mortise & tenon configuration • Talus is wedge-shaped • Lateral malleolus extends more distally than medial malleolus

  22. Arches of the foot • Support body weight • Absorb forces from the ground • Provide space for blood vessels, tendons, & muscles

  23. Arches of the foot • Metatarsal Arch – across metatarsal heads • Transverse Arch – across metatarsal bases & cuneiforms • Medial Longitudinal Arch – along the medial aspect • Lateral Longitudinal Arch – along the lateral aspect

  24. Arches of the foot

  25. Plantar fascia • Broad, thick tissue covering the bottom of the foot • Extends from the calcaneus to the base of each metatarsal • Supports the foot against downward forces

  26. Muscles & tendons • Intrinsic muscles of the foot: • Toe extensor • Toe flexors (3) • Great toe & 5th toe abductors • Great toe adductor

  27. Muscles & tendons • Extrinsic muscles of the foot: • Divided by compartments • Anterior • Lateral • Superficial posterior • Deep posterior

  28. Muscles & tendons • Anterior compartment • Tibialis anterior • Extensor hallucislongus • Extensor digitorumlongus • Dorsiflex the foot

  29. Muscles & tendons • Lateral compartment • Peroneus longus • Peroneus brevis • Evert the foot

  30. Muscles & Tendons • Superficial posterior compartment • Gastrocnemius • Soleus • Plantaris • Plantarflex the foot

  31. Muscles & tendons • Deep posterior compartment • Tibialis posterior • Flexor hallucislongus • Flexor digitorumlongus • Plantarflex & invert the foot

  32. Neurological & Vascular • Tibial nerve • Posterior leg & plantar aspect of foot • Common peroneal nerve • Anterior leg & foot • Blood supply • Anterior tibial artery  Dorsal pedal artery • Posterior tibial artery

  33. Distal pulse

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