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LEA FINAL EXAM > 1st and 2nd muscular layers of the plantar foot > Flashcards

1st and 2nd muscular layers of the plantar foot Flashcards

1
Q

What dermatome is in the lateral aspect of the plantar foot?

A

S1 ( L5 medial aspect)

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2
Q

What nerve serves this dermatome?

A

Lateral calcaneal and lateral dorsal cutaneous nerves (from Sural N) Lateral planar nerve- tibial

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3
Q

What nerves supply the plantar foot?

A

Medial calcaneal from tibial nerve ( heel) Lateral calcaneal and lateral dorsal cutaneous from sural nerve- lateral posterior, lateral plantar nerve from tibial lateral 4th and 5th digit, saphenous nerve medial, medial plantar nerve from tibial- 1-3 1/2 ray

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4
Q

Lateral osteofacial compartment of the foot include:

A

lateral plantar aponeurosis ( calcaneometatarsal ligament) and abductor digiti minimi

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5
Q

What are three muscles of the 1st layer of the plantar foot?

A

flexor digitorum brevis, abductor hallucis, abductor digiti minimi 2 abductors, 1 flexor

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6
Q

What muscle is dually innervated?

A

Flexor digitorum brevis

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7
Q

What nerves innervate the three muscles of the 1st layer on the plantar aspect?

A

medial plantar nerve and lateral plantar nerve , The FDB is dually innervated.

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8
Q

What is the relationship between ADM and the lateral plantar aponeurosis?

A

ADM is deep to the lateral plantar aponeurosis

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9
Q

What are the origins, insertions and actions of ADM?

A

lateral and medial processes of calcaneal tub, lateral plantar aponeurosis, lateral intermusc septum. I: MTPJ capsule, MT 5 head and PP5 base Action: abducts 5th digit, flexes 5th digit

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10
Q

Fibers that distinctly insert onto the MT 5 base and shaft form what muscle?

A

abductor ossis metatarsi digiti minimi

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11
Q

What are the origins and insertions of Flexor digitorum brevis?

A

O: medial processes of calcaneal tub. plantar aponeuro. medial and lateral intermuscular septum I: after entering the fibrous flexor sheath near respective MTPJ (2-5) each tendon.. splits into 2 , 2 come back together, splits into 2 , each insert onto opposite sides of MP/IP base

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12
Q

What path does the flexor digitorum brevis tendons take?

A

1st bifurcation at level of fibrous flexor sheath/ MTPJ, reunion at head of PP, 2nd bifurcation at proximal IPJ, insertion onto MP/IP at middle phalanx

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13
Q

What are the major actions of flexor digitorum brevis?

A

Plantarflexes MTPJs 2-5 , plantarflexes proximal IPJs 2-5

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14
Q

What are the origins, insertions, and actions of abductor hallucis?

A

O: medial processes of calcaneal tuber, plantar aponeur. medial intermuscular septum, flexor retinaculum I: plantar metatarsophalangeal ligament, medial sesamoid and MTPJ capsule along with medial tendon of FHB. Actions: abducts hallux, flexes hallux

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15
Q

What structures are comprised within the 2nd layer of the plantar foot?

A

FHL, Lumbricals, FDL, Quadratus plantae

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16
Q

What are the origins, insertions, and actions of Quadratus plantae?

A

O: medial head/medial surface of the calcaneus . Lateral head: ant to the lat process of the calcaneus I: medial head: joins deep side of FDLT and can contribute 2-4 tendons. Lateral head: joins FDLT proximal to its division. A: provides traction to the FDL to assist in plantarflexion of the lateral MTP and IP joints.

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17
Q

What ligament is deep to the QP?

A

the long plantar ligament

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18
Q

What is the innervation of Quadratus plantae?

A

Lateral plantar nerve (tibial nerve) lateral plantar neurovasc runs btw QP and FDB

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19
Q

What is the origin and insertion of lumbricals on the plantar foot?

A

O: each of the four arise from a FDL I: each lumbrical passes deep to the transverse MT ligament and inserts onto the medial side of the respective extensor hood (2-5th digit)

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20
Q

What is the innervation of the lumbricals and what are their major action?

A

1st= 1st common plantar digital branch of medial plantar n. 2nd-4th: deep division of lateral plantar nerve action: simultaneously flexes the MTPJ and extends the IPJs.

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21
Q

What structures run between QP and FDB??

A

lateral plantar neurovasculature

22
Q

Where does the medial QP head insert?

A

onto the FHL

23
Q

How many tendinous slips come from QP and head towards FDL’s digital slips?

A

2

24
Q

How many possible tendinous slips with FDL flipped over?

A

4 possible slips, 2nd and 3rd are most obvious ( from FHL to MQP)

25
Q

What four intrinsic muscles of the foot are innervated by the medial plantar nerve?

A

L4- S3 LAFF First lumbrical, abductor hallucis, flexor hallucis brevis, flexor digitorum brevis* also can be innervated by the lateral plantar nerve. All the rest of the INTRINSIC muscles of the foot are innervated by the lateral plantar nerve S1-S3

26
Q

Foot intrinsics are at which spinal nerve level

A

S2 *** flex met and extend interphal. joints

27
Q

paper grip test

A

way to test intrinsic flexors along with extrinsic flexors for the lesser toes

28
Q

1st layer includes:

A

2 abductors, 1 flexor** medial 2 are innervated by the medial plantar nerve (L4-S3) Lateral 2 innervated by lateral plantar nerve (S1-S3)

29
Q

Can FDB be dually innervated?

A

YES medial and lateral plantar nerve

30
Q

Where does FDB lie?

A

DEEP to central portion of PA and btw medial and lateral intermuscular septum Lies SUPERFICIAL TO lateral plantar neurovasculature

31
Q

What are the origins of FDB?

A

medial process of calcaneal tub. med and lateral intermuscular septum , central plantar apo.

32
Q

After entering the fibrous flexor sheath near the respective MTPJ 2-5, each tendon…

A

1st bifurcation at MTPJ then reunites at head of PP, then 2nd bifurcation at proximal IPJ, groove forms for superficial travel of FDL, and then inserts onto MP/IP. * TENDON OF FLEXOR DIGITORUM LONGUS IS DEEP TO FDB. FDL continues to distal phalanx. VERY DIFFERENT FROM EXTENSOR tendons

33
Q

Where does FDB insert?

A

both sides of middle phalanges 2-5

34
Q

Abductor hallucis origins/ insertions:

A

most MEDIAL AND SUPERFICIAL/LARGEST. Can palpate, covers neurovasculature entering plantar foot O: medial process of calc tub. flexor retinaculum, medial part of plantar ap, medial intermusc septum. I: plantar metatarsophalangeal ligament, MTPJ capsule, med sesamoid base of HPP

35
Q

Abductor digiti minimi, interesting features:

A

slender, lateral muscle of the 1st layer, Lateral plantar neurovas passes along its medial border. Can also be palpated.

36
Q

All muscles of the 1st layer do what?

A

plantarflex their respective digits, 2 abductors at the MTPJ, FDB at MTPJ and Proximal IPJ, 2 abductors have an additional action

37
Q

All muscles of the 2nd layer are innervated by what nerve except for the first lumbrical?

A

lateral plantar nerve. 1st lumberical is innervated by the medial plantar nerve.

38
Q

What is Quadratus plantae deep to?

A

Flexor digitorum brevis,

39
Q

What are the actions of the lumbricals?

A

simultaneously plantarflexes MTPJs and dorsiflexes IPs and DPs of lateral 4 digits.

40
Q

all 1st layer plantar muscles ( abdDm, FDB, and AbH originate from what two locations?

A

the medial process and PA

41
Q

the lateral process is only the origin for….

A

AbDM

42
Q

Both medial and lateral septum serve as an origin site for …

A

FDB

43
Q

What four muscles are innervated by the Medial plantar nerve ?

A

L4-S3 LAFF first lumbrical, abductor hallucis, flexor hallucis brevis, flexor digitorum brevis

44
Q

Intrinsic muscles act as a group to do what?

A

active during terminal stance phase to provide stabilization for forefoot propulsion.

45
Q

medial plantar nerve rami

A

L4- S3

46
Q

Lateral plantar nerve rami

A

S1-S3

47
Q

what muscle is dually innervated?

A

FDB

48
Q

what muscles originate on central apne?

A

FDB, QP , lumbricals, adductor hallucis

49
Q

FDB lies deep to what

A

central portion of PA and btw medial and lateral intermuscular septum

50
Q

FDB lies superficial to what..

A

to lateral plantar neurovasculature

51
Q

Abductor ossis metatarsi digiti minimi

A

ext of abductor dig. minimi insert onto the MT 5 base and shaft.

52
Q

all 2nd layer muscles are innervated by…… except….

A

lateral plantar nerve except the 1st lumbrical (medial planter nerve)

LEA FINAL EXAM (4 decks)

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