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Anatomy Upper limb > Anatomy of the foot and ankle > Flashcards

Anatomy of the foot and ankle Flashcards

1
Q

What is in the tasral tunnel

A

Tarsal Tunnel – Posterior and inferior to medial malleolus, roofed by flexor retinaculum,
passage from leg to foot.
Contains (medial to lateral): tibialis posterior, flexor digitorum longus, posterior tibial
artery, posterior tibial vein, tibial nerve and flexor hallucis longus.
“Tom, Dick And Very Nervous Harry” or “Tiny Dogs Are Very Nervous Hunters”

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2
Q

What are the two retinicula at the front of the foot

A

Superior extensor retinaculum –
attached to tibia and fibula
* Inferior extensor retinaculum –
Y-shaped
Lateral to medial: fibularis
tertius, extensor digitorum
longus, dorsalis pedis,
extensor hallucis longus and
tibialis anterior.

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3
Q

How is integrity of the foot arches maintained

A

Integrity maintained by :
* Shape of bones
* Connective tissues
(passive)
* Plantar aponeurosis
* Ligaments
* Muscles (dynamic)

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4
Q

What is the plantar aponeurosis

A

Central thickening of deep
fascia composed of
longitudinal bands from
calcaneus to fibrous digital
sheaths of toes
Supports longitudinal (medial
and lateral) arches

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5
Q

What is the spring ligament of the foot

A

Spring ligament (plantar calcaneonavicular)

  • Connects sustentaculum tali of calcaneus and navicular
  • Supports head of talus and maintains medial arch of foot
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6
Q

What is the long plantar ligament of the foot

A

Long plantar ligament
* Connects calcaneus to cuboid and metatarsal bases
* Supports transverse tarsal joint and crucial to maintain lateral
arch of foot

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7
Q

What is the short plantar ligament of the foot

A

Short plantar ligament (plantar calcaneocuboid)
* Connects anterior calcaneus to cuboid
* Supports transverse tarsal joint and important to maintain
lateral arch of foot

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8
Q

Which muscles support which arches of the foot

A

Flexor hallucis longus – medial
arch
Tibialis posterior – transverse
and medial arches
Tibialis anterior – medial arch
Fibularis longus – transverse
and lateral arches
Intrinsic muscles – lateral,
medial and transverse arches

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9
Q

Describe pes planus (flat foot)

A
  • Arch appears normal when unloaded (flexible flat feet)
  • Typical in childhood
  • Can occur due to looser ligaments with age (fallen arch) or
    dysfunction of tibialis posterior
  • Foot flat when unloaded due to bone deformity (rigid flat feet)
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10
Q

What is extensor digitorum brevis

A

Innervation – deep
fibular nerve
* Action – extends toes I
- IV

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11
Q

What are the muscles in the first layer of the foot

A

ABDUCTOR HALLUCIS
* Innervation – medial plantar
nerve
* Action – abducts and flexes big
toe

FLEXOR DIGITORUM BREVIS
* Innervation – medial plantar
nerve
* Action – flexes digits II – V at
proximal IP joints

ABDUCTOR DIGITI MINIMI
* Innervation – lateral plantar
nerve
* Action – abducts digit V

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12
Q

What are the muscles in the second layer of the foot

A

QUADRATUS PLANTAE
* Innervation – lateral plantar
nerve
* Action – assists FDL in flexing
digits II - V
LUMBRICALS
* Innervation – medial plantar
nerve first lumbrical; lateral
plantar nerve second, third and
fourth lumbricals
* Action – flexion of MP and
extension of IP joints

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13
Q

What are the muscles in the 3rd layer of the foot

A

FLEXOR HALLUCIS BREVIS
* Innervation – medial plantar
nerve
* Action – flexes MP joint of big
toe

ADDUCTOR HALLUCIS
* Innervation – lateral plantar
nerve
* Action – adducts big toe at MP
joint

FLEXOR DIGITI MINIMI
* Innervation – lateral plantar
nerve
* Action – flexes little toe at MP
joint

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14
Q

What are the muscles in the 4th layer of the foot

A

DORSAL INTEROSSEI (4)
* Innervation – lateral plantar
nerve, also deep fibular (1st and
2
nd)
* Action – abduct digits II – IV, flex
MP joints, extend IP joints

PLANTAR INTEROSSEI (3)
* Innervation – lateral plantar
nerve
* Action – adducts toes III – V,

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15
Q

What is the blood supply to the posterior foot

A

Popliteal artery > divides to
anterior and posterior tibial
arteries > posterior tibial enters
foot

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16
Q

What is the blood supply to the sole of the foot

A

Posterior tibial artery branches into
* Medial plantar artery
* Lateral plantar artery

Lateral plantar becomes deep plantar
arch and anastomoses with deep
plantar artery

Medial plantar travels along medial
side of foot to supply big toe and joins
deep plantar arch

17
Q

Describe dorsalis pedis

A

Anterior tibial artery becomes
dorsalis pedis as it crosses in front
of the ankle.
It passes between two heads of
first interosseous to join deep
plantar arch (deep plantar artery)
Branches include:
* Arcuate – passes laterally across
foot and gives off dorsal MT and
dorsal digital arteries
* 1
st dorsal metatarsal – supplies
digital branches to 1st and 2nd
toes

18
Q

What is the venous drainage from the foot

A

Dorsal venous arch receives
blood from metatarsal veins and
drains into great (medial) and
small (lateral) saphenous veins

19
Q

What is the nerve supply to the sole of the foot

A

Tibial nerve
* Enters though tarsal tunnel and
branches into:

  • Medial plantar n. – MOTOR to
    abductor hallucis, flexor
    hallucis brevis, flexor
    digitorum brevis, first
    lumbrical; SENSORY to sole
    including medial 3 ½ toes
  • Lateral plantar n.– MOTOR to
    all other intrinsic muscles of
    sole (remember 1st and 2nd
    dorsal interossei get
    additional from deep fibular);
    SENSORY to lateral sole and
    lateral 1 ½ toes. All via:
  • Deep branch
  • Superficial branch
20
Q

What is motor’s neuroma

A

In some cases the medial and lateral plantar nerves can fuse to form a
common plantar nerve – this sometimes occurs between the third and fourth
toes. This enlarged, superficial nerve can be squeezed during “toe off” leading
to inflammation and severe pain.

21
Q

What is the nerve supply to the dorsum of the foot

A

Deep fibular nerve
* Descends with anterior tibial
artery
* Innervates extensor digitorum
brevis, first two dorsal
interossei and skin between
first and second toes
Superficial fibular nerve
* Sensory to dorsal aspect of skin
and toes except digits I – II, and
dorsolateral side

22
Q

How does foot drop occur

A

Common fibular nerve
* Most frequently injured nerve in the body due to
superficial position around head and neck of fibula
* Impairs eversion, dorsiflexion of foot and
extension of toes
* Results in foot drop and a high-stepping gait as
well as loss of sensation on the dorsum of the foot

Anatomy Upper limb (10 decks)

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