The Ankle and Foot Joints

1
The Ankle and Foot Joints
2
Function of the foot

• Provide a stable platform
• Generate propulsion
• Absorb shock

3
Bones

• Ankle foot 28 bones
• foot 26 bones
• Leg tibia, fibula
• Foot
• Tarsals (7) talus, calcaneus, navicular, cuboid,
  and cuneiforms (3)
• Metatarsals (5)
• Phalanges (14)

4
Joints

• Tibiofibular
• articulation between tibia and fibula
• amphiarthrodial joint
• Ankle joint
• Talocrural
• articulation between talus and tibia talus and
  fibula
• classified as a ginglymus

5
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

6
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

7
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

8
Classifying Arch Type

• Pes Planus Flat foot
• Pes Cavus High Arch
• Normal

9
Movements

• Ankle joint
• dorsiflexion raising the toes
• plantarflexion point the toes
• Subtalar Transverse tarsal joints
• Calcaneal inversion and eversion
• Interphalangeal joints
• flexion
• extension

10
Movements

• Supination
• inversion
• plantar flexion
• adduction
• Pronation
• eversion
• dorsiflexion
• abduction

11
Summary

• Bones of the foot
• tarsals, metatarsals, phalanges
• Joints of the foot and ankle
• 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

12
Muscles

• Plantar flexors
• Dorsi flexors
• Evertors
• Invertors

13
Plantar Flexors

• Gastrocnemius
• Flexor digitorum longus
• Peroneus longus
• Plantaris
• Soleus
• Tibialis Posterior

14
Dorsiflexors

• Tibialis anterior
• Peroneus tertius
• Extensor digitorum longus

15
Invertors

• Tibialis anterior
• Tibialis posterior
• Flexor hallucis longus

16
Evertors

• Peroneus longus
• Peroneus brevis
• Peroneus tertius
• Extensor digitorum longus

17
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

18
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

19
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

20
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

21
Peroneus brevis (p48)

• Origin
• fibula, lower two-thirds, lateral aspect
• Insertion
• 5th metatarsal tuberosity
• Action
• eversion

22
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

23
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

24
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

25
Gastrocnemius (p52)

• Origin
• medial and lateral epicondyle of the femur
• Insertion
• posterior surface of calcaneus
• Action
• plantar flexion
• knee flexion

26
Soleus (p54)

• Origin
• 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

27
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).

28
Plantaris (p53)

• Origin
• posterior surface of lateral epicondyle of femur
• Insertion
• posterior surface of calcaneus
• Action
• plantar flexion

29
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

30
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