The human musculoskeletal system is a complex system that works continuously from birth until the last day of life, performing a number of vital functions. Maintaining a constant body shape, walking upright, protecting organs and tissues are its main functions. Interacting with other departments and organs of the human body, they create and maintain its integrity and help adapt to various living conditions.

The entire musculoskeletal system of the human body is represented by two sections: passive (skeleton and its parts) and active (muscular system).

The skeleton is the collection of all the bones of the body, which are connected to each other through joints and ligaments.

It forms a kind of frame that performs a protective function for the internal organs and systems of the body. The skeleton also provides support, and through it the body moves in space and its position is determined. The motor function is performed through the combined coordinated actions of bones, joints, muscles and nerve endings. The supporting function lies in the fact that the bones of the skeleton serve as the basis for the attachment of soft tissues and organs, which allows them to remain in place all the time and not fall off. The protective function is ensured by the presence of cavities in which the vital organs of the human body are located. Thus, the heart and lungs are closed by the chest, the brain is hidden in a strong skull. The skeleton also has a hematopoiesis function - the bones of the skeleton are located in the bones that take part in hematopoiesis.

Bone composition

The skeleton of any person consists of more than 200 bones. They are formed by a large number of mineral and organic compounds. Minerals provide strength, while organic substances are responsible for flexibility and elasticity. The share of inorganic compounds in the composition of skeletal bones accounts for about 70%. With age, this figure increases, which leads to an increase in bone fragility and a decrease in their strength. For this reason, in older age, bones will take longer to heal.

Bone structure

Any bone in the human body consists of bone plates, crossbars and beams. The only difference is how compactly these elements are located. A section of a tubular bone shows that the bone substance is dense on the outside and looser on the inside. In the spongy substance, the crossbars are arranged so that they form cells between themselves. If the bone elements are tightly located to each other in the form of concentric circles, then cavities are formed inside in which blood vessels and nerves are located. The compact substance is localized on the outside and makes the bone strong, while the spongy substance, due to its structure, reduces bone mass. Their ratio can be different and depends on the function performed, form and location in the body.

Periosteum

The outside of the bones is covered with periosteum. The exception is the surfaces of the joints, which are covered with hyaline cartilage. The periosteum is represented by dense connective tissue, which is fused with the body of the bone. It contains a large number of blood vessels that carry nutrients to the bone, as well as osteoblasts involved in the formation of new bone cells. Therefore, the periosteum contributes to the growth of bones in thickness and their fusion during fractures.

Anatomy. Skeleton of the lower limbs

The musculoskeletal system has a very complex structure. All its features are directly related to the functions performed. The skeleton of the human lower extremities consists of two sections that are interconnected. One of them is motionless and serves as the basis for attaching the bones of the second. The first is represented by the pelvic girdle and its bones - the skeleton of the lower limb girdle. Its peculiarity is the fixed arrangement of the bones. The second - the bones directly involved in the movement of the body - the skeleton of the free lower limb. The bones that make up it are characterized by the possibility of changing position in various planes, and for some, rotation.

The skeleton of the human lower extremities is adapted to perform the following functions: supporting, motor and spring. Thanks to the coordinated work of joints, ligaments and muscle joints, body movements are absorbed when walking, running or jumping. This allows you to reduce the load on the overlying parts of the body and organs.

Hip joint

The skeleton of the lower extremities, located below the pelvic bones, is represented by the femur and the lower leg is represented by the tibia and fibula.
The femur bone is the most massive and durable bone in the human body; its upper part is connected to the pelvic bone and forms the hip joint. The ligaments of the hip joint are the strongest. Since the main load of maintaining the integrity of the joint is concentrated on them.

Knee

The lower part of the femur is attached to the tibia, forming the knee joint, which is covered by the kneecap. The knee joint is capable of flexion, extension and rotation. Its ligaments are arranged crosswise.

Ankle joint

Connecting with the talus, it forms the ankle joint. The foot consists of the bones of the tarsus, metatarsus and phalanges. It increases the support area and provides shock absorption to the body.

The muscles connecting the skeleton of the lower extremities of a person are the most massive and strong in the body, due to the fact that they bear the greatest load associated with holding and moving the entire human body.

At the junction of the bones of the lower extremities there are thick cartilage pads that provide the body with uprightness and shock absorption when jumping and running. They consist of elastic connective tissue that can compress under load and return to its original state. Any cartilage tissue has a high rate of regeneration, that is, restoration, in case of damage or abrasion.

Foot structure

The tarsal skeleton is represented by 7 bones, which are located in two rows between the tibia and metatarsus. The heel bone is located slightly back and performs a supporting function. The metatarsus is represented by 5 tubular bones, which are connected to the phalanges of the fingers through joints. The skeleton of the toes consists of phalanges: the first toe is represented by two phalanges, the rest by three.

The foot is characterized by flexion, extension, abduction and rotation. The movement of all bones is also carried out by the feet. This determines a large number of options when determining the human body in space.

The foot, constantly in contact with shoes, can change. Calluses, corns or growths appear on it, which leads to pain. This is due to the fact that the shape and structure of the foot differs from person to person. It depends on the proportions of the body, its weight and the person’s lifestyle. If you choose the wrong shoes, flat feet can develop - a decrease in the arch of the foot, which also causes certain inconvenience.

Thus, it is clear that the skeleton of the human lower extremities performs a very important function in the body. It determines the posture of the human body when walking, while reducing the load on overlying organs and systems, thereby extending their service life. The human musculoskeletal system through itself unites all organs and systems into a single whole. The structure of the skeleton of the human lower extremities fully corresponds to the functions performed.

The skeleton of the lower extremities includes the bones of the lower extremity girdle (pelvic girdle) and the bones of the free part of the lower extremity (Fig. 2.15).

The lower limbs serve to move a person in space and are a kind of supports on which the entire weight of the body rests. Due to their function, the bones of the lower limbs are more massive and less mobile compared to the bones of the upper limbs. The foot lost its grasping function, the fingers became shortened. The thumb is located in the same plane as the rest and does not have the mobility that is characteristic of the hand. The foot has an arched structure and performs a spring function, softening shocks and impacts when walking and running.

Lower limb belt consists of paired pelvic bones, between which the sacrum is located at the back. When the pelvic bones connect to the sacrum, a bony pelvis is formed.

Rice. 2.15.

A - skeleton of the right limb: 1 - hip bone; 2 - femur;

• 3 - patella; 4 - tibia; 5 - fibula; b- pelvic bone, right (external view): 1 - iliac crest; 2 - wing of the ilium; 3 - superior posterior iliac spine; 4 - greater sciatic notch; 5 - ischial spine; 6 - pubic tubercle; 7 - acetabulum;
• 8 - inferior anterior iliac spine

Hip bone- a flat bone formed as a result of the fusion of three bones: the ilium, the pubis and the ischium. Fusion occurs in the area of ​​greatest load - the acetabulum, where the pelvic girdle articulates with the free part of the lower limb (see Fig. 2.15). The ilium is located superior to the acetabulum, the ischial bone is located inferiorly and posteriorly, and the pubic bone is located anteriorly and inferiorly. The acetabulum is formed by the bodies of all three bones and has the shape of a deep, rounded pit. The articular surface of the fossa is smooth, crescent-shaped and interrupted by a notch.

Ilium formed by a body and a wing, which ends in a curved crest of the ilium. In front, the ridge ends with the anterior superior spine. Below it is the anterior inferior iliac spine. Posteriorly, the iliac crest also ends with the posterior superior and inferior iliac spines. The anterior, inner surface of the iliac wing has a slightly concave surface and is called the iliac fossa, which is filled with the muscle of the same name. The outer surface of the ilium has gluteal lines - traces of the attachment of the gluteal muscles. The medial surface of the ilium is occupied by an auricular surface (articular), which articulates with the surface of the sacrum of the same name and forms the sacroiliac joint. This joint is paired, flat, and stiff. In addition to the capsule, the joint is strengthened by the anterior and posterior sacroiliac ligaments. Ligaments run from the anterior and posterior surfaces of the sacrum to the inner and outer surfaces of the ilium. The interosseous sacroiliac ligament runs under them (passes outside the joint cavity). The iliopsoas ligament runs from the iliac crest to the transverse processes of the lumbar vertebrae. Movement in the joint is very limited.

Ischium has a body that is part of the acetabulum. The thickening of the branch of the ischium forms the ischial tuberosity.

Lonnaya, or pubic bone, has a body and two branches (lower and upper), located at an angle to each other. Here is the symphysial surface - the place of connection with the pubic bone of the opposite side (pubic symphysis). This connection belongs to the semi-joints. Fusion occurs due to the interpubic disc, which is a fibrocartilaginous plate. The pubic symphysis is strengthened by the superior and inferior pubic ligaments, which are located along its upper and lower edges. There is practically no movement.

The proper ligaments of the pelvis are the sacrospinous ligament, the sacrotuberous ligament, and the obturator membrane, i.e. fibrous connective tissue plate covering the obturator foramen.

Connecting to each other, both pelvic bones and the sacrum form a cavity for the internal organs. The pelvis is divided into two sections: the upper, wider one - the large pelvis and the lower, narrower one - the small pelvis.

Big pelvis formed by the wings of the ilium, which limit it laterally; in front it has no bone walls, and in the back it is supplemented by lumbar vertebrae.

Small pelvis delimited from the large one at the top by the boundary line, which is formed by the promontory of the sacrum, on the sides by the arcuate line of the iliac bones and in front by the upper branches of the pubic bones (this is the entrance to the small pelvis).

The anterior wall of the pelvis is represented by the pubic bones and is very short. The posterior wall is long and consists of the sacrum and the tip. The lateral walls of the pelvis are formed by the ischial bones. The pelvic cavity ends at the pelvic outlet.

Gender differences in the structure of the pelvis are as follows: the bones of the female pelvis are thinner and smoother, the wings of the ilium in women are more turned to the sides, the entrance to the female pelvis has a transverse oval shape, and in men it is longitudinally oval. The place where the lower branches of the pubic bones meet in the female pelvis has the shape of an arc, while in the male it has an acute angle. The pelvic cavity in women has the shape of a cylinder, and in men it is funnel-shaped. Consequently, the male pelvis is higher and narrower, while the female pelvis is low and wide.

Included skeleton of the free part of the lower limb(Fig. 2.15,

A) The following sections are distinguished: thigh, lower leg, moan.

Hip represented by one bone - the femur. It is a long tubular bone, the largest of the tubular bones. The bone consists of two ends (proximal and distal epiphyses) and a body (diaphysis).

At the proximal end of the femur there is a head, which is attached to the body of the bone using a neck. An angle is formed at the junction; in men it is obtuse (approx. 130°), and in women it is close to straight. At the junction of the neck and the body of the femur there are two bony protrusions - trochanters. The greater trochanter is the superior end of the body of the femur and has an intertrochanteric fossa on its medial surface. The lesser trochanter is placed at the lower edge of the neck on the medial side and behind. Both trochanters are connected to each other on the anterior surface by the intertrochanteric line, and on the posterior surface by the intertrochanteric ridge. Muscles are attached to all these bone formations.

The body of the femur is round in shape, the anterior surface is flat, smooth and forms a forward bend. On the back surface there is a rough line - the place of attachment of the thigh muscles. The linea aspera consists of the medial and lateral lips. At the top, the medial lip passes into the pectineal line - the place of attachment of the muscle of the same name. The lateral lip contains the gluteal tuberosity (the insertion site of the gluteus maximus muscle). Below, both lips diverge and limit the popliteal surface of a triangular shape.

The distal epiphysis is represented by two bone formations - condyles (medial and lateral), which bear the corresponding epicondyles. On the anterior surface of the condyles there are surfaces of the patella, since the patella, the largest sesamoid bone, is adjacent to them with the posterior surface. On the posterior side and below, both condyles are separated by the intercondylar fossa.

Shin bones - tibia and fibula - but in structure they are long tubular bones. The tibia is located medially, and the fibula is located laterally. The proximal epiphysis of the tibia contains two condyles (medial and lateral), which are separated along the upper surface by the intercondylar eminence. On the anterior surface of the body is the tibial tuberosity - the site of attachment of the patellar ligament. The body of the bone is triangular in shape and has three edges - anterior, medial and interosseous (facing the fibula) and three surfaces: posterior, medial and lateral. The distal epiphysis of the tibia has a medial malleolus and articular surface for articulation with the bones of the foot. The fibula is thin, long, with thickened ends (epiphyses). The proximal epiphysis contains the head, which articulates with the lateral condyle of the tibia. The body of the fibula is triangular in shape. The lower distal epiphysis thickens into the lateral malleolus.

In the foot three parts are distinguished: tarsus, metatarsus, toe bones (Fig. 2.16).

Tarsus formed by seven short spongy bones. The proximal row is formed by two fairly large bones: the talus and the calcaneus. The distal section is represented by the scaphoid, three cuneiform (medially) and cuboid (lateral) bones.

Rice. 2.16.

• 1 - talus block; 2 - head of the talus; 3 - scaphoid bone;
• 4 - sphenoid bones (medial, intermediate, lateral);
• 5 - first metatarsal bone; 6 - proximal phalanx of the first finger;
• 7 - distal phalanx of the first finger; 8 - distal phalanges of the second to fifth fingers; 9 - middle phalanx of the fifth finger; 10 - proximal phalanx of the fifth finger; 11 - metatarsal bones; 12 - cuboid;
• 13 - calcaneus

Metatarsus consists of five short tubular metatarsal bones. Each metatarsal bone is distinguished: the proximal end is the base, the middle part is the body, and the distal end is the head.

Toe bones- phalanges are short tubular bones. Each finger, except the thumb, has three phalanges: proximal, middle, nail (distal).

When the first symptoms of lower extremity injuries appear, immediate diagnosis should be carried out to identify the problem at an early stage.

The first symptoms may be:

• the appearance of pulling;
• general weakness of the legs;
• nervous spasms;
• constant hardening of various muscles.

Moreover, if there is even slight pain on a constant basis, this also indicates possible damage or illness.

General inspection

The doctor checks the lower extremities for visual abnormalities (enlarged kneecap, tumors, bruises, blood clots, etc.). The specialist asks the patient to perform some exercises and tell him if pain is felt. In this way, the area where the disease may occur is identified.

Goniometry

Goniometry is an additional examination of the lower extremities using modern technologies. This method allows you to identify deviations in the amplitude of vibration of the joints and patella. That is, if there is any difference from the norm, there is reason to think about it and begin to conduct further research.

Goniometry

Radiation diagnostics of the lower extremities

There are several types of radiation diagnostics:

X-ray in two projections to clarify the severity of the disease

• X-ray. An image is taken to help replace skeletal damage. However, you should not think that X-rays reveal only cracks and fractures; in some cases, you can notice cavities, a problem associated with a lack of calcium in the body.
• Artography similar to the previous method, however, pictures are taken pointwise in the area of ​​the knee joint to check the integrity of the menisci.
• CT scan- a modern and expensive method, but extremely effective, because the measurement accuracy error is only a millimeter.
• Radionuclide methods. They help the specialist identify pathologies in the lower extremities and joints.

There are additional research methods prescribed privately:

• ultrasound examination();
• magnetic resonance imaging ().

However, despite the effectiveness of some methods, the most reliable solution is to combine several in order to minimize the possibility of not noticing an illness or injury.

Conclusion

If a person notices any strange sensations in the area of ​​the lower extremities, then an examination should be immediately carried out in one of the city clinics, otherwise the symptoms may become more serious and lead to diseases, the treatment of which will take more than one year.

The functions of the upper and lower extremities in humans are different. The upper limbs are organs of labor; they are very mobile, capable of performing a wide variety of very precise movements. The lower limbs are used for support and movement. Their bones and joints are more massive, their mobility, compared to the upper limbs, is limited.

The skeleton of the limbs, both upper and lower, is a system of levers with a similar structure. The limbs consist of a belt and a free part. The bones of the belt are connected to the skeleton of the body. The free part of the limbs (upper and lower) consists of three segments: the proximal (upper) is represented by one bone, the middle by two bones, the distal (lower) consists of many bones.

Bones of the upper limbs and their connections

The skeleton of the upper limbs consists from the girdle of the upper limbs (shoulder girdle) and free upper limbs. The upper limb girdle has two bones on each side - the collarbone and the scapula.

Only the collarbone is connected to the skeleton of the body by a joint. The shoulder blade is inserted between the collarbone and the free part of the upper limb.

Bones of the upper limb girdle. The girdle of the upper limbs includes paired shoulder blades and a collarbone connected by joints.

Collarbone -- a paired, curved tubular bone with a body and two ends - the sternum and the acromion.

The collarbone is easily palpable in a living person. The functional role of the clavicle is very important - it moves the shoulder joint away from the chest, providing freedom of movement of the arm.

Spatula is a flat, triangular-shaped bone adjacent to the posterior surface of the chest at the level of the 2nd to 5th rib. The dorsal surface is divided by a transversely oriented protrusion - the spine of the scapula - into two fossae: supraspinatus and infraspinatus. Laterally, the spine of the scapula continues into the acromion, which has an articular surface for articulation with the clavicle. The scapula has three angles - inferior, lateral and superior. The upper edge of the scapula passes laterally and anteriorly into the coracoid process. The thickened lateral angle of the scapula has a glenoid cavity that forms an articulation with the head of the humerus.

The skeleton of the free part of the upper limb consists of the humerus, the bones of the forearm (ulna, radius) and the hand (bones of the wrist, metacarpus and phalanges of the fingers).

Brachial bone - a long tubular bone, has a body and two ends - the upper and lower epiphyses. The upper epiphysis is thickened and forms a spherical head that articulates with the glenoid cavity of the scapula. Just below the head there are two tubercles (large and small), to which the muscles are attached. The tubercles are separated by a longitudinal groove in which the long tendon of the biceps brachii muscle lies. The bone in the area where the upper epiphysis meets the body of the bone is thin. When injured in this area, the bone often breaks, which is why it is called the surgical neck of the humerus. The lower epiphysis is expanded and ends at the condyle for articulation with the ulna and radius bones at the elbow joint. On the sides of the condyle are the lateral and medial epicondyles, which can be easily felt in the area of ​​the elbow joint.

Bones of the forearm classified as long tubular bones. There are two of them - elbow bone lies medially (closer to the midline of the body); radius located next to the ulna, on the lateral side of the forearm. The upper ends of the ulna and radius bones participate in the formation of the elbow joint, and the lower ends participate in the formation of the wrist joint along with the upper row of carpal bones. The upper (proximal) epiphysis of the ulna is thickened, has two processes - ulnar (back) and radial (front), separated by a trochlear notch. On the lateral side of the upper and lower epiphyses there are articular platforms for articulation with the adjacent radius.

At the radius, on the medial side of the upper and lower epiphyses, there are corresponding articular fossae for articulation with the ulna. The thickened lower end of the radius bears an articular surface that forms a joint with the upper (proximal) row of carpal bones.

Hand bones include the carpal bones, metacarpal bones and bones (phalanxes) of the fingers.

Skeleton of the wrist consists of 8 spongy bones (short), arranged in two rows, 4 bones in each row, and having articular surfaces for articulation with neighboring bones. Pastern has five short tubular metacarpal bones, which have a base, a body and a head. The bases of the metacarpal bones are equipped with articular surfaces for articulation with the bones of the second row of the wrist, and their heads with the bases of the first phalanges of the fingers. Finger bones- these are short tubular bones (phalanxes), located one behind the other. Four fingers have three phalanges - proximal, middle and distal (ungual). The exception is the thumb, which has two phalanges (proximal and distal).

Skeleton of the lower limbs

The skeleton of the lower extremities consists of the girdle of the lower extremities (paired pelvic bone) and the free part of the lower extremities (bones of the thigh, lower leg and foot). The bones of the girdle of the free part of the lower limb are more massive and thick than those of the upper limb, since they are adapted to bear the weight of the entire body both in a calm state and under dynamic loads: walking, running, jumping.

The girdle of the lower extremities (pelvic girdle) is formed by a pair of massive, flattened pelvic bones, between these bones the sacrum is located at the back.

Hip bone up to 12-14 years old, it consists of three separate bones connected by cartilage: the ilium, the pubis and the ischium. The fused bodies of these bones form depression (vertugular), which is the articular surface for articulation with the head.

Ilium located above the acetabulum, ischium - below and behind her, pubic bone - anteriorly and downward. The ischium and pubis bones limit the large, oval shape obturator foramen , closed by a connective tissue obturator membrane. The pelvic bones articulate with the posterior sacrum , in front - with each other, forming a bony pelvis.

The skeleton of the free part of the lower limb is similar in structure to the skeleton of the upper limb and consists of three sections: the femur, the bones of the lower leg (tibia and fibula) and the bones of the foot (tarsal bones, metatarsals and phalanges of the fingers).

Lower limb belt,

• 1 Ilium
• 2 Hip [pelvic] bone
• 3 Femur
• 4 Patella
• 5 Fibula
• 6 Tibia
• 7 Foot bones
• 8 Ischium,
• 9 Pubic bone

The bones of the lower limb girdle also include the sacrum and coccygeal bones. The bones of the lower limb girdle connect and form the pelvis, which is the skeleton for the internal organs, a support for the torso and serves to connect with the part of the free lower limb.

Femur-- the largest tubular bone in the human body, upper (proximal) end (pineal gland) has a head that articulates with the pelvic bone. A long, thin neck connects the ball-shaped head to the body of the femur. At the junction of the neck and the body, the femur has two massive tubercles for muscle attachment. Lower epiphysis The femur is thickened. It bears two elevations - condyle, by means of which the femur articulates with the tibia and the patella, and two protruding to the sides epicondyle-- medial and lateral.

Patella It is a large flattened bone that lies deep within the quadriceps tendon. With its posterior surface, the patella is adjacent to the lower end of the femur. The patella is an integral part of the knee joint.

Skeleton of the lower leg consists of two long tubular bones: the tibia and fibula. Tibia thicker than the fibula. Its upper end is massive and thick. It has articular surfaces for connection with the condyles of the femur and with the head of the fibula. The lower end of the fibula on the inner (medial) side continues into a flattened outgrowth - the medial malleolus. The anterior, pointed edge of the tibia is located directly under the skin.

Fibula thin, long, with thickened ends, located on the side (lateral) of the tibia. The upper end of the fibula forms an articulation with the lateral surface of the superior epiphysis of the tibia, and the lower end ends in the flattened lateral malleolus. The lateral malleolus, together with the medial malleolus and the lower surface of the tibia, participate in the formation of the ankle joint.

Foot bones, like the bones of the hand, are divided into three groups: tarsal bones, metatarsal bones and phalanges of the fingers.

Tarsal bones include seven bones arranged in two rows. The largest of them is the talus bone, which participates in the formation of the ankle joint, and the calcaneus bone lying underneath it. The other tarsal bones (cuboid, navicular, and three cuneiforms) are located anterior to the calcaneus and talus. Five short tubular metatarsal bones are located anterior to the tarsal bones. The first metatarsal bone is shorter and thicker than the others. Toe bones -- These are short tubular bones - phalanges. The big toe has two phalanges, the other four toes have three phalanges.

The lower limbs of a person can withstand heavy loads and completely take over the functions of movement. They have a more massive skeleton, large and stable joints and arched feet. Only humans have developed longitudinal and transverse arches of the foot. The fulcrum points of the foot are the heads of the metatarsal bones in front and the calcaneal tubercle in the back. Springy arches of the feet distribute the weight on the foot, reduce shocks and jolts when walking, and impart a smooth gait. The muscles of the lower limb have greater strength, but at the same time less variety in their structure than the muscles of the upper limb.

The skeleton of the upper and lower extremities is divided into the skeleton of the free limb and the skeleton of the belt. The skeleton of the upper limb girdle (shoulder girdle) consists of two paired bones - the scapula and the clavicle, and the skeleton of the free part of the upper limb - of three sections: the humerus, the bones of the forearm and the bones of the hand. The skeleton of the lower limb girdle (pelvic girdle) consists of a paired pelvic bone, and the skeleton of the free part of the lower limb is also divided into three sections: the femur, the bones of the lower leg and the bones of the foot. The skeleton of the upper limb is used to grasp and move objects in space, and the skeleton of the lower limbs is used for support and movement. Each bone is an independent organ that performs a specific function.

We forgot the patella - the flat bone that covers the knee joint.

Let's mentally walk along the lower limb from the hip joint to the fingertips. We will examine three “floors” of the lower limb:

During this amazing excursion you will understand the anatomy of the leg. And perhaps you will make many discoveries for yourself.

Bone frame of the femur: anatomy

The strong and long femur is the support of the thigh, the attachment point for the most powerful muscles of the lower limb. Its length is approximately 25–27% of your height. How much is this, figure it out for yourself. The structure of the femur resembles a tube with two widened ends. The middle part of this bone tube is the diaphysis, and the widened round ends are the epiphyses.

Inside the diaphysis there is a cavity - the bone canal. In the embryo, it contains red bone marrow, a hematopoietic organ. In a child aged 3–4 years, red bone marrow gradually begins to be replaced by yellow. In an adult, there are no hematopoietic elements in it. But in the case of acute blood loss, when the need for new blood cells increases, the yellow bone marrow can also be populated with hematopoietic cells and be included in the process of hematopoiesis.

The epiphyses have a spongy structure. They resemble pumice. The upper epiphysis - the head of the femur - is almost ideally round in shape. It is attached to the diaphysis at an angle. The femoral neck (the section between the diaphysis and the femoral head) is a known weak point. It often breaks, especially in the elderly.

The lower epiphysis of the femur has a structure resembling two fused apples. Two rounded condyles, covered with cartilage, form the knee joint with the bones of the lower leg. Thus, the epiphyses of the femur are part of two large joints of the lower limb - the hip and knee. There are about 400 joints in the human body, but these two are of great strategic importance.

The knee joint is protected in front by the patella. This leg bone resembles a triangular shield.

In order not to interfere with movements in the knee joint, it comes into contact only with the epiphysis of the femur. The protective function of the patella can hardly be overestimated. How many times in childhood did we scrape our knees... without any harm to the knee joints!

Shin: inside view

The bone frame of the lower leg in humans is represented by two bones: the tibia and fibula. The thin fibula is on the outside, and the strong, thick tibia is on the inside. Both of them have a tubular structure. The name “tibial”, which is strange for modern people, comes from the outdated word “börze” or “tibia”. Once upon a time, this was the name for the lower leg - the part of the lower limb from the knee to the foot.

The diaphysis, or body of the tibia, has a triangular structure. One of its faces faces forward. Run your hand along the front of your shin and you will feel it. The upper epiphysis is bifurcated and forms two condyles. They connect to the femoral condyles to form the knee joint. These condyles are concave, like saucers, and covered with articular cartilage. The convex femoral condyles rest on them.

The structure of the lower diaphysis of the tibia is a bit like an inverted cap of a russula. On its inner edge there is a bony outgrowth - the inner malleolus. The lower surface is covered with articular cartilage. It connects to the talus bone of the foot to form the ankle joint.

The fibula resembles a thin triangular rod.

It is slightly twisted around a vertical axis. Its lower end forms a long outgrowth - the outer ankle. The upper end connects to the tibia in the area of ​​its upper diaphysis. You may have noticed an interesting fact: the lower articular surface of the knee joint is formed only by the tibia, and not by both bones of the lower leg. The anatomy of the ankles is also a surprise to many. It turns out that these are not separate bones, as it seems at first glance.

Foot and its structure

When first introduced, the anatomy of the human foot invariably surprises medical students. How many of these small bones there are, it turns out! But really, how much? Let's do the math together.

Total... seven, yes five, yes fourteen... How many? Exactly 26 bones. So, not a single one was forgotten.

You noted three parts of the foot - tarsus, metatarsus and toes. The tarsus roughly corresponds to the heel. This is the part of the foot on which the lower leg rests. Like a three-dimensional puzzle, it is made up of small spongy bones of irregular shape. They are connected to each other by joints and ligaments. This gives a person's foot flexibility, since a small range of movement is possible between adjacent bones.

The metatarsus is the part of the leg from the front of the shin to the toes. It consists of five short tubular bones. They are connected at one end to the tarsus, and at the other to the phalanges of the fingers. The tarsus and metatarsus form the arches of the foot, transverse and longitudinal. This gives us the opportunity to absorb shocks when walking.

The phalanges of the fingers are tiny tubular bones connected to each other by joints. The first phalanx of each toe connects to the metatarsal bone. When you move your toes, you make movements in this joint.

How the leg skeleton is formed

During the development of each person, a number of metamorphoses occur with the bones of the lower extremities. During intrauterine development, only the diaphysis is formed. First, a cartilaginous model of each diaphysis is formed, which ossifies by the time of birth. After birth, cartilaginous epiphyses of bones are formed. They become osseous within... the first decade of life! Throughout the entire period of human growth, cartilaginous layers remain between the diaphysis and epiphyses. They allow bones to grow in length. And only by the age of 25 do the epiphyses finally fuse with the diaphyses.

It is easy to see how similar the anatomy of the upper and lower human limbs is. Shoulder with a single humerus, ulna and radius bones of the forearm, multiple spongy bones of the wrist, five metacarpal bones, phalanges of the fingers - each has three, except the thumb. As you can see, “everything fits together.”

The radius and ulna bones also finally ossify by the age of 20–25. The difference between the bones of the upper and lower limbs is size and proportion. The radius is smaller and thinner than the fibula. The phalanges of the fingers of the hand are longer than those of the foot. This is understandable: the human foot does not need long flexible toes. The radius connects to the ulnar membrane - exactly the same as between the bones of the lower leg... the list goes on. The similarity in the structure of the arm and leg is obvious.

What do the lower limbs “feed” on?

Like all organs of the human body, the bones of the lower extremities are fed with arterial blood. A network of small arteries penetrates deep into the bone substance. Osteons, the structural units of bone matter, form around the smallest arteries. An osteon is a bone cylinder in the lumen of which one of the arteries passes. During the growth process, a constant restructuring of the osteon system occurs. The network of arteries is also expanding. New osteons are formed around the arteries, and old ones are destroyed.

The thighs are supplied with blood from the femoral arteries, the legs - from the popliteal arteries, which give off multiple branches, the anterior and posterior tibial arteries. Two vascular networks are formed on the feet: on the back of the foot and on the sole. The sole is supplied with blood by the branches of the external and internal plantar arteries. Rear – dorsal artery of the foot.

Proper metabolism is impossible without nervous regulation.

The lower limbs are innervated by branches of the sacrolumbar plexus. These are the femoral nerve, sciatic nerve, tibial and peroneal nerves. Nerve endings are also responsible for sensitivity. Sensitive endings are located in the periosteum. They allow us to feel pain.

So our imaginary tour of the three “floors” of the leg has ended. We hope you found it useful. The anatomy of the leg is only one of the sections of the fascinating science called “human anatomy”.

Structure of the ankle and foot

The ankle joint is the supporting point of the human lower limb skeleton. It is on this joint that the body weight falls when walking, running, or playing sports. Unlike the knee joint, the foot withstands loads not by movement, but by weight, which affects the features of its anatomy. The structure of the ankle and other parts of the foot plays an important clinical role.

Anatomy of the foot

Before talking about the structure of the various parts of the foot, it should be mentioned that in this part of the leg bones, ligamentous structures and muscle elements organically interact.

In turn, the bony skeleton of the foot is divided into the tarsus, metatarsus and phalanges. The tarsal bones articulate with the tibia elements at the ankle joint.

Ankle joint

One of the largest bones of the tarsus is the talus. On the top surface there is a protrusion called a block. This element connects to the fibula and tibia on each side.

In the lateral sections of the joint there are bone outgrowths - ankles. The inner one is the tibia, and the outer one is the fibula. Each articular surface of the bones is lined with hyaline cartilage, which performs nutritional and shock-absorbing functions. The articulation is:

• The structure is complex (more than two bones are involved).
• The shape is block-shaped.
• The volume of movement is biaxial.

Ligaments

Holding bone structures together, protecting, and limiting movements in the joint are possible due to the presence of ligaments of the ankle joint. The description of these structures should begin with the fact that they are divided into 3 groups in anatomy. The first category includes fibers that connect the bones of the human leg to each other:

1. The interosseous ligament is the lower section of the membrane stretched along the entire length of the leg between its bones.
2. The posterior inferior ligament is an element that prevents internal rotation of the bones of the leg.
3. Anterior inferior fibular ligament. The fibers of this structure run from the tibia to the lateral malleolus and help keep the foot from turning outward.
4. The transverse ligament is a small fibrous element that stabilizes the foot from turning inward.

In addition to the listed functions of the fibers, they provide reliable attachment of the fragile fibula to the powerful tibia. The second group of ligaments are the outer lateral fibers:

1. Anterior talofibular
2. Posterior talofibular.
3. Calcaneofibular.

These ligaments begin on the lateral malleolus of the fibula and diverge in different directions towards the elements of the tarsus, so they are collectively called the deltoid ligament. The function of these structures is to strengthen the outer edge of this area.

Finally, the third group of fibers are the internal collateral ligaments:

1. Tibiofanavicular.
2. Tibiocalcaneal.
3. Anterior tibiotalus.
4. Posterior tibiotalus.

Similar to the anatomy of the previous category of fibers, these ligaments originate at the medial malleolus and keep the tarsal bones from moving.

Muscles

Movements in the joint and additional fixation of the elements are achieved through the muscular elements surrounding the ankle. Each muscle has a specific attachment point on the foot and its own purpose, however, structures can be grouped into groups according to their predominant function.

Muscles involved in flexion include the tibialis posterior, plantaris, triceps, and flexor hallucis longus and other toes. The tibialis anterior, extensor pollicis longus, and extensor pollicis longus are responsible for extension.

The third muscle group is the pronators - these fibers rotate the ankle inward towards the midline. They are the short and long peroneus muscles. Their antagonists (supinators): extensor pollicis longus, peroneus anterior muscle.

Achilles tendon

The ankle joint in the posterior region is strengthened by the largest Achilles tendon in the human body. The formation is formed by the fusion of the gastrocnemius and soleus muscles in the lower leg.

The powerful tendon, stretched between the muscle bellies and the heel tubercle, plays a vital role in movement.

An important clinical point is the possibility of ruptures and sprains of this structure. In this case, the traumatologist must carry out complex treatment to restore function.

Blood supply

Muscle work, restoration of elements after stress and injury, metabolism in the joint is possible thanks to the special anatomy of the circulatory network surrounding the joint. The structure of the ankle arteries is similar to the blood supply to the knee joint.

The anterior and posterior tibial and peroneal arteries branch in the area of ​​the external and internal ankles and cover the joint on all sides. Thanks to this arrangement of the arterial network, the full functioning of the anatomical region is possible.

Venous blood flows from this area through internal and external networks, which form important formations: the saphenous and tibial internal veins.

Other joints of the foot

The ankle joint unites the bones of the foot with the lower leg, but small fragments of the lower limb are also connected to each other by small joints:

1. The human calcaneus and talus participate in the formation of the subtalar joint. Together with the talocaleonavicular joint, it unites the bones of the tarsus - the hindfoot. Thanks to these elements, the rotation volume increases to 50 degrees.
2. The tarsal bones are connected to the middle part of the foot skeleton by tarsometatarsal joints. These elements are strengthened by the long plantar ligament, the most important fibrous structure that forms the longitudinal arch and prevents the development of flat feet.
3. The five metatarsal bones and the bases of the basal phalanges of the toes are connected by the metatarsophalangeal joints. And inside each finger there are two interphalangeal joints that connect small bones to each other. Each of them is strengthened on the sides by collateral ligaments.

This complex anatomy of the human foot allows it to maintain a balance between mobility and support function, which is very important for human upright walking.

Functions

The structure of the ankle joint is primarily aimed at achieving the mobility necessary for walking. Thanks to the coordinated work of the muscles in the joint, movements in two planes are possible. In the frontal axis, the human ankle performs flexion and extension. In the vertical plane, rotation is possible: inward and, to a small extent, outward.

In addition to its motor function, the ankle joint has a supporting role.

In addition, thanks to the soft tissues of this area, movement is absorbed, keeping the bone structures intact.

Diagnostics

In such a complex element of the musculoskeletal system as the ankle, various pathological processes can occur. To detect a defect, visualize it, and correctly make a reliable diagnosis, there are various diagnostic methods:

1. Radiography. The most economical and accessible way of research. Images of the ankle are taken in several projections, which can reveal a fracture, dislocation, tumor and other processes.
2. Ultrasound. At the present stage of diagnosis, it is rarely used, since, unlike the knee joint, the ankle cavity is small. However, the method is good at being economical, fast, and lacking harmful effects on tissue. You can detect accumulation of blood and swelling in the joint capsule, foreign bodies, and visualize ligaments. A description of the procedure and the results seen is given by a functional diagnostics doctor.
3. CT scan. CT is used to assess the condition of the skeletal system of the joint. For fractures, neoplasms, arthrosis, this technique is the most valuable in diagnostic terms.
4. Magnetic resonance imaging. As with the examination of the knee joint, this procedure will indicate better than any other the condition of the articular cartilage, ligaments, and Achilles tendon. The technique is expensive, but extremely informative.
5. Athroscopy. A minimally invasive, low-traumatic procedure that involves inserting a camera into the capsule. The doctor can examine the inner surface of the bag with his own eyes and determine the source of the pathology.

Instrumental methods are supplemented by the results of a medical examination and laboratory tests; based on the totality of data, the specialist makes a diagnosis.

Pathology of the ankle joint

Unfortunately, even such a strong element as the ankle joint is prone to the development of diseases and injuries. The most common ankle diseases are:

How to suspect diseases? What to do first and which specialist should you contact? It is necessary to understand each of the listed diseases.

Deforming arthrosis

The ankle joint is often subject to the development of deforming arthrosis. With this pathology, due to frequent stress, trauma, and lack of calcium, degeneration of bones and cartilaginous structures occurs. Over time, outgrowths - osteophytes - begin to form on the bones, which impair range of motion.

The pathology is manifested by pain of a mechanical nature. This means that the symptoms increase in the evening, intensify after exercise and decrease with rest. Morning stiffness is short-lived or absent. There is a gradual decrease in mobility in the ankle joint.

With such symptoms you need to consult a general practitioner. If necessary, if complications develop, the doctor will prescribe a consultation with another specialist.

Arthritis

Inflammation of the joint can occur when an infection enters the cavity or the development of rheumatoid arthritis. The ankle joint can also become inflamed due to the deposition of uric acid salts during gout. This happens even more often than a gouty attack of the knee joint.

The pathology manifests itself as pain in the joint in the second half of the night and in the morning. Movement relieves the pain. Symptoms are relieved by taking anti-inflammatory drugs (Ibuprofen, Nise, Diclofenac), as well as after using ointments and gels on the ankle area. You can also suspect the disease by simultaneous damage to the knee joint and the joints of the hand.

Diseases are treated by rheumatologists who prescribe basic remedies to eliminate the cause of the disease. Each disease has its own drugs that are designed to stop the progression of inflammation.

To eliminate symptoms, therapy similar to the treatment of arthrosis is prescribed. It includes a range of physiotherapy and medications.

It is important to distinguish infectious arthritis from other causes. It usually manifests itself with vivid symptoms with intense pain and edema syndrome. Pus accumulates in the joint cavity. Treatment is carried out with antibiotics, bed rest is required, and the patient often requires hospitalization.

Injuries

With direct trauma to the ankle joint in sports, during road traffic accidents, and at work, various tissues of the joint can be damaged. Damage causes bone fractures, ligament rupture, and tendon damage.

Common symptoms will be: pain after injury, swelling, decreased mobility, inability to stand on the injured limb.

After receiving an ankle injury, you need to apply ice to the injury site, provide rest for the limb, then go to the emergency room. After examination and diagnostic tests, the traumatologist will prescribe a set of treatment measures.

Therapy most often includes immobilization (immobilization of the limb below the knee joint), the prescription of anti-inflammatory and painkillers. Sometimes, to eliminate the pathology, surgical intervention is required, which can be performed classically or using arthroscopy.

Achilles tendon rupture

During sports activities, a fall on the leg or a direct blow to the back of the ankle can cause a complete rupture of the Achilles tendon. In this case, the patient cannot stand on his toes or straighten his foot. Swelling forms in the area of ​​damage and blood accumulates. Movement in the joint is extremely painful for the affected person.

A traumatologist will most likely recommend surgical treatment. Conservative therapy is possible, but in case of complete tendon rupture it is ineffective.

How to forget about joint pain?

• Joint pain limits your movements and full life...
• You are worried about discomfort, crunching and systematic pain...
• You may have tried a bunch of medications, creams and ointments...
• But judging by the fact that you are reading these lines, they did not help you much...

Anatomy of the foot

If we consider the foot as a whole, then, as in any other part of the human musculoskeletal system, three main structures can be distinguished: the bones of the foot; ligaments of the foot, which hold the bones and form joints; foot muscles.

Antonym - medial edge. .

Antonym - lateral edge. .

Plantar side (bottom view).

Foot bones

The foot skeleton consists of three sections: tarsus, metatarsus and toes.

Tarsal bones

The posterior part of the tarsus is made up of the talus and calcaneus, the anterior part is made up of the navicular, cuboid and three cuneiform bones.

The talus is located between the distal

The calcaneus forms the posteroinferior part of the tarsus. It has an elongated, laterally flattened shape and is the largest among all the bones of the foot. It reveals the body and a well-palpable tubercle of the calcaneus protruding posteriorly. This bone has articular surfaces that serve to articulate superiorly with the talus and anteriorly with the cuboid. There is a protrusion on the inside of the heel bone that supports the talus.

The navicular bone is located at the inner edge of the foot. It lies in front of the talus, behind the sphenoid bones and inside the cuboid bones. At the inner edge, it has a tuberosity of the navicular bone, facing downwards, which can be easily felt under the skin and serves as an identification point for determining the height of the inner part of the longitudinal arch of the foot. This bone is convex anteriorly. It has articular surfaces that articulate with adjacent bones.

The cuboid bone is located at the outer edge of the foot and articulates posteriorly with the calcaneus, internally with the navicular and external cuneiform, and in front with the fourth and fifth metatarsal bones. Along its lower surface there is a groove in which the tendon of the peroneus longus muscle lies.

The sphenoid bones (medial, intermediate and lateral) lie in front of the scaphoid, inside the cuboid, behind the first three metatarsal bones and make up the anterior internal part of the tarsus.

Metatarsus bones

Each of the five metatarsal bones is tubular in shape. They distinguish between the base, body and head. The body of any metatarsal bone is shaped like a triangular prism. The longest bone is the second, the shortest and thickest is the first. At the bases of the metatarsal bones there are articular surfaces that serve for articulation with the tarsal bones, as well as with adjacent metatarsal bones, and on the heads there are articular surfaces for articulation with the proximal bones.

Finger bones

The toes are made up of phalanges. As on the hand, the first toe has two phalanges, and the rest have three. Often the two phalanges of the fifth finger grow together so that its skeleton can have two phalanges. There are proximal, middle and distal phalanges. Their significant difference from the phalanges of the hand is that they are short, especially the distal phalanges.

The foot, like the hand, has sesamoid bones. Here they are expressed much better. They are most often found in the area where the first and fifth metatarsals meet the proximal phalanges. Sesamoid bones increase the transverse arch of the metatarsus in its anterior section.

Back surface (top and right view).

Ligamentous apparatus of the foot

The mobility of the foot is ensured by several joints - the ankle, subtalar, talocaleonavicular, tarsometatarsal, metatarsophalangeal and interphalangeal.

Ankle joint

The ankle joint is formed by the bones of the lower leg and the talus. The articular surfaces of the bones of the lower leg and their ankles, like a fork, cover the block of the talus. The ankle joint has a block-like shape. In this joint around the transverse axis passing through the block of the talus, the following are possible: flexion (movement towards the plantar surface of the foot) and extension (movement towards its dorsal surface). The amount of mobility during flexion and extension reaches 90°. Due to the fact that the block at the back narrows somewhat, when the foot is flexed, some adduction and abduction becomes possible. The joint is strengthened by ligaments located on its inner and outer sides. Located on the inner side, the medial (deltoid) ligament is approximately triangular in shape and runs from the medial malleolus towards the navicular, talus and calcaneus bones. On the outside there are also ligaments running from the fibula to the talus and calcaneus (anterior and posterior talofibular ligaments and calcaneofibular ligament).

One of the characteristic age-related features of this joint is that in adults it has greater mobility towards the plantar surface of the foot, while in children, especially newborns, it moves towards the dorsum of the foot.

Subtalar joint

The subtalar joint is formed by the talus and calcaneus and is located in their posterior section. It has a cylindrical (somewhat spiral) shape with an axis of rotation in the sagittal plane. The joint is surrounded by a thin capsule equipped with small ligaments.

Talocaleonavicular joint

In the anterior section between the talus and calcaneus is the talocaleonavicular joint. It is formed by the head of the talus, the calcaneus (with its anterior superior articular surface) and the scaphoid. The talocaleonavicular joint has a spherical shape. Movements in it and in the subtalar joints are functionally related; they form one combined articulation with an axis of rotation passing through the head of the talus and the calcaneal tubercle. Pronation occurs around this axis

One of the age-related features of the position of the bones and their movements in the joints of the foot is that with age the foot pronates somewhat and its internal arch drops. A child’s foot, especially in the first year of life, has a distinctly supinator position, as a result of which the child, when starting to walk, often places it not on the entire plantar surface, but only on the outer edge.

Tarsometatarsal joints

The tarsometatarsal joints are located between the tarsal bones and between the tarsal and metatarsal bones. These joints are small, mostly flat in shape, with very limited mobility. On the plantar and dorsal surfaces of the foot there are well-developed ligaments, among which it is necessary to note the powerful syndesmosis - a long plantar ligament that runs from the heel bone to the bases of the II-V metatarsal bones. Thanks to numerous ligaments, the tarsal bones (scaphoid, cuboid and three cuneiform) and the I-V metatarsal bones are almost immovably connected to each other and form the so-called hard base of the foot.

Metatarsophalangeal joints

The metatarsophalangeal joints are spherical in shape, but their mobility is relatively low. They are formed by the heads of the metatarsal bones and the bases of the proximal phalanges of the toes. Mostly they allow flexion and extension of the fingers.

Interphalangeal joints

The interphalangeal joints of the foot are located between the individual phalanges of the fingers and have a block-like shape; on the sides they are strengthened by collateral ligaments.

Back surface (top view).

Plantar surface (bottom view).

Foot muscles

*Muscles that are attached by their tendons to various bones of the foot (tibialis anterior, tibialis posterior, peroneus longus, peroneus brevis, long extensor muscles and flexor toes), but begin in the lower leg area, belong to the lower leg muscles and are considered in the article Anatomy of the lower leg.

There are two muscles on the dorsum of the foot: the extensor digitorum brevis and the extensor hallucis brevis muscle. Both of these muscles originate from the outer and inner surfaces of the calcaneus and attach to the proximal phalanges of the corresponding fingers. The function of the muscles is to extend the toes.

On the plantar surface of the foot, the muscles are divided into internal, external and middle groups.

The internal group consists of muscles acting on the big toe: the abductor pollicis muscle; flexor pollicis brevis and adductor pollicis muscle. All these muscles begin from the bones of the metatarsus and tarsus, and are attached to the base of the proximal phalanx of the big toe. The function of these muscles is clear from their name.

The outer group includes the muscles that act on the fifth toe: the abductor of the little toe and the flexor of the little toe. Both of these muscles attach to the proximal phalanx of the fifth finger.

The middle group is the most significant. It includes: the short flexor digitorum, which is attached to the middle phalanges of the second to fifth fingers; the quadratus plantae muscle, which attaches to the flexor digitorum longus tendon; lumbrical muscles, as well as dorsal and plantar interosseous muscles, which are directed to the proximal phalanges of the second to fifth fingers. All of these muscles originate on the tarsal and metatarsal bones on the plantar side of the foot, with the exception of the lumbrical muscles, which originate from the tendons of the flexor digitorum longus. All of them are involved in flexing the toes, as well as in spreading them and bringing them together.

When comparing the muscles of the plantar and dorsum of the foot, it is clear that the former are much stronger than the latter. This is due to the difference in their functions. The muscles of the plantar surface of the foot are involved in maintaining the arches of the foot and largely provide its spring properties. The muscles of the dorsal surface of the foot are involved in some extension of the toes when moving it forward when walking and running.

Diagram of the structure of the bones of the human foot

Since a person moves in an upright position, the lion's share of the load falls on the lower extremities. Therefore, it is important to monitor your body weight, making it easier for the bones of the foot to work.

The structure of the ankle joint in humans is represented by the articulation of the bones of the foot with the shin bones, ensuring the performance of complex functions.

Human ankle joint

The bones are clearly shown in the diagram and classified into groups.

1. Articulation of the bones of the lower leg with the bones of the foot.
2. Internal articulation of the tarsal bones.
3. Articulations between the bones of the metatarsus and tarsus.
4. Articulations of the proximal phalanges with the metatarsal bones.
5. Articulation of the phalanges of the fingers with each other.

The anatomical abilities of the foot require a high level of motor activity. For this reason, a person can perform heavy physical activity.

Both the foot and the entire leg are designed to help a person move freely in the environment.

Anatomical structure of the foot

The structure of the foot is divided into 3 working parts:

The skeletal base of the foot includes 3 sections: toes, metatarsus and tarsus.

The design of the toes includes phalanges. Just like the hand, the big toe consists of 2 phalanges, and the remaining 4 fingers - of 3.

There are often cases when the 2 components of the 5th fingers grow together, forming a finger structure of 2 phalanges.

The structure has proximal, distal and middle phalanges. They differ from the phalanges of the hand in that their length is shorter. A clear expression of this is seen in the distal phalanges.

The tarsal bones of the posterior section have talus and calcaneal components, and the posterior section is divided into the cuboid, scaphoid and sphenoid bones.

The talus lies at a distance from the distal end of the tibia, becoming the bony meniscus between the bones of the foot and knee.

It consists of a head, neck and body, and is designed to connect with the shin bones, ankle bones and calcaneus.

The calcaneus is part of the posterior lower lobe of the tarsus. It is the largest part of the foot and has a laterally flattened, elongated appearance. At the same time, the calcaneus is the connecting link between the cuboid and talus bones.

The navicular bone is located on the inside of the foot. It has a convex forward appearance with articular components connecting to nearby bones.

The cuboid part is located on the outer side of the foot, articulating with the calcaneus, navicular, cuneiform and metatarsal bones. At the bottom of the cuboid bone there is a groove in which the tendon of the elongated peroneus muscle is laid.

The composition of the sphenoid bones includes:

They lie in front of the scaphoid, inboard of the cuboid, behind the first 3 metatarsal fragments and represent the anterior inner part of the tarsus.

The skeleton of the metatarsus appears in tubular segments, consisting of a head, body and base, where the body is similar to a triangular prism. In this case, the longest bone is the second, and the thickest and shortest is the first.

The bases of the metatarsal bones are equipped with articular surfaces that serve as a connection to the bony components of the tarsus. In addition, it articulates with the adjacent bones of the metatarsus. At the same time, the heads equipped with articular surfaces are connected to the proximal phalanges.

The metatarsal bones are easily palpated due to the fairly thin covering of soft tissue. They are placed in multi-angle planes, creating a vault in a transverse line.

Circulatory and nervous systems of the foot

Nerve endings and blood arteries are considered an important component of the foot.

There are 2 main arteries of the foot:

Also, the circulatory system includes small arteries that distribute to all tissue areas.

Due to the distance of the arteries of the feet from the heart, circulatory disorders are often recorded due to oxygen deficiency. The results of this manifest themselves in the form of atherosclerosis.

The longest vein that carries blood to the heart area is located at the point of the big toe, extending inside the leg. It is commonly called the great saphenous vein. In this case, the small saphenous vein runs along the outside of the leg.

The tibial anterior and posterior veins are located deep in the leg, and the small ones drive blood into the large veins. Moreover, small arteries supply tissues with blood, and tiny capillaries connect veins and arteries.

A person suffering from circulatory disorders notes the presence of edema in the afternoon. In addition, varicose veins may appear.

As in other parts of the body, nerve roots in the foot read all sensations and transmit them to the brain, controlling movement.

The nervous system of the foot includes:

1. Superficial fibular.
2. Deep fibula.
3. Posterior tibial.
4. Calf.

Tight shoes can compress any nerve, causing swelling, which will lead to discomfort, numbness and pain.

Diagnostic measures

At the moment when alarming symptoms arise in the foot area, a person comes to an orthopedist and traumatologist, who, knowing the complete structure of the ankle joint, can determine a lot by external signs. But at the same time, specialists prescribe the examination necessary for a 100% correct diagnosis.

Examination methods include:

• X-ray examination.
• Ultrasonography.
• Computed and magnetic resonance imaging.
• Athroscopy.

Detecting pathologies using x-rays is the most cost-effective option. Pictures are taken from several sides, recording possible dislocations, tumors, fractures and other processes.

Ultrasound helps to detect concentrations of blood, find foreign bodies, a possible swelling process in the joint capsule, and also check the condition of the ligaments.

Computed tomography provides a complete examination of bone tissue for neoplasms, fractures and arthrosis. Magnetic resonance imaging is an expensive research technique that provides maximum reliable information about the Achilles tendon, ligaments and articular cartilage.

Atroscopy is a minimally invasive intervention that involves inserting a special camera into the joint capsule, through which the doctor can see all the pathologies of the ankle joint.

After collecting all the information using instrumental and hardware means, examining doctors and receiving laboratory test results, an accurate diagnosis is made with the determination of treatment methods.

Pathologies of the ankle and feet

Frequent pain, external changes, swelling and impaired motor functions can be signs of foot ailments.

Typically, a person may experience the following diseases:

• Arthrosis in the ankle joint.
• Arthrosis of the toes.
• Valgus change of the thumb.

Arthrosis of the ankle joint is characterized by crunching, pain, swelling, and fatigue during running and walking. This is due to the course of the inflammatory process, which damages the cartilage tissue, leading to typical deformation of joint tissue.

The causes of the disease can be constant increased loads and injuries, provoking the development of dysplasia, osteodystrophy and negative changes in statics.

Treatment is carried out based on the degree of arthrosis with means that reduce pain, restore blood circulation and block the spread of the disease. In difficult cases, surgical intervention is performed to relieve the patient of damaged joint segments, restoring mobility and eliminating pain.

Arthrosis of the toes is noted as a result of disruption of metabolic processes and typical blood circulation in the metatarsophalangeal joints. This is facilitated by a lack of moderation in exercise, uncomfortable narrow shoes, injuries, excess weight and frequent hypothermia.

Symptoms of the disease include swelling, deformation of the structure of the fingers, pain during movement and crunching.

At the initial stage of finger arthrosis, measures are taken to avoid deformation and relieve pain. If an advanced stage is detected, in most cases the doctor prescribes arthrodesis, endoprosthesis replacement or surgical arthroplasty, which should completely solve the problem of the disease.

Hallux valgus, better known as a “bump” at the base of the big toe. This disease is characterized by displacement of the head of one phalangeal bone, inclination of the big toe to the other four, weakening of the muscles and resulting deformation of the foot.

Treatment that inhibits the development of the disease is determined by prescribing baths, physiotherapy, and physical therapy. When the form of changes becomes obvious, an operation is performed, the method of which is determined by the attending orthopedist, taking into account the stage of the disease and the general well-being of the patient.

Anatomy of the foot joints and their diseases

The foot is the distal section of the human lower limb and is a complex articulation of small bones that form a unique and strong arch and serve as support during movement or standing. The bottom of the foot that is in direct contact with the ground is called the sole (or foot), the opposite side is called the dorsum of the foot. According to the structure of the foot skeleton, it can be divided into 3 parts:

Thanks to its multiple joints and arched design, the foot is remarkably strong, yet flexible and resilient. The main function of the foot is to hold the human body in an upright position and ensure its movement in space.

Skeleton of the foot

To understand the structure of the joints of the foot, you need to have an idea of ​​the anatomy of its bones. Each foot is made up of 26 individual bones, which are divided into 3 parts.

• talus,
• calcaneal,
• scaphoid,
• lateral, intermediate and medial wedge-shaped,
• cuboid.

Metatarsus, which consists of 5 short tubular bones located between the tarsus and the proximal phalanges of the toes.

The phalanges are short tubular bones that form the segments of the toes (proximal, intermediate and distal phalanges). All fingers, except the first, consist of 3 phalanges. The thumb has only 2 phalanges, just like on the hands.

Structure of the foot skeleton

Features of the foot joints

Intertarsal

The metatarsal bones form a whole group of joints among themselves. Let's take a closer look at them.

Subtalar

The calcaneus and talus bones take part in its formation. The joint has a cylindrical shape. The joint capsule is poorly stretched. The surfaces of the bones that form the joint are covered with smooth hyaline cartilage, along the edge of which the joint capsule is attached. Outside, the joint is additionally strengthened by several ligaments: interosseous, lateral and medial, talocalcaneal.

Talocaleonavicular

As the name implies, the articulation is formed by the articular surfaces of the talus, calcaneus and navicular bones. Located in front of the subtalar. The talus forms the head of the joint, and the other two form the glenoid cavity for it. The joint is spherical in shape, but movements in it are possible only around one sagittal axis. The articular capsule is attached to the edges of the hyaline cartilage that covers the articular surfaces. The joint is strengthened by the following ligaments: talonavicular, calcaneonavicular plantar.

Calcaneocuboid

Located between the articular surfaces of the calcaneus and cuboid bones. The joint is saddle-shaped in shape, but movements are possible only around one axis. The capsule is stretched tightly and attached to the edges of the articular cartilages. The joint participates in the movements of the two previous joints, increasing the range of motion. It is strengthened by the following ligaments: long plantar ligament, calcaneocuboid plantar ligament.

This joint, together with the talocaleonavicular joint, is usually divided into one joint, which is called the transverse tarsal joint. The articulation line is S-shaped. Both joints are separated from each other, but have one common ligament - a bifurcated one.

Wedge-scaphoid

This is a complex articulation, in the construction of which the scaphoid, cuboid and three wedge-shaped bones of the tarsus take part. All individual joints are enclosed in one joint capsule, which is attached to the edges of the articular cartilages. The joint is strengthened by such ligaments and is inactive:

• dorsal and plantar cuneiform,
• dorsal and plantar cuboid-scaphoid,
• dorsal and plantar wedge-cuboid,
• dorsal and plantar intersphenoidal.

Tarsometatarsal

This group of joints connects the bones of the tarsus and metatarsus. There are three such joints:

• between the medial wedge-shaped bone and 1 metatarsal;
• between the lateral, intermediate cuneiform and 2-3 metatarsal bones;
• between the cuboid and 4-5 metatarsal bones.

The first joint is saddle-shaped, the rest are flat. The line of these joints is uneven. Each joint has a separate capsule, which is attached to the edges of the articular hyaline cartilages. The joints are strengthened by the following ligaments: dorsal and plantar tarsometatarsal, interosseous metatarsal and cuneiformatatarsal.

Joints and bones of the foot

Intermetatarsal

These are small joints that connect the bases of the individual metatarsal bones. Each such joint is strengthened by ligaments: interosseous metatarsal, dorsal and plantar metatarsal. The space between the long bones of the metatarsus is called the interosseous metatarsal space.

Metatarsophalangeal

The heads of the 5 metatarsal bones and the bases of the proximal phalanges of the fingers take part in the construction of these joints. Each joint has its own capsule, which is attached to the edges of the joint cartilage; it is poorly stretched. All these joints are spherical in shape.

On the dorsal side the capsule is not strengthened by anything, there are collateral ligaments on the sides, and plantar ligaments on the plantar side. In addition, a deep transverse metatarsal ligament runs between the heads of all metatarsal bones.

Interphalangeal joints of the foot

This group of joints connects the proximal phalanges of the fingers with the intermediate ones, and the intermediate ones with the distal ones. They are block-shaped in shape. The articular capsule is thin, reinforced below by plantar ligaments, and on the sides by collateral ligaments.

Joints and ligaments of the metatarsus and phalanges of the toes

Frequent illnesses

Every day, the joints of the foot are exposed to enormous loads, supporting the weight of the entire body. This leads to frequent trauma to individual components of the joints, which may be accompanied by inflammation and deformation. As a rule, the main symptom of diseases of the foot joints is pain, but it is difficult to immediately determine its cause, since there are many pathologies that affect these joints. Let's take a closer look at the most common of them.

Arthrosis

Deforming osteoarthritis of the joints of the feet is a fairly common pathology, especially among women. As a rule, the disease begins in adulthood, although earlier cases of pathology also occur. The metatarsophalangeal joint of the big toe is most often affected.

This disease is often mistakenly called gout due to the similarity in the localization of the pathological process, although there is nothing in common between these ailments. Also, many associate the disease with mythical salt deposits and unhealthy diet, which also does not correspond to reality.

In fact, the formation of a lump on the big toe joint and deformation of other structural components of the foot is associated with the negative influence of the following factors and, as a rule, develops in people genetically prone to this:

• traumatic injuries to the foot skeleton in the past (bruises, fractures, dislocations);
• some structural features of the foot, for example, in people with wide feet;
• the presence of congenital or acquired types of deformities, for example, flat feet;
• wearing uncomfortable and fashionable shoes that do not fit in size, high-heeled shoes;
• overweight and obesity;
• constant overload of the foot joints (activities that involve prolonged standing, walking, running, jumping);
• history of arthritis;
• endocrine and metabolic diseases;
• congenital or acquired deformities of the joints of the legs (hip, knee, ankle), which leads to improper distribution of the load on the feet and their constant microtrauma.

The disease is characterized by 3 stages and slow but steady progression:

• Stage 1: the patient complains of pain in the feet, which occurs after prolonged overload or at the end of the working day, quickly disappears after a few hours of rest on its own. There is no deformation as such yet, but those who are attentive to themselves may notice a minimal outward deviation of the thumb. A crunching sound also often appears when moving the joints.
• Stage 2: now pain appears even after normal exercise, and patients often have to resort to treatment with painkillers and anti-inflammatory drugs to eliminate it. The deformation of the toe becomes noticeable, in all patients the shoe size increases, it becomes difficult to fit, given the protruding bone and deviation of the big toe to the side.
• Stage 3: the pain becomes constant and is not completely relieved by analgesics. The toe and the entire foot are severely deformed, and the supporting function of the foot is partially lost.

Three stages of deforming osteoarthritis of the foot

Treatment of the disease must begin at the initial stages. Only in this case can its progression be slowed down. The main treatment measures are the elimination of all risk factors and possible causes of arthrosis. In addition, medicinal therapy methods, various folk remedies, physiotherapy and physical therapy can be used. In cases where the pathological process has gone far, only surgery will help. Surgical intervention can be gentle (arthrodesis, resection of exostoses, arthroplasty) or radical (endoprosthetics).

Arthritis

Absolutely all joints of the foot can become inflamed. Depending on the causes, primary and secondary arthritis are distinguished. In the first case, the joint itself is damaged; in the second, its inflammation is a consequence of the underlying disease.

Foot deformity in a patient with rheumatoid arthritis

Regardless of the cause, the symptoms of arthritis are more or less similar. Patients complain about:

• pain in the affected joints, the nature and intensity of which depend on the etiology of inflammation;
• swelling of the affected joint or the entire foot;
• redness of the skin over the inflamed area;
• in some cases, signs of general malaise appear: fever, general weakness, fatigue, pain in the body muscles, sleep and appetite disturbances, skin rash;
• dysfunction of the joint due to pain and swelling;
• in the case of chronic arthritis - gradual deformation of the foot and partial or complete loss of its functions.

Gouty arthritis of the metatarsophalangeal joint of the big toe

Treatment for arthritis should first be aimed at eliminating its underlying cause. Therefore, only a specialist should engage in therapy after making a correct diagnosis. Incorrect treatment is a direct path to the development of chronic inflammation and deformation of the foot joints.

Foot deformities

Foot deformities can be either congenital or acquired. They are caused by changes in the shape or length of bones, shortening of tendons, pathology of the muscles, articular and ligamentous apparatus of the foot.

Flat feet

With the development of this pathology, all the arches of the foot become flattened, which disrupts its shock-absorbing abilities. Flat feet can be congenital, or can arise during a person’s life as a result of excessive loads on the lower limbs, rickets, the development of osteoporosis, various injuries, obesity, wearing inappropriate shoes, and damage to the nerve endings of the legs.

This is what flat feet look like

Clubfoot

This is a fairly common type of foot deformity and, as a rule, is congenital. It is characterized by shortening of the foot and its supination-type position, which is caused by subluxation of the ankle. The acquired form of deformity develops due to paresis or paralysis, traumatic injuries to the soft tissues or skeleton of the lower extremities.

It is very easy to identify congenital clubfoot in a child - a routine examination is sufficient.

Other types of foot deformities (less common) include cauda equina, calcaneal, and cavus.

Cauda and calcaneal foot

There are many other diseases that can affect the joints of the feet, such as traumatic injuries or tumors. But, as a rule, they all manifest themselves with fairly similar symptoms. Therefore, if you develop pain, fatigue, swelling, or deformation of the foot structures, be sure to seek specialized help, since not only your health and activity, but also your life may depend on this.