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Dorsum of the Foot > Dorsum of the Foot > Flashcards

Dorsum of the Foot Flashcards

1
Q

the interosseous talocalcaneal ligament blends with the attachment of the medial root of inferior extensor retinaculum. This ligament forms a sling around what structures?

A

tendons of the extensor digitorum longus and peroneus tertius muscles

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2
Q

the superomedial oblique band of the inferior extensor retinaculum passes superficial to what structures?

A
  1. tendon of extensor hallucis longus
  2. anterior tibial artery and vein
  3. deep fibular nerve
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3
Q

after passing the extensor hallucis longus tendon, the superomedial oblique band of the inferior extensor retinaculum fuses with the deep layer to form a tunnel for what structure?

A

tendon of tibialis anterior

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4
Q

the inferomedial oblique band of the inferior extensor retinaculum passes superfcially to what structures?

A
  1. dorsalis pedis artery
  2. deep peroneal nerve
  3. tendons of extensor hallucis longus
  4. tendon of tibialis anterior
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5
Q

Where does the superolateral oblique band of the inferior extensor retinaculum attach medially? what about the inferomedial oblique band?

A

superolateral- attaches on the anterior surface of medial malleolus

inferomedial- attaches to plantar fascia, navicular tuberosity, and medial cuneiform

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6
Q

what are teh extensor expansions formed by?

A

tendons of the extensor digitorum longus and brevis muscles

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7
Q

what is the only intrinsic muscle to the dorsum of the foot?

A

extensor digitorum brevis

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8
Q

O/I for extensor digitorum brevis?

A

(only intrinsic muscle to the dorsum of the foot)
Origin- tubercle on the superolateral surface of calcaneus anterior to sinus tarsi, from the interosseous talocalcaneal ligament and from the frondiform ligament
Insertion- lateral surface of the tendons of the extensor digitorum longus muscle of the 2nd, 3rd, 4th digits distal to the MPJ (and extensor hallucis brevis inserts on the dorsal surface of the base of the proximal phalanx of the 1st digit)

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9
Q

innervation of extensor digitorum brevis?

A

lateral terminal branch of deep peroneal nerve

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10
Q

what is the saphenous nerve a branch of?

A

a sensory branch off the femoral nerve

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11
Q

where does the saphenous nerve run anatomically?

A

runs on the medial side of the leg, coursing laterally along the great saphenous vein, and enters the dorsum of the foot anterior to the medial malleolus

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12
Q

what surfaces in the foot does the saphenous nerve innervate?

A

skin along the medial side of the foot as far as the base of the 1st met

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13
Q

the sural nerve continues as what in the foot as it courses the lateral side of the foot?

A

lateral dorsal cutaneous nerve of the foot

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14
Q

the lateral dorsal cutaneous nerve gives off a branch- what is it?

A

the 10th dorsal digital nerve that supplies the lateral side of the 5th toe

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15
Q

what are the 2 terminal branches of the superficial peroneal nerve?

A

intermediate and medial dorsal cutaneous nerve

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16
Q

what does the medial dorsal cutaneous nerve give rise to?

A

1st dorsal digital nerve and

1st common dorsal digital nerve

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17
Q

where does the 1st dorsal digital nerve arise from? where does the 10th dorsal digital nerve arise from?

A

1st –> from medial dorsal cutaneous nerve

10th –> from lateral dorsal ctuaneous nerve

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18
Q

where do the 2nd and 3rd dorsal digital nerves arise from?

A

medial terminal branch of the deep peroneal nerve

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19
Q

Where do the 4th and 5th dorsal digital nerves arise from?

A

1st common dorsal digital branch

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20
Q

the deep peroneal nerve has a lateral and medial terminal branch? what does each do?

A

lateral terminal branch- passes deep to extensor digitorum brevis and innervates it

medial terminal branch- (found w/ DP artery); divides into 2 dorsal digital nerves in the 1st intermetatarsal space

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21
Q

what is the arterial supply for extensor digitorum brevis?

A

lateral tarsal artery (off of the dorsalis pedis artery)

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22
Q

in which toe interspace does the 1st common dorsal digital nerve go t?

A

second toe space (in btwn digits 2 and 3)- gives off the 4th and 5th dorsal digital nerves

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23
Q

what gives rise to the 2nd common dorsal digital nerves?

A

intermediate dorsal cutaneous nerve

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24
Q

Where does the 3rd common dorsal digital nerve come from?

A

intermediate dorsal cutaneous nerve

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25
Q

What artery continues into the dorsum of the foot as the dorsalis pedis artery?

A

anterior tibial artery

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26
Q

what are the terminal branches of the dorsalis pedis artery?

A

deep plantar artery

1st dorsal metatatarsal artery

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27
Q

describe the path the dorsalis pedis artery takes, in relation to other structures.

A

The tendon of the extensor hallucis longus follows the artery distally along its medial side, while the extensor digitorum longus can be located along its lateral side. At its distal end, it is crossed by the tendon of the extensor hallucis brevis.

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28
Q

what relationship does the dorsalis pedis artery have in relation to extensor hallucis longus and extensor digitorum longus?

A

extensor hallucis longus- lies medial to DP artery

extensor digitorum longus- lies laterally

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29
Q

the blood supply to the dorsum of the foot is provided by which branches of the DP artery?

A
  1. lateral tarsal
  2. medial tarsal
  3. arcuate
  4. 1st dorsal metatarsal
  5. deep plantar
30
Q

what is the largest branch of the dorsalis pedis artery?

A

lateral tarsal artery

*arises at the neck of the talus

31
Q

where, and with which artery, does the lateral tarsal artery anastamose with?

A

passes below the tendon of the peroneus brevis to anastomose with the lateral plantar artery

32
Q

what muscle does the lateral tarsal artery supply?

A

extensor digitorum brevis

33
Q

what artery provides vascular supply to the head and the neck of the talus?

A

proximal part of the lateral tarsal artery

34
Q

what does the medial tarsal artery supply?

A

medial aspect of tarsal bones and terminate by contributing to the medial malleolar rete

35
Q

on the lateral side fo the foot, what does the arcuate artery anastomose with?

A

lateral tarsal and lateral plantar arteries

36
Q

which branches does the arcuate artery give rise to?

A

2nd, 3rd, and 4th dorsal metatarsal arteries

*note that the 1st dorsal metatarsal artery is a terminal branch of the dorsalis pedis

37
Q

how many dorsal metatarsal arteries are there? name the origin of each.

A

4: the first is from the dorsalis pedis directly

- the 2nd, 3rd and 4th dorsal metatarsal are branches of the arcuate artery

38
Q

how many common digital nerves are there? name the origin of each.

A

3: the first common digital nerve is from the medial dorsal cutaneous n. (and goes to the 2nd interspace)
- the 2nd and 3rd common digital n. is from the intermediate dorsal cutaneous n. (and goes to the 3rd and 4th interspace)

39
Q

where does the 1st dorsal digital artery arise from?

A

the medial branch of the 1st dorsal metatarsal artery

40
Q

what artery gives rise to the 2nd and 3rd dorsal digital artery?

A

the lateral branch of the 1st dorsal metatarsal artery

41
Q

At the proximal end of the interosseous spaces, the dorsal metatarsal arteries receive perforating branches from where?

A

posterior perforating branches of the plantar arch

42
Q

At the distal end of the interosseous spaces, the dorsal metatarsal receive branches from where?

A

anterior perforating branches of the plantar metatarsal arteries

43
Q

after receiving distal (anterior) perforating arteries , the dorsal metatarsal arteries are known as what?

A

common dorsal digital arteries

44
Q

which dorsal digital arteries does the first dorsal metatarsal artery supply?

A

dorsal digital arteries 1 to 3

45
Q

what gives off the 10th dorsal digital artery?

A

either directly from the lateral part of the arcuate artery or from the 4th dorsal metatarsal artery

46
Q

what does the deep plantar artery anastamose with/

A

first plantar metatarsal artery of the deep plantar arch

47
Q

the dorsal digital veins of the foot unite with the plantar digital veins to form what?

A

dorsal metatarsal veins

48
Q

describe the general pathway of the venous system for the dorsum of the foot.

A

dorsal digital veins –> dorsal metatarsal veins –> dorsal venous arch –> medial/lateral marginal vein –> great saphenous/ small saphenous vein

49
Q

what forms the lateral marginal vein?

A

lateral dorsal digital vein of the 5th toe (aka 10th dorsal digital vein) + lateral end of the dorsal venous arch

50
Q

what is the medial marginal vein formed by?

A

medial dorsal digital vein of the 1st toe (aka 1st dorsal digital vein) and the medial end of the dorsal venous arch

51
Q

what does the medial marginal vein give rise to?

A

great saphenous vein

52
Q

what does the lateral marginal vein give rise to?

A

small saphenous vein

53
Q

the deep fascia divides the dorsum of the foot into 3 layers arranged from superficial to deep. What is in each layer?

A

1st layer- tibialis anterior, extensor hallucis longus, extensor digitorum longus and peroneus tertius
2nd layer- extensor digitorum brevis
3rd layer- dorsalis pedis artery, deep peroneal nerve, veins, and the termination of perforating branch of peroneal artery

54
Q

what are the attachments for superior extensor retinaculum?

A

laterally: distal end of fibula on its anterior border & lateral malleolus
medially: anterior border of tibia & medial malleolus

55
Q

what are the lateral and medial attachments for dorsalis pedis fascia?

A
  • lateral attachments: peroneal trochlea, cuboid, and tuberosity of the 5th met
  • medial attachments:navicular tuberosity, sustentaculum tali, and 1st met
56
Q

the superior extensor retinaculum binds which tendons in its synovial sheath?

A

extensor digitorum longus
extensor hallucis longus
peroneus tertius
tendon of tibialis anterior

57
Q

the tendons of which muscles share teh same synovial sheath?

A

extensor digitorum longus

peroneus tertius

58
Q

how often is the superolateral oblique band of the inferior extensor retinacula present in people?

A

about 25% of people have it

59
Q

what is the function of extensor digitorum longus in terms of the extensor expansions?

A

tightens the sling and loosens the wing –> results in hyperextension of MPJ
*cannot extend the IPJ bc the wing portion is loose

60
Q

what is the extensor wing? and what is it mostly formed by?

A

(distal part of the extensor hood)

-formed mostly from expansions of the tendons of the lumbrical muscles

61
Q

what is the extensor sling? what is it mostly formed by?

A

(proximal part of extensor hood)

-formed from fibers which encircle the digit and attach to the plantar plate

62
Q

what is the function of lumbrical muscles?

A

tighten the wing and loosen the sling –> flexion in MPJ and extension in IPJ

63
Q

what is the function of the interosseous muscles?

A

act as lumbricals- flex MPJ, extend IPJ

64
Q

describe the extensor expansion of the hallux (which is different from the rest).

A
  • only the tendon of the extensor hallucis longus is attached to the extensor expansion
  • the plantar plate is attached to the deep transverse ligament on the lateral side only
  • a wing and sling are present, but lumbricals and interossei do not contribute to them
65
Q

what is the perecentage of cases that an accessory peroneal branch of the superficial peroneal nerve is present that aids in innervating the extensor digitorum brevis (in addition to lateral terminal br. of peroneal n.)?

A

20%

66
Q

in which intermetatarsal space does the dorsalis pedis artery divide?

A

1st intermetatarsal space.

67
Q

trace the course of the DP artery. what is the % of time the DP can be found in this path?

A

(75%) trace DP distally across talus, navicular, intermediate cuneiform, and the base of the 2nd met to the 1st intermetatarsal space

68
Q

what percentage is the DP artery deviated to the medial or lateral side?

A

10% of cases

69
Q

in what % of individuals is the diameter of the artery smalller in size?

A

5-10%

70
Q

what percentage of time is the anterior tibial artery absent? then where does the DP arise from/

A

(5%)- DP usually originates from the perforating branch of the peroneal artery

71
Q

what % of cases does teh arcuate artery originate from the dorsalis pedis artery at the level of the first tarsomeatarsal joint?

A

65%

*in other cases, its origin can be slightly more proximal

Dorsum of the Foot (1 decks)

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