The Foot and Toes

1
Chapter 4

• The Foot and Toes

2
Introduction

• The foot provides a stable platform to balance
  and support the body
• Phases of Gait figure 4-1, pg 87
• Foot, toes, and ankle are highly interrelated

3
Clinical Anatomy

• Intrinsic vs. extrinsic muscles
• Divided into 3 sections (Figure 4-2, pg 88)
• Rearfoot
• Midfoot
• Forefoot
• Tarsals, metatarsals, phalanges

4
Rearfoot

• Calcaneus and talus
• Ankle mortis Figure 4-4, page 89
• Talus articulations

5
Midfoot

• Shock-absorbing segment
• Navicular, 3 cuneiforms, cuboid
• Navicular keystone of medial longitudinal arch

6
Forefoot and Toes

• 5 MTs and 14 phalanges
• Acts as a lever during preswing phase

7
Articulations and Ligamentous Support

• Ligaments
• Thin dorsal tarsal ligaments
• Thick plantar tarsal ligaments
• Interosseous tarsal ligaments

8
Subtalar Joint

• 1o of freedom of movement
• Supination and pronation
• No muscles attach to talus
• Ligament names reflect bony attachments

9
Midfoot

• Talocalcaneonavicular joint (TCN)
• Calcaneocuboid joint (CC)
• Spring ligament plantar calcaneonavicular
  ligament
• Midtarsal joint
• increases ROM during inversion and eversion
• Allows for compensation for uneven terrain

10
Forefoot

• Tarsometatarsal joint Lisfrancs joint
• Deep transverse ligament secures distal joints
• Plantar and dorsal joint capsules
• Collateral ligaments

11
Muscles Acting on the Foot and Toes

• Intrinsic vs. Extrinsic
• Table 4-2, pages 92-94
• Table 4-3, page 95
• Table 4-4, page 96
• Figure 4-5, page 96

12
Arches of the Foot

• Shock absorber
• Increase foots flexibility
• Weight-bearing vs. non-weight-bearing

13
Medial Longitudinal Arch

• Five bones form arch
• Importance of navicular bone
• Ligamentous support
• Plantar fascia (Figure 4-7, page 97)
• Static vs. dynamic weight-bearing

14
Lateral Longitudinal Arch

• Lower and more rigid than medial arch
• Calcaneus, cuboid, fifth MT
• Continuation of medial arch
• Rarely injured

15
Transverse Metatarsal Arch

• Figure 4-9, page 98
• Originates at MT heads and continues to calcaneus
• 1st and 5th MT heads weight-bearers
• 2nd MT apex of arch