Anatomy Review Part III the Knee Ankle Foot

Anatomy Review Part III: the Knee, Ankle, & Foot Jan Mc. Elroy PT, MS, PCS 2009 Do not copy without permission

Knee

Knee: skeletal system

OVERVIEW The knee joint connects: • Patella the femur superiorly to the (or knee cap) Femur Tibia and fibula inferiorly • movements Fibula are primarily in the sagittal plane: flexion & extension • Knee Tibia Anterior view Right knee

FEMUR: LANDMARKS Left Femur. Posterior view • Medial condyle • Lateral condyle • Intercondylar fossa • Medial epicondyle • Lateral epicondyle • Patellar surface Left Femur. Anterior view

TIBIA & FIBULA: LANDMARKS TIBIA • Medial condyle • Lateral condyle • Tuberosity • Tibial plateau FIBULA • Right knee Anterior view Head of the fibula Right knee Posterior view

Knee: muscular system

ANTERIOR MUSCLES OF THE KNEE Quadriceps (rectus femoris, vastus medialis, vastus lateralis, vastus intermedialis Note: The rectus femoris is the only muscle of the quadriceps group that crossed both the hip and the knee. Referred to as a “ 2 joint muscle”. From: Novartis Interactive Atlas, Frank Netter artist Anterior view right thigh

POSTERIOR MUSCLES OF KNEE Hamstrings › Biceps femoris › Semitendinosus › semimembranosus Note: All of the hamstrings cross both the hip joint and the knee joint. They are all referred to as “ 2 joint muscles”. Posterior view right thigh

POSTERIOR MUSCLES OF KNEE Gastrocnemius › Lateral head › Medial head Note: The gastrocnemius crosses both the knee and the ankle making it a “ 2 joint muscle”. Posterior view right thigh

Ankle & Foot

Ankle & Foot: skeletal system

OVERVIEW The distal end of the fibula forms the lateral malleolus The distal end of the tibia forms the medial malleolus Anterior view Right foot & ankle

OVERVIEW The foot is divided into 3 general regions: Tibia Fibul Midfoot Forefoot Hindfoot Lateral view Right foot & ankle

HINDFOOT The Hindfoot consist of 2 bones: Calcaneus (heel bone) & Talus Tibia Fibul Hindfoot Lateral view Right foot & ankle

MIDFOOT The midfoot consists of 5 small bones: • Navicular Cuboid & • 3 Cuneiforms • These 5 bones of the midfoot are called Tarsals Superior view Left foot

FOREFOOT The forefoot consists of: 5 Metatarsals (first thru 5 th) • & 5 proximal phalanges • & • 4 middle phalanges (the “big toe” only has a proximal and a distal…no middle phalange) & • 5 distal phalanges

JOINTS OF THE FOOT Talocrural joint Subtalar joint Midtarsal joint (ankle joint) tibia, fibula, talus calcaneocuboid, talonavicular talus, calcaneus Tarsometatarsal joints Metatarsophalangeal joints

Ankle & Foot: muscular system

ANTERIOR LOWER LEG Tibialis Anterior (commonly called the anterior tib) • • Peroneus longus • Extensor digitorum longus (digitorum refers to the digits or “toes”) Anterior view Right leg From: Novartis Interactive Atlas, Frank Netter artist

POSTERIOR LOWER LEG • Gastrocnemius (often called the “gastroc”) • Achilles tendon (also called the “heel cord”) • Soleus Note: though the gastroc and soleus both insert into the achilles tendon, the soleus only crosses the ankle joint…while the gastroc is a 2 joint muscle crossing both the knee and the ankle. Posterior view Right leg From: Novartis Interactive Atlas, Frank Netter artist

Recommended References: 1. Atlas of Human Anatomy, Frank Netter 2. Mc. Minn’s Color Atlas of Human Anatomy, Abrahams, Hutchings, & Marks 3. Kinesiology of the Musculoskeletal System, Donald Neumann 4. Anatomy Coloring Book, Kapit & Elson