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Quiz 10 LEA > 3rd and 4th muscular layers of the foot > Flashcards

3rd and 4th muscular layers of the foot Flashcards

1
Q

What are the three muscles of the 3rd compartment?

A

Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis, 2 flexors 1 adductor FHB innervated by medial plantar nerve and 2 flexors by lateral plantar nerve

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2
Q

What are the main origins of FHB?

A

Y shaped tendon, medial arm: slip from tibialis posterior tendon, lateral arm: cuboid and lateral cuneiform

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3
Q

What are the insertions of FHB?

A

Main: HPP base on each side, minor: sesamoids and plantar mt ligament

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4
Q

What is the innervation of Flexor hallucis brevis?

A

Medial plantar nerve

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5
Q

What is the major action of FHB?

A

Flexes MTPJ 1

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6
Q

What are the main origins of Adductor hallucis?

A

Two heads, oblique: peroneal sheath and bases of MT 2-4 transverse: fibrous capsule and plantar MT ligaments of MTPJs3-5, deep transverse MT ligament

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7
Q

What is the insertion to adductor hallucis?

A

Lateral side of the base of the HPP

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8
Q

What is the innervation of Adductor hallucis?

A

Lateral plantar nerve , deep branch

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9
Q

What are the major actions of Adductor hallucis?

A

adducts first digit

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10
Q

What is the main origin of flexor digiti minimi brevis?

A

MT 5 base, peroneal sheath, and promontory of cuboid

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11
Q

What is the insertion of FDMB?

A

MTPJ capsule, MT5 head and PP5 base

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12
Q

What are the major actions of FDMB?

A

Plantarflexes MTPJ 5 and can also abduct the 5th toe

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13
Q

What is the innervation of FDMB?

A

Lateral plantar nerve (superficial branch)

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14
Q

What muscle is formed when some fibers of FDMB distinctly insert onto the lateral aspect of MT 5?

A

Opponens digiti minimi

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15
Q

What are two extrinsic muscle tendons and 2 intrinsic muscle types located in the 4th compartment?

A
  1. tib posterior, 2. Fib longus 3. dorsal interosseus 4. plantar interosseus
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16
Q

DAB AND PAD: What do the abbreviations stand for?

A

Dorsal interossei= abduction and Pad= plantar int. adduction

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17
Q

Why are there 4 dorsal interossei?

A

1st- has its own abductor, 2- 2 DI because either medial or lateral movt =abduction, 3 and 4- have 1 DI 5th= has its own abductor

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18
Q

Each dorsal interossei attach to the lateral side of the respective digit except for…

A

1st dorsal interosseus

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19
Q

Why are there 3 plantar interossei?

A

1st digit has its own adductor: adductor hallucis, 2nd digit cannot ADDUCT, 3,4,5 digits each have 1 DI

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20
Q

What are the origins of Dorsal interossei?

A

adjacent sides of MT shafts 1-5, peroneal sheath

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21
Q

Where do interossei muscles insert?

A

MTPJ capsule, extensor expansion and PP base, digit 2 - both sides, digit 3 and 4- lateral sides

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22
Q

What are the actions of dorsal interossei?

A

abducts 2-4 digits weak MTPJ flexion and IP extension Simultaneous

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23
Q

What is the innervation of dorsal interrossei?

A

Lateral Plantar N( deep 1-3, superficial-4) , 1st and 2nd , also deep fib nerve

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24
Q

What is the origin of plantar interossei?

A

plantar aspect of medial sides of MT shaft 3-5

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25
Q

What is the insertion of the plantar interossei?

A

MTPJ capsule, extensor expansion and PP base

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26
Q

What are the major actions of plantar inter?

A

Abducts 3-5 digits, weak simultaneous MTPJ flexion and IP extension

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27
Q

What is the innervation of the plantar interossei?

A

Lateral plantar nerve ( deep 1-2, superficial-3)

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28
Q

What does the superficial division of the lateral plantar nerve innervate?

A

FDMB, 4th dorsal interossei and 3rd plantar interossei

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29
Q

What does the deep branch of the lateral plantar nerve innervate?

A

adductor hallucis, 1-3 dorsal interossei, 1-2 plantar interossei, 2-4th lumbricals.

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30
Q

What muscles does the lateral plantar nerve innervate before it divides into its superficial and deep branches?

A

FDB, Abductor digiti minimi, Quadratus plantae

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31
Q

What are the 1st and 2nd Dorsal interossei innervated by

A

the deep fibular nerve

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32
Q

What muscles originate at the peroneal sheath

A

plantar - medial sides of MT 3-5 and peroneal sheath, Dorsal- two heads arising from adjacent metatarsals and peroneal sheath.

33
Q

Where do the interossei insert?

A

medial sides of pp2-5, lateral sides of pp2-4 Mtpj capsule, Sling /wing portion of extensor expansion

34
Q

en route to their respective insertions, interossei pass ______ in relation to the deep transverse MT ligament.

A

SUPERIORLY /DORSALLY

35
Q

How do the lumbricals travel in relation to the deep transverse Metatarsal ligament

A

the lumbricals travel INFERIORLY to the Deep transverse metatarsal ligament

36
Q

Why are there 4 dorsal interossei?

A

1st digit has its own abductor: abductor hallucis, 2nd has 2 DI because medial or lateral movement-abduction, 3rd and 4th- each have one DI ( attach to lateral side of digits to pull from 2nd digit), 5th digit has its own abductor- abductor digiti minimi

37
Q

What side does the 1st dorsal interossei attach to?

A

Attach to lateral side of digits to pull from 2nd digit

38
Q

Each of the dorsal interossei attach on the lateral side of the respective digit except for the ______

A

1st dorsal interosseus with the medial side

39
Q

Why are there 3 plantar interossei

A

1st digit has its own adductor- adductor hallucis, 2nd digit cannot adduct, 3-5 digits each have 1 DI

40
Q

Extensor expansion purpose

A

allows the EDL to dorsiflex the PP to which it has no direct attachment . Attch side for interossei and lumbricals. SLING PORTION RECEIVES THE INTEROSSEI , wing/hood receives lumbricals and possibly interossei

41
Q

What tendons contribute to the Hallux’s EE?

A

Dorsally, EHL( no EHB contribution) medially- AbH and FHB medial head and laterally- AdH and FHB lateral head * ONLY LATERAL PORTION OF THE SLING will attach to the deep transverse MT ligament

42
Q

What tendon’s contribute to the extensor expansion of the 5th Digit?

A

Dorsally, EDL usually no tendon from EDB medially- 4th lumbrical and 3rd PI laterally- abDM

43
Q

All adductor hallucis , FDMB, and all interosseui (dabs and pads) have attachment/origin at what location

A

peroneal sheath( from long plantar ligament)

44
Q

Interossei pass ___________ to deep transverse MT ligament

A

superiorly / dorsally

45
Q

Lumbricals travel__________ to the deep transverse metatarsal ligament

A

inferiorly

46
Q

How do fibers run on extensor sling

A

transversely covering extensor tendons

47
Q

how is extensor wing/hood formed

A

by 2 triangular sheets on each side of toe that meet at dorsal edges to fuse with extensor tendons. Attached to side of PP, but distal part is free.

48
Q

sling portion receives

A

interossei

49
Q

wing/hood portion receives

A

lumbricals and possibly interossei

50
Q

Flexor digitorum brevis runs _______ to FDL

A

superficially but inferiorly (closer to plantar side of foot)

51
Q

FDL tendons are _______ to FDB tendons

A

superior ( closer to dorsum of foot)

52
Q

extensor expansion- hallux tendon contributions

A

dorsally- EHL ( EHB does not contribute) medial and lateral- adh and FHB

53
Q

5th digit’s EE

A

dorsally- EDL medially- 4th lumbrical and 3rd PI laterally- abdm and fdmb

54
Q

Major group contributions to gait Ant:

A

heel strike ( lengthening eccentric) and swing phase (force, concentric)

55
Q

Posterior compartment

A

Foot flat- mid stance: eccentric controls dorsiflexion and heel off-toe off : concentric general force

56
Q

Lateral compartment

A

foot flat: eccentric heel off: concentric

57
Q

intrinsic pedal muscles:

A

foot flat to toe off concentric

58
Q

at heel strike/ initial contact

A

foot is supinated, inversion- calcaneus moves medially. Anterior dorsiflexors - control descent of ant foot onto the ground and Lateral everters- prevent excessive inversion

59
Q

At initial contact weak ankle dorsiflexion will result in

A

foot slap, No heel strike , will have toe strike , no lengthening contraction.

60
Q

paralyzed ankle dorsiflexors will result in

A

high steppage gait , drop foot no heel strike

61
Q

Foot flat and midstance

A

foot transitions to pronating adaptor. Medial long. arch is compressed. Lat comp aids in pronation/eversion , posterior comp - controls dorsiflexion and supports MLA against compression

62
Q

late midstance

A

peroneus longus plantarflexes 1st ray to provide stability and TP, FHL, FDL support restoration of MLA

63
Q

heel off / heel up

A

windlass mechanism is activated. heightens MLA, triceps surae produce heel off, TP, FHL, FDL, and intrinsic support MLA and toe flexors stabilize digits against ground as passive MTPJ dorsiflexion takes place.

64
Q

Paralysis of the posterior compartment muscles could result in teh adoption of what gait

A

calcaneus/ apropulsive gait - no dorsiflexion control of ankle, not able to lift heel off ground

65
Q

toe off

A

hallux or second digit last to leave ground. Tp, fhl, fdl and intrinsic muscles of the foot support MLA and stabilize toes against ground as passive MTPJ dorsiflexion takes place

66
Q

MLA changes

A

early stance phase- pronation occurs and MLA flattens, invertors help moderate compression

67
Q

pronation

A

MLA reduction

68
Q

evertors

A

flatten MLA

69
Q

Late stance phase

A

resupination needs to take place. made possible by invertors and windlass mech.

70
Q

Supination

A

MLA accentuation

71
Q

invertors

A

and windlass mechanism will heighten the MLA - deforms during stance phase

72
Q

swing phase

A

initial and midswing - ant compartment ensures the foot clears groud terminal swing- ant compartment readies foot for heal strike

73
Q

paralysis of dorsiflexors

A

deep fibular nerve, foot drop, high steppage gait

74
Q

Interossei- plantar are more_______

A

lateral and inferior

75
Q

dorsal interossei are more ____________

A

superior and medial

76
Q

Interossei are ________ to adductor hallucis

A

deep / superior

77
Q

Most inferior tendons

A

flexor digitorum brevis

78
Q

what muscle has only soft tissue instertions

A

transverse head of adductor hallucis

79
Q

blood supply to Flexor digitorum brevis

A

medial plantar artery

Quiz 10 LEA (5 decks)

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