10) Plantar Foot (Part II) Flashcards

1
Q

The 2nd layer of the plantar aspect of the foot contains

A
5 muscles (4 lumbircals and quadratus plantae)
2 tendons (FDL and FHL)
*all muscles attach to FDL*
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2
Q

Characteristics of Quadratus plantae (Flexor accessorius)

A
Deep to Flexor digitorum brevis
2 heads (origins)
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3
Q

Origins of Medial and Lateral head of Quadratus plantae

A

Medial surface of calcaneus (Medial)

Trigonum plantare and Inferior calcaneus distal to lateral tubercle

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4
Q

Origins of Quadratus plantae separated by

A

Long plantar ligament

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5
Q

Insertion of Quadratus plantae

A

Heads unit to insert onto FDL tendon

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6
Q

Blood supply to Quadratus plantae

A

Medial and Lateral plantar arteries

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7
Q

Innervation to Quadratus plantae

A

Lateral plantar nerve

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8
Q

Function of Quadratus plantae

A

Redirecting line of pull of FDL

Assisting in flexion of phalanges

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9
Q

Characteristics of lumbricals (Lumbricale muscles)

A

1 - Unipennate

2, 3, 4 - Bipennate

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10
Q

Origin of 1st lumbrical

A

Medial side of `1st tendon of FDL (which goes to 2nd digit)

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11
Q

Origin of 2nd-4th lumbrical

A

Adjacent tendons

For 3rd lumbrical (medial side of 3rd and lateral side of 2nd)

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12
Q

Path of tendons of lumbricals

A

Distally, they pass plantar to the transverse metatarsal ligament

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13
Q

Inesrtion of lumbricals

A

Medial aspect of extensor wing of extensor expansion at base of proximal phalanx of digits 2-5
(1st lumbrical to 2nd digit, etc.)

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14
Q

Blood supply to lumbricals

A

Respective plantar metatarsal arteries

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15
Q

Innervation to lumbricals

A
1st lumbrical (Medial plantar nerve)
2nd-4th lumbrical (Deep branch of lateral plantar nerve)
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16
Q

Function of lumbricals

A

Flexion of MTP joints

Extension of PIP and DIP joints

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17
Q

Origin of Flexor hallucis brevis (2 heads)

A

Lateral (Plantar surface of cuboid and lateral cuneiform)

Medial (Tibialis posterior tendon)

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18
Q

Insertion of Flexor hallucis brevis

A

Medial and lateral base of proximal phalanx

Invest respective hallux sesamoids before phalangeal insertion

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19
Q

Halux sesamoids and FHB

A

Sesamoids increase the mechanical advantage of FHB

Act as weightbearing structures and decrease friction

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20
Q

Blood supply to Flexor hallucis brevis

A

1st plantar metatarsal artery

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21
Q

Innervation to Flexor hallucis brevis

A

Medial plantar nerve

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22
Q

Function of flexor hallucis brevis

A

Plantarflexion of hallux MTP joint

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23
Q

Origin of Flexor digiti minimi brevis

A

Base of 5th metatarsal

Tendon sheath of fibularis longus

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24
Q

Insertion of Flexor digiti minimi brevis

A

Plantar/lateral aspect of base of proximal phalanx of 5th toe

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25
Q

Blood supply to Flexor digiti minimi brevis

A

Lateral plantar artery

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26
Q

Innervation to Flexor digiti minimi brevis

A

Superficial branch of Lateral plantar nerve

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27
Q

Function of Flexor digiti minimi brevis

A

Plantarflexion of 5th digit at MTP joint

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28
Q

Origin of Adductor hallucis heads

A

Transverse (Fibrous capsule, Plantar plates of digits 3-5, Deep transverse metatarsal ligament)
Oblique (Plantar aspect of metatarsal bases 2-4, Fibulari longus tendon sheath)

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29
Q

Insertion of Adductor hallucis

A

Lateral sesamoid

Lateral aspect of proximal phalanx base of 1st digit

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30
Q

Blood supply to Adductor hallucis

A

Plantar metatarsal arteries

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31
Q

Innervation to Adductor hallucis

A

Deep branch of lateral plantar nerve

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32
Q

Function of Adductor hallucis

A

Adduction of hallux

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33
Q

Origin of Opponens digiti minimi

A

Base of 5th metatarsal
Long plantar ligament
FDMB

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34
Q

Insertion of Opponens digiti minimi

A

Lateral shaft of 5th metatarsal and surrounding fascia

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35
Q

Function of Opponens digiti minimi

A

Abduction and flexion of 5th toe

36
Q

The 4th layer of the Plantar aspect of the foot has how many muscle groups?

A

2

Dorsal and Plantar Interossei

37
Q

Dorsal/plantar interossei are located

A

Within metatarsal spaces (no association with hallux)

38
Q

Path of tendons of dorsal/plantar interossei

A

Dorsal to deep transverse metatarsal ligament

39
Q

of interossei

A

3 Plantar

4 Dorsal

40
Q

PAD DAB

A

Plantar ADducts

Dorsal ABducts

41
Q

What tendons in 4th layer?

A

Tibialis posterior

Fibularis longus

42
Q

Characteristics of Plantar Interossei muscles

A

3 in number
Assoc. with digits 3, 4, 5
Unipennate

43
Q

Origin of Plantar interosseus muscles

A

Base and medial aspect of shafts of metatarsals 3, 4, 5

44
Q

Inserion of Plantar interosseus muscles

A

Medial aspect of base of proximal phalanx

Extensor expansion of the same digit

45
Q

How is the origin/ insertion of Plantar interossei organized?

A
1st plantar interossei originates from 3rd met
Inserts onto proximal phalanx/extensor expansion of 3rd digit
2nd PI (4th digit)
3rd PI (5th digit)
46
Q

Blood supply to Plantar interossei muscles

A

Plantar metatarsal arteries 2-4

47
Q

Innervation to Plantar interossei muscles

A
Lateral plantar nerve
Superficial branch (3rd PI)
Deep branch (1st and 2nd PI)
48
Q

Function of Plantar interossei muscles

A

Adduction of digits 3-5 toward foot midline
Plantarflexion 3-5 MTP joint
Ext (dorsiflexion) of IP joints 3-5

49
Q

Characteristics of Dorsal interossei muscles

A
4 in number
Assoc. with digits 2-4
Digit 2***** has two dorsal interossei inserting
BIpennate
Located within intermetatarsal space
50
Q

Origin of Dorsal interossei muscles

A

Adjacent metatarsal shafts

51
Q

How is the origin of Dorsal interossei organized?

A

1st DI originates at lateral aspect of 1st met shaft and medial aspect of 2nd

52
Q

Insertion of Dorsal interossei

A
1st DI (medial aspect of base of proximal phalanx and extensor expansion of 2nd digit)
2nd-4th DI (lateral aspect of base of proximal phalanx and extensor expansion of corresponding digit)
53
Q

How is the insertion of Dorsal interossei organized?

A

2nd DI inserts on lateral base of proximal phalanx and extensor expansion of digit 2
3rd - Digit 3
Etc.

54
Q

Blood supply to Dorsal interossei muscles

A

Corresponding dorsal metatarsal artery

55
Q

Innervation to Dorsal interossei muscles

A

Lateral plantar nerve

56
Q

Deep branch of lateral plantar nerve innervates

A

1st, 2nd, 3rd DI

57
Q

Superficial branch of lateral plantar nerve innervates

A

4th DI

58
Q

1st and 2nd DI also receive innervation from

A

Deep fibular nerve

59
Q

Function of Dorsal interossei muscles

A

Abduction of digits 2-4
Plantarflexion of MTP joints
Ext (dorsiflexion) of IP joints

60
Q

IM spaces, DI, and PI

A

Write out on paper (too much for here)

61
Q

What keeps the tendons anchored to the bone?

A

Fibrous flexor sheath

62
Q

FHL, FDB, and FDL are surrounded by

A

Synovial sheath (to reduce friction)

63
Q

Vincula brevia and Vincula longa???

A

idk

64
Q

The Extensor Expansion is

A

A tendinofibroaponeurotic structure that is involved in the extensor function of the digits

65
Q

The extensor expansion is formed by

A
Extrinsic muscles (EDL and EHL)
Intrinsic muscles (EDB, lumbricals, interossei)
66
Q

Other than providing the extensor function to digits, the Extensor expansion also

A

Stabilizes ligaments via
Sling and wing
Triangular lamina

67
Q

The extensor sling is located

A

proximally

68
Q

Fibers of the extensor sling

A

Transversely oriented

Pass around MTP joint

69
Q

The extensor sling attaches

A

Plantar plate and deep transverse metatarsal ligament

70
Q

What inserts into the extensor sling?

A

Interossei muscles

71
Q

The extensor sling anchors

A

EDL (allows it to extend all digits)

72
Q

The extensor wing makes up

A

The distal portion of the extensor expansion

73
Q

Fibers of the extensor wing

A
Oriented obliquely (triangular shaped)
Located at proximal phalanx
74
Q

What inserts into the medial side of the extensor wing?

A

Lumbricals

75
Q

EDL tendon characteristics

A

Form central axis of extensor expansion

Stabilized by sling at MTP joint

76
Q

EDL tendons divide

A

Into 3 slips at MTP joint (some say proximal phalanx)

77
Q

What are the slips of the EDL tendon?

A

Medial, Lateral, and Central

78
Q

Path of Medial and Lateral slips of the EDL tendons

A

Extend over dorsum of middle phalanx

Insert into base of distal phalanx as a terminal tendon

79
Q

Path of Middle slip of the EDL tendons

A

Inserts into base of middle phalanx

80
Q

Location of Triangular lamina

A

Between lateral slips of EDL

81
Q

Function of triangular lamina

A

Not known

82
Q

The triangular lamina is believed to anchor

A

Medial and lateral slips (keeps them from sliding plantarward)

83
Q

EDB tendons can take two paths:

A

Joining the EDL tendon

OR

Forming lateral slip instead

84
Q

The EHB attaches

A

To the base of the proximal phalanx

85
Q

Lumbrical tendons path

A

Tendons pass plantar to deep transverse metatarsal ligament
Inserts into wing
May form medial slip

86
Q

Insertion of the lumbrical tendon into the wing allows for

A

Flexion of the MTP joint

Extension of the IP joints

87
Q

Interosseus tendons path

A

Tendons pass dorsal to deep transverse metatarsal ligament
Insert into base of proximal phalanx at tubercle
Inserts into extensor apparatus at the sling (semi-disputed)