foot Flashcards
medial biomechanical portion of foot
calcaneus talus navicular three cuneiforms first , second and third metatarsals with respective phalalnges, constant sesamoirs
lateral biomechanical portion of foot
calcaneus, cuboid, fourth and fifth metatarsals with respective phalanges
surgical divisions of foot
forefoot (anterior unit): metarsals, phalanges and sesamoids
midfoot (middle unit or lesser tarsus): navicular, cuboid, and three cuneiforms
rearfoot (posterior unit, hindfoot or greater tarsus): calcaneus and talus
what is midtarsal joint
joint betwen rearfoot and midfoot (transverse tarsal joint or chopart’s joint)
lisfranc’s joint
joint between forefoot and midfoot (tarsometatarsal joint))
two types of accessory bones
ossicles; sesamoids
ossicles: result of anomalous dev or ossification patterns
sesamoids: in tendons, reduce friction
what forms ankle synovial joint
malleolar fork or ankle mortice articulating with body of talus
ankle mortice made of
lateral surface of medial malleolus
inferior surface of distal extremity of tibia
medial surface of lateral malleolus
talar dome
body of talus: articulates with ankle mortice at medial, superior and lateral surfaces
major ligaments of ankle joint are
articular capsule, lateral ankle ligaments, medial ankle ligaments or deltoid ligament
lateral ankle ligaments
anterior talofibular
posterior talofibular
calcaneofibular
deltoid ligament
superficial deltoid: tibionavicular, calcaneotibial and posterior talotibial
deep deltoid: anterior talotibial
subtalar joint is formed by
three articular ares on the talus articulating with the corresponding areas on the calcaneus
why is subtalar joint motion important
supination and pronation of foot
what are major ligaments of subtalar joint
anterior talocalcaneal; interosseous talocalcaneal
what two joints make the midtarsal joint or transverse tarsal joint?
talonavicular and calcaneocuboid joints
why is midtarsal joint motion important
in supination and pronation of foot
major ligaments of midtarsal joint
spring, bifurcate, short and long plantar
what arches exist in foot
transverse and longitudinal
longitudinal arch
posterior base is the tuberosity of calc., anterior base is metatarsal heads and sesamoids
body formed by metatarsal and tarsal bones with the talus being the keystone or highest point
lateral part or rigid component is flatter and composed of the calcaneus, cuboid, lateral two metatarsals and their phalanges
transverse arch
cuboid, cuneis, and bases of metatarsals from transverse arch. highest point of arch lies at second cuneiform and base of second metatarsal.
what is knot of Henry
fibrous cord that connected tendon of flexor hallucis longus to tendon of FDL
muscles inn dorsum of foot
extensor hallucis brevis and extensor digitorum brevis
where do dorsum muscles origionate
calcaneus
where does EHB insert; action?
bone of prox phalanx of hallux
dorsiflex proximal phalanx
EDB inserrtion and action
lateral side of 2, 3 and 4 tendons of EDL
dorsiflex phalanges 2, 3, 4
innervation of EHB and EDB
deep fibular nerve
first layer of plantar muscles
AH, FDB, ADM
what first layer plantar muscle is not innervated by medial plantar nerve?
ADM
AH, origin, insertion, action
o: calcaneal tuberosity; tuberosity of navicular
i: medial sesamoid and then into base of proximal phalanx of hallux
ac; abducts and plantar flexes hallus
FDB o, i, and a
calcaneal tuberosity, middle phalanges of lesser digits, plantarflexes middle and proximal phalanges of lesser digits
ADM o, i and a
o: calcaneal tuberosity, tuberosity of the fifth metatarsal base
i: lateral side of proximal phalanx of fifth toe
o; abducts and plantar flexes fifth toe
second layer of plantar muscles
quadratus plantae, lumbricals
QP, o, i and
o: medial head; medial surface of calcaneus; lateral head planter surface of calcaneus
i: tendon of flexor digitorum longus;
a: assist flexor digitorum longus
QP is innervated by
lateral plantar nerve
lumbricals: o, i and a
o: tendons of flexor digitorum longum
i: medial side of extensor hoods of lesser digits
a: plantarflex proximal phalanges; extend middle and distal phalanges
what innervates lumbricals?
first: medial plantar nerve
2-4: lateral plantar nerve
third layer of plantar muscles
FHB, AH, FDMB
FHB o, i and action
o: plantar surface of cuboid, third cuneiform, tendon of tibialis posterior;
i: medial and lateral sesamoids and then into the plantar surface of the base of the proximal phalanx of the hallux
a: plantarflexes hallux
what innervates FHB
medial plantar nerve
AH o, i and i
o: oblique head: bases of metatarsals 2-4, transverse head: plantar ligaments of lesser MPJs
i: lateral sesamoid and then into lateral surface of base of the proximal phalanx of the hallux
a: adducts and plantar flexes the hallux
FFDMB o, i and a
o: plantar surface of the base of the fifth metatarsal
i: lateral surface of base of proximal phalanx of fifth toe
a: plantar flex toe
AH and FDMB innervated by
lateral plantar nerve
fourth layer of plantar muscles
dorsal and plantar interossei
DI, o, i and a
o: adjacent sides of metatarsal shafts
i; 1: medial side of base of the proximal phalanx of the second toe
2-4: lateral sides of the bases of the proximal phalanges of the 2-4 toes
a; abduct 2-4 toes; plantar flex proximal phalanges
PI, o, i and a
o: bases and medial sides of metatarsal shafts
i; medial sides of the bases of the proximal phalanges of the lesser digits and then into extensor hooda: adduct 3-5 toes. plantarflex proximal phalanges
what innervates PI and DI
lateral plantar nerve
superficial veins of digits flow into
dorsal venous arch
dorsal venous arch flows
medially into the medial marginal vein
how does medial marginal vein flow
courses anterior to medial malleolus to become great saphenous vein and laterally into the lateral marginal vein
what does lateral marginal vein become
small saphenous vein
major branches of dorsalis pedis
lateral tarsal, medial tarsal, arcuate, first dorsal metatarsal, deep plantar
dermatomes involved in cutaneous innervation of foot
L4, L5, S1 and S2
cutaneous nerves involved in innervation of foot
saphenous, superficial fibular, deep fibular, lateral dorsal cutaneous, medial plantar, lateral plantar, medial calcaneal; at foot, neuropathy
what is a deep tendon reflex?
tap tendon to a muscle results in an afferent impulse to spinal cord which synapses either directly or indirectly (thorugh interneuron) on alpha motor neurons. motor neurons generate an efferent impulse to muscle causing contraction
patellar or quadriceps reflex
tap ligamentum patellae which results in leg extension (L3 and L4 via femoral nerve)
achilles, tendo calcaneus or triceps surae reflex
tap tendo achilles which results in plantarflexion of foot (S1 via tibial nerve)
superficial reflexes?
stimulation of receptors in the skin generates an afferent impulse to a level of the spinal cord that results in the stimulation of alpha motor neurons causing contraction of muscles innervated by that same level
plantar reflex:
stroke sole of foot from the heel, along lateral side and across the metatarsal heads results in plantarflexion of the toes
lymphatics of lower extremity drain into?
the popliteal and inguinal lymph nodes
