Meyr Ligaments

How does the foot supinate?

- talus dorsiflexes and abducts - as a result of this the navicular, cuboid and calcaneus relatively plantarflex and adduct - calcaneus also inverts at subtalar joint

Lesser Metatarsophalangeal Joint

MT 2-5, covex, dorsal tubercles near the surgical neck proximal phalanx bases- ovoid and concave, plantar tubercles

No formal joint/ligament exists between what

1st and 2nd MT bases

keystone of 2nd MT

2 MT

What ligaments hold the superior tibiofibular joint together?

2 capsular ligament: ASTFL and PSTFL

what ligaments hold the intercuneiform and cuneocuboid joints together

2 dorsal intercuneiform and dorsal cuneocuboid ligaments, 2 plantar intercuneiform/cuneocuboid ligaments relatively strong, Interosseous intercuneiform /cuneocuboid lig x2 short strong ligaments

3rd MT has how many articular faces

2 medially for 2nd base mt, 1 laterally for 4th met base

do the proximal intermetatarsal joints communicate with the great tarsal synovial cavity?

2-3 yes, 3-4 yes, 4-5 NO

forefoot arthrology

21 bones, 15 joints

What ligaments hold interphalangeal joints together

2x collateral ligaments that run obliquely from dorsal tubercles on head to plantar tub on base. 1x plantar ligaments- fibrocartilaginous NO DORSAL LIGAMENTS

tibia and fibular have how many joints

3 , superior tibiofibular joint, crural interosseous membrane, tibiofibular syndesmosis

The ankle joint

3 bones, 1 joint, tibia: plafond is wholly articular, wider ant than posterior , continuous with medial malleolus fibula: lateral malleolar fossa

What ligaments hold the cuneonavicular joint together

3 dorsal cunonavicular lig (apex/crest mc, base ic, base lc) 3 plantar cuneonavicular lig to crest of ic and lc, medial cuneonavicular lig medial nav to med surface of mc

the 2nd MT base has how many facets laterally

4 ( 1 medially)

Which parts of which bones make up the ankle joint

4 parts: ant: wide, AITFL. posterior: narrow, Inferior transverse ligament, medial- "gutter", lateral- "gutter"

foot has

41 joints, 132 ligaments

plantar tarsometatarsal ligaments

5 , reinforcement from posterior tibial tendon and long plantar ligament make these stronger than dorsal ligaments

What ligaments hold this joint together? Lesser met

5 total, plantar metatarsophalangel( plantar pads), 2 x collateral lig, 2 x suspesory

What ligaments hold the ankle joint together

7 lateral 3, medial 4, capsular 6, extracapsular 1

How many dorsal tarsometatarsal ligaments are there

7, dorsal of 1st base to crest of mc, 2nd mT base to mc, 2MT to IC, 2nd MT to LC, 3MT to LC, 4MT to cuboid, 5th MT to cuboid

Rearfoot Ligaments

8 joints, 27 ligaments

Lis Franc articulations, tarsometatarsal joints

9 bones, 3 joints, 8 articulations

interphalangeal joints

9 possible joints, Hallux IPJ, 4 digits each with PIPJ and DIPJ, synostoses very common, synovial ginglymus/ hinge joints, flexion and extension. Can dorsiflex/plantarflex

transverse tarsal joint (chopart's joint)

Anterior surfaces of talus and calcaneus articulate with posterior surfaces of navicular and cuboid. Gliding. Inversion and eversion. TCN joint and calcaneoboid joint

superior tibiofibular joint

Articulation between head of fibula and posterior lateral aspect of proximal tibia. Synovial, Plane (gliding) joint with small amount of rotation. close to fibular nerve

talonavicular joint/talocalcaneonavicular TCN

Articulation between the talus and the poster surface of navicular bones, includes calcaneus; part of the midtarsal joint, calcaneus and navicular form a socket for talus to fit in. Triangular gap closed by spring ligament

Fusion of which joint in the rearfoot complex has the most effect on the other joints?

TCN has largest effect, subtalar joint has least effect

posterior Talocalcaneal ligament

Y shaped ligament running from superior surface of the calcaneus to each of the post talar processess, forms a groove for FHL tendon, capsular

Deep transverse metatarsal ligament

a relatively firm ligament that connects one metatarsal head to the next. Short, strong ligaments connecting to PLANTAR PAD, DOES NOT directly attach to bone, prevents spreading of MT's , not a true joint.

Subtalar Joint

a synovial plane, gliding joint in the ankle found between the talus and calcaneus, 2 posterior facets are most important.

as ankle plantarflexes, it also

adducts

Fibula faces ________________ STF joint

anterior superior medial FASM

lateral ankle ligaments

anterior talofibular ATFL posterior talofibular PTFL calcaneofibular CFL

Collateral ligaments of the Hallucal met joint

are NOT part of the sesamoid apparatus

inferior transverse ligament

at the most inferior portion of the PITFL, it's fibrocartilaginous, it's also referred to as the "intermalleolar ligament"

bifurcate ligament

attaches calcaneus to cuboid and navicular. Lateral end of sulcus calcanei and splits into calcaneocuboid and calcaneonavicular portions. EXTRACAPSULAR

dorsal aspect of IC and LC

base

keystone

base of 2nd MT is locked in to a keystone or mortise by all 3 cuneiforms

What makes up the socket of the TCN?

bifurcate lig laterally, tibionavicular medially, posterior tibial tendon, FHL underneath sus tali

the hallucal metatarsophalangeal joint

bigger, has sesamoids, first ray has an independent range of motion. 1st MT head- rounded and convex. proximal phalanx- concave, medial and lateral sesamoids ( medial larger)

Only saddle joint of the foot

calcaneocuboid joint

Open Chain Kinetic Action

calcaneus dorsiflexes, abudcts, and everts while the talus plantarflexes and adducts

Closed chain kinetics

calcaneus everts while the talus plantarflexes and adducts

calcaneocuboid joint

calcaneus(ant) to cuboid( post), synovial, SADDLE JOINT, limited motion

medial and lateral metatarsosesamoid lig

comparable to the suspensory ligaments of the lesser MPJs - connect dorsal tubercles of 1mt head to sesamoid

ankle joint features

compound synovial modified ginglymus hinge joint, has capsular membranes that are weakest ant and post, reinforced medially and laterallly (stronger)

TCN joint (talocalcaneal navicular)

compound, synovial joint similar to ball and socket, MULTIPLANAR motion including eversion/inversion, addu/abduc

medial cuneiform posterior surface

concave and pear shaped, largest, base inferior

Lateral cuneiform posterior surface

convex and triangular shaped, base suprior

the calcaneal posterior facet is __________ along its long axis, while the talar posterior facet is __________ along its axis

convex, concave

dorsal aspect of medial cuneiform

crest/ apex

lateral tarsometatarsal joint

cuboid and bases of metatarsals 4 and 5, DOES NOT contribute to great tarsal synovial cavity

lateral interosseous tarsometatarsal ligament

cuboid to medial surface of 4th MT

Cuboideonavicular joint

cuboid( post-medial) and navicular (ant lat) can be synovial or syndesmotic, no motion, moves as unit with calcaneus, connects medial and lateral columns

great tarsal synovial cavity

cuneonavicular joints x3, intercuneiform x2, cuneocuboid x1, iintermediate tarsomet joint 4 articulations, proximal intermetatarsal joints 2

medial ankle ligaments

deltoid ligament one large fan like sheet of tissue from medial mal to foot. Anterior tibiotalar lig, posterior tibiotalar, tibocalcaneal lig, tibionavicular lig ALL ARE capsular

anterior cuboid facet

divided by a vertical ridge, 4th met is square, 5th is triangular

If the talus plantarflexes and adducts( pronation), what will the navicular, cuboid, and calcaneous do

dorisflex and abduct. The calcaneus also everts at the subtalar joint

suspensory ligaments x2

dorsal tubercles of MT heads to edge of plantar pad, superior to inferior soft tissue driection

syndesmosis can have what motion

dorsiflexion of ankle, can have shortening force fibula ext rotates on the tibia

long plantar ligament

extends from the plantar surface of calcaneus to the promontory of cuboid and lateral 2-4 metatarsals. Helps to maintain the longitudinal arch of the foot, Extracapsular, LONGEST ligament in the foot , one of the strongest ligaments of body

CFL is ___________________

extracapsular, runs inferior and posterior, easy to distinguish

intermediate cuneiform posterior surface

flat/concave and triangular shaped, smallest, base superior

Interosseus ligament of tibiofibular joint function

STRONGEST most important, run between the fibular notch and inte. crest

talar head and neck of TCN joint

head is convex in all directions

lis franc articulation- 1 st MT movement

in independent range of motion

tibiofibular syndesmosis

inferior fibrous attachment of tibia and fibula that prohibits movement between the two bones, tibia- fibular notch, fibula- triangular area ONLY CONSTANT SYNDESMOTIC JOINT IN THE BODY. FIBROUS

What way do fibers run in the interosseus membrane

inferior lateral direction, IM is CT , has two perforations for ant tib and perforating peroneal/fibular

calcaneofibular ligament

intrinsic ligament located on the lateral side of the ankle joint, between the retrotrochlear eminence calcaneus bone and "summit" of lateral malleolus of the fibula; supports the talus bone at the ankle joint and resists excess inversion of the foot.

What type of motion occurs at the subtalar joint

inversion/eversion

medial-intermediate cuneiform joints

inverted L shape posteriorly

4th MT base has how many facets

medial -2 for 3rd MT and lateral cuneiform, lateral 1 facet for articulation with 5th met base.

The proximal MT only articulates with what

medial cuneiform

medial tarsometatarsal joint

medial cuneiform and first metatarsal, greatest freedom of movement, has its own synovial capsule, DOES NOT contribute to the great tarsal synovial cavity

lateral cuneiform-cuboid

oval shaped facet

lateral talocalcaneal ligament

parallel and deep to CFL on lateral side from lateral talar process to lat surface of calcaneus

medial talocalcaneal ligament

passes from the medial tubercle of the posterior process of the talus to the posterior edge of the sustentaculum tali and the adjacent medial surface of the calcaneus; reinforces the anatomic subtalar joint, medially, capsular

Where are sesamoid bones embedded

plantar metatarsophalangeal lig

The sesamoid apparatus consists of 5 ligaments which hold the sesamoids strongly in relation to the proximal phalanx and relatively weakly to the first metatarsal. Which ligaments are these?

plantar metatarsophalangeal lig, metatarsosesamoid, medial and lateral, intersesamoid, phalangeosesamoid, deep transverse connects to sesamoid instead of MT

supination

plantarflexion, adduction, inversion

posterior tibiotalar ligament

post medial mal to post medial talar tub

Tibia faces __________________ . STF joint

posterior inferior lateral TPIL

5th MT base articulations

posterior is triangular shaped, medial side has 1 facet for 4th MT base, lateral no facets

What action takes place at the ankle joint

primarily dorsiflexion/plantarflexion but joint axis is OBLIQUE not horizantal , essentially no eversion/inversion Together the ankle and subtalar joints work together to produce a pro/supination joint

talonavicular ligament

provides dorsal support, somewhat thin band that extends from the dorsal surface of the neck of the talus to the dorsal surface of the navicular bone, WEAK

cuneonavicular joints

proximal facets of the 3 cuneiforms with the distal surface of the navicular; plane, synovial articulations, all three share common synovial space and contribute to the great tarsal synovial cavity

collateral ligaments of foot

run obliquely from the dorsal tubercles on MT heads to plantar tubercles on phalangeal bases Run proximal/distal to plantar side

posterior talofibular ligament

runs from lateral malleolar fossa horizantally to the posterior strip on lateral surface of talus. Capsular, "Strongest "lateral ankle ligament

lateral supporting ligaments/ intraosseous lig

runs medially and laterally from base of distal phalanx to tuft. protects neurovasc. at tip of toe, owl's eyes, not a true joint

interosseous talocalcaneal ligament

runs through the sinus tarsi, Fills space of the sinus tarsi, blends with the stem of inferior extensor retinaculum

interosseous cuboideonavicular ligament

short, strong ligament connecting cuboid and navicular

squatter's facet

space /room to maneuver ant to ankle joint

plantar calcaneonavicular ligament

spring ligament

Lesser Metatarsophalangeal Joints are...

synovial, ellipsoidal, BIAXIAL motion, able to dorsiflex/plantarflex, adduct, abduct, NO DORSAL LIGAMENTS

Intercuneiform and cuneocuboid joints

synovial, plane joints, contribute to great tarsal synovial cavity

the bifurcate ligament also holds what joint together

talonavicular, extracapsular

The long plantar ligament is physically separated from what ligament? When sheath does it form?

the plantar calcaneocuboid ligament, forms the peroneal sheath enclosing the tendon of peroneus longus

cervical ligament of foot

-strongest ligament/ connection between talus and calcaneus on lateral side -between talus and calcaneus, between lateral edge of sinus tarsi to lateral aspect of the neck of the talus, lateral to interosseous talocal. lig

midfoot and lisfranc articulations

10 bones, 18 joints

PITFL is stronger than

AITFL

What ligaments hold the tibiofibular syndesmosis together

AITFL- ant border of fib notch of tibia to ant border of lat malleolus . PITFL-post border of fib notch to lat mal sulcus STRONGER than AITFL interosseus ligament- VERY STRONG

intermediate tarsometatarsal joint

Between all cuneiforms and the bases of the 2nd and 3rd metatarsals. The second metatarsal is restricted in movement and is therefore more likely to be fractured. IS part of great tarsal synovial cavity

What ligaments hold the subtalar joint together?

People love my irresistable cookies capsular: Posterior talocalcaneal, Lateral talocalcaneal, medial talocalcaneal Extracapsular: interosseus calcaneal and cervical- strongest

pronation

abduction, eversion dorsiflexion

As ankle dorsiflexes, it also

abducts

CFL crosses what joints

ankle and subtalar joints

tibiocalcaneal ligament crosses what joints

ankle and subtalar joints

tibionavicular ligament crosses what joints

ankle and talonavicular joints

tibonavicular ligament

ant colliculus to tuberosity of navicular.

cuneonavicular joint

ant surface of navicular, wholly articular, divided by 2 vertical ridges into 3 facets for cuneiforms

Plantar calcaneocuboid ligament

ant tubercle of calcaneus to the plantar surface of the cuboid, post to promentory. Capsular, little brother of long plantar ligament, short ligament

Distal tibiofibular syndesmosis

forms a socket or mortise for the ankle joint, complete RING of tissue. posterior ring: inferior transverse ligament the most inferior fibrocartilaginous portion of the PITFL

anterior tibiotalar ligament

from ant colliculus of medial malleolus to rough area below comma facet. DEEPEST

crural interosseous membrane

from interosseous border of the tibia to the interosseous border of the fibula lateral border of tibia to media border of fibula, essentially no movement

dorsal calcaneocuboid ligament

from the distal dorsal /lateral calcaneal surface to the proximal dorsal surface of the cuboid; reinforces the calcaneocuboid joint, dorsally weak , capsular

Dorsal cuboideonavicular ligament

from the lateral dorsal surface of the navicular to the medial dorsal surface of the cuboid; reinforces this area of the great tarsal joint if this articulation is synovial; blends with the fibers of the interosseous cuboideonavicular ligament when this joint is a fibrous joint

plantar cuboideonavicular ligament

from the lateral plantar aspect of the navicular to the medial plantar aspect of the cuboid; blends with fibers of the interosseous cuboideonavicular ligament when this is a syndesmosis

tibiocalcaneal ligament

from tibia to the free edge of sustentaculum tali, merges with spring ligament

extracapsular ligaments of the subtalar joint

interosseous talocalcaneal and cervical

anterior talofibular ligament

intrinsic ligament located on the lateral side of the ankle joint(ant border of lat malle), between talus bone and lateral malleolus of fibula; supports talus at the talocrural joint and resists excess inversion of the foot. CAPSULAR ligament, shortest and weakest. low ankle/inversion sprains

posterior joint capsule

large potential space for insulflation, injecting. Posterior comm with FHL

The hilus of the medial cuneiform is on what side

lateral

Proximal Intermetatarsal Joints

lateral aspects of 2, 3, 4 met to medial aspect of adj digit synovial , plane joints

plantarcalcaneonavicular (spring) ligament

lateral portion from calcaneus to navicular tuberosity. medial portion from sus tali and navicular, fuses with tibiocalcaneal ligament proximally and distally tibionavicular, tough fibrocartilage.

2-4 fxn as a unit

lis franc articulation

Intermediate interosseous ligament

medial surface of LC to lat 2nd base

Chopart's joint

midtarsal joint

the foot ankle have two main fxns

mobile, pronating adaptor pronation, and rigid lever arm supination

interosseous intermetatarsal ligaments

stronges x3

interosseous tarsometatarsal ligaments

strongest of the strong, connects lateral surface of the medial cuneiform to medial surface of the base of the 2nd MT. *** lis franc's ligament

calcaneofibular ligament and the tibiocalcaneal ligament (medial) cross and support what joint

subtalar joint