Unit Three Part I Student Notes

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Unit 3/ Chapter 18: The Foot
Part I
ANATOMY OF THE FOOT
Bones
 Toes- ____________________________ (14)
o Wider base for ______________________
o Propelling the body
o 2 sesmoid bones
 Metatarsal Bones (5 bones)
o Between the tarsals and phalanges
o Semimovable- gives elasticity to the foot
o _______________________________ is the main weight bearing bone of the
foot
 Tarsal Bones (7 Bones)
o Calcaneus- ______________________ bones
 Supports the talus and Achilles attach
o ___________________ - most superior tarsal bone
 Gives lateral and dorsi/ plantar flexion
o ______________________ (Medial side)
 Anterior to the talus
 Cuboid (lateral side)
 Articualtes with the calcaneus and the 4TH and 5TH metatarsal
o Cuneiforms (3 bones)
 Medial aspect
 Between the navicular and the 3 metatarsals
QUESTION
How many phalanges are there on one foot?
______________________________________________________________________________
How many metatarsal bones?
______________________________________________________________________________
Name the 7 tarsals?
______________________________________________________________________________
Arches of the Foot
 Roles:
o _____________________ the body weight
o Absorbing ___________________________
o Providing space for blood vessels, nerves, and muscles

4 Arches
o __________________________ Arch: Shaped by the distal heads of the
metetarsals
 Stretches from the 1ST to the 5TH
o _______________________________: Extends across the transverse tarsal
bones
 Half dome
o Medial Longitudinal: Along the _____________________________________
 Plantar Calcaneonavicualr ligament (spring) returns arch to normal
position after pressure
o Lateral Longitudinal: Along the lateral border
 Much lower and less flexible
Plantar Fascia
 Thick, white band of fibrous tissue from the medial calcaneus to the proximal heads of
the metatarsals
 Supports the foot against downward forces
 Extension of the “calf” muscles
Draw & Label the 4 Arches
Articulations (Joints)
 _________________________________:
o Flexion and extension
o Reinforcing medial and lateral collateral ligaments as well as plantar and dorsal
ligaments
 Metatarsophalengeal:
o Flexions, extension, adduction and abduction
o Collateral ligaments as well as plantar and dorsal
 Intermetatarsal: _____________________________
o Between the metatarsals
 Tarsometatarsal Joint: (_________________________)
o Between the tarsals and the heads of the metatarsals
 Subtalar: ____________________________________________
o Inversion, Eversion, Pronation and Supination
 Midtarsal (Chopart’s): Calcaneocubiod and talonavicular
Label the Articulations
Stabilizing Ligaments
 Subtalar Ligaments
o Interosseus talocalcaneal and the anterior, posterior, lateral and medial
talocalcaneal
 Plantar Calcaneonavicular
o __________________________ for the medial arch
 Midtarsal Joint
o Dorsal talonavicualr, bifurcate, Dorsal calcaneocuboid, Long plantar ligament
 Anterior Tarsal Joints
o Cuneonavicular, cuboideonavicualr, intercuniform and cuneocuboid
Muscles and Movement
 Dorsiflexion: (________________________________________)
o Tibialis anterior, extensor digitorum longus, extensor hallucus longus and
peroneus tertius
 Plantar Flexion: (_________________________________________)
o Gastrocnemius, soleus, plantaris, perioneus longus/ brevis, tibilais posterior,
flexor hallucis longus and flexor digitorum longus
 Inversion, Adduction & Supination
o Medial movements of the foot
o Muscles pass behind and in front of the medial malleolus
o Behind Malleolus: tibialis posterior, flexor digitorum longus, and flexor hallucis
longus (__________________________________________)
o Front of Malleolus: Tibialis anterior and extensor hallucis longus
 Eversion, Abduction & Pronation
o ______________________________________ of the ankle
o Muscles pass behind and in front of the lateral malleolus
o Behind the malleolus: Peroneus longus and peroneus brevis
o In front of the malleolus: Peroneus tertius and extensor digitorum longus
 Movement of the Phalanges (Flexion, extension, abduction and adduction)
o Flexion of the 2nd through 5 th : Flexor ___________________ longus and brevis


Flexion of Great Toe: Flexor _______________________ longus
Extension: Extensor digitorum longus and brevis. (2nd- 5th)
o Extensor __________________________ longus great toe
Nerve and Blood Supply
 Plantar side nerve: medial and lateral plantar nerves from the tibial nerve
 Dorsal side nerve: Deep peroneal nerve
 Blood supply: anterior tibial artery and the posterior tibial artery
Functional Anatomy of the Foot and Biomechanics
 Kinetic Chain- Segments are joined together
o When considering foot, ankle, and leg injuries, need to look at kinetic chain
 Each segment has an effect on ___________________________________ segments
 Lower-extremity chronic and overuse injuries need to look at biomechanical factors
New Vocab Word
 Stance Phase
o From initial contact to toe-off
 Swing Phase
o Period of non-weight bearing
Normal Gait
 Stance Phase
o Accounts for ______________% of gait cycle
o __________________ kinetic chain
o Five periods
 Initial contact (double limb support)
 Loading response (double limb support)
 Mid stance (single limb support)
 Terminal stance (single limb support)
 Pre swing
 Swing Phase
o Period of non-weight bearing
o Three periods
 Initial swing
 Mid swing
 Terminal swing
 Running Gait
o Loading and mid-stance = more rapid
o After toe off – _____________________________________ contact for both feet
o Stance phase = ______________% of gait cycle
o Shock absorber at heel strike and adapts to uneven surface during stance
o At push-off foot serves as rigid lever to provide propulsive force
o 80% of distance runners follow heel strike pattern
o Sprinters tend to be _______________________ strikers
Subtalar Joint Pronation and Supination
 Excessive or prolonged pronation or supination can contribute to
_______________________________________________
 Subtalar joint allows foot to make stable contact with ground and get into weight bearing
position
 Excessive motion, compensates for structural deformity

Structural Deformities
o Forefoot and rearfoot varus are usually associated with over-pronation
o Forefoot valgus causes excess supination
o May interfere with shock absorption
New Vocab Word
 Excessive Pronation
o Produced in Stance phase or prolonged pronation in propulsive phase
 Excessive Supination
o At heel strike, excessive supination in the subtalar joint
Prevention of Foot Injuries
 Forces foot encounters can result in acute traumatic and overuse injuries
 Injuries best prevented by:
o Selecting appropriate footwear
o Correcting biomechanical structural deficiencies through orthotics
o Paying attention to hygiene

Selecting Appropriate Footwear
o Pronators: _________________ shoe is recommended
o Supinators: Require ________________________ footwear with increased
cushioning
o Basic form shoe is constructed on (last) dictates stability of shoe
 Slip last shoe (moccasin style) is very flexible (Supinators)
 Board last provides firm inflexible base (Pronators)
 Combination last provides rearfoot stability and forefoot mobility

Using Orthotics
o Used to correct for _________________________________ problems in the foot
o Can be constructed of plastic, rubber, cork, or leather
o Can be prefabricated or custom fitted

Foot Hygiene
o Keeping toenails trimmed correctly
o Shaving down excessive calluses
o Keeping feet ______________
o Wearing clean and correctly fitting socks and shoes
o Keeping feet as dry as possible to prevent development of athlete’s foot
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