Anatomy Tables - Anterior & Lateral Leg & Foot

Anatomy Tables - Anterior & Lateral Leg & Foot

Osteology
Bone	Structure	Description	Notes
tarsal bones		the bones of the ankle	there are seven tarsal bones: talus, calcaneus, navicular, medial cuneiform, intermediate cuneiform, lateral cuneiform, cuboid
	transverse tarsal joint	formed by the combined talonavicular part of the talocalcaneonavicular and calcaneocuboid joints	synovial joint responsible for inversion/eversion of the foot; transection across this joint is a standard method for surgical amputation of the foot
talus		the most proximal of the tarsal bones	the talus articulates with the medial malleolus of the tibia and the lateral malleolus of the fibula to form the ankle mortise joint (Latin, talus = ankle bone)
	body	the proximal part of the talus	its superior (trochlear) part participates in the ankle joint and its inferior part articulates with the calcaneus
	subtalar joint	occurs where the talus rests on and articulates with the calcaneus
	trochlea	the superior portion of the body of the talus that lies between the two malleoli	it has a smooth articular surface; it participates in the formation of the ankle joint (Latin, trochlea = pulley)
	head	the portion of the talus that projects anteriorly	it articulates with the navicular bone
	neck	the constricted part of the talus located proximal to the head
calcaneus		the tarsal bone which forms the heel	it is the largest and strongest bone in the foot; a fracture of the calcaneus which separates the tuberosity from the body can be a debilitating injury (Latin, calcis = heel)
	calcaneal tuberosity	the posterior roughened area of the calcaneus which contacts the ground during weight-bearing	it is the insertion site of the calcaneal (Achilles') tendon
	sustentaculum tali	the shelf-like medial projection of bone located inferior to the medial malleolus	it is a shelf of bone that articulates with and supports the talus; it is grooved inferiorly by the tendon of the flexor hallucis longus m. (Latin, sustento = to hold upright)
navicular		the tarsal bone located distal to the talus and proximal to the three cuneiform bones	it articulates with the head of the talus and all three cuneiform bones; it is the attachment site for an important ligament (plantar calcaneonavicular or "spring" ligament) that supports the medial longitudinal arch of the foot (Latin, navicular = small boat shaped structure)
cuneiform, medial		the most medial bone in the distal row of tarsal bones	the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally
cuneiform, middle		the intermediate bone of the three cuneiform bones	the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally
cuneiform, lateral		the bone that is located between the middle cuneiform and the cuboid bone	the cuneiform bones articulate with the navicular bone proximally and the bases of the metatarsal bones distally
cuboid		the most lateral bone in the distal row of tarsal bones	the cuboid bone articulates with the calcaneus proximally and the fourth and fifth metatarsal bones distally
metatarsals		the bones located between the tarsal bones and the phalanges	there are five metatarsal bones in the foot
	base	the proximal end of the metatarsal	it articulates with the distal row of tarsal bones
	body	the slender shaft of the metatarsal	it is also known as the diaphysis
	head	the rounded distal end of the metatarsal	it articulates with the proximal phalanx of the corresponding digit
phalanx (phalanges)		the distal two or three bones in the digits of the foot	there are a total of 14 phalanges in the foot; the great toe has two phalanges (proximal and distal) and each of the other four toes has three phalanges (proximal, middle and distal); (Latin, phalanx = line of soldiers)
	base	the proximal end of the phalanx	the base of the proximal phalanx articulates with the head of the corresponding metatarsal bone; the base of the middle or distal phalanx articulates with the head of the next most proximal phalanx
	body	the slender shaft of the phalanx	also known as the diaphysis; the body of the distal phalanx is very short
	head	the distal end of the phalanx	the proximal, middle and distal phalanges each have a head; the head of a proximal or middle phalanx articulates with the base of the next most distal phalanx

Muscles
Muscle	Origin	Insertion	Action	Innervation	Notes
abductor hallucis	medial side of tuberosity of calcaneus	medial side of base of proximal phalanx of hallux	abducts hallux; flexes metatarsophalageal joint	medial plantar nerve	(Latin, hallex = great toe)
adductor hallucis	oblique head: bases of metatarsals 2-4; transverse head: heads of metatarsals 3-5	lateral side of base of proximal phalanx of hallux	adducts great toe (moves it toward midline of foot; i.e. 2nd digit)	deep branch of lateral plantar nerve	(Latin, hallex = great toe)
flexor hallucis brevis	cuboid, lateral cuneiform, medial side of first metatarsal	medial belly: medial side of proximal phalanx of hallux; lateral belly: lateral side of proximal phalanx	flexes metatarsophalangeal joint of hallux	medial plantar nerve (lateral belly occasionally receives innervation from lateral plantar nerve)	each tendon of insertion contains a sesamoid bone (Latin, hallex = great toe)
flexor digitorum brevis	tuberosity of calcaneus, plantar aponeurosis, intermuscular septa	base of middle phalanx of digits 2-5 after splitting to allow passage of flexor digitorum longus tendons	flexes metatarsophalangeal & proximal interphalangeal joints of digits 2-5	medial plantar nerve	none
fibularis (peroneus) longus	upper two/thirds of lateral surface of fibula	after crossing plantar surface of foot deep to intrinsic muscles, it inserts on medial cuneiform and base of 1st metatarsal	plantarflexes and everts the foot	superficial fibular (peroneal) nerve	lies superficial to fibularis brevis m.
fibularis (peroneus) brevis	lower one third of lateral surface of fibula	tuberosity of base of 5th metatarsal	plantarflexes and everts the foot	superficial fibular (peroneal) nerve	none
tibialis anterior	lateral tibial condyle and upper lateral surface of tibia	medial surface of medial cuneiform and 1st metatarsal	dorsiflexes and inverts foot	deep fibular (peroneal) nerve	acts as both an antagonist and a synergist of tibialis posterior
peroneus mm. (SEE fibularis mm.)					peroneus is the old terminology used for fibularis mm.
extensor hallucis longus	middle half of anterior surface of fibula & interosseous membrane	base of distal phalanx of hallux	extends metatarsophalangeal & interphalangeal joints of hallux	deep fibular (peroneal) nerve	(Latin, hallex = great toe)
extensor hallucis brevis	superolateral surface of calcaneus	dorsum of base of proximal phalanx of hallux	extends great toe	deep fibular (peroneal) nerve	often considered medial-most part of extensor digitorum brevis m. (Latin, hallex = great toe)
extensor digitorum longus	lateral condyle of tibia, anterior surface of fibula, lateral portion of interosseous membrane	dorsum of lateral 4 toes via extensor expansions (central slip inserts on base of middle phalanx, lateral slips on base of distal phalanx)	extends metatarsophalangeal, proximal interphalangeal and distal interphalangeal joints of lateral 4 toes	deep fibular (peroneal) nerve	none
extensor digitorum brevis	superolateral surface of calcaneus	extensor expansion of toes 1-4 (tendon to hallux is called extensor hallucis brevis)	extends toes 1-4	deep fibular (peroneal) nerve	none
fibularis (peroneus) tertius	distal part of anterior surface of fibula	dorsum of shaft of 5th metatarsal bone	everts foot	deep fibular (peroneal) nerve	fibularis tertius is in the anterior compartment of the leg, not the lateral compartment (which contains fibularis longus and brevis)
quadratus plantae	anterior portion of calcaneus & long plantar ligament	tendons of flexor digitorum longus m.	assists flexor digitorum longus in flexing toes	lateral plantar nerve	(Latin, quadratus = square)
dorsal interosseous, of foot	four muscles, from shafts of adjacent metatarsal bones	bases of proximal phalanges for digit 2 (both sides) & digits 3,4 (lateral side)	abduct digits 2-4 (move these digits away from midline as defined by a line passing through 2nd digit), flex metatarsophalangeal joints and extend interphalangeal joints of those digits	deep branch of lateral plantar nerve	remember DAB (dorsal interossei ABduct) and PAD (plantar interossei ADduct), then logic can tell you where these muscles insert (Latin, inter = between + os = bone)
plantar interosseous, in foot	base and medial side of metatarsals 3-5	bases of proximal phalanges and extensor expansions of digits 3-5	adduct digits 3-5 (move these digits toward the midline of the foot as defined by the second digit),flex metatarsophalangeal and extend interphalangeal joints of digits 3-5	deep branch of lateral plantar nerve	remember PAD (plantar interossei ADduct) and DAB (dorsal interossei ABduct), and logic will tell you where these muscles must insert (Latin, inter = between + os = bone)

Nerves
Nerve	Source	Branches	Motor	Sensory	Notes
fibular, common	sciatic	lateral sural cutaneous, superficial and deep fibular nn.	superficial fibular br.: muscles of lateral compartment of leg (fibularis longus and brevis mm.); deep fibular br.: mm. of anterior compartment of leg (tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius); mm. of dorsum of foot (extensor digitorum brevis and extensor hallucis brevis)	superficial fibular: distal 1/3 of anterior leg; dorsum of foot excluding web between great toe and 2nd toe and distal interphalangeal segments of all toes; deep fibular: skin of the web between great and 2nd toes	peroneal is old terminology which has been replaced by fibular
fibular, superficial	common fibular	medial dorsal cutaneous n. to medial side of foot; dorsal digital nn. to lateral 3 digits	muscles of lateral compartment of leg (fibularis longus and brevis mm.)	distal 1/3 of anterior leg; dorsum of foot excluding web between great toe and 2nd toe and distal interphalangeal segments of all toes;
fibular, deep	common fibular	one proper digital br. to the 1st and 2nd toes	mm. of anterior compartment of leg (tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius); mm. of dorsum of foot (extensor digitorum brevis and extensor hallucis brevis)	skin of the web between great and 2nd toes	peroneal is old terminology which has been replaced by fibular
peroneal, nn.	SEE: fibular				peroneal is old terminology which has been replaced by fibular
plantar, medial	tibial	plantar cutaneous brs., proper plantar digital (medial side of hallux), common plantar digital (1st-3rd)	abductor hallucis, flexor hallucis brevis, flexor digitorum brevis, 1st lumbrical	skin of medial plantar surface of foot & plantar surface of medial 3 1/2 toes (and nail bed of these digits)
plantar, lateral	tibial	superficial & deep brs.	quadratus plantae, abductor digiti minimi, flexor digiti minimi brevis, lateral 3 lumbricals, adductor hallucis, plantar & dorsal interossei	skin of lateral plantar surface of foot & plantar surface of lateral 1 1/2 digits (and nail bed of these digits)
plantar digital, common	medial plantar (1st-3rd); superficial br. of lateral plantar (4th)	proper plantar digital nn.	1st lumbrical	skin of plantar surface of toes (except medial side of hallux & lateral side of 5th toe) & nail bed of these toes
plantar digital, proper	common plantar digital, medial plantar (to medial side of great toe), superficial br. of lateral plantar (to lateral side of 5th toe)		flexor hallucis brevis (from plantar digital on medial side of great toe)	skin of plantar surface of toes & dorsal surface of distal interphalangeal segment (including nail bed)

Arteries
Artery	Source	Branches	Supply	Notes
plantar, medial	posterior tibial	digital brs. (3)	superficial foot medially	anastomoses with plantar metatarsal aa., but does not usually participate in formation of the plantar arch
plantar, lateral	posterior tibial	becomes continuous with the plantar arch; proper plantar digital a. to lateral side of 5th digit	deep foot; the plantar arterial arch and its brs. supply the toes, including the distal phalangeal segment dorsally
arch, plantar arterial	lateral plantar	plantar metatarsal aa. (4)	deep foot; its plantar metatarsal brs. and their brs. supply the toes, including the distal phalangeal segment dorsally	anastomoses with the deep plantar br. of the dorsalis pedis a.
tibial, anterior	popliteal	anterior & posterior tibial recurrent; anterior, medial & lateral malleolar; dorsalis pedis	anterior leg, dorsal & deep foot	anterior tibial a. becomes continuous with the dorsalis pedis a.; name change occurs at the level of the ankle joint
dorsalis pedis	anterior tibial a.	lateral & medial tarsal aa., arcuate a., 1st dorsal metatarsal a., deep plantar a.	dorsal aspect of foot; anastomoses with plantar arterial arch	the anterior tibial artery continues as the dorsalis pedis; the name change occurs at the level of the ankle (Latin, pes = foot)
plantar, deep	dorsalis pedis		deep foot	anastomoses with lateral plantar a. to form the plantar arterial arch

Topographic Anatomy
Structure/Space	Boundaries/Description	Significance
anterior compartment (extensor), leg	tibia, fibula, interosseous membrane, anterior intermuscular septum	contains tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius; also anterior tibial artery, deep fibular nerve
extensor retinaculum, superior	strong band of deep fascia passing from the fibula to the tibia, proximal to the malleoli	binds down the tendons of the muscles in the anterior compartment, preventing bowstringing during dorsiflexion of the ankle (Latin, retinaculum = a band or halter)
extensor retinaculum, inferior	a Y-shaped band of fascia attached laterally to the anterosuperior surface of the calcaneus	forms a strong loop around the tendons of the fibularis tertius and extensor digitorum longus muscles (Latin, retinaculum = a band or halter)
fibular retinaculum, superior	a band of deep fascia that extends from the tip of the lateral malleolus to the calcaneus	binds down the tendons of the fibularis longus and brevis (Latin, retinaculum = a band or halter)
lateral compartment (evertor), leg	anterior & posterior intermuscular septa, fibula	contains: fibularis longus & brevis mm.; superficial fibular nerve
calcaneometatarsal ligament	deep fascia forming an investment of the plantar surface of the lateral compartment of the foot	continuous with the plantar aponeurosis
plantar aponeurosis	deep fascia forming an investment of the plantar surface of the central and medial compartments of the foot	continuous with the calcaneometatarsal ligament
medial compartment, foot	compartment of the great toe	contains: abductor hallucis and flexor hallucis brevis mm., tendon of flexor hallucis longus m., medial plantar a., v., & n.
lateral compartment, foot	compartment of the little (5th) toe	contains: abductor digiti minimi and flexor digiti minimi brevis mm., branches of lateral plantar a., v., & n.
central compartment, foot	associated with the lateral 4 toes	contains: flexor digitorum brevis & quadratus plantae mm. & lumbrical mm., tendons of flexor digitorum longus m., branches of lateral plantar a., v., & n.
adductor-interosseous compartment, foot	deepest of the foot compartments	contains: adductor hallucis & plantar & dorsal interossei mm., deep branch of lateral plantar n. & plantar arterial arch
medial longitudinal arch, foot	formed by talus, navicular, cuneiforms, medial 3 metatarsals	supported by spring ligament (plantar calcaneonavicular), assisted by tibialis anterior m.
lateral longitudinal arch, foot	formed by calcaneus, cuboid, lat. 2 metatarsals	supported by long & short plantar ligaments, assisted by fibularis longus m.
transverse arch, foot	formed by cuneiforms & cuboid	supported by long & short plantar ligaments, assisted by fibularis longus & tibialis anterior & posterior mm.
tarsal sinus	space between the neck of the talus and the calcaneus	contains the interosseous talocalcaneal ligament

Clinical Terms
Term	Definition
compartment syndrome	a group of symptoms which indicate a nerve, blood vessel or tendon is being constricted due to swelling within a closed anatomic space. A compartment syndrome may occur in an extremity after trauma (fracture) or inflammation (carpal tunnel syndrome). Some medications can also precipitate this condition. Symptoms include numbness, tingling, pain or loss of movement in an extremity. Surgery may be indicated if symptoms are severe or prolonged.
foot drop	the most commonly injured nerve in the lower limb is the common fibular nerve, which wraps around the fibular neck. Severence of this nerve causes paralysis of all the muscles of the anterior and lateral compartments (dorsiflexors of the ankle and evertors of the foot). The loss of eversion of the foot and dorsiflexion of the ankle causes foot-drop.
shin splints	an inflammatory condition of the anterior portion of the tibia that results from overuse (for example running on hard surfaces). Occurs in either trained athletes who don't stretch or individuals who lead a sedentary lifestyle and then start running. The cause is swelling of the muscles in the anterior compartment, then edema and muscle-tendon inflammation which reduces bloodflow to the muscles. Shin splints are a mild form of anterior compartment syndrome.
bunion/hallux valgus	a swelling or deformity at the head of the first metatarsal of the great toe (big toe) (Latin, hallux = great toe)
flat foot	a condition in which one or more of the arches of the foot have flattened out so that the entire sole of the foot rests upon the ground; also, the deformity, usually congenital, exhibited by such a foot; also known as splayfoot.
talipes equinovarus (club foot)	the most common congenital abnormality of the foot. Clubfoot may occur in several forms, but talipes equinovarus is the most common. In this case the foot turns downward and inward. Treatment involves the extended use of orthopaedic splints or casts to correct the position of the foot, often combined with surgery. (Latin, talus = ankle + pes = foot)

The material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger
Published by ILOC, Inc., New York
Copyright © 1995, unauthorized use prohibited.

The excellent editorial assistance of
Dr. Pat Tank, UAMS
is gratefully acknowledged.

Anatomy Tables - Anterior & Lateral Leg & Foot

Osteology

Muscles

Nerves

Arteries

Topographic Anatomy

Clinical Terms