Foot & Ankle

Plantar

the sole, or the bottom of the foot

Dorsal

The top or superior portion of the foot

Hindfoot

made up of the talus and calcaneus; the pink section of this picture

Midfoot

made up of the navicular, cuboid and the 3 cuneiform bones; the green section of this picture

Forefoot

made up of the 5 metatarsals and all phalanges; the blue section of this picture

Metatarsals

numbered 1-5 starting medially; the proximal end of each metatarsal is the base; the distal end of each metatarsal is the head; the 1st and 5th metatarsals are weight bearing bones

Metatarsal Articulations

Distally, all metatarsals articulate with a proximal phalanx of the toe; Proximally: the 1st metatarsal articulates with the 1st cuneiform; the 2nd metatarsal articulates with the 2nd cuneiform; the 3rd metatarsal articulates with the 3rd cuneiform; and the 4th & 5th metatarsals articulate with the cuboid bone

Phalanges

The bones of the toes. The first digit (the hallux or the great toe) has a proximal and distal , but no middle; Toes 2-5 (the lesser toes) each have a proximal, middle and distal

Hallux

The great toe; the most medial toe; the first toe

Calcaneus

the largest of the tarsal bones (heel bone)

Talus

the anklebone that articulates with the tibia and fibula (proximally); and "sits on top of" the calcaneus

Navicular

One of the tarsal bones; it is located medially on the foot, just distal (or anterior) to the calcaneus

Cuboid

One of the tarsal bones; it is located laterally on the foot, just distal (or anterior) to the calcaneus

Cuneiforms

The 3 smallest tarsal bones; located medial to cuboid; distal articular surfaces articulate with base of metatarsals

Superior Tibiofibular Joint

articulation between head of fibula and posterior lateral tibia; small amount of glide and rotation of fibula and tibia; has joint capsule

Inferior Tibiofibular Joint

syndesmosis (fibrous union); provides a very firm union between the tibia and fibula which adds significantly to the integrity of the talocrural joint; no joint capsule; articulation between the distal concave tibia and the convex distal fibula

Talocrural Joint

An articulation between the distal ends of the tibia and fibula in the lower limb with the proximal end of the talus; dorsiflexion & plantarflexion occur at this joint

Subtalar Joint

Articulation between the inferior surface of the talus with the superior surface of the calcaneus; where inversion and eversion occur

Transverse Tarsal Joint

AKA midtarsal joint; articulation between the anterior surfaces of the talus and calcaneus with the posterior surfaces of the navicular and cuboid; we cannot functionally separate this joint from the subtalar joint; so for the sake of simplicity > inversion and eversion are motions that occur at both joints

Metatarsophalangeal (MTP) Joints

Where the metatarsal heads articulate with the proximal phalanges of the toes; osteokinematics = flexion, extension, hyperextension, abduction, adduction

Foot point of reference for MTP abduction/adduction

The 2nd toe

IP, DIP, PIP joints

Articulations between the phalanges; osteokinematics = flexion and extension

Ankle pronation

combination of dorsiflexion, eversion, abduction

Ankle supination

combination of Plantar flexion, inversion, adduction

Deltoid Ligament

Triangle-shaped collateral ligament on the medial side of the ankle; limits eversion; has 3 sets of fibers (tibionavicular, tibiocalcaneal, tibiotalar)

Lateral Collateral Ligaments

Collateral ligament on the lateral side of the ankle; limits inversion; consists of 3 ligaments (anterior & posterior talofibular and calcaneofibular)

Spring Ligament

Ligament of the foot spanning the distance between the calcaneus and the navicular

Long & Short Plantar Ligaments

Ligaments of the foot spanning the distance between the calcaneus and the cuboid and the bases of metatarsals 3, 4, 5

Plantar fascia

superficial fascia from the calcaneus to the proximal phalanes

Anterior Extrinsic Ankle Muscles

Tibialis anterior, extensor halluces longus, extensor digitorum longus, peroneus tertius; all 4 muscles innervated by Deep Peroneal Nerve; all 4 muscles perform dorsiflexion as one of their primary actions

Lateral Extrinsic Ankle Muscles

peroneus longus, peroneus brevis; both muscles are innervated by the Superficial Peroneal Nerve; both muscles originate on the fibula; both muscles perform ankle eversion as one of their primary actions

Deep Posterior Extrinsic Ankle Muscles

tibialis posterior, flexor digitorum longus, flexor hallucis longus; all muscles innervated by the Tibial Nerve; all muscles perform plantarflexion as one of their primary actions

Superficial Posterior Extrinsic Ankle Muscles

gastrocnemius, soleus, plantaris; all muscles innervated by the Tibial Nerve; all muscles perform plantarflexion as one of their primary actions

Tibialis Anterior action

Ankle dorsiflexion, inversion

Tibialis Anterior location

Anterior ankle; originates on the proximal 2/3 of the lateral surface of the tibia and interosseus membrane; inserts on the medial and plantar aspects of the medial cuneiform and the base of the first metatarsal

Tibialis Anterior innervation

Deep branch of the peroneal nerve

Extensor Hallucis Longus action

Ankle dorsiflexion; extension of the hallux (great toe)

Extensor Hallucis Longus location

originates on the middle section of the fibula and interosseus membrane; inserts on the dorsal base of the distal phalanx of the hallux (great toe)

Extensor Hallucis Longus innervation

Deep branch of the peroneal nerve

Extensor Digitorum Longus action

Ankle dorsiflexion; extension of all joints (MTP, PIP and DIP joints) of lesser toes #2-5

Extensor Digitorum Longus location

originates on the lateral condyle of the tibia, proximal 2/3 of the medial surface of the fibula and interosseus membrane; inserts by splitting into 4 tendons that attach to the proximal base of the dorsal surface of the middle and distal phalanges of toes #2-5

Extensor Digitorum Longus innervation

Deep branch of the peroneal nerve

Peroneus Tertius action

ankle dorsiflexion; eversion

Peroneus/Fibularis Tertius location

Originates on the distal third of the medial surface of the fibula and interosseus membrane; inserts on the dorsal surface of the base of the 5th metatarsal

Peroneus Tertius innervation

Deep branch of the peroneal nerve

Peroneus Longus action

Ankle eversion, plantarflexion

Peroneus/Fibularis Longus location

Originates on the lateral fibular head and interosseus membrane; inserts on the lateral surface of the medial cuneiform and plantar base of the 1st metatarsal

Peroneus Longus innervation

Superficial Peroneal Nerve

Peroneus Brevis action

Ankle eversion, plantarflexion

Peroneus/Fibularis Brevis location

Originates on the distal 2/3 of the lateral surface of the fibula; inserts on the styloid process of the 5th metatarsal

Peroneus Brevis innervation

Superficial Peroneal Nerve

Tibialis Posterior action

ankle plantarflexion, inversion

Tibialis Posterior location

originates on the proximal 2/3 of the posterior aspect of the tibia, fibula and interosseus membrane; inserts via multiple attachments to every tarsal bone except the talus, also attaches to the bases of metatarsals 2-4; its most prominent insertion is on the navicular tuberosity

Tibialis Posterior innervation

Tibial Nerve

Flexor Digitorum Longus action

Ankle plantarflexion, inversion, flexion of toes 2-5

Flexor Digitorum Longus location

originates on the posterior surface of the middle third of the tibia; inserts by 4 separate tendons to the base of the distal phalanx of the 4 lesser toes

Flexor Digitorum Longus innervation

Tibial Nerve

Flexor Hallucis Longus action

ankle plantarflexion, inversion, flexion of the hallux (great toe)

Flexor Hallucis Longus location

originates on the distal 2/3 of the posterior fibula; inserts on the plantar surface of the base of the distal phalanx of the hallux (great toe)

Flexor Hallucis Longus innervation

Tibial Nerve

Gastrocnemius action

ankle plantarflexion; knee flexion

Gastrocnemius location

medial head originates on the posterior aspect of the medial femoral condyle; lateral head originates on the posterior aspect of the lateral femoral condyle; inserts on the calcaneal tuberosity of the calcaneus via the Achilles tendon

Gastrocnemius innervation

Tibial Nerve

Soleus action

Ankle Plantarflexion

Soleus location

Originates on the proximal third of the posterior fibula, fibular head and posterior tibia; inserts on the calcaneal tuberosity of the calcaneus via the Achilles tendon

Soleus innervation

Tibial Nerve

Plantaris action

ankle plantarflexion; initiates knee flexion

Plantaris location

originates on the posterior surface of the pateral epicondyle of the femur; inserts on the medial aspect of the Achilles tendon to insert on the calcaneal tuberosity

Plantaris innervation

Tibial Nerve