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70 Sutures, joints and ligaments

1Ankle (talocrural) joint. Articulatio talocruralis. 1 Upper ankle joint between the talus, tibia and

fibula. D

22 Medial or deltoid ligament. Lig. mediale (del-

 

toideum) articulationis talocruralis. Ligament on

3

the medial side of the ankle which consists of the

four segments described below. D

3 Tibionavicular part. Pars tibionavicularis. Group

4of fibers connecting the medial malleolus to the dorsal and medial surfaces of the navicular bone. D

54 Tibiocalcaneal part. Pars tibiocalcanea. Group of fibers connecting the medial malleolus to the sustentaculum tali. B D

65 Anterior tibiotalar part. Pars tibiotalaris ante-

rior. Segment of the deltoid ligament that connects

7the medial malleolus to the medial surface of the talus as far as the neck of the talus. D

6 Posterior tibiotalar part. Pars tibiotalaris poste-

8rior. Fibers extending posteriorly from the medial malleolus almost as far as the posterior process of

9the talus. B D

7Anterior talofibular ligament. Lig. talofibulare

anterius. Ligament extending from the lateral mal- 10 leolustothelateralsurfaceoftheneckofthetalus.A

8Posterior talofibular ligament. Lig. talofibulare

11posterius.Itoriginatesinthelateralmalleolarfossa and inserts at the lateral tubercle of the posterior

12

 

process of the talus. A B

9 Calcaneofibular ligament. Lig. calcaneofibulare.

 

 

 

It passes obliquely and posteriorly from the apex of

13

 

 

the alteral malleolus to the calcaneus. A B

 

10

Intertarsal joints. Articulationes intertarseae.

 

14

 

Joints between the tarsal bones.

 

11

JOINTS OF THE FOOT. Articulationes pedis.

 

1512 Talocalcaneonavicular joint. Articulatio talocalcaneonavicularis. The anterior portion of the lower ankle joint in which the talus articulates with the

16calcaneus and navicular bones. A C

13 Subtalar joint. Articulatio subtalaris (talocal-

17canea). Joint between the talus and calcaneus that represents the posterior part of the lower ankle joint. A B C D

1814 Lateral talocalcaneal ligament. Lig. talocal-

caneum laterale. Ligament that passes from the

19trochlea of the talus to the lateral surface of the calcaneus. It is partially covered by the calcaneofibular ligament. A

2015 Medial talocalcaneal ligament. Lig. talocal-

caneum mediale. Ligament on the medial side of

21the foot that extends from the medial tubercle of the posterior process of the talus to the sustantaculum tali. B D

2215 a Posterior talocalcaneal ligament. [[Lig. talocal-

caneum posterior.]] Fibrous band extending from

23the posterior process of the talus to the calcaneus, thereby bridging the sulcus of the tendon of the flexor hallucis longus muscle.

2416 Transverse tarsal (midtarsal) joint [[Chopart’s joint]] Articulatio tarsi transversa. Joint situated in

25front of the talus and calcaneus but proximal to the cuboid and navicular bones. C

17Calcaneocuboid joint. Articulatio calcaneocuboidea. Joint between the calcaneus and cuboid bones. A C

17 a Cuneocuboid joint. Articulatio cuneocuboidea. Articulation between the cuboid bone and lateral cuneiform bone. C

18Cuneonavicular joint. Articulatio cuneonavicularis. Joint between the navicular bone and cuneiform bones. C D

18 a Intercuneiform joints. Articulationes intercuneiformes. Joint between the cuneiform bones.

19Interosseous ligaments of the tarsus. Ligg. tarsi interossea. The following three interosseous ligaments are present between the tarsal bones:

20Interrosseous talocalcaneal ligament. Lig. talocalcaneum interosseum. Strong mass of ligaments in the sinus tarsi. A C

21Interosseous cuneocuboid ligament. Lig. cuneocuboideum interosseum. Taut connection betweenthelateralcuneiformboneandthecuboid bone. A C

22Interosseous intercuneiform ligaments. Ligg. intercuneiformia interossea. Taut ligaments between the three cuneiform bones. C

23Dorsal ligaments of the tarsus. Ligg. tarsi dorsalia. The following eight dorsal ligaments are present between the tarsal bones.

24Talonavicular ligament. Lig. talonaviculare. Dorsal ligament between the head of the talus and the navicular bone. A D

25Dorsal intercuneiform ligaments. Ligg. intercuneiformia dorsalia. Dorsal ligaments between the cuneiform bones. A

26Dorsal cuneocuboid ligaments. Lig. cuneocuboideum dorsale. Dorsal ligaments between the lateral cuneiform bone and the cuboid bone. A

27Dorsal cuboideonavicular ligament. Lig. cuboideonaviculare dorsale. Ligament between the cuboid and navicular bones. A

28Bifurcate ligament. Lig. bifurcatum. V-shaped double ligament in front of the sinus tarsi on the dorsum of the foot. It extends forward from the calcaneus and consists of the following two parts. A

29 Calcaneonavicular ligament. Lig. calcaneonaviculare. It extends laterally from the head of the talus to the navicular bone. A

30 Calcaneocuboid ligament. Lig. calcaneocuboideum. It extends from the calcaneus and attaches near the middle of the cuboid bone. A

31Dorsal cuneonavicular ligaments. Ligg. cuneonavicularia dorsalia. Broad group of ligaments on the dorsum of the foot connecting the navicular bone with the three cuneiform bones. A

31 a Dorsal calcaneocuboid ligament. Lig. calcaneocuboideum dorsale. Moderate reinforcement of the joint capsule lateral to the bifurcate ligament. A

Sutures, joints and ligaments 71

8

 

 

 

 

12

31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

24

 

25

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

6

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

27

 

 

 

 

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15

 

 

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

26

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

20

30 29

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

21

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

31a

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ligaments of right foot,

 

 

 

 

 

 

Ligaments of right ankle

A

 

 

 

 

 

B

 

lateral view

 

 

 

 

 

 

 

(talocrural) joint,

 

 

 

 

 

 

 

 

 

 

 

 

 

posterior view

 

 

 

1

2

3

4

5

6

7

8

9

10

11

12

13

22

21

 

18

17a

16

17

 

20

12

13

CTarsometatarsal bones of right foot, horizontal section

 

24

1

 

 

2

 

 

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

6

18

 

 

 

3

4

 

 

 

 

 

18

14

15

16

1

15

17

1318

19

20

D

Ligaments of right foot,

21

 

medial view

 

 

22

23

24

25

a

a

72 Sutures, joints and ligaments

1

 

1

Plantar ligaments of tarsus. Ligg. tarsi 14

Interosseous

metatarsal ligaments. Ligg.

 

 

plantaria. Ligaments on the palmar aspect of

metatarsalia

interossea. Ligaments between

 

 

 

the foot. They are particularly important for the

the bases of the metatarsal bones. They form

 

 

 

2

 

 

bracing of both plantar arches of the foot.

the distal limits of the articular spaces between

 

2

Long plantar ligament. Lig. plantare longum.

the metatarsal bones. C

 

 

 

3Stout ligament which passes from the cal15 Dorsal metatarsal ligaments. Ligg. metatarcaneus closely in front of its tuber to the cuboid salia dorsalia. Ligaments between the bases of

 

 

bone and to the bases of metatarsals II−V. It

 

the metatarsal bones on the dorsum of the foot.

4

 

 

 

supports the longitudinal arch. A

 

 

B

 

3

Plantar calcaneocuboid ligament or short

16

Plantar metatarsal ligaments. Ligg. metatar-

 

5

 

plantar

ligament.

Lig. calcaneocuboideum

 

salia plantaria. Ligaments found between the

 

 

plantare. Shorter portion of the long plantar

 

bases of the metatarsal bones on the plantar

 

 

 

6

 

ligament. A

 

 

 

 

aspect of the foot. A

4 Plantar

calcaneonavicular

(spring)

liga-

17

Metatarsal interosseous spaces. Spatia inter-

 

 

7

 

ment. Lig. calcaneonaviculare plantare. It lies

 

ossea metatarsi. Spaces between the shafts of

 

medial to the above-mentionend ligament and

 

the metatarsal bones. They are occupied by the

 

 

supports, according to more traditional view,

 

corresponding muscles. A

8

 

the articular cavity for the head of the talus.

18

Metatarsophalangeal joints. Articulationes

 

 

Since the talar side of the ligament is quite

 

metatarsophalangeales. A

 

 

loose and contains no fibrocartilage, this con-

 

9

 

 

 

 

 

 

cept is questionable. A

 

 

19

Collateral ligaments. Ligg. collateralia. A

 

5

Plantar cuneonavicular ligaments. Ligg. 20

Plantar ligaments. Ligg. plantaria. Connective

10

 

cuneonavicularia plantaria. Groups of liga-

 

tissue reinforcement of the capsule of the

 

 

ments that connect the navicular bone with the

 

metatarsophalangeal joint. It is more firmly

 

 

 

11

 

cuneiform bones lodged in front of it. A

 

 

fused with the proximal phalanx than with the

6

Plantar

cuboideonavicular

ligament.

Lig.

 

head of the metatarsals and forms a stroma for

 

 

 

 

the flexor tendons. A

12

 

cuboideonaviculare

plantare. A plantar

liga-

 

 

21

Deep transverse metatarsal ligament. Lig.

 

ment coursing somewhat obliquely to the axis

 

 

 

 

of the foot connecting the cuboid and navicular

 

metatarsale transversum profundum. Trans-

13

 

 

 

bones. It supports the transverse plantar arch of

 

versely oriented ligament connecting the heads

 

 

the foot. A

 

 

 

 

of the metatarsal bones. A

 

 

 

 

 

 

14

7

Plantar intercuneiform ligaments. Ligg. in-

22

Interphalangeal joints of the foot. Articula-

 

 

tercuniformia plantare. Fibrous bands lying on

 

tiones interphalangeales pedis. The middle and

 

 

 

15

 

the plantar aspect of the foot between the

 

terminal joints between the phalanges of the

 

cuneiform bones. They support the transverse

 

foot. A

 

 

plantar arch of the foot. A

 

 

23 Collateral ligaments. Ligg. collateralia. A

16

 

 

 

 

 

 

 

 

 

8

Plantar

cuneocuboid ligament. Lig. cuneo-

24

Plantar ligaments. Ligg. plantaria. Fibrous

 

 

cuboideum plantare. Fibrous brace on the plan-

 

 

 

bands that reinforce the plantar aspect of the

17

 

tar aspect of the foot between the lateral

 

 

 

interphalangeal articular capsules.

 

 

cuneiform and cuboid bones. A

 

 

 

 

189 Tarsometatarsal joints. Articulationes tarsometatarsales. Joints between the tarsal and metatarsal bones of the foot. A B C

1910 Dorsal tarsometatarsal ligaments. Ligg. tarsometatarsalia dorsalia. Ligaments located on

20the dorsum of the foot between the tarsal and metatarsal bones. B

2111 Plantar tarsometatarsal ligaments. Ligg. tarsometatarsalia plantaria. Ligaments located on the plantar aspect of the foot between the tar-

22sal and metatarsal bones. A

23

12

Interosseous cuneometatarsal ligaments.

 

 

Ligg. cuneometatarsalia interossea. Ligaments

 

 

occupying the joint spaces between the

24

 

cuneiform and metatarsal bones. C

13 Intermetatarsal joints. Articulationes inter-

25metatarsales. Joints between the bases of the metatarsal bones. B C

Sutures, joints and ligaments 73

 

 

22

 

 

 

 

 

 

 

 

 

23

 

 

 

 

 

 

 

22

 

 

 

 

 

 

 

 

 

 

 

 

 

22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

17

17

 

 

17

 

17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

16

 

2

2

 

 

 

 

 

9

 

 

 

 

 

 

2

 

 

 

 

11

 

 

 

 

 

11

11

 

11

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

7

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

36 5

3 2 4

4

50.27

50.3

ALigaments of right foot, plantar view

C Ligaments of sectioned foot, dorsal view

15

 

13

15

9

 

10

B Ligaments of foot, dorsal view

12 13

9

14

9

13 14

9 13 14

9

913

14 12

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

a

a

 

74

 

Muscles

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

M. longissimus cervicis. o: Transverse proces-

 

 

 

 

 

 

 

1

 

 

 

 

MUSCULAR SYSTEM

 

 

1 DORSAL MUSCLES. Musculi dorsi. The muscles

 

ses T1−6. i: Transverse processes of vertebrae

 

 

 

 

of the back. True back muscles are innervated

 

C2−7. It lies between the iliocostalis cervicis

2

 

 

 

by the dorsal rami of spinal nerves, whereas the

 

and longissimus capitis muscles. C

 

 

 

 

 

 

muscles of the shoulder girdle are not. A B C

14

M. longissimus capitis. o: Transverse

 

 

 

2 M. trapezius. o: Spinous processes of vertebrae

 

processes

of

vertebrae

C3−T3.

i:

Mastoid

3

 

 

 

 

 

 

T1-T12 and C1, the nuchal ligament, occipital

 

process. It lies between the longissimus cervi-

 

 

 

 

protuberance, and superior nuchal line. i: Spine

 

cis and semispinalis capitis muscles. A: Lateral

4

 

 

 

of scapula, acrimonion, and clavicle. A: Rotates,

 

and backward flexion of the head. It rotates the

 

 

 

 

raises, lowers, and adducts the scapula; rotates

 

face toward the ipsilateral side. C

 

 

 

 

 

 

 

 

 

5

 

 

 

the head. I: Accessory nerve, cervical plexus. A

15

M. iliocostalis. Iliocostal muscle, which con-

 

 

3 M. transversus nuchae. (Rare, 25%). Platysmal

 

sists of the following three segments.

 

 

 

 

 

 

 

 

 

 

muscle situated between the insertions of the

16

M. iliocostalis lumborum. o: Iliac crest. i:

6

 

 

 

 

 

 

trapezius and sternocleidomastoid. It passes

 

Angle of ribs 5−12. A: Extenson and lateral flex-

 

 

 

 

transversely, either superficial or deep, to the

 

ion of lower vertebral column. B C

 

 

 

 

 

 

 

 

 

7

 

 

 

trapezius. A

17

M. iliocostalis thoracis. o: Medial sides of 6

 

 

4 M. latissimus dorsi. o: Thoracolumbar fascia,

 

 

 

 

lower rib angles. i: Six uppermost rib angles. A:

 

 

 

 

spinous processes of vertebrae T7−L5, sacrum,

 

Flattening of thoracic kyphosis, lateral flexion.

8

 

 

 

 

 

 

 

iliac crest, and four lower ribs. i: Crest of lesser

 

B C

 

 

 

 

 

 

 

 

 

 

tubercle of humerus. A: Adduction and medial

18

M. iliocostalis cervicis. o: Upper and middle

 

 

 

 

9

 

 

 

rotation of the arm. I: Thoracodorsal nerve. A

 

ribs. i: Transverse processes of middle cervical

 

 

5 M. rhomboideus major. o: Spinous processes

 

 

 

 

 

vertebrae. C

 

 

 

 

 

 

 

 

of vertebrae T1−4. i: Medial margin of scapula.

19

M. splenius cervicis. o: Spinous processes of

10

 

 

 

 

 

 

A: Medial and upward movement of scapula. I:

 

T3−5.

i:

Posterior tubercle of

transverse

 

 

 

 

Dorsal scapular nerve. A

 

processes of C1−2. A: Backward flexion and ro-

 

 

 

 

 

11

6

M. rhomboideus minor. o: Spinous processes

 

tation of head. B

 

 

 

 

 

 

 

of cervical vertebrae 6−7. i: Medial margin of

20 M. splenius capitis. o: Spinous processes of C4−

 

 

 

 

scapula above the spine. A: Medial and upward

12

 

 

 

 

T3. i: External half of superior nuchal line and

 

 

 

movement of scapula. I: Dorsal scapular nerve.

 

 

 

 

 

mastoid process. A: Backward flexion and rota-

 

 

 

 

A

 

 

 

 

 

 

tion of head. A B

 

 

 

13

 

 

7 M. levator scapulae. o: Posterior tubercle of

 

 

 

 

 

 

21

MM. INTERTRANSVERSARII. Muscular connec-

 

 

 

transverse processes of cervical vertebrae 1−4.

 

 

 

 

 

tion of adjacent transverse processes. A: Lateral

 

 

 

 

i: Superior angle of scapula. A: Elevates super-

 

14

 

 

 

 

flexion. See p. 77 C D E

 

 

 

 

 

 

ior angle of scapula and rotates neck. I: Dorsal

 

 

 

 

 

 

 

22 Mm. intertransversarii laterales lumborum.

 

 

 

 

scapular nerve and cervical plexus. A

 

 

 

 

 

Muscles between adjacent costal processes. I:

15

8

M. serratus posterior inferior. o: Spinous

 

 

Ventral rami of spinal nerves. See p. 77 C

 

 

 

 

processes of vertebrae T11−L2. i: Four lower

23 Mm. intertransversarii mediales lumborum.

 

 

 

 

ribs. A: Retroversion of four lower ribs. I: Inter-

16

 

 

 

 

Muscles between the mamillary processes. See

 

 

 

costal nerves. A

 

 

9

M. serratus posterior superior. o: Spinous

 

p. 77 C

 

 

 

 

 

 

24 Mm. intertransversarii thoracis. Usually ab-

17

 

 

 

processes of vertebrae C6−T2. i: Second to fifth

 

 

 

 

sent. See p. 77 C

 

 

 

 

 

 

ribs. A: Raises ribs in inspiration. I: Intercostal

 

 

 

 

 

 

 

 

nerves. A B

25

Mm. intertransversarii

posteriores

cervicis.

18

 

 

 

10

M. ERECTOR SPINAE. Collective term for the

 

Muscles between posterior tubercles of trans-

 

 

 

 

muscles of the lateral and medial tracts of the

 

verse processes of cervical vertebrae. See p. 77

 

 

 

 

 

19

 

 

 

back. I: Posterior rami of spinal nerves. o: Iliac

26

Pars medialis. Medial part of 25.

 

 

 

 

 

 

crest, spinous processes of L1−S4, mamillary

27

Pars lateralis. Lateral part of 25. I: Ventral

 

 

 

 

processes of L1−2, transverse processes of T7−

 

ramus of spinal nerves.

 

 

 

20

 

 

 

 

 

 

 

 

 

 

12. i: Costal and accessory processes of lumbar

28

Mm.

intertransversarii

anteriores

cervicis.

 

 

 

 

vertebrae, angle of 11 lower ribs, all thoracic

 

 

 

 

 

Muscles connecting the anterior tubercles of

21

 

 

 

transverse processes. A: Lateral and backward

 

 

 

 

 

the cervical

transverse

processes. I: Ventral

 

 

 

flexion of vertebral column. B C

 

 

 

 

 

 

ramus of spinal nerves. See p. 77 E

 

 

 

 

 

 

 

 

 

 

 

 

10 a [[Lateral tract]]. [Tractus laterale].

2211 M. longissimus. It consists of the following three parts. B

2312 M. longissimus thoracis. o: Iliac crest, spinous processes of L1−S4, mamillary processes of L1− 2, transverse processes of T7−I2. i: Costal and

24accessory processes of lumbar vertebrae, angle

of lower 11 ribs all thoracic transverse

25processes, A: Lateral and backward flexion of vertebral column. B C