Fascia of Plantar Foot Flashcards
Peroneal retinacula
Located laterally
- Superior peroneal retinacula
- Inferior peroneal retinacula
Superior peroneal retinacula
- Crosses superficial to peroneus longus and brevis
- Originates at the posterior border of the lateral malleolus (of fibula)
- inserts into the lateral surface of the calcaneus and the tendocalcaneus (Achilles)
Inferior peroneal retinacula
- Originates at the lateral rib of sinus tarsi
- Inserts into the lateral surface of the calcaneus and the peroneal trochlea
- Forms two tunnels between the origin and insertion
- Superior tunnels encloses the peroneus brevis tendon
- Inferior tunnel encloses the peroneus longus tendon
NOTE: ONLY deep fibers form the tunnels, superficial fibers lie flat over teh ligaments
Flexor retinaculum
Located medially
- Recall that the peroneal retinacula is located laterally
- AKA lacinate ligament or medial annular ligament
- Triangular in shape
Attachment sites of flexor retinaculum
- Anteromedial surface of the medial malleolus
- Continuous with deep fascial of the leg
- Continuous with dorsal aponeurosis of the foot
- Superior border of the abductor hallucis
- Medial process of calcaneal tuberosity (FFA)
Description of flexor retinaculum formation
Flexor retinaculum forms one tunnel with 4 compartments
NOTE: the flexor retinaculum is the “roof” of the tarsal tunnel or the talocalcaneal tunnel
Compartments of flexor retinaculum
- Compartment 1 = Tibialis posterior
- Compartment 2 = Flexor digitorum longus
- Compartment 3 = Posterior tibial artery and nerve
- Compartment 4 = Flexor hallucis longus
NOTE: tibialis posterior is found directly posterior to the medial malleolus and it continues back from there
REMEMBER: Tom (1), Dick (2), Very Nervous (3), Harry (4)
Plantar aponeurosis
- Formed by the deep fascia of the plantar foot
- Thickens where the foot contacts the floor
- Fat globules are found superficial to the aponeurosis and are considered to be shock absorbers
3 parts of the plantar aponeurosis
- Central
- Lateral
- Medial
Central part of plantar aponeurosis
- Thickest of the three parts
- The central portion becomes thinner as it passes anteriorly
Attachments of central plantar aponeurosis
- Posterior attachment = medial process of calcaneal tuberosity (“P” of LAP)
- Anterior attachment = 5 processes to the 5 digits
- Digital processes attach to the skin, tendon sheath
- Superficial stratum attaches to the skin of the transverse sulcus
- Deep stratum divides into two slips, one on each side of the flexor tendons) then blends with the tendon sheath
- Between the digital processes of the central plantar aponeurosis we see digital nerves, vessels and lumbrical tendons
Lateral part of plantar aponeurosis
- Found superficial to abductor digiti minimi muscle of the 1st layer
- Thicker proximally, thins out distally (same as central portion)
- Creates a strong band between the lateral process of the calcaneal tuberosity and the base of the 5th metatarsal
Attachments of lateral part of plantar aponeurosis
- Posterior attachment = lateral process of calcaneal tuberosity (“P” in LAP)
- Anterior attachment = base of 5th metatarsal
Medial part of plantar aponeurosis
- Lies superficial to abductor hallucis (1st layer)
- Attaches posterior to the flexor retinaculum
Intermuscular septa
- There are two vertical septa which dive deep into the foot
- They are formed by the junction of the lateral and central parts of the plantar aponeurosis
- Creates 3 compartments (medial, lateral, central)
