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Questions and Answers
What movement is associated with supination of the foot?
Which structure primarily supports the medial longitudinal arch?
Which muscle is innervated by the medial plantar nerve?
What is the primary function of the arches of the foot?
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Which layer contains the quadratus plantae muscle?
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What is a characteristic of the plantar interossei muscles?
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Which nerve roots supply the plantar foot?
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What is the primary type of joint formed by the posterior articulation of the subtalar joint?
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Which ligament is primarily responsible for stabilizing the head and neck of the talus on the calcaneus?
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What is the major risk associated with fractures of the talus?
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Which of the following ligaments does NOT contribute to the stability of the subtalar joint?
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Which motion is characterized by turning the sole of the foot away from the midline?
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Which of the following statements about the sinus tarsi is true?
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What are the two main joints that make up the transverse tarsal joint?
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Which ligament connects the sustentaculum tali to the navicular bone?
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Study Notes
Subtalar Joint
- Two articulations between the talus and calcaneus
- Posterior articulation is the major one and is considered a planar synovial joint, but the talus is concave and the calcaneus is convex.
- Anterior articulation is between the head and neck of the talus and the anterior facets of the calcaneus, and is considered more with the talonavicular or calcaneonavicular joint.
- Sinus tarsi space is between anterior and posterior joint surfaces, doesn't have cartilage.
- Cervical or interosseous talocalcaneal ligament is located within the sinus tarsi.
- Cervical and interosseous ligaments anchor the talus to the calcaneus.
- Plantar calcaneonavicular ligament travels from the sustentaculum tali to the navicular.
Transverse Tarsal Joint
- Part of the midfoot, connecting the hindfoot and midfoot
- Made up of the talonavicular (spheroidal) and calcaneocuboid (sellar) joints
Ligaments of the Transverse Tarsal Joint
- Long Plantar Ligament: long, fibrous, deep to the plantar fascia, extending from the calcaneus to the bases of the lateral three metatarsals.
- Plantar Calcaneonavicular Ligament (Spring Ligament): thick, strong ligament connecting the sustentaculum tali to the navicular.
- Plantar Calcaneocuboid Ligament: also known as the short plantar ligament, connects the anterior inferior surface of the calcaneus to the cuboid.
- Tibialis Posterior Tendon: connects the navicular and metatarsals.
Motions of Pronation and Supination - Open Chain
- Pronation: Dorsiflexion, Eversion, Foot Abduction
- Supination: Plantar Flexion, Inversion, Forefoot Adduction
Arches of the Foot
- Functions: Shock absorption, foot stabilization, prevent compression of neurovascular structures, distribute weight.
- Types: Medial Longitudinal, Lateral Longitudinal, Transverse Tarsal
Medial Longitudinal Arch Supports
- Tibialis Posterior, Flexor Hallucis Longus, Flexor Digitorum Longus, Tibialis Anterior, Abductor Hallucis, Plantar Calcaneonavicular Ligament
Plantar Foot Muscles
- The plantar surface of the foot has 4 layers of muscles.
- Knowledge of insertions and origins is not needed, but understanding locations, layers, innervation, and primary actions is essential.
Layer 1 of Plantar Foot Muscles
- Abductor Hallucis: pulls the big toe away from midline, innervated by the medial plantar nerve
- Abductor Digiti Minimi: pulls the little toe away from midline, innervated by the lateral plantar nerve
- Flexor Digitorum Brevis: helps flex the toes, innervated by the medial plantar nerve
Layer 2 of Plantar Foot Muscles
- Flexor Digitorum Longus: tendon goes to the toes
- Flexor Hallucis Longus: tendon goes to the toes
- Quadratus Plantae: attaches from calcaneus to flexor digitorum longus tendon, assists in aligning the pull of the tendon, innervated by the lateral plantar nerve
- Lumbricals: help to stabilize the toes, 1st lumbrical is innervated by the medial plantar nerve, the rest are innervated by the lateral plantar nerve
Layer 3 of Plantar Foot Muscles
- Adductor Hallucis: pulls the big toe towards the midline (often referred to as the "flip-flop" muscle), innervated by the lateral plantar nerve
- Flexor Hallucis Brevis: crosses towards the medial side, innervated by the medial plantar nerve
- Flexor Digiti Minimi Brevis: innervated by the lateral plantar nerve
Layer 4 of Plantar Foot Muscles
- Dorsal Interossei: abduct the toes, innervated by the lateral plantar nerve
- Plantar Interossei: adduct the toes, innervated by the lateral plantar nerve
- Mnemonic: 'Pad' (plantar ADduct) and 'Dab' (dorsal ABduct).
Plantar Foot Nerve Supply
- The posterior tibial artery splits into the medial and lateral plantar arteries.
- Nerves that supply the plantar foot arise from the posterior tibial nerve.
- Nerve roots that innervate the plantar foot are S2 and S3.
- Medial Plantar Nerve: innervates the medial side of the foot
- Lateral Plantar Nerve: innervates the lateral side of the foot
- Calcaneal Branches: innervate the heel
Plantar Foot Blood Supply
- The posterior tibial artery splits into the medial and lateral plantar arteries.
- Tarsal Tunnel Syndrome: compression of the artery and nerve in the foot can cause numbness and tingling in the foot, and reduced blood supply.
Foot Muscles: Interossei
- Interossei are located between the metatarsals.
- Plantar interossei are located on the plantar side of the foot and help with toe adduction.
- Dorsal interossei are located on the dorsal side of the foot and help with toe abduction.
- Innervation: All interossei muscles are innervated by the lateral plantar nerve.
General Foot Muscles
- Foot muscles play a crucial role in stabilizing the toes, especially during walking.
- Focus on recognizing the layers and identifying the muscles within each layer.
- Knowing the general action and innervation of each muscle is essential.
- Detailed muscle attachments are less important for physical therapists.
- Understanding muscle function is critical for diagnosing and treating nerve injuries..
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Description
Explore the detailed anatomy of the subtalar and transverse tarsal joints, including their articulations and ligaments. This quiz highlights the structural complexities and functions of these crucial joints in the foot. Test your knowledge on their anatomy and interconnections.
