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
