Dorsal And Plantar Foot Flashcards
Ankle joint is formed by
Talus articulates superriorly with the lower end of tibial and medial and lateral malleoli
Talus articulations
Ankle joint Subtalar joint (with superior aspect of calcaneus) Talonavicular joint (head of talus and navicular bone)
Cuboid articulates
Proximally with calcaneus
Distally with lateral two metatarsals
Navicular articulates
Proximally with head of talus
Distally with 3 cuneiforms
What are the muscles in the dorsum of the foot?
Extensor hallucis brevis
Extensor digitorum brevis
Nerves in dorsum of foot?
Superficial and deep fibular nerve
Blood supply of dorsum of foot?
Dorsalis pedis artery
Extensor hallucis brevis origin and insertion
Anterior aspect of the superior surface of the calcaneus to base of proximal phalanx of big toe
Extensor hallucis brevis action and innervation
Extension of metatarsophalangeal joint of big toe
Deep fibular nerve
Extensor digitorum brevis origin and insertion
Anterior aspect of superior aspect of calcaneus to lateral side of tendons of extensor digitorum longus of the second 3rd and 4th toes
Extensor digituorum brevis action and innervation
Extension of all joints of 2,3 and 4th toes.
Deep fibular nerve
Dorsalis pedis artery course
Starts under extensor retinaculum as continuation of anterior tibial artery
Arises lateral and parallel to the tendon of extensor hallucis longus
Descends into dorsal surface of foot
Passes via the first interosseus space as deep plantar artery, where it joins the medial end of the plantar arch
Dorsalis pedis artery branches
Medial and lateral tarsal branches Arcuate artery (> 3 dorsal metatarsal arteries> digital branches for lateral three and a half toes) First dorsal metatarsal artery (> dorsal digital branches to supply medial side of big toe and and adjacent sides of big and 2nd toes)
Deep fibular nerve course
Enter the foot lateral to the dorsalis pedis artery
Divides into lateral terminal branch (muscles) and medial terminal branch (adjacent sides of 1 and 2nd toe)
Muscle supplied by lateral terminal branch (of deep fibular nerve)
Extensor digitorym brevis and extensor hallucis brevis
Medial terminal branch (< deep fibular nerve) innervation
Adjacent sides of 1st and 2nd toe
Superficial fibular nerve course
Lower 3rd of leg pierces the deep fascia to descend in the superficial fascia
Crossing superficial to inferior and superior extensor retinacula to enter the dorsal surface of the foot
Divides into medial and lateral terminal branches
Superficial fibular nerve branches
Medial and lateral terminal branches Cutaneous branches (lower 3rd of lateral surface of leg -middle part of dorsal surface of the foot- dorsal surface of toe exept lateral side of 5th toe and distal adjacent sides of 1st and 2nd toe)
Nerves and vessels in plantar aspect of foot
Medial plantar and lateral plantar nerves and vessels
Muscles of first layer of plantar foot (3)
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi
Muscles of 2nd layer of plantar foot (2-2)
Quadratus plantae
Lumbricals
Two tendons (flexor hallucis longus and flexor digitorum longus)
Muscles in 3rd layer of plantar foot (3)
FLexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis
Muscles in 4th layer of plantar foot
3 Plantar interossei
4Dorsal interossei
Tendon for fibularis longus and tibialis posterior
Abductor hallucis origin and insertion
Medial tubercle of calcaneus to medial side of base of proximal phalanx of 1st toe
Abductor hallucis action and innervation
Medial plantar nerve
Flexion and abduction of big toe at metatarsophalangeal joint
Maintains medial longitudinal arch of foot
Flexor digitorum brevis origin and insertion
Medial tubercle of calcaneus to middle phalanges of the lateral four toes (via 4 tendons)
Flexor digitorum brevis action and innervation
Medial plantar nerve
Flexion of metatarsophalangeal and proximal inter phalange all joints of lateral 4 toes
Abductor digiti minimi origin and insertion
Medial and lateral tubercles of calcaneus to lateral side of the base of proximal phalanx of the 5th toe.
Abductor minimi action and innervation
Lateral plantar nerve
Abduction of 5th toe at metatarsophalangeal joint
Quadratus plantae origin and insertion
Medial head- medial surface of calcaneus
Lateral head- lateral margin of the inferior surface of calcaneus
Insertion- tendon of flexor digitorum longus
Quadratus plantae action and innervation
Lateral plantar nerve
Flexion of lateral 4 toes when the foot is plantarflexed
Corrects the oblique line of pull of flexor digitorum longus
Lumbricals origin and insertion
4 lumbricals
1st - from medial side of tendon for 2nd toe
Lateral 3 - from sides of two adjacent tendons of flexor digitorym longus
4 tendons pass superiorly across the medial side of the metatarsophalangeal joints to blend with extensor expansions and the proximal phalanges of the lateral 4 toes
Lumbricals action and innervation
1st -medial plantar nerve
2nd to 4th- lateral plantar nerve
Flexion of metatarsophalangeal joint of lateral 4 toes
Extension of interphalangeal joint of lateral 4 toes
Flexor hallucis brevis origin and insertion
Cuboid and tendon of tibialis posterior to medial and lateral sides of base of proximal phalanx of 1st toe (vial medial and lateral tendons- each containing a sesamoid bone)
Flexor hallucis action and innervation
Medial plantar nerve
Flexion of metatarsophalangeal joint of big toe
Adductor hallucis origin and insertion
Oblique head - fibularis longus tendon and base of 2,3rd and 4th metatarsals
Transverse head - capsule and ligaments of lateral 4 metatarsophalangeal joints
Insertion- lateral side of proximal phalanx of big toe
Adductor hallucis action and innervation
Lateral plantar nerve
Oblique head- adduction of big toe
Transverse head- helps maintain transverse arch of the foot
Flexor digiti minimi brevis origin and insertion
Base of 5th metatarsal to base of proximal phalanx of 5th toe
Flexor digiti minimi action and innervation
Lateral plantar nerve
Flexion of metatarsophalangeal joint of the 5th toe
Plantar interossei origin and insertion
3 each arises from
Metatarsal of the digit upon which it acts
(1st acts on the 3rd, 2nd on 4th etc..)
Each inserts partly into the base of the proximal phalanx and partly into extensor expansion
Plantar interossei action and innervation
Lateral plantar nerve
Adduction of lateral 3 toes towards 2nd toe
Help in flexion of metatarsophalangeal and extension of interphalangeal joints (through the extensor expansions)
Dorsal interossei origin and insertion
4
Each arises from 2 adjacent metatarsals
Each inserts into the proximal phalanx and and extensor expansion of the digit upon which it acts
Dorsal interossei action and innervation
Lateral plantar nerve
Abduction of 2 3 and 4th toes from midline of 2nd toe (1st and 2nd interossei act on 2nd toe, 3 on 3 and 4 on 4)
Flexion of metatarsophalangeal and extension of interphalangeal joints ()through attachment to extensor expansion)
Medial plantar nerve course
Starts deep to flexor retinaculum as terminal branch of tibial nerve
Passes deep to abductor hallucis
Runs forward between abductor hallucis and flexor digitorum brevis (along the lateral side of the medial plantar artery)
Medial planter nerve branches
Cutaneous branches to skin of medial 2/3 of plantar surface of foot
Muscular branches to abductor hallucis, flexor digitorym brevis, flexor hallucis brevis and 1st lumbricals
Articulate branches to the inter Tara’s and tarsometatarsal joints
Lateral plantar nerve course (
Starts deep[ to flexor retinaculum
Runs aterolateral between flexor digitorum brevi sin the 1st layer and quadratus plantar in the 2nd layer
Terminates at the interval between flexor digitoruym brevis and abductor digiti minimi
Divides into two terminal branches (superficial and deep)
Lateral plantar nerve
Superficial and deep terminal branches
Muscular branches to flexor digitorum brevis and quadratus plantar
Cutaneous branch to the skin of the lateral side of the anterior 2/3 rds of the plantar surface of the foot.
Superficial branch (from deep plantar nerve) branches
Proper plantar digital nerve
Common plantar digital nerve
Proper plantar digital nerve supply
Flexor digiti minimi brevis
Dorsal interossei muscles
Plantar interossei muscles (between 4th and 5th toes)
Cutaneous supply of lateral side of 5th toe
Common plantar nerve branches
Digital nerves - skin on adjacent sides of 4th and 5th toes
Deep branch (
Adductor hallucis
2nd, 3rd an death 4th lumbricals
Interossei muscles (exept those between 4th and 5th toes- >superficial nerve)
Intertarsal and tarsometatarsal joints
Medial plantar artery (
Runs anteriorly in the groove between abductor hallucis and flexor digitorum brevis
Terminates by joining the digital branch of the deep plantar arch (this supplies the medial side of big toe?)
Muscular branches to the adjacent muscles
Digital branches (at the base of first metatarsal ) to anastomose with metatarsal branches of the plantar arch
Lateral plantar artery
Starts deep to the flexor retinaculum
Runs anterolateral between flexor digitorym brevis(1st layer) and quadratus plantae(2nd layer)
At the interval between flexor digitorym brevis and abductor digiti minimi curves medially to form the deep plantar arch.
Arch joins with deep plantar artery between 1st and second metatarsals
Where does deep plantar arch lies?
Between 3rd and 4th layers
Where does deep plantar arch joins with the deep plantar artery (dorsalis pedis terminal branch)
Between bases of 1st and 2nd metatarsals
Lateral plantar artery branches
Digital branch to the lateral side of the little toe
Four plantar metatarsal arteries (which give digital branches to the adjacent side of the 1-5 and medial side of big toe)
Recheck its 1-5
3 perforating arteries (passing between the bases of metatarsals to anastomose with the dorsal metatarsal arteries).