Review the bones of the ankle and foot

region.
Correlate the different anatomical structures
of the ankle and foot with its anatomical and
clinical significance.
Describe the joints of the ankle and foot as
to:
Articulating surfaces
Type of joint
Movement

Describe the attachments and functions of

the ligaments of the ankle and foot.

Discuss the origin, insertion, action and nerve

supply of the muscles of the ankle and foot.
Discuss the different arches of the foot.
Integrate the radiographic appearance of the ankle
and foot with the knowledge of basic anatomy.

Medial malleolus
Articular facet for talus
Fibular notch

Lateral malleolus
Articular facet for talus

Talus
Calcaneus

Trochlear surface
Head
Neck
Medial and lateral
tubercles

Calcaneal tuberosity
Lateral and medial
processes
**sinus tarsi
Sustentaculum tali

Navicular
Cuboid
3 cuneiforms

Proximal surface
Distal surface
Tuberosity

Metatarsals
Phalanges

Articulating surfaces
Type of joint
Motions

Articulating surfaces
Type of joint
Motions

Articulating surfaces
Type of joint
Motions

Articulating surfaces
Type of joint
Motions

Talocalcaneonavicular
Calcaneocuboid
Articulating surfaces
Type
Motions

Articulating surfaces
Type
Motions

Articulating surfaces
Type
Motions

Articulating surfaces
Type
Motions

Articulating surfaces
Type
Motions

Interosseus ligament
Anterior and posterior
distal tibiofibular ligaments

MCL/ deltoid ligament

Tibionavicular
Tibiotalar
tibiocalcaneal

LCL
Anterior talofibular
Calcaneofibular
Posterior talofibular

Medial Talocalcaneal
ligament
Lateral Talocalcaneal
ligament
Interosseous
Talocalcaneal ligament

Plantar calcaneonavicular
ligament (spring ligament)
Long and short plantar
ligaments

Ankle sprain

MUSCLES OF THE
ANTERIOR
COMPARTMENT OF
THE LEG

TIBIALIS
ANTERIOR

Lateral surface of
shaft of tibia and
interosseous
membrane

Medial cuneiform
and base of first
metatarsal bone

Deep peroneal
nerve

Extends foot at
ankle joint;
inverts foot at
subtalar and
transverse tarsal
joints; holds up
medial
longitudinal arch
of foot

TIBIALIS ANTERIOR

PERONEUS
TERTIUS

Anterior surface Base of fifth

of shaft of fibula metatarsal bone

Deep peroneal
nerve

Extends foot at
ankle joint;
everts foot at
subtalar joint
and transverse
tarsal joints

PERONEUS TERTIUS

EXTENSOR
DIGITORUM
LONGUS

Anterior surface
of the shaft of
fibula

Extensor
expansion of
lateral four toes

Deep peroneal
nerve

Extends toes;
extends foot at
ankle joint

EXTENSOR
DIGITORUM LONGUS

EXTENSOR
DIGITORUM BREVIS

Calcaneum

By four tendons into

the proximal
phalanx of big toe
and long extensor
tendons to second,
third, and fourth
toes

Deep peroneal nerve Extends toes

EXTENSOR
DIGITORUM BREVIS

EXTENSOR
Anterior surface
HALLUCIS LONGUS of shaft of fibula

Base of distal
phalanx of great
toe

Deep peroneal
nerve

Extends big toe;

extends foot at
ankle joint; inverts
foot at subtalar
and transverse
tarsal joints

EXTENSOR
HALLUCIS LONGUS

MUSCLES OF THE
POSTERIOR
COMPARTMENT OF
THE LEG


1.
2.

3.

SUPERFICIAL GROUP
Gastrocnemius
Soleus
Plantaris

GASTROCNEMI
US

Lateral head
from lateral
condyle of
femur and
medial head
from above
medial condyle

Via tendo
calcaneus into
posterior
surface of
calcaneum

Tibial nerve

Plantarflexes
foot at ankle
joint; flexes
knee joint

GASTROCNEMIUS

SOLEUS

Shafts of tibia
and fibula

Via tendo
calcaneus into
posterior
surface of
calcaneum

Tibial nerve

SOLEUS

Together with
gastrocnemius
and plantaris is
powerful
plantarflexor of
ankle joint;
provides main
propulsive
force in walking
and running

Posterior
PLANTARIS Lateral
supracondy surface of
lar ridge of calcaneum
femur

Tibial nerve Plantarflexe

s foot at
ankle joint;
flexes knee
joint

PLANTARIS


1.
2.
3.

DEEP GROUP
Tibialis Posterior
Flexor Digitorum
Longus
Flexor Hallucis Longus

TIBIALIS POSTERIOR

Posterior surface of
shafts of tibia and
fibula and
interosseus
membrane

Tuberosity of
navicular bone and
other neighboring
bones

Tibial nerve

Plantarflexes foot at
ankle joint; inverts
foot at subtalar and
transverse tarsal
joints; supports
medial longitudinal
arch of foot

TIBIALIS POSTERIOR

FLEXOR
DIGITORUM
LONGUS

Posterior surface
of shaft of tibia

Bases of distal
phalanges of
lateral four toes

Tibial nerve

Flexes distal
phalanges of
lateral four toes;
plantarflexes foot
at ankle joint;
supports medial
and lateral
longitudinal
arches of foot

FLEXOR
DIGITORUM LONGUS

FLEXOR HALLUCIS
LONGUS

Posterior surface of Base of distal

shaft of fibula
phalanx of big toe

Tibial nerve

Flexes distal
phalanx of big toe;
plantar flexes foot
at ankle joint;
supports medial
longitudinal arch
of foot

FLEXOR
HALLUCIS LONGUS

MUSCLES OF THE
LATERAL
COMPARTMENT OF
THE LEG

PERONEUS LONGUS Lateral surface of

shaft of fibula

Base of first
metatarsal and the
medial cuneiform

Superficial
peroneal nerve

Plantarflexes foot
at ankle joint;
everts foot at
subtalar and
transverse tarsal
joints; supports
lateral longitudinal
and transverse
arches of foot

PERONEUS LONGUS

PERONEUS BREVIS Lateral surface of Base of fifth

shaft of fibula
metatarsal bone

Superficial
peroneal nerve

Plantarflexes foot
at ankle joint;
everts foot at
subtalar and
transverse tarsal
joint; supports
lateral
longitudinal arch
of foot

PERONEUS BREVIS

MUSCLES OF THE
SOLE OF THE FOOT


1.
2.
3.

FIRST LAYER
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi

Flexion

of the

big toe
Abduction of
the big toe
ABDUCTOR
HALLUCIS

Flexion

of the
lateral 4 toes

FLEXOR
DIGITORUM BREVIS

Flexion
th
5 toe

of the

Abduction
th
the 5 toe

of

ABDUCTOR
DIGITI MINIMI

SECOND LAYER
1. Lumbricals
2. Quadratus Plantae

Extension

toes at IP
joints

of

LUMBRICALS

Assists

FDL in
flexing lateral
4 toes

QUADRATUS
PLANTAE


1.
2.
3.

THIRD LAYER
Flexor Hallucis brevis
Adductor hallucis
Flexor digiti minimi

Flexion

of MTP
joint of the
big toe

FLEXOR
HALLUCIS BREVIS

Flexion

of MTP
joint of big
toe

ADDUCTOR
HALLUCIS

Flexion

of
MTP joint of
little toe

FLEXOR DIGITI
MINIMI BREVIS

FOURTH LAYER
1. Interossei (dorsal and
plantar)

Abduction of
toes
Flexion of MTP jts
Extension of IP jts
DORSAL
INTEROSSEI

Adduction of
toes
Flexion of MTP jts
Extension of IP jts
PLANTAR
INTEROSSEI

Medial longitudinal
arch
Lateral longitudinal
arch
Transverse arch

BONES

KEYSTONE

Calcaneus, talus,
navicular bone, the
three cuneiforms, and
the first three
metatarsal bones
Talus

BONES

KEYSTONE

Calcaneus, cuboid, and the

fourth and fifth metatarsal
bones
Cuboid

BONES

Bases of the metatarsal

bones and the cuboid and
the three cuneiforms

KEYSTONE

The marked wedge shaping

of the cuneiform bones and
the bases of the metatarsal
bones

Pes Planus

Topic Organizer:
Nestor Don N. Santiago, MD