Functional Anatomy of the Foot: Difference between revisions
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=== Foot Articulations === | === Foot Articulations === | ||
The ''hindfoot'' has a [[talus]] and calcaneus articulation called the [[Subtalar Joint Arthritis|'''subtalar joint''']] (ST, also known as the talocalcaneal joint). Three facets of the talus and of the calcaneus are part of this joint. The main motions are inversion and eversion of the ankle and hindfoot. | |||
The '''talonavicular''' and '''calcaneocuboid''' joints are known as [[Chopart fracture-dislocation|Chopart's joint]] (MT, midtarsal or transverse tarsal joint), which is located between the ''hindfoot and midfoot''. This joint allows forefoot rotation. The navicular articulates with all three cuneiform bones distally. In addition to the navicular and cuneiforms bones, the cuboid bone has a distal articulation with the base of the fourth and fifth metatarsal bones. | |||
The '''tarsometatarsal joint''' (TMT or [[Lisfranc Injuries|Lisfranc's joint]]) connects the ''midfoot with the forefoot'' and originates from the lateral, intermediate and medial cuneiforms articulating with the bases of the three metatarsal bone (1st, 2nd, and 3rd). The small movement that occurs in the joint is described as dorsal and plantarflexion. The bases of the remaining metatarsal bones (4th and 5th) connect with the cuboid bone. | |||
The five rays, metatarsal and corresponding phalanges create the ''forefoot'' medial and lateral columns where rays 1,2, and 3 belong to the middle column, rays 4 and 5 to the lateral column. The '''metatarsophalangeal''' joints (MTP joints) are the main components of the forefoot. Each toe, except for the great toe, has proximal and distal '''interphalangeal''' joints (IP joints). The latter has only one IP joint. | |||
Below is a summary of the ankle and foot articulations | |||
Revision as of 09:16, 29 March 2023
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Introduction[edit | edit source]
Human feet allow for bipedal locomotion [1], and they are an essential sensory structure for postural control.[2] The foot structure is complex, with many bones, joints and ligaments that divide the foot into a rearfoot, midfoot, and forefoot. Clinicians’ ability to understand anatomical structures of the foot is a crucial component of their examination and treatment intervention, especially when treating clients with musculoskeletal conditions. [3] [4] This article discusses the foot assessment's elements, including key anatomical structures.
Anatomy Basic Vocabulary[edit | edit source]
Axes: lines around which an object rotates. Axis of rotation is a line which passes through the centre of mass.There are three axes of rotation: saggital passing from posterior to anterior, frontal passing from left to right, and vertical passing from inferior to superior.
Bursae: reduces friction between body's joints moving parts. It is fluid filed sac. There are four types of bursae: adventitious, subcutaneous, synovial, and sub-muscular.
Capsule: one of the characteristics of the synovial joints. It is a fibrous connective tissue which forms a band that seals the joint space, provides passive and active stability and may even form articular surfaces for the joint.[5]
Closed pack position: most amount of the area of joint contact between the two sides of the joint. In this position the joint stability increases. Closed pack position for interphalangeal joints is at full extension.
Degrees of freedom: the direction of joint movement or rotation, with six being a maximum and including three translations and three rotations.
Ligament: fibrous connective tissue that holds the bones together.
Open (loose) pack position: least amount of the area of joint contact where joint stability is reduced.
Planes of movement: describe how the body moves. Up and down movements (flexion/extension) occur in a saggital plane. Sideways movements (abduction/adduction) are done is frontal plane. Movements in transverse plane are rotational (internal and external rotation).
Foot Structure[edit | edit source]
The anatomical structure of the foot consists of the hindfoot, midfoot and forefoot. Each part of the foot is composed of several bones.
Foot Bones[edit | edit source]
The talus and calcaneus form the posterior aspect of the foot, which is called the hindfoot. The midfoot (located between the hindfoot and forefoot) is made up of five tarsal bones: the navicular, cuboid, and medial, intermediate, and lateral cuneiforms. The most anterior aspect of the foot including the metatarsals, phalanges, and sesamoid bones is called the forefoot. Each digit, except for the great toe, consists of a metatarsal and three phalanges. The great toe has only two phalanges.
Foot Articulations[edit | edit source]
The hindfoot has a talus and calcaneus articulation called the subtalar joint (ST, also known as the talocalcaneal joint). Three facets of the talus and of the calcaneus are part of this joint. The main motions are inversion and eversion of the ankle and hindfoot.
The talonavicular and calcaneocuboid joints are known as Chopart's joint (MT, midtarsal or transverse tarsal joint), which is located between the hindfoot and midfoot. This joint allows forefoot rotation. The navicular articulates with all three cuneiform bones distally. In addition to the navicular and cuneiforms bones, the cuboid bone has a distal articulation with the base of the fourth and fifth metatarsal bones.
The tarsometatarsal joint (TMT or Lisfranc's joint) connects the midfoot with the forefoot and originates from the lateral, intermediate and medial cuneiforms articulating with the bases of the three metatarsal bone (1st, 2nd, and 3rd). The small movement that occurs in the joint is described as dorsal and plantarflexion. The bases of the remaining metatarsal bones (4th and 5th) connect with the cuboid bone.
The five rays, metatarsal and corresponding phalanges create the forefoot medial and lateral columns where rays 1,2, and 3 belong to the middle column, rays 4 and 5 to the lateral column. The metatarsophalangeal joints (MTP joints) are the main components of the forefoot. Each toe, except for the great toe, has proximal and distal interphalangeal joints (IP joints). The latter has only one IP joint.
Below is a summary of the ankle and foot articulations
Retrocalcaneal bursae is located between calcaneus and the anterior surface of the Achilles tendon[6]
Resources[edit | edit source]
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References[edit | edit source]
- ↑ Farris DJ, Kelly LA, Cresswell AG, Lichtwark GA. The functional importance of human foot muscles for bipedal locomotion. PNAS 2019; 116(5).
- ↑ Viseux FJF. The sensory role of the sole of the foot: Review and update on clinical perspectives. Neurophysiol Clin. 2020 Feb;50(1):55-68.
- ↑ Lee SW, Le PU, Van Dien C, Hansen M, Tiu T. Evaluation of Resident Palpation Skills in Foot and Ankle Anatomic Structures Using Bedside Ultrasound. HCA Healthcare Journal of Medicine 2020; 1(3).
- ↑ Kitagawa T, Aoki Y, Sugimoto H, Ozaki N. Randomised controlled trial for evaluation of an ultrasound-guided palpation intervention for palpation skill training. Sci Rep. 2022 Jan 24;12(1):1189.
- ↑ Ralphs JR, Benjamin M. The joint capsule: structure, composition, ageing and disease. J Anat. 1994 Jun;184 ( Pt 3)(Pt 3):503-9.
- ↑ Aaron DL, Patel A, Kayiaros S, Calfee R. Four common types of bursitis: diagnosis and management. J Am Acad Orthop Surg. 2011 Jun;19(6):359-67.
