Anatomy of the Foot Quiz

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Questions and Answers

What is the primary movement facilitated by the subtalar joint?

Dorsiflexion and plantarflexion

Flexion and extension

Inversion and eversion (correct)

Rotation and stability

Which position of the hindfoot involves weight bearing on the medial side?

Supinated

Valgus (correct)

Neutral

Varus

What type of joint is the transverse tarsal joint classified as?

Hinge joint

Fibrous joint

Cartilaginous joint

Synovial joint (correct)

What is the primary function of the midfoot?

Adapts to ground and provides minimal motion Signup and view all the answers

How many metatarsophalangeal (MTP) joints are present in the foot?

5 Signup and view all the answers

Which of the following ligaments does not support the midfoot joints?

Patellar ligament Signup and view all the answers

Which joint is primarily responsible for adapting the forefoot to different ground surfaces?

Metatarsophalangeal joint Signup and view all the answers

What type of motion occurs at the intertarsal joints in the midfoot?

Roll and glide Signup and view all the answers

Which structure serves as the keystone for the medial longitudinal arch?

Talus Signup and view all the answers

What is the main difference between the lateral longitudinal arch and the medial longitudinal arch?

The cuboid is the keystone in the lateral arch. Signup and view all the answers

Which ligament stabilizes the medial arch of the foot?

Tibionavicular ligament Signup and view all the answers

What part of the foot acts as the base for the anterior section of the lateral longitudinal arch?

Heads of fourth and fifth metatarsals Signup and view all the answers

How do the arches of the foot typically respond to weight-bearing?

They become shallower and flatter. Signup and view all the answers

Which ligament would be categorized as a medial ankle ligament?

Anterior Tibiotalar ligament Signup and view all the answers

Which structure acts as the keystone in the transverse arch of the foot?

Middle cuneiform Signup and view all the answers

What is the primary role of ligaments in the foot's arches?

To provide stabilization and support. Signup and view all the answers

What is the primary action of the gastrocnemius muscle?

Plantar flexion and knee flexion Signup and view all the answers

Which muscle is primarily responsible for plantar flexion of the ankle and does not flex the knee?

Soleus Signup and view all the answers

Which muscle belongs to the deep posterior group and is responsible for inversion and plantar flexion?

Tibialis posterior Signup and view all the answers

What is the primary action of the tibialis anterior muscle?

Dorsiflexion and inversion Signup and view all the answers

Which of the following muscles is involved in eversion of the foot?

Fibularis longus Signup and view all the answers

Which action is NOT associated with the flexor hallucis longus muscle?

Knee flexion Signup and view all the answers

Which muscle corresponds to both MTP and IP joint extension of the great toe?

Extensor hallucis longus Signup and view all the answers

Which nerve supplies the gastrocnemius and soleus muscles?

Tibial nerve Signup and view all the answers

What is the primary function of the flexor digitorum longus muscle?

Flexing the metatarsophalangeal and interphalangeal joints of digits 2-5 Signup and view all the answers

Which nerve innervates the tibialis anterior muscle?

Deep peroneal nerve Signup and view all the answers

Where does the flexor hallucis longus originate?

Lower 2/3 of the posterior fibula Signup and view all the answers

Which function is NOT associated with the extensor digitorum longus?

Flexing the metatarsophalangeal joints Signup and view all the answers

What action does the peroneus longus muscle perform?

Eversion of the foot Signup and view all the answers

What are the primary actions of the extensor hallucis longus muscle?

Dorsiflexion of the ankle and extension of the great toe Signup and view all the answers

Which muscles contribute to inversion of the foot?

Flexor digitorum longus and tibialis anterior Signup and view all the answers

Which of the following does NOT originate from the fibula?

Flexor digitorum longus Signup and view all the answers

What is the primary cause of shin splints?

Overuse injury Signup and view all the answers

Which ligament is commonly associated with an avulsion fracture during an ankle sprain?

Anterior talofibular ligament Signup and view all the answers

What type of fracture involves both malleoli?

Bi-malleolar fracture Signup and view all the answers

Which foot condition is characterized by a fixed hindfoot in plantar flexion?

Equinus foot Signup and view all the answers

Which condition is associated with pain at the metatarsal heads?

Morton's neuroma Signup and view all the answers

What is a characteristic feature of pes cavus?

High medial longitudinal arch Signup and view all the answers

What occurs in turf toe?

Forceful hyperextension of the MTP joint Signup and view all the answers

Which of the following conditions is characterized by a flat medial longitudinal arch?

Pes planus Signup and view all the answers

What is the primary function of the Spring Ligament in the medial foot?

Maintains medial longitudinal arch Signup and view all the answers

Which ligament is most commonly affected in an inversion sprain?

Anterior talofibular ligament Signup and view all the answers

Which ligament provides lateral support in the foot structure?

Long plantar ligament Signup and view all the answers

How does the Plantar Fascia contribute to foot stability?

By connecting the heel to the toe bones Signup and view all the answers

What effect does the Windlass Effect have on the foot during push-off?

It locks the bones of the arch in place Signup and view all the answers

What is the role of the Short Plantar Ligament?

It provides support to the Long Plantar Ligament Signup and view all the answers

Which of the following ligaments is NOT part of the lateral ankle ligaments?

Short plantar ligament Signup and view all the answers

During weight-bearing activities, how does the plantar fascia affect foot stability?

It increases fascial tension Signup and view all the answers

Study Notes

Chapter 19: Ankle Joint and Foot

Chapter covers the anatomy, function, and pathologies of the leg, ankle, and foot
Chapter objectives include describing the leg, ankle, and foot; identifying osteokinematic and arthrokinematic movements, normal end feels, bones/landmarks, ligaments/unique structures; and the effects of active/passive insufficiency on range of motion (ROM)

Function of Leg, Ankle, and Foot

Transmission of forces from body to support surface and vice versa
Base of support (BOS)
Ability to accommodate various support surfaces, including irregular ones.
Plantigrade position: plantar surface of foot is perpendicular to the leg when standing (normal)

Ankle Joint and Foot Anatomy

Ankle Joint:
- Talocrural joint (made up of the tibia, talus, and fibula)
Foot:
- Hindfoot, midfoot, forefoot (including phalanges) and regions of foot
  - Forefoot: metatarsals (5), phalanges (14)
  - Midfoot: cuboid, navicular, three cuneiform bones
  - Hindfoot: talus, calcaneus

Ankle and Foot Joints

All joints are synovial joints
Distal tibiofibular joint
Ankle joint = talocrural joint (talus/tibia/fibula)
Subtalar joint = Talocalcaneal joint (Hind Foot)
Transverse Tarsal (Midtarsal) joint = Talonavicular and Calcaneocuboid joints
Intertarsal Joints: 10 (between talus, calcaneus, navicular, cuboid, and cuneiforms)
Tarsometatarsals: 5
Intermetatarsals: 8
Metatarsophalangeal: 5
Interphalangeal: 9

Osteokinematic Motions

Anatomists use cardinal planes to describe movements
Clinicians use oblique axis of motion to describe movements
Descriptions of ankle movements are used by clinicians

Movements

Plantar flexion (0-50)/dorsiflexion (0-20) (sagittal plane, frontal axis)
Inversion (0-35)/eversion (0-15) (frontal plane in sagittal axis)
Adduction/abduction – movement of forefoot toward/away from midline (transverse plane in vertical axis)
Triplanar Motions: Supination (PF, INV, and ADD); Pronation (DF, EV, and ABD)

Arthrokinematic Motions

Open Kinetic Chain:
- Dorsiflexion: Convex surface of talus rolls anteriorly and glides posteriorly on concave surface of tibia
- Plantar flexion: Convex surface of talus rolls posteriorly and glides anteriorly on concave surface of tibia
Closed Kinetic Chain: Concave moving on convex = same direction
Ankle end feel = firm all directions
Talocrural: Close-packed = full dorsiflexion (DF); Open-packed = 10 degrees of plantar flexion (PF); Capsular pattern = PF > DF
Movement between bones of foot (talus, calcaneus, navicular, cuboid, three cuneiforms, tarsometatarsal, intermetatarsal joints) is minimal and planar
End feel = firm all directions

Movements (Foot Motion)

Metatarsophalangeal joint (MTP): Flexion/extension, abduction/adduction
Interphalangeal joints (PIP/DIP/IP): Flexion/extension

Metatarsophalangeal Joint (MTP)

Condyloid joint with two degrees of freedom
Flexion/extension (sagittal plane about frontal axis)
Abduction/adduction (transverse plane about vertical axis)
Reference point is second metatarsal
Open chain = concave on convex; Flexion = roll/glide inferiorly; Extension = roll/glide superiorly
Closed chain = convex on concave; Extension = roll superior, glide inferior
Abduction/adduction: open chain = concave on convex, roll/glide same direction as motion relative to second metatarsal

Interphalangeal (IP) Joints

Hinge joint with one degree of freedom
Flexion/extension in a sagittal plane about a frontal axis
Concave on convex – same direction roll/glide

Bones and Landmarks

Tibia: Medial condyle, lateral condyle, crest, medial/lateral plateau, tibial tuberosity, interosseous membrane, medial malleolus
Fibula: Head, lateral malleolus
Tarsals (7): Calcaneus (calcaneal tuberosity, sustentaculum tali), Talus, Navicular (navicular tuberosity), Cuboid, Cuneiforms (3)
Metatarsals (5): Base, head
Phalanges (14): Base, head

Joints – Tibiofibular

Superior Tibiofibular joint: Synovial plane joint; little motion
Inferior Tibiofibular joint: Synovial; makes up talocrural joint; convex distal fibula and concave distal tibia; held together by fibrous ligaments; slight motion; tibia is weight-bearing

Joints – Talocrural

Uniaxial weight-bearing hinge joint
“Horseshoe” or “mortise and tenon” (talotibial, talofibular, tibiofibular joints)

Joints – Hind Foot/Subtalar

Plane synovial joint
Inversion / eversion and part of supination/pronation

Joints – Hindfoot Positions

Neutral, Valgus (WB load into arch/medial foot), Varus (WB load onto lateral foot)

Joints – Transverse Tarsal

Synovial “midtarsal” joint
Talus and calcaneus to navicular and cuboid; separation of hindfoot and midfoot
Accommodate to surfaces; gliding motions

Midfoot

Includes remaining intertarsal joints: talocalcaneonavicular, calcaneocuboid, cuneonavicular, cuboideonavicular, intercuneiform, and cuneocuboid
Synovial plane joints; minimal motion: roll and glide
Numerous ligaments support joints and limit motion

Joints – Foot – MTP, IPS

Metatarsophalangeal joints (MTP = 5)
Proximal interphalangeal joints (PIP = 4)
Distal interphalangeal joints (DIP = 4)
Interphalangeal joint (1)

Functional Aspects of the Foot

Forefoot (metatarsals [5], phalanges [14]): Adapts to ground; assists with propulsion
Midfoot (navicular, cuboid, cuneiform [3]): Provides mobility and stability; adapts to ground
Hindfoot (talus, calcaneus): Contacts ground first; influences gait

Unique Structures of the Foot (Arches)

Arches (3): Medial longitudinal (Talus = keystone), Lateral longitudinal (Cuboid = keystone), Transverse (Middle cuneiform = keystone)
Arches supported by ligaments, fascia, and muscles

Support Structures of the Foot and Arches

Diagrams show the 1st and 5th metatarsals and the calcaneus

Ligaments (Tibiofibular)

Anterior Tibiofibular ligament
Posterior Tibiofibular ligament
Calcaneofibular ligament

Ligaments (Medial Ankle)

Deltoid ligament (4 parts):
- Tibionavicular lig
- Tibiocalcaneal lig
- Anterior Tibiotalar lig
- Posterior Tibiotalar lig
Stabilize medially including medial arch
Very stable

Ligaments (Medial Foot)

Spring ligament (plantar calcaneonavicular lig) - Maintains medial longitudinal arch
Long Plantar Ligament - Maintains lateral arch
Short Plantar Ligament -Helps support Long Plantar ligament

Ligaments (Lateral Ankle)

Lateral “collateral” ligament (3 parts):
- Anterior talofibular
- Calcaneofibular
- Posterior talofibular
Commonly injured – Inversion sprain
Ant. Talofibular, calcaneofibular, Posterior talofibular

Ligaments (Plantar Surface)

Plantar ligaments and aponeurosis
Spring ligament (medial support)
Long plantar ligament (lateral support)
Short plantar ligament (support long plantar lig)
Plantar aponeurosis (fascia)

Plantar Fascia

Anterior plantar surface of calcaneus to proximal phalanges
Supports longitudinal arches
Increases foot stability during weight-bearing

Role of Plantar Fascia (Windlass Effect)

PF and MTP Ext
Increase fascial tension
Locks bones of arch in place
Creates rigid foot; Push-off

Muscles (Extrinsic muscles of the leg, ankle, and foot)

Superficial posterior group:
Gastrocnemius: plantar flexion, knee flexion
Soleus: plantar flexion
Plantaris: plantar flexion, knee flexion
Deep posterior group:
Tibialis posterior: plantar flexion, inversion
Flexor digitorum longus: MTP and IP flexion, plantar flexion, inversion
Flexor hallucis longus: MTP and IP great toe flexion, plantar flexion, inversion
Anterior Group:
Tibialis anterior: dorsiflexion, inversion
Extensor hallucis longus: MTP and IP great toe extension, dorsiflexion, inversion
Extensor digitorum longus: MTP and IP of four lesser toes extension, dorsiflexion
Lateral Group:
Fibularis longus: eversion, plantar flexion
Fibularis brevis: eversion, plantar flexion
Fibularis tertius: eversion, dorsiflexion

Muscles (Intrinsic muscles on plantar surface)

Four layered intrinsic muscles
First layer: Abductor hallucis, Flexor digitorum brevis, Abductor digiti minimi
Second layer: Quadratus plantae, Lumbricals
Third layer: Flexor hallucis brevis, Adductor hallucis
Fourth layer: Dorsal interossei, Plantar interossei

Muscles of the Ankle and Foot

Diagrams show anatomical relations to other structures
Tables/graphics show innervation and actions of the bones

Dermatomes

Diagrams showing root levels and peripheral nerve (skin) innervation.

Common Ankle Pathologies

Shin splints: inflammation of periosteum of tibia, overuse injury
Ankle sprain (lateral – often inversion sprain; medial)
Calcaneal (Achilles) tendonitis: inflammation of calcaneal tendon
Ruptured calcaneal tendon
Ankle fracture (lateral malleolus, bi-malleolar, tri-malleolar)
Calcaneal valgus/varus
Equinus foot: hindfoot fixed in PF
Calcaneal foot: hindfoot fixed in DF
Pes cavus: High medial longitudinal arch
Pes planus: Flat medial longitudinal arch
Hallux valgus: Lateral deviation of great toe
Hallux rigidus: Degenerative condition of the first MTP joint
MTP pain; loss of range of motion
Hammer toe: PIPs flexed and DIPs extended
Mallet toe: PIPs extended and DIPs flexed
Claw toe: PIP and DIPs both flexed
Metatarsalgia: pain at metatarsal heads; Morton's neuroma: between 3rd and 4th metatarsals, plantar digital nerves, pain with WB
Turf toe: force hyperextension of the great toe MTP
Plantar fasciitis: overuse injury, pain in heel during weight-bearing
Fractures: toes and metatarsals

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Description

Test your knowledge on the anatomy and function of the foot with this quiz focused on joints, ligaments, and movements. Answer questions about the subtalar joint, midfoot function, and more. Perfect for students of anatomy and physical therapy!