Anatomy

1. LECTURE 9: NAVICULAR, CUBOID AND CUNEIFORM BONES
external features and attachments
Dr. EIMAAN SUMAYYAH
DPT (IPMR-KMU) MS NEUROLOGY (KMU)

2. • There are seven tarsal bones. Proximal row is formed by talus above,
and the calcaneus below. The distal row contains, from medial to lateral
side, medial cuneiform, the intermediate cuneiform, the lateral
cuneiform and the cuboid.
• Navicular is interposed between the talus and the three cuneiform
bones. In other words it is interposed between the proximal and distal
rows.

3. CUBOID
• The cuboid is the lateral most bone of the distal row. It is situated in
front of the calcaneum and behind the 4th and 5th metatarsal bones. It
has six surfaces.
• It is cuboidal in shape but has a broader base oriented medially

6. Structure of Cuboid Bone
• The dorsal surface is rough for the attachment of ligaments. It is directed upwards
and laterally.
• The plantar surface is crossed anteriorly by an oblique groove. The groove is
bounded posteriorly by a prominent ridge. The groove is called the peroneal sulcus
and it runs obliquely anteromedially.
• It lodges the tendon of the peroneus longus.
• The ridge ends laterally in an eminence, the tuberosity which presents an oval facet
for gliding of sesamoid bone or cartilage frequently found in the tendon of the
peroneus longus.
• The lateral surface is short and notched.

7. • The medial surface is extensive, being partly articular and partly nonarticular.
• An oval facet in the middle articulates with the lateral cuneiform bone.
Proximal to this a small facet may be present for the navicular bone. It is
rough in the rest of its extent, for the attachment of strong interosseous
ligaments.
• The proximal or posterior surface is concavoconvex for articulation with the
anterior surface of calcaneum. Its inferomedial angle projects backward as a
process, which underlies and supports the anterior end of the calcaneus.
• The distal surface is triangular and also articular. It is divided by a vertical
ridge into two areas. The medial, quadrilateral in form, articulates with the
fourth.

8. Articulations:
• The cuboid articulates with:
• Calcaneus
• Third cuneiform
• Fourth metatarsal
• Fifth metatarsal. It occasionally articulates with a fifth, the navicular.

9. Attachments on Cuboid
• The notch on the lateral surface, and the groove on the plantar surfaces, are
occupied by the tendon of the peroneus longus .
• The ridge posterior to the groove gives attachment to the deep fibers of the long
plantar ligament.
• Rough surface behind the groove gives attachment to plantar calcaneocuboid
ligament, few fibers of the flexor hallucis brevis, and a fasciculus from the tendon of
the tibialis posterior.
• The short plantar ligament is attached to the posterior border of the plantar surface.
• The plantar surface provides:
• Insertion to a slip from the tibials posterior
• Origin to the flexor hallucis brevis.

10. Navicular
• The navicular bone is boat-shaped. It is situated on the medial side of
the foot, in front of the head of the talus, and behind the three
cuneiform bones.
• It forms the uppermost portion of the medial longitudinal arch of the
foot and acts as a keystone of the arch.
• The navicular bone has 6 surfaces.

11. • The posterior or proximal navicular surface is oval, concave, broader laterally than
medially, and articulates with the rounded head of the talus.
• The medial surface has a blunt and prominent tuberosity, directed downwards. The
tuberosity is separted from the plantar surface by a groove.
• The anterior surface is convex, and is divided into 3 facets for the three cuneiform
bones.
• The dorsal surface is convex from side to side, and rough for the attachment of
ligaments
• The plantar surface is irregular, and also rough for the attachment of ligaments.
• The lateral surface is rough and irregular for the attachment of ligaments and
occasionally presents a small facet for articulation with the cuboid bone.

12. Attachments on Navicular
• Tibialis posterior attaches at the tuberosity of the navicular bone.
• The groove below the tuberosity transmits a part of the tendon of this muscle
to other bones.
• The plantar surface provides attachment to the spring ligament.
• The calcaneonavicular part of the bifurcate ligament is attached to the lateral
surface.
• Talonavicular, cuneonavicular and cubonavicular ligaments attach to the
dorsal surface

13. Articulations of Navicular
• The navicular articulates with 4 bones: the talus and the 3 cuneiforms.
Sometimes, a fifth articulation for the cuboid is also present.

14. Cuneiform Bones
• There are three cuneiform bones, medial, intermediate or middle and
lateral.
• The medial cuneiform is the largest and the intermediate or middle
cuneiform, the smallest.

17. Medial Cuneiform
• It is the largest cuneiform bone. It is situated at the medial side of the foot, between the navicular
behind and the base of the first metatarsal in front.
• The medial surface is broad, quadrilateral and subcutaneous. Except for its anterior inferior edge
which carries a smooth oval impression [for part of tibialis anterior tendon], this surface is rough.
• The lateral surface is marked by an inverted L-shaped facet along the posterior and superior margins
for the intermediate cuneiform bone.
• The anterosuperior part of the facet is separated by a vertical ridge which creates an anterior area
for articulation with the base of the second metatarsal bone.
• The anteroinferior part of the lateral surface is rough for the attachment of ligaments and part of the
tendon of the peroneus longus.

18. • The anterior surface is convex and is much larger than the posterior surface. It
articulates with the first metatarsal bone.
• The posterior surface is triangular, concave, and articulates with the most
medial and largest of the 3 facets on the anterior surface of the navicular.
[piriform facet].
• The plantar surface is formed by the base of the wedge. It is rough posterior
part has a tuberosity for the insertion of fibers of the tendon of the tibialis
posterior. Anterior part provides insertion to part of the tendon of the tibialis
anterior.
• The dorsal surface is the narrow end of the wedge and is directed upward and
lateralward. It is rough for the attachment of ligaments.

19. • The first cuneiform articulates with
• Navicular
• Second cuneiform
• First metatarsal
• Second metatarsal.

20. • Attachments of Cuneiform
• The greater part of the tibialis anterior is inserted into an impression on
the anteroinferior angel of the medial surface.
• The plantar surface receives a slip from the tibialis posterior.
• A part of the peroneus longus is inserted into the rough antroinferior
part of the lateral surface.

21. Middle Cuneiform
• It is smallest of three cuneiforms. It forms a dorsal base and apex is plantar.
• Situated between the other two cuneiforms, it articulates with the navicular behind and the second
metatarsal in front.
• The anterior surface is triangular and narrower than the posterior. It articulates with the base of the
second metatarsal bone.
• The posterior surface is also triangular. It articulates with the middle facet on the anterior surface of
the navicular.
• The medial surface carries an L-shaped articular facet, along the superior and posterior borders, for
articulation with the medial cuneiform. Rest of medial surface is rough for the attachment of
ligaments.

22. Middle Cuneiform
• The lateral surface presents a smooth facet for articulation with the
third cuneiform bone.
• The rough dorsal surface forms the base of the wedge.
• The plantar surface is sharp and tuberculated. It is also rough for the
attachment of ligaments and for the insertion of a slip from the tendon
of the tibialis posterior.

23. • The medial cuneiform articulates with
• Navicular
• First cuneiform
• Third cuneiform
• Second metatarsal.
• Attachments
• The plantar surface receives a slip from the tibialis posterior.

24. Lateral Cuneiform
• The dorsal surface is oblong and formed by the base of the wedge. Its posterolateral angle
prolong backward
• The plantar surface is formed by the edge of the wedge, has a rounded margin and serves
for the attachment of part of the tendon of the tibialis posterior, part of the flexor hallucis
brevis, and ligaments.
• Posterior or proximal surface is rough in its lower one third, and has a triangular facet in its
upper two thirds for the navicular bone.
• The lateral surface is marked in its posterosuperior part by a triangular or oval facet for the
cuboid. At the anteroinferior angel, a small facet may be present for the fourth metatarsal
bone.

25. • The anterior surface bears triangular articular facet and articulates with the
third metatarsal bone. the rough, nonarticular area serves for the attachment
of an interosseous ligament. The 3 facets for articulation with the 3
metatarsal bones are continuous with one another; those facets for
articulation with the second cuneiform and navicular are also continuous, but
the facet for articulation with the cuboid is usually separate.
• The medial surface is marked along its posterior margin by a vertical strip
indented in the middle, for articulation with the intermediate cuneiform
bone. Along the anterior margin of the surface there is a facet, sometimes
divided, for the base of the second metatarsal bone.
•

26. • The third cuneiform articulates with
• Navicular
• Intermdiate or middle cuneiform
• Cuboid
• Second, third, and fourth metatarsals.

27. • Attachments
• The plantar surface receives a slip from the tibialis posterior, and may
give origin to the flexor hallucis brevis.