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propulsive phase of the gait cycle. The other four toes each have three bones and two joints. The phalanges are connected to the metatarsals by five metatarsophalangeal joints at the ball of the foot. The forefoot bears half the body's weight and balances pressure on the ball of the foot.

The midfoot consists of the three cuneiform bones, the cuboid, and the navicular. The mid-foot has five irregularly shaped tarsal bones, forms the foot's arch, and serves as a shock absorber. The bones of the midfoot are connected to the forefoot and the hindfoot by muscles and the plantar fascia (arch ligament).

Figure 20-10 Range of motion at the wrist joint. A, Dorsiflexion (extension) and palmar flexion. B, Supination and pronation.

Adduction

Adduction

Figure 20-11 Range of motion at the finger joints. A, Abduction and adduction. B, Flexion.
Flexion

The rear foot is composed of the talus and the calcaneus. The foot contains two arches: the longitudinal in the midpart and the transverse in the forepart. The midtarsal joint is formed by the articulations of the navicular to the talus and the calcaneus to the cuboid. The largest tarsal bone is the calcaneus, the bottom of which is cushioned by a layer of fat. The attachment of the foot to the leg occurs through the talus. The joint movements at the ankle are dorsiflexion and plantar flexion. The motion of the subtalar joint is inversion and eversion. These motions are illustrated in Figure 20-18.

Extension

Extension

Flexion

Flexion

Opposition

Figure 20-12 Range of motion of the thumb. A, Flexion and extension. B, Opposition.

Sacrum

Anterior superior iliac spine

Figure 20-13 Anatomy of the hip joint.

Femur

Sacrum

Anterior superior iliac spine

Femur

A Extension

Flexion

A Extension

Flexion

B Abduction Adduction C

Internal rotation

B Abduction Adduction C

Internal rotation

External rotation

Figure 20-14 Range of motion at the hip joint. A, Flexion and extension. B, Abduction and adduction. C, Internal and external rotation.

Figure 20-15 Anatomy of the knee joint.

Tibia

Figure 20-14 Range of motion at the hip joint. A, Flexion and extension. B, Abduction and adduction. C, Internal and external rotation.

Tibia

Femur

Patella

Fibula

Femur

Patella

Fibula

The anatomy of the cervical spine is shown in Figure 20-19. The joint movements of the neck are flexion and extension, rotation, and lateral flexion. These motions are illustrated in Figure 20-20.

The anatomy of the lumbar spine is illustrated in Figure 20-21. The joint movements of the lumbar spine are flexion and extension, rotation, and lateral extension. These motions are illustrated in Figure 20-22.

Figure 20-17 Anatomy of the ankle and foot joints. A, View from above. B, Medial view.

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