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II. Osteology
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6d. 4. Comparison of the Bones of the Hand and Foot
The hand and foot are constructed on somewhat similar principles, each consisting of a proximal part, the carpus or the tarsus, a middle portion, the metacarpus, or the metatarsus, and a terminal portion, the phalanges. The proximal part consists of a series of more or less cubical bones which allow a slight amount of gliding on one another and are chiefly concerned in distributing forces transmitted to or from the bones of the arm or leg. The middle part is made up of slightly movable long bones which assist the carpus or tarsus in distributing forces and also give greater breadth for the reception of such forces. The separation of the individual bones from one another allows of the attachments of the Interossei and protects the dorsi-palmar and dorsi-plantar vascular anastomoses. The terminal portion is the most movable, and its separate elements enjoy a varied range of movements, the chief of which are flexion and extension.   1


FIG. 290– Skeleton of foot. Medial aspect. (See enlarged image)
 
  The function of the hand and foot are, however, very different, and the general similarity between them is greatly modified to meet these requirements. Thus the foot forms a firm basis of support for the body in the erect posture, and is therefore more solidly built up and its component parts are less movable on each other than those of the hand. In the case of the phalanges the difference is readily noticeable; those of the foot are smaller and their movements are more limited than those of the hand. Very much more marked is the difference between the metacarpal bone of the thumb and the metatarsal bone of the great toe. The metacarpal bone of the thumb is constructed to permit of great mobility, is directed at an acute angle from that of the index finger, and is capable of a considerable range of movements at its articulation with the carpus. The metatarsal bone of the great toe assists in supporting the weight of the body, is constructed with great solidity, lies parallel with the other metatarsals, and has a very limited degree of mobility. The carpus is small in proportion to the rest of the hand, is placed in line with the forearm, and forms a transverse arch, the concavity of which constitutes a bed for the Flexor tendons and the palmar vessels and nerves. The tarsus forms a considerable part of the foot, and is placed at right angles to the leg, a position which is almost peculiar to man, and has relation to his erect posture. In order to allow of their supporting the weight of the body with the least expenditure of material the tarsus and a part of the metatarsus are constructed in a series of arches (Figs. 290, 291), the disposition of which will be considered after the articulations of the foot have been described.   2


FIG. 291– Skeleton of foot. Lateral aspect. (See enlarged image)
 


 

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The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) sponsors USMLE.
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