joints and muscles of the foot. architecture of the...
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Joints and muscles of the foot.
Architecture of the foot.
Sándor Katz M.D.,Ph.D.
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Ankle (talocrural) jointtype: hinge
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Talocrural joint - medial collateral ligament
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Medial collateral = deltoid ligament
Tibionavicular part (1)(partly covers the anteriortibiotalar part)
Tibiocalcaneal part (2-3)
Posterior tibiotalar part(4)
Medial process (6)Sustentaculum tali (7)Tendon of tibialis posteriormuscles (9)
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Talocrural joint - lateral collateral ligament
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Lateral collateral ligament
Anterior talofibularligament (5, 6)
Calcaneofibular ligament(10)
Lateral malleolus (1)Tibia (2)Syndesmosis tibiofibularis (3, 4)Talus (7)Collum tali (8)Caput tali (9)Interosseous talocalcanealligament (11)Cervical ligament (12)Talonavicular ligament (13)Navicular bone (14)
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Posterior talofibular ligament (5)
Fibula (1)Tibia (2)Proc. tali, tuberculum laterale (3)Proc. tali, tuberculum mediale (11)Tendo, musculus felxor hallucis longus (8)Lig. calcaneofibulare (12)Tendo, musculus peroneus brevis (13)Tendo, musculus peroneus longus (14)Art. subtalaris (15)
Lateral collateral ligament
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Talocrural joint - movements
Dorsiflexion: 15°
Plantarfelxion: 40°
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Talotarsal joint (lower ankle joint): talocalcaneonavicular joint and subtalar
joint
Type: restricted ball-and-socket
Bony surfaces: anterior and middletalar articular surfacesand head of the talus+anterior and middle calcanealarticular surfaces, navicular.
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Talotarsal joint (lower ankle joint): talocalcaneonavicular joint and subtalar
joint
Plantarcalcaneonavicularliament:connects calcaneusto the navicular andkeeps anarticulating surfacefor the head of talus.
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Talotarsal joint (lower ankle joint): talocalcaneonavicular joint and subtalar
joint
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Talotarsal joint: talocalcaneonavicular joint and subtalar joint
Bony surfaces: posterior talar articular surface+posterior calcaneal articular surface
Type: pivot joint
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Talotarsal joint: talocalcaneonavicular joint and subtalar joint
Lateral and medial talocalcaneal ligaments reinforce the articular capsule.
Type: pivot joint
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Talocalcaneonavicular joint
• Interosseous talocalcaneal ligament (19) – in the sinus tarsi (15)
• Bifurcate ligament (24): calcaneonavicular lig. + calcaneocuboid lig.
Lig. talofibulare anterius (17)Lig. calcaneofibulare (18)Lig. cervicale (20)Lig. talonaviculare (21)Lig. calcaneocuboideum leterale (22)Lig. cuneonaviculare dorsale (23)
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Talotarsal joint - ligaments and movements
„PADS”:plantarflexion+adduction+supination (inversion)
„DABP”:dorsiflexion+abduction+pronation (eversion)
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Transverse tarsal (Chopart’s) joint: talocalcaneonavicular joint and
calcaneocuboid joint
Type:amphyarthrosis.
Minimal plantar anddorsal movementsand rotation. Supportsthe longitudinal archof the foot.
Chopart’s amputation.
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• Intertarsal joints: Amphyarthroses.
• Tarsometatarsal (Lisfranc’s) joints:Amphyarthrosis. Lisfranc’s amputation.
• Metatarsophalangeal joints:Restricted ball-and-socket. Collateraland plantar ligaments and deeptransverse metatarsal ligament.
• Interphalangeal joints: Hinge.Collateral ligaments.
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• Intertarsal joints: Amphyarthroses.
• Tarsometatarsal (Lisfranc’s) joints:Amphyarthrosis. Lisfranc’s amputation.
• Metatarsophalangeal joints:Restricted ball-and-socket. Collateraland plantar ligaments and deeptransverse metatarsal ligament.
• Interphalangeal joints: Hinge.Collateral ligaments.
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Plantar architecture
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Arches of foot
The weight of the body is transmitted to thetalus from the tibia. Then it is transmittedposteriorly to the calcaneal tubercle andanteriorly to the heads of the 1st-5thmetatarsals.The cuneiforms and the bases of the metatarsalstogether form the transverse arch. Itsuppermost point is the medial cuneiform.
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• Plantar aponeurosis: fromcalcaneal tubercle to theplantar surfaces of toes. Workswhen the body is standing;stabilizes the transverse arch aswell.
• Long plantar ligament: fromcalcaneus to the bases ofmetatarsals. Stabilizes thebones at the lateral side.
• Plantar calcaneocuboidligament: from calcaneus to thecuboid bone. Stabilizes thebones at the lateral side.
• Plantar calcaneonavicularligament: extendes thearticular surface for the head oftalus.
Arches of the foot - ligaments
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• Tibialis ant. + post.: atthe medial side
• Tibialis ant. + fibularislongus: stabize thetransverse arch
• Fibularis tertius +fibularis brevis: at thelateral side
• Other stabilizers:• flexor hallucis longus• abductor hallucis• abductor digiti minimi• flexor digitorum brevis
Arches of the foot - muscles
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Walking
During walking, many anatomicalfeatures of the lower limbscontribute to minimizingfluctuations in the body’s center ofgravity and thereby reduce theamount of energy needed tomaintain locomotion and producea smooth, efficient gait.They include pelvic tilt in thecoronal plane, pelvic rotation inthe transverse plane, movement ofthe knees toward the midline ,flexion of the knees, and complexinteractions between the hip, knee,and ankle.As a result, during walking thebody’s center of gravity normallyfluctuates only 5cm in both verticaland lateral directions.
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Foot muscles
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Foot muscles - plantar side
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Foot muscles - plantar side
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Foot muscles - plantar side
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Foot muscles - plantar side
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Foot muscles - plantar side
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Foot muscles - dorsal side
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Foot muscles - interossei
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Thank you for your attention.
References: Drake: Gray’s Anatomy for Students, 2nd ed.Standring: Gray’s Anatomy, 39th ed.Radiopaedia.orgSpringer: SH Atlasz, Anatómia I.Apáthy István Pályázat 2012, Martinovszky F., Bardosh D.