2. The foot
• It consists of
–The root(ankle) or tarsus
–The middle of the foot or
metatarsus
–The toes or digits
3.
4. Difference between Hand & foot
Hand Foot
Grasps Supports the weight of
the body
Carpus =1/6 of the
hand
Tarsus forms ½ of the
skeleton of the foot
Fingers are long Toes are short
5. The foot
• The bones of the foot can be divided into three
categories:
• Tarsals – A set of seven irregularly shaped bones.
They are situated proximally in the foot, in the ankle
area.
• Metatarsals – These bones connect the phalanges
to the tarsals. There are five in number – one for
each digit.
• Phalanges – The bones of the toes. Each toe has
three phalanges – a proximal, intermediate and
distal (except the big toe, which only has two
phalanges).
6.
7. Dorsal refers to the top of the foot. Plantar refers to the bottom of the foot
Anterior refers to the front of the body. Posterior refers to the back of the body
8.
9. The foot
• The feet are flexible structures of bones, joints,
muscles, and soft tissues that let us stand upright
and perform activities like walking, running, and
jumping.
• (L. hallux) is also the 1st toe (L. digitus primus);
• The little toe (L. digitus minimus) is also the 5th toe
(L. digitus quintus).
10. The foot
• The feet are divided into three sections:
• The forefoot contains
– Five toes (phalanges)
– Five longer bones (metatarsals).
• The midfoot is a pyramid-like collection of bones that
form the arches of the feet. These include
– Three cuneiform bones,
– Cuboid bone,
– Navicular bone.
• The hindfoot forms the heel and ankle.
– The talus bone supports the leg bones (tibia and fibula),
forming the ankle.
– The calcaneus (heel bone) is the largest bone in the foot.
11.
12. The Tarsal Bones
• The Tarsal Bones are 7 in number.
• All these are short bones which collectively create
tarsus.
• These are arranged in 3 rows:
– Proximal row includes talus and calcaneus.
– Middle row is made of navicular.
– Distal row is composed of 3 cuneiforms (medial,
intermediate, and lateral) and cuboid.
• Only one bone, the talus, articulates with the leg
bones.
17. Identification of bones in the
skeleton of the foot
• Calcaneus (heel bone) is the largest and most proximal
bone.
• Talus is the 2nd largest bone and is located above the
calcaneus like a rider, therefore maximum bone in
the skeleton of foot.
• Navicular is boat-shaped and is located in front of the
head of talus.
• Cuboid is cubical in shape in front of the lateral part of
calcaneum.
• Cuneiforms are small wedge-shaped bones and
ordered from side to side in front of navicular.
18. CALCANEUS (LATIN CALCANEUS = HEEL)
• The calcaneus is the largest and strongest bone of
the foot.
• It is situated below the talus and goes behind it.
• It is most posterior tarsal bone.
• It is a rectangular block of bone.
• Its anterior end has an articular surface for the
cuboid bone.
• Its posterior end is thick, called calcaneal tuberosity
& divided into 3 parts:
–Upper smooth part
–Middle rough ridge for tendoachilis insertion.
–Lower subcutaneous part.
19.
20. The calcaneus
• The calcaneus lies underneath the talus.
• It has two articulations:
• Superiorly:
– Subtalar joint
• Anteriorly:
– Calcaneocuboid joint
• It is thick and transmits forces from the talus to the
ground.
• The posterior aspect of the calcaneus is marked by
calcaneal tuberosity, to which the Achilles tendon
attaches.
21. SIDE CONCLUSION AND ANATOMICAL POSITION
• The side of calcaneus is ascertained by holding it in
its anteroposterior axis in this style that:
• Its narrow end bearing concavo-convex facet faces
anteriorly.
• Its concave surface bearing shelf like projection
faces medially.
• Surface bearing large convex articular facet faces
dorsally.
22. FEATURES
• The calcaneum presents 6 surfaces:
– anterior, posterior, superior, plantar, lateral, and medial.
1. Anterior surface
• It’s the smallest and bears a concavo-convex articular facet
to joint with cuboid.
2. Posterior surface
• It’s split into the following 3 parts:
– Smooth upper part for Tendocalcaneus .
– Convex lower part is grooved for longitudinally for the
attachment of posterior fibres of planter aponeurosis.
– The extreme upper part below an upturned lip has a bare area for
a bursa lies deep to Tendocalcaneus .
23. FEATURES
3. Superior (dorsal) surface
The superior or dorsal surface bears three facets:
anterior, middle and posterior that articulate with
corresponding facets on the talus.
• From the anterior part, sustentaculum tali carries
an articular facet for the head of the talus.
• The middle part carries a facet for the body of
talus.
• Most anteriorly there is a third small facet for the
talus.
24. FEATURES
4. Plantar (inferior) surface
• It’s rough and marked by 3 tubercles.
– A small tubercle at the anterior end referred to as
anterior tubercle.
– An elevation at its posterior end termed calcaneal
tuberosity presenting a large medial and small lateral
tubercles.
• Triangular area between the 3 tubercles gives connection to
the long plantar ligament.
• A groove in front of the anterior tubercle supplies
attachment to short plantar ligament.
25. FEATURES
5. Lateral surface
• It’s virtually flat and subcutaneous.
• It presents a small elevation in its anterior
part named peroneal trochlea (tubercle)
which is located 2 cm below the tip of lateral
malleolus.
• Peroneal trochlea is located between the
groove for the tendon of peroneus
brevis above and the groove for the tendon
of peroneus longus below.
26. FEATURES
6. Medial surface
• It’s concave from above downward.
• A shelf like projection referred to as sustentaculum
tali projects from its upper anterior part.
• Superior surface of sustentaculum tali bears a facet
for talus while its inferior surface carries a groove
for the tendon of flexor hallucis longus.
• Tendon of flexor digitorum longus is related to the
medial surface of sustentaculum tali.
27. CLINICAL SIGNIFICANCE
• Calcanean fracture:
• It takes place when someone falls on
his cures from a large height.
• The calcaneum breaks into a number
of bits and fracture lines generally
run vertically.
31. SIDE CONCLUSION AND ANATOMICAL POSITION
• The side of talus is discovered by keeping it upon
the table-top in such a way that:
• Its rounded head is directed forwards.
• Its trochlear articular surface (that is convex
anteroposteriorly and concave from side to side)
faces upward.
• Triangular articular surface on the side of body
faces laterally while the comma-shaped articular
surface on the side of body is directed medially.
32. FEATURES OF TALUS
• The talus presents a head, a neck, and a
body.
• Head:
–It’s directed forwards, medially, and somewhat
downward.
–Its anterior surface presents a convex articular
surface which articulates with the concavity
of navicular bone.
–Its inferior surface rests on Sustentaculum Tali and
anteromedial part of upper surface of the
cacaneum
33. FEATURES OF TALUS
• Neck:
• It’s a constriction between the head and the body.
• It projects forwards and medially from the body making
an angle of 150 ° with the body (neck-body angle).
• Distal part of dorsal surface of neck gives connection to
the dorsal talonavicular ligament.
• Lateral surface of the neck gives connection to the
anterior talofibular ligament.
• Plantar surface of the neck presents a narrow deep
groove termed sulcus tali which creates sinus tarsi with
the corresponding groove of calcaneus.
– The sulcus tali and the sulcus calcanei in the articulated foot
form a tunnel, the sinus .
39. Sustentaculum Tali
• This sustentaculum tali is also known as Talar Shelf.
• The sustentaculum tali is a horizontal shelf that arises
from the anteromedial portion of the calcaneus.
• The superior surface is concave and articulates with the
middle calcaneal surface of the talus.
• The inferior surface has a groove for the tendon
of flexor hallucis longus.
• Several ligamentous structures attach to the
sustentaculum tali:
– Plantar calcaneonavicular ligament (anterior surface)
– Deltoid ligament (medial surface)
– Medial talocalcaneal ligament
40. FEATURES OF TALUS
BODY(CUBOIDAL IN SHAPE)
1. Superior surface: It presents trochlear articular surface
being wide anteriorly. It articulates with all the distal
outermost layer of the tibia.
2. Inferior surface: It presents a large oval concave facet which
articulates together with the posterior facet of calcaneus to
create the subtalar joint.
3. Medial surface: Its upper part presents a comma-shaped
articular facet which articulates together with the medial
malleolus.
4. Lateral surface: It presents a triangular articular facet to
joint with lateral malleolus.
5. Posterior surface: It’s narrow and projects backwards as the
posterior process of talus. It presents an oblique groove limit
by a small medial and large lateral tubercles. The groove
lodges the tendon of flexor hallucis longus.
41. CLINICAL SIGNIFICANCE
• Fracture neck of talus:
• It occasionally takes place because of
strong dorsiflexion of foot.
• The arteries supplying the talus goes into
via the front part of the neck and pass
backwards.
• These arteries are damaged in the
fracture neck of talus and cause delayed
union or necrosis of the posterior section
43. Intermediate Group
• The intermediate row of tarsal bones
contains one bone, the navicular (given its
name because it is shaped like a boat).
• It articulates with the talus posteriorly, the
cuneiform bones anteriorly, and the cuboid
bone laterally.
• On the plantar surface of the navicular, there
is a tuberosity for the attachment of
the tibialis posterior tendon.
45. The navicular bone
• Anterior surface:
– Convex and possesses 3 articular facets for 3 cuneiforms.
• Posterior surface:
– Deeply concave and articulates with the head of talus.
• Dorsal surface:
– Convex and rough, and gives connection to the dorsal talonavicular
ligament.
• Plantar surface:
– Presents a groove in its medial part via which enters the tendon of
tibialis posterior.
– Its lateral part gives connection to the spring ligament.
• Medial surface:
– Projects downward to create tuberosity of navicular bone, which gives
insertion to the major part of the tendon of tibialis posterior.
• Lateral surface:
– Rough and might present a facet for cuboid.
48. SIDE DECISION AND ANATOMICAL POSITION
• The side of navicular bone is discovered
by holding it in this type of manner that:
• Its deep concave surface faces
posteriorly.
• A notable projection, the navicular
tuberosity, is directed medially.
• A groove adjacent to tuberosity faces
inferiorly.
49. Distal Group
• In the distal row, there are:
• Four tarsal bones
–The cuboid and the three cuneiforms.
–These bones articulate with the
metatarsals of the foot.
• The shape of the bones helps form
a transverse arch across the foot.
52. The cuboid bone
1. Anterior (distal) surface joins the bases of fourth and
fifth metatarsals.
2. Posterior (proximal) surface articulate with the
calcaneum.
3. Dorsal (superior) surface is rough and flat. It gives
connection to dorsal ligaments of the foot.
4. Plantar (inferior) surface presents an oblique groove in
its distal part for the passage of tendon of peroneus
longus.
5. Medial surface makes joint together with the navicular
and lateral cuneiform bones.
6. Lateral surface is small and grooved by the tendon of
peroneus longus
55. Cuneiform bones
• These bones are wedge shaped and 3 in number- medial
(first cuneiform), intermediate (second cuneiform), and
lateral (third cuneiform).
• The medial cuneiform is the largest and the intermediate
cuneiform is the smallest.
• Proximal surfaces of cuneiforms joint with all the navicular
bone.
• Distal surface of medial cuneiform articulates with the base
of first metatarsal.
• Distal surface of intermediate cuneiform articulates with
the base of second metatarsal.
• Distal surface of lateral cuneiform articulates with the base
of third metatarsal.
56.
57. Cuneiform Bones
• The three small, wedge-shaped cuneiform bones
articulate proximally with the navicular bone and
distally with the first three metatarsal bones.
• Their wedge shape contributes greatly to the formation
and maintenance of the transverse arch of the foot.
• The base of second metatarsal is the most fastened
because it fits into the mortise created by 3
cuneiforms.
• Because of this, the axial line of foot goes through
the second toe and movements of abduction or
adduction of toes are mentioned with reference to
the 2nd toe.
58. The metatarsal bones and phalanges
• Resemble the metacarpals and phalanges of the hand, and
each possesses a head distally, a shaft, and a base
proximally.
• The five metatarsals are numbered from the medial to the
lateral side.
• The first metatarsal bone is large and strong and plays an
important role in supporting the weight of the body.
• The head is grooved on its inferior aspect by the medial and
lateral sesamoid bones in the tendons of the flexor hallucis
brevis.
• The fifth metatarsal has a prominent tubercle on its base
that can be easily palpated along the lateral border of the
foot. The tubercle gives attachment to the peroneus brevis
tendon.
• Each toe has three phalanges except the big toe, which
possesses only two.
59. Tarsal
bones
The bones of the ankle There are seven tarsal bones: talus, calcaneus, navicular, medial cuneiform,
intermediate cuneiform, lateral cuneiform, cuboid
Talus
The most proximal of the tarsal
bones
The talus articulates with the medial malleolus of the tibia and the lateral
malleolus of the fibula to form the ankle mortise joint
Body The proximal part of the talus Its superior (trochlear) part participates in the ankle joint and its inferior part
articulates with the calcaneus
Trochlea The superior portion of the body
of the talus that lies between the
two malleoli
It has a smooth articular surface; it participates in the formation of the ankle
joint
Head The portion of the talus that
projects anteriorly
It articulates with the navicular bone
Neck The constricted part of the talus
located proximal to the head
Calcaneus The tarsal bone which forms the
heel
It is the largest and strongest bone in the foot; a fracture of the calcaneus which
separates the tuberosity from the body can be a debilitating injury
Calcaneal tuberosity The posterior roughened area of
the calcaneus which contacts the
ground during weight-bearing
It is the insertion site of the calcaneal (Achilles') tendon
Sustentaculum tali The shelf-like medial projection of
bone located inferior to the medial
malleolus
It is a shelf of bone that articulates with and supports the talus; it is grooved
inferiorly by the tendon of the flexor hallucis longus m.
Navicular The tarsal bone located distal to
the talus and proximal to the three
cuneiform bones
It articulates with the head of the talus and all three cuneiform bones; it is the
attachment site for an important ligament (plantar calcaneonavicular or "spring"
ligament) that supports the medial longitudinal arch of the foot
Cuneiform
medial
The most medial bone in the distal
row of tarsal bones
The cuneiform bones articulate with the navicular bone proximally and the
bases of the metatarsal bones distally
Cuneiform
middle
The intermediate bone of the
three cuneiform bones
The cuneiform bones articulate with the navicular bone proximally and the
bases of the metatarsal bones distally
Cuneiform
lateral
The bone that is located between
the middle cuneiform and the
cuboid bone
The cuneiform bones articulate with the navicular bone proximally and the
bases of the metatarsal bones distally
Cuboid The most lateral bone in the distal
row of tarsal bones
The cuboid bone articulates with the calcaneus proximally and the fourth and
fifth metatarsal bones distally
60. Talipes/club foot
• A deformity in
which the
foot is twisted
out of normal
position.
