This ppt will give you the basic knowledge about bony structure of the foot, every foot joints and associated muscles.

1. By:
HERMIZAN BIN HALIHANAFIAH
TARSAL, METATARSAL
ANDPHALANGEAL
BONES. ANKLE AND
FOOT JOINTS

2. TARSAL BONESTARSAL BONES
 Proximal part of the foot.
 7 tarsal bones :
- talus – superior ankle bone
- calcaneus – heel bone
- cuboid – anterior
- navicular – anterior
- 3 cuneiforms – anterior
* first (medial)
* second (intermediate)
* third (lateral)

3. TALUS BONE
 Talus which is most superior
tarsal bone.
 The only bone of the foot that
articulates with the fibula and tibia
on medial malleolus of the tibia
and on the others side with the
lateral malleolus of fibula 
form talocrural (ankle) joint.
 During walking, talus transmits
about half of the body weight to
the calcaneus.

4. NAVICULAR BONE
 The anterior tarsal bones.
 Like a little boat.
 It is located on the medial side of
the foot, and articulates
proximally with the talus,
distally with the three cuneiform
bones, and occasionally laterally
with the cuboid.

5. CUNEIFORM BONES
 Wedge shaped
 There are three cuneiform bones in
the human foot:
 the medial cuneiform
 the intermediate cuneiform also
known as the middle
 the lateral cuneiform
 They are located between the
navicular bone and the first, second
and third metatarsal bones and are
medial to the cuboid bone.

6. CUBOID BONES
 Cube-shaped
 Cuboid articulates distally with
the fourth and fifth metatarsals
 form fourth and fifth
tarsometatarsal joints
 articulates Proximally with the
calcaneus  form
calcaneocuboid joint

7. CALCANEUS BONE
 In humans, the calcaneus or heel
bone is a bone of the tarsus of
the foot which constitute the
heel.
 Located in the posterior part of
the foot.
 The largest & strongest tarsal
bone.
 Articulation between anterior
surface calcaneus and posterior
surface cuboid  form
calcaneocuboid joint

9. METATARSUSMETATARSUS
 Intermediate region of foot.
 5 metatarsal bones
 Numbered I to V from medial
to lateral
 Each metatarsal bone consists of
proximal base, distal head and
an intermediate shaft.

10.  Articulate proximally with the
first, second and third
cuneiform bones and with the
cuboid  form the
tarsometatarsal joints.
 Distally articulate with the
proximal row of phalanges 
form metatarsophalangeal
joints.
 The first metatarsal is thicker
than the others because it bears
more weight.

11. PHALANGES
 Comprise the distal
component of the foot and
resemble the hand both
numbers and arrangement.
 Toes numbered I to V
beginning with the great
toe (hallux)
 Each consists of a proximal
base, an intermediate shaft
and a distal head.

12. PHALANGES
 Great or big toe has large, heavy phalanges called
proximal and distal phalanges.
 The other four toes each have 3 phalanges called
proximal, middle and distal.
 Joints between phalanges of the foot are called the
interphalangeal joint.

13. Figure 8.40a

15. ANKLE JOINT
 The ankle joint is formed where the foot and
the leg meet.
 The ankle, or talocrural joint, is a synovial
hinge joint that connects the distal ends of the
tibia and fibula in the lower limb with the
proximal end of the talus bone in the foot.
 The articulation between the tibia and the talus
bears more weight than between the smaller
fibula and the talus.

17. ANKLE JOINT

18. Articulation
 The lateral malleolus of the fibula and the
medial malleolus of the tibia along with the
inferior surface of the distal tibia articulate with
three facets of the talus.
 These surfaces are covered by cartilage.
 The anterior talus is wider than the posterior
talus. When the foot is dorsiflexed , the wider
part of the superior talus moves into the
articulating surfaces of the tibia and fibula,
creating a more stable joint than when the foot is
plantar flexed.

19. Ligaments
 The ankle joint is bound by the strong deltoid
ligament and lateral ligaments
 Deltoid ligament support medial side of the
joint
 Lateral ligaments support lateral side of the
joint

20. Lateral ligaments:
 Anteriortalofibularligament (AFTL): passes from the fibula
to the front of the talus bone.
 PosteriortalofibularLigament (PTFL)- passes from the back
of the fibula to the talus bone posteriorly.
 Calcaneofibularligament (CFL)- connects the calcaneus and
the fibula

23. Deltoid ligaments:
- Tibionavicularligament:
Attached at medial malleolus of tibia
and connect to the navicular bone
- Tibiocalcaneal ligament:
Attached at medial malleolus of tibia and connect to the
calcaneus bone
- Tibiotalarligament:
Attached at medial malleolus of tibia and connect to the
talus

24. medial ankle

25. INTERTARSAL JOINTS
 Joints between tarsal bones are
called intertarsal joint.
 Specific articulation between:
1. inferior surface talus and
superior surface calcaneus 
form talocalcaneal joint
(subtalarjoint)
2. head of talus and posterior
surface navicular  form
talocalcaneonavicularjoint
3. anterior surface calcaneus and
posterior surface cuboid 
form calcaneocuboid joint

26. Movements
 Ankle joint:
 Plantarflexion
 Dorsiflexsion
 Intertarsal joint:
 Inversion
 Eversion

27.  Metatarsophalangeal joint:
 Adduction
 Abduction
 Flexion
 Extension
 Interphalangeal joint:
 Flexion
 Extension

28. Clinical significance
 Fracture:
 Most traumatic incidents involving the ankle result
in ankle sprains.
 Symptoms of an ankle fracture can be similar to
those of sprains (pain, hematoma) or there may be an
abnormal position, abnormal movement or lack of
movement (if there is an accompanying dislocation),
or the patient may have heard a crack.

29.  Sprains:
 Damage to ligamentous structures
 More common on lateral side of ankle
 Inversion Injuries
- Sprain lateral ligaments of ankle
- Stress lateral side of ankle
- Result of excessive foot inversion
 Eversion Injuries
- Stress medial side of ankle
- Result of excessive foot eversion

30. Ankle sprain. Inversion injury of ankle.
Note it is turned inward.
Medial and lateral malleolus . the
"bumps" on either side of the ankle.

31. MUSCLE OF FOOT
 Divided into Extrinsic muscle & Intrinsic
muscle of foot

32. Deep fascia
 Deep fascia of the foot forms the plantar
aponeurosis that extends from the calcaneus
bone to the phalanges of the toes.
 The aponeurosis supports the longitudinal
arch of the foot and enclosed the flexor
tendons of the foot

33. EXTRINSIC MUSCLES OF THE FOOT
 Tibialis anterior
 Extensor hallucis
longus
 Extensor digitorum
longus
 Fibularis (peroneus)
tertius
 Fibularis (peroneus)
longus
 Fibularis (peroneus)
brevis
 Gastrocnemius
 Soleus
 Tibialis posterior
 Flexor digitorum
longus
 Flexor hallucis longus
 Popliteus

34. INTRINSIC MUSCLE OF THE SOLE
 Divided into 2 groups :
1. Dorsal : only 1 muscle – extensor
digitorum brevis
2. Plantar : arranged in 4 layers
- 1st
layer (superficial layer) : abductor
hallucis, flexor digitorum brevis and
abductor digiti minimi
- 2nd
layer : quadratus plantae, lumbricals
- 3rd
layer : flexor hallucis brevis, adductor
hallucis, flexor digiti minimi brevis
- 4th
layer : dorsal interossei and plantar
interossei

35. DORSAL MUSCLE
Extensor digitorum brevis
 Origin : calcaneus & inferior
extensor retinaculum
 Insertion : tendons of extensor
digitorum longus on toes 2 – 4 &
proximal phalanx of great toe
 Action : extends toes 2 – 4 at
interphalangeal joints.
 Innervation : deep fibular
(peroneal) nerve

37. PLANTAR MUSCLE : FIRST LAYER
Abductor hallucis
 Origin : Calcaneus, plantar
aponeurosis & flexor
retinaculum
 Insertion : medial side of
proximal phalanx of the great
toe with the tendon of the
flexor hallucis brevis.
 Action : abducts & flexes
great toe at
metatarsophalangeal joint.
 Innervation : medial plantar
nerve

38. Flexor digitorum brevis
 Origin : Calcaneus & plantar
aponeurosis
 Insertion : sides of middle
phalanx of toes 2 – 5
 Action : flexes toes 2 – 5
proximal interphalangeal &
metatarsophalangeal joint
 Innervation : medial plantar
nerve
PLANTAR MUSCLE : FIRST LAYER

39. Abductor digiti minimi
 Origin : Calcaneus & plantar
aponeurosis
 Insertion : lateral side of proximal
phalanx of little toe with the
tendon of the flexor digiti minimi
brevis.
 Action : abducts & flexes little toe
at metatarsophalangeal joint
 Innervation : lateral plantar nerve
PLANTAR MUSCLE : FIRST LAYER

40. Quadratus plantae
 Origin : calcaneus
 Insertion : tendon of flexor
digitorum
 Action : assists flexor digitorum
longus to flex toes 2 – 5 at
interphalangeal &
metatarsophalangeal joint
 Innervation : lateral plantar
nerve
PLANTAR MUSCLE : SECOND LAYER

41. Lumbricals
 Origin : tendon of flexor
digitorum longus
 Insertion : tendon of extensor
digitorum longus on proximal
phalanges of toes 2 – 5
 Action : extends toes 2 – 5 at
interphalangeal joints & flex
toes 2 – 5 at
metatarsophalangeal joint
 Innervation : medial & lateral
plantar nerve
PLANTAR MUSCLE : SECOND LAYER

42. Flexor hallucis brevis
 Origin : cuboid & 3rd
cuneiform
 Insertion : medial & lateral sides
of proximal phalanx of great toe
via a tendon containing a
sesamoid bone.
 Action : flexes great toe at
metatarsophalangeal joint
 Innervation : medial plantar
nerve
PLANTAR MUSCLE : THIRD LAYER

43. Adductor hallucis
 Origin : metatarsal 2 – 4,
ligaments of 3 – 5
metatarsophalangeal joint &
tendon of peroneus longus.
 Insertion : lateral side of
proximal phalanx of great toe
 Action : adducts & flexes great
toe at metatarsophalangeal
joint
 Innervation : lateral plantar
nerve.
PLANTAR MUSCLE : THIRD
LAYER

44. Flexor digiti minimi brevis
 Origin : metatarsal 5 & tendon of
peroneus longus
 Insertion : lateral side of
proximal phalanx of little toe
 Action : flexes little toe at
metatarsophalangeal joint
 Innervation : lateral plantar
nerve.
PLANTAR MUSCLE : THIRD LAYER

45. Dorsal interossei
 Origin : adjacent side of all
metatarsals
 Insertion : proximal phalanges ;
both side of toe 2 & lateral side of
toes 3 and 4
 Action : abducts & flex toes 2 – 4 at
metatarsophalangeal joint & extend
toes at interphalangeal joints.
 Innervation : lateral plantar nerve.
PLANTAR MUSCLE : FOURTH
LAYER

46. Plantar interossei
 Origin : metatarsal 3 – 5
 Insertion : medial side of
proximal phalanges of toes 3-
5
 Action : adducts & flex
proximal at
metatarsophalangeal joint &
extend toes at
interphalangeal joints.
 Innervation : lateral plantar
nerve.
PLANTAR MUSCLE : FOURTH
LAYER

47. ARCHES OF THE FOOT
 Bone of foot arranged in 2 arches:
1. Longitudinal arch
2. Transverse arch
 Arches enable the foot :
1. to support the weight of the body
2. provide an ideal distribution of body weight
over the hard and soft tissues of the foot.
3. provide leverage when walking

48. ARCHES OF THE FOOT
 Arches are not rigid – they yield as weight is
applied and spring back when the weight is
lifted, thus helping to absorb shocks
 Arches are fully developed by the time
children reach age 12 or 13

50. Longitudinal arch
 Has 2 parts
 Both consist of tarsal and metatarsal bones
 Arranged to form an arch from the anterior to
the posterior part of the foot
 The medial part of the longitudinal arch
originates at the calcaneus
 It raises to the talus and descends through the
navicular, the 3 cuneiform, and the heads of
the 3 medial metatarsals.

51. Longitudinal arch
 Lateral part of the longitudinal arch begins at
the calcaneus
 It rises at the cuboid and descends to the
heads of the 2 lateral metatarsals.

53. Figure 8.42a

54. Transverse arch
 Found between the medial & lateral aspects of
the foot.
 Formed by the navicular, 3 cuneiforms and the
bases of the 5 metatarsals

55. Figure 8.42

58. Flatfoot & clawfoot
 Flat foot : decrease the height of the medial
longitudinal arch due weak tendons &
ligaments – results in weight and postural
abnormalities and weaking the supporting
tissues

59. normal foot
flat foot

60.  Clawfoot : medial longitudinal arch
abnormally elevated – caused by deformities
e.g. in DM whose neurological lesions lead to
atrophy of muscles of the foot.

62.  Muscles of the hand :
specialized for precise and intricate
movements
 Muscles of the foot :
specialized for support and locomotion