5 LE Foot Flashcards
podiatry
study y care of feet
FCN of foot
(1) platform to support body weight
(2) movement
synovial joints (7)
talocrural subtalar (talocalcaneal) talocalcaneonavicular calcneocuboid tarsometatarsal metatarsophalangeal interphalangeal
talocrural joint
synovial joint @ ankle
- hinge
- dorsiflexion + plantar flexion
subtalar joint
synovial joint
- made up of talocalcaneonavicular + calcaneocuboid joints
- inversion + eversion
(aka) talocalcaneal
talocalcaneonavicular joint
augment (add to) subtalar joint
calcaneocuboid joint
augment (add to) subtalar joint
tarsometatarsal joint
synovial joint
- allows slight movement
metatarsophalangeal joint
synovial joint
- hinge
- flexion + extension
interphalangeal joint
synovial joint
- hinge
- flexion + extension
skin of the foot
dorsal surface
plantar surface
dorsal surface (skin of the foot)
thin
loose y low fat
plantar surface (skin of the foot)
thick
many sweat glands
high fat
sensitive
dorsal fascia
deep fascia of the foot continuous w/ inferior extensor retinaculum
plantar fascia
deep fascia of the foot
- thick centrally
- forms plantar aponeurosis
plantar aponeurosis
acts like a superficial ligament in the deep fascia of the foot
FCN plantar apoenurosis
(1) hold parts of foot juntos
(2) protect from injuries [include VAN]
(3) support longitudinal arches of the foot
specializations of the foot
(1) tendinous sheaths y bursae
(2) calcaneal y malleolar bursae
(3) MP y IP ligaments
(4) extensor y flexor expansions
long plantar ligament
spans calcaneous to base MT #2-5
- 1st layer (most superficial)
plantar calcaneocuboid ligament
(aka) short plantar ligament
- 2nd layer
plantar calcaneonavicular ligament
connects calcaneus y navicular
- (aka) spring ligament
- 3rd layer
deep transverse metatarsal ligament
located btwn MTs
- 4th layer
intertarsal ligaments
deepest ligament
FCN arches of the foot
(1) distribute weight
(2) shock absorption
(3) “springs” to propel during movement
arches of the foot (3)
medial longitudinal arch
lateral longitudinal arch
transverse arch
medial longitudinal arch (foot)
higher + stronger arch
lateral longitudinal arch (foot)
flatter arch
- rests on ground when standing
transverse arch (foot)
includes cuboid, cuneiforms y bases of MTs
- tendons of tibialis posterior + fibularis longus maintain curvature of arch
passive factors that maintain integrity of arches
(1) shape of interlocking bones
(2) four layers of fibrous tissue
four layers of fibrous tissue (passive factors)
(1) plantar aponeurosis
(2) long plantar ligament
(3) short plantar ligament
(4) spring ligament
dynamic factors that maintain integrity of arches
(1) intrinsic muscle contractions
(2) extrinsic muscle contractions
(3) active + tonic
extrinsic muscles of the foot
I (general): distal phalanx
intrinsic muscles of the foot
I (general): proximal phalanx
dorsal group (2) + plantar group (4 layers)
dorsal group
extensor digitorum brevis
extensor halluces brevis
extensor digitorum brevis
dorsal group
O: calcaneus + inferior extensor retinaculum
I: tendons of extensor digitorium longus (digits 2 – 4)
A: extend phalanges of digits #2 -4
N: deep fibular nerve
extensor hallucis brevis
(dorsal group)
O: calcaneus + inferior extensor retinaculum
I: proximal phalanx of hallux
A: extend proximal hallux
N: deep fibular nerve
abductor hallucis
(plantar group - layer 1)
O: calcaneus + flexor retinaculum + plantar aponeurosis
I: proximal phalanx of hallux (medial side)
A: ABDuct hallux
N: medial plantar
flexor digitorum brevis
(plantar group - layer 1)
O: calcaneus + plantar aponeurosis
I: middle phalanx of digits #2 – 5
A: flex digits #2 – 5
N: medial plantar
abductor digit minimi
(plantar group - layer 1)
O: calcaneus + plantar aponeurosis
I: proximal phalanx of digit #5 (lateral side)
A: ABDuct digit #5
N: lateral plantar
quadratus plantae
(plantar group - layer 2)
O: calcaneus
I: tendon of flexor digitorum longus
A: assist flexor digitorum longus in flexing digits #2 – 5
N: lateral plantar
lumbricals #1 - 4
(plantar group - layer 2)
O: tendons of flexor digitorum longus
I: proximal phalanx of digits #2 – 5
A: flex proximal phalanges #2 – 5
N: medial plantar + lateral plantar
flexor hallucis brevis
(plantar group - layer 3)
O: cuboid + lateral cuneiform
I: proximal phalanx of hallux
A: flex proximal phalanx of hallux
N: medial plantar
sometimes absent
adductor hallucis
(plantar group - layer 3)
O: MTs #2 – 4 + MTP joints
I: proximal phalanx of hallux (lateral side)
A: ADDuct hallux
N: lateral plantar
2 heads: oblique + transverse
flexor digiti minimi brevis
(plantar group - layer 3)
O: MT #5
I: proximal phalanx of digit #5
A: flex proximal phalanx #5
N: lateral plantar
plantar interossei (PAD)
(plantar group - layer 4 / deepest layer)
O: medial sides of MTs #3 – 5
I: medial sides of proximal phalanges 3 – 5
A: ADDuct digits + flex MTP joints
N: lateral plantar
dorsal interossei (DAB)
(plantar group - layer 4 / deepest layer)
O: adjacent sides of MTs #1 – 5
I: proximal phalanges #2 – 4
A: ABDuct digits + flex MTP joints
N: lateral plantar
hallux valgus
lateral deviation of big toe
- creates bunion (MT #1 sticks out)
- sesamoid bones rotate into MT #1 - 2 space creating pain
- result: tender / inflamed bursa
- causes: footwear + degenerative joint diseases (arthritis)
hammer toes
proximal phalanx becomes permanently dorsiflexed (hyper-extend) @ MTP joint
- middle phalanx plantar flexed (PIP joint)
- caused by osteoarthritis, rheumatoid arthritis, weakness of lumbricals / interosseus muscles due to nerve damage
- calluses develop on dorsum of toes
**high heals
claw toes
proximal phalanx dorsiflexed (MTP joint)
- distal phalanx flexed (DIP joint)
- caused by osteoarthritis, rheumatoid arthritis, weakness of lumbricals / interosseus muscles due to nerve damage
- calluses develop on plantar surface of MTs
**high heals
types of flatfeet (pes planus) [3]
(1) flexible flatfeet
(2) rigid flatfeet
(3) acquired flatfeet
flexible flatfeet
flat when weight-bearing only due to loose/degenerative intrinsic ligaments
rigid flatfeet
always flat due to bone deformity
acquired flatfeet
“fallen arches” - arches disappeared
- occurs w/ age
- spring ligament weak b/c trauma, degenerative of muscle
**obesity = factor
clubfeet
congenital foot deformity where foot turns inward
- 1 in 1000 births
- subtalor joint problems [foot twisted out of position]
- inverted, plantar flexed, forefoot adducted
- forced weight on lateral surface [unnatural]
- caused by tightness / shortness of muscles y tendons on medial side
