16. Plantar Foot Flashcards
Fibrous Septa
Superficial fascia
Improve grip
Fat Filled Areas
Shock absorption
eg: calcaneal fat pad
Deep Fascia
aka plantar fascia
Protection
Maintains arches
Plantar Aponeurosis
Deep fascia
Calcaneus –> toes
Plantar Fasciitis
Inflammation of the plantar aponeurosis
Can induce ossification –> calcaneal spur, bursa
Plantar Foot: Muscles and Tendons
4 layers
superficial to deep
1 - 2 - 3 - 4
Layer 1
Superficial
Origin: posterior calcaneus
ABductor hallucis
ABductor digiti minimi
Flexor digitorum brevis
ABductor Hallucis
Layer 1: medial
Insertion: proximal phalanx
Action: ABduct and flex hallux (MTP)
ABductor Digiti Minimi
Layer 1: lateral
Insertion: proximal phalanx
Action: ABduct and flex digit 5 (MTP)
Flexor Digitorum Brevis
Layer 1: midline
Insertion: middle phalanx
Action: flex digits 2-5 (MTP, PIP)
Tendons: divide to insert on middle phalanges of digits 2-5
Layer 2
Tendon of flexor hallucis longus
Tendon of flexor digitorum longus
Quadratus plantae
Lumbricals
Tendon of Flexor Hallucis Longus
Layer 2: along hallux
Emerges from tarsal tunnel, deep to FDL tendon, bt two sesamoids
Insertion: distal phalanx of hallux
Action: flex MTP, IP
Innervation: tibial nerve
Tendon of Flexor Digitorum Longus
Layer 2: toward lumbricals
Insertion: distal phalanx 2-5
Emerges from tarsal tunnel, crosses sf FHL tendon, splits into 4, passes through FDB
Action: flex MTP, PIP, DIP of 2-5
Innervation: tibial nerve
Quadratus Plantae
Layer 2: rectangular,
Calcaneus to tendon of FDL
Action: assist FDL in flexing MTP, PIP, DIP of 2-5
Lumbricals
Layer 2: 4 total
Origin: tendon of FDL
Insertion: extensor expansions of 2-5
Action (2-5):
- flex MTP
- extend PIP, DIP
Layer 3
Flexor hallucis brevis
ADductor hallucis
Flexor digiti minimi brevis
Flexor Hallucis Brevis
Layer 3: 2 bellies along hallux
Insertion: 2 tendons w/ sesamoids proximal phalanx of hallux
Action: flex hallux - MTP
Sesamoid embedded tendon - provide leverage, hold in place, protect from compression
ADductor Hallucis
Layer 3: looks like a 7
Transverse and oblique heads
Insertion: proximal phalanx
Action: ADduct hallux - MTP
Flexor Digiti Minimi Brevis
Action: flex digit 5 - MTP
Layer 4
3 plantar interossei
4 dorsal interossei
Plantar Interossei
Layer 4: 3 total
Action: ADduct MTP joints of 3-5
PAD: plantar ADduct
Dorsal Interossei
Layer 4: 4 total
Action: ABduct MTP joints of 2-4
DAB: dorsal ABduct
2 on either 2nd
1 per 3rd and 4th
Tibial Nerve Branches
Lateral plantar N
(S2-3)
Medial plantar N
(S2-3)
Medial Plantar Nerve
S2-3
Motor: LAFF
- 1st lumbrical
- ABductor hallucis
- Flexor hallucis brevis
- Flexor digitorum brevis
Sensory:
- medial aspect of sole
- tips & plantar aspects of medial 3 1/2
