This document provides an overview of the anatomy of the foot. It describes the bones that make up the foot, including the tarsal bones, metatarsals, and phalanges. It discusses the joints of the foot, including the talocalcaneal joint, talocalcaneonavicular joint, and calcaneocuboid joint. It also describes the ligaments that support these joints, such as the plantar calcaneonavicular ligament and bifurcate ligament. Additionally, it outlines the longitudinal and transverse arches of the foot and their supporting muscles and structures. The document concludes with sections on common foot problems, nerve supply to the foot, and footprints.
5. MOB TCD
Inversion and Eversion
• Inversion is raising the medial
border of the foot
• Sole of the foot looks medially
• Close pack
• Eversion is raising the lateral
border of the foot
• Sole of the foot looks laterally
• Least pack
5
6. MOB TCD
Inversion and Eversion
• Initiated at the
transverse tarsal joint
• Calcaneocuboid
• Anterior portion of the
talocalcaneonavicular
Last, 1963
6
7. MOB TCD
Inversion and Eversion
• Main movement takes
place at the clinical
sub-talar joint i.e.
• Talocalcaneal
• Inferior portion of the
talocalcaneonavicular
• The pivot is the
ligament of the neck of
the talus
7
8. MOB TCD
Axis
• Upwards forwards and
medially
• Middle of most convex
posterior facet on superior
surface of calcaneus
• Middle of most convex of
the anterior head of talus
8
9. Talocalcaneal Anatomical
SubTalar Joint
MOB TCD
• Synovial plane joint
• Concave inferior aspect of
body of talus
• Convex posterior facet on
superior surface of the
calcaneus
• Articular surface is
covered with hyaline
cartilage
• Part of the clinical subtalar
joint
9
10. Talocalcaneal Anatomical
SubTalar Joint
MOB TCD
• Capsule attached just beyond
the articular margins
• Synovial membrane lines
capsule and non articular
structures
• Interosseous ligament
10
13. MOB TCD
Talocalcaneonavicular Joint
• Socket
• Two anterior facets on the
superior surface of the
calcaneus
• Posterior aspect of the
navicular
• Spring ligament
• Medial limb of birfurcate
i.e. lateral
calcaneonavicular (LCN)
13
14. MOB TCD
Talocalcaneonavicular Joint
• Capsule attached just
beyond the articular margin
• Interosseous ligament post
• Medial are the
• Spring ligament and
superficial portion deltoid
ligament
• Lateral are the lateral
calcaneo navicular ligament
of bifurcate
• Ligament neck of talus
14
15. MOB TCD
Plantar Calcaneonavicular Ligament
• Plantar calcaneonavicular or
spring ligament is attached
to
• Sustentaculum tali
• Tuberosity of navicular
• Covered by articular
cartilage
15
16. MOB TCD
Ligaments of Sub-Talar Joint
•
•
•
•
Inferior extensor retinaculum
Ligament of the neck of talus
Interosseous ligament
Bifurcate ligament
16
17. MOB TCD
Ligament of Neck of Talus
• Sinus tarsi to
• Lateral aspect of neck of
talus
• Pivot of inversion and
eversion
*
Last,1963
17
18. MOB TCD
Inferior Extensor Retinaculum
• Medial root inside the
tarsal sinus
• Intermediate to talus with
the interosseous ligament,
inside sinus
• Lateral root to calcaneus
outside sinus
Klein & Spreitzer, 1993
18
19. MOB TCD
Tarsal Canal and Tarsal Sinus
• Fat
• Nerve endings
• Branches of posterior
tibial and peroneal
arteries
• Capsules and ligaments
of talocalcaneal and
talocalcaneonavicular
joints
19
23. MOB TCD
Lateral Calcaneonavicular Ligament
• Folded and twisted appearance
• Prominent medial and lateral
edges/folds
• Three groups of fibres
• Medial
• Lateral (deep)
• Intra-articular
N
C
A
Smith 2001
23
24. MOB TCD
Medial Calcaneo Cuboid Ligament
• Intra-capsular CC joint
• Smaller than CNL, always
present
• Hourglass shaped fibres,
twisted medially
Smith 2001
24
25. MOB TCD
Talocalcaneonavicular Joint
• Synovial membrane lines
the capsule and
non-articular structures
nerve supply
• Tibial nerve
• Deep and superficial
peroneal nerves
25
28. Calcaneo Cuboid Joint
MOB TCD
•
•
•
•
Plane synovial
Ligaments
Capsular
Ligament of neck of
talus
• Long and short plantar
ligament
• Bifurcate ligament
28
29. Calcaneo Cuboid Joint
MOB TCD
• The long plantar ligament
• Short plantar ligament
• Support the calcaneo cuboid
portion of the transverse tarsal joint
29
30. MOB TCD
Long Plantar Ligament
• Long plantar is attached to
• Medial, lateral and anterior
tubercles of calcaneus
• Either side of the groove on the
cuboid
• Base of middle three
• Metatarsals
30
31. MOB TCD
Short Plantar Ligament
• Short plantar
• Broader and wider and deep to
long plantar
• Anterior to anterior tubercle of
calcaneus
• Posterior to posterior ridge on
cuboid
31
34. MOB TCD
Sole of Foot
•
•
•
•
•
•
•
•
Skin
Plantar aponeurosis
Attached to
Medial and lateral tubercles of
calcaneus
Five slips
Divide into two
Fuse deep transverse ligament of sole
Abduction and adduction from a line
drawn through the middle of second
toe
34
35. MOB TCD
First Layer of Sole
•
•
•
•
•
•
Abductor hallucis
Medial plantar nerve
Flexor digitorum brevis
Medial plantar nerve
Abductor digiti minimi
Lateral plantar nerve
35
36. MOB TCD
Second Layer of Sole
•
•
•
•
•
•
•
•
•
•
•
Long flexor tendons
Tibial nerve
Flexor hallucis longus
Tibial nerve
Flexor digitorum longus
Tibial nerve
Four lumbricals
Unipennate medial plantar nerve
Bipennate lateral plantar nerve
Flexor accessorius
Lateral plantar nerve
36
37. MOB TCD
Third Layer of Sole
•
•
•
•
•
•
Flexor hallucis brevis
Medial plantar nerve
Adductor hallucis
Flexor digiti minimi
Lateral plantar nerve
Vessels run between
1st and 2nd layer
3rd and 4th layers
37
39. MOB TCD
Seasmoid Bones
• Larger medial in
• Abductor hallucis and
medial half of flexor
hallucis brevis
• Smaller lateral in
• Adductor hallucis and
• Lateral half of flexor
hallucis brevis
39
40. MOB TCD
Foot
• If sesamoid bones are
bipartite
• It is always bilateral
• If fracture single
• Take off point of walking
is hallux
• Flexor hallucis longus
• Tibial nerve
40
41. MOB TCD
Joints of Foot
•
•
•
•
•
•
Mid-tarsal compound synovial
Metatarso-phalangeal joint
Synovial condylar joint
Deep transverse ligament of sole
Interphangeal joints
Synovial hinge
41
52. MOB TCD
Supports of Lateral Arches
•
•
•
•
Peroneus longus
Peroneus brevis
Short flexor muscles on lateral aspect
Long and short plantar ligaments
52
56. MOB TCD
Transverse Arch
• Depressed arch
• Head of the third
metatarsal compresses
the lateral branch of
medial digital nerve
• Morton’s metatarsalgia
• Pain increased by tight
shoes, relieved by taking
shoes off
56
60. MOB TCD
Nerve Supply of the Foot
•
•
•
•
•
Medial calcaneal nerve
Medial plantar nerve
Three and half toes
Lateral plantar nerves
One and half toes
60
61. MOB TCD
Nerve Supply of Dorsum
• Superficial peroneal nerve
• Deep peroneal nerve, first
cleft
• Saphenous nerve, medial
border to base of big toe
• Sural nerve, lateral border
61