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Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Plate 7.32

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Plate 7.32

Upper Left Quadrant

Lower Left Quadrant

Lower Right Quadrant

Upper Right Quadrant

1. Tendon m. extensor hallucis longus
2. Tendon m. tibialis anterior
3. Medial (deltoid) ligament
4. Talus, neck
5. Bursa, tibialis posterior tendon

6. Tendon m. flexor digitorum longus
7. Tendon m. flexor hallucis longus
8. Posterior tibial a. and v.
9. Medial plantar nerve
10. Lateral plantar nerve
11. Tendon m. plantaris
12. Bursa for tendon m. flexor digitorum longus and flexor hallucis longus m.
13. Calcaneal tendon (Achilles)

14. Sural and lateral calcaneal brs. of sural nerve
15. Small saphenous v.
16. Tendon m. peroneus longus
17. Tendon m. peroneus brevis
18. Trochlea of talus, articular cartilage
19. Talus, body
20. Anterior lateral malleolar a. and v.

21. Interosseous talocalcaneal ligament
22. Extensor digitorum brevis m.
23. Tendon m. peroneus tertius
24. Talus, head
25. Tendon m. extensor digitorum longus
26. Navicular
27. Intermediate cuneiform (second or middle)
28. Dorsalis pedis a.

This section passes through the talus (4, 18, 19, 24), the navicular (26), and the middle cuneiform (27) bones. There are seven tarsal bones grouped in two rows: the proximal group consists of the talus and calcaneus; the distal row consists of four bones (starting on the tibial side), the medial, intermediate, and lateral cuneiforms and the cuboid. On the tibial side, interposed between the two rows, is the navicular bone. The interosseous talocalcaneal ligament (21) is seen for the first time. The interosseous talocalcaneal ligament, located in the sinus tarsi (the hollow or canal formed by the groove of the talus and the groove of the calcaneus), is a strong band connecting the surfaces of the apposed grooves of the calcaneus and talus. It is composed of several laminae of connective tissue fibers separated by fatty connective tissue. The laminae of the interosseous ligament extend from the roof of the sinus tarsi obliquely inferiorly and laterally to the calcaneus immediately anterior to the posterior facet, thus entering into the anterior part of the capsule of the subtalar joint.

The lateral (10) and medial (9) plantar nerves are identified. The lateral plantar nerve is the smaller of the two terminal branches of the tibial nerve. Near its origin it supplies abductor digiti minimi and quadratus plantae and provides an articular branch to the calcaneocuboid Joint. It supplies, via its proper digital branches, the adjacent and lateral sides of the fourth and fifth digits. There are branches to the nail bed, the lateral three lumbrical muscles, the interossei muscles, and the adductor of the great toe. There are also articular branches to the intertarsal, tarsometatarsal, and frequently to the metatarsophalangeal joints.

The larger of the plantar nerves, the medial plantar, supplies the abductor hallucis and flexor digitorum brevis muscles. It supplies the skin of the medial part of the sole, flexor hallucis brevis, the skin on the medial side of the great toe, first lumbrical, and the skin on adjacent sides of the second and third toes and adjacent sides of the third and fourth toes. It anastomoses with the lateral plantar nerve and supplies the Joints of the toes, the skin over the second and terminal phalanges, and the nail beds.

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