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MSK Exam 2 > Foot > Flashcards

Foot Flashcards

1
Q

Where is a common site for amputation of the foot?

A

Transverse tarsometatarsal joint. This allows the patient to still heel strike

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2
Q

What bone do they attempt to keep in foot amputations?

A

Calcaneus, so the person maintains the height of the limb.

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3
Q

What ray comes in closest contact to the ground?

A

Lateral ray- particularly the

  • heads of the 4th and 5th metatarsals
  • Cuboid
  • Calcaneus.
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4
Q

How do we distribute weight on our foot?

A
  1. 1/3 on the calcaneus
    2 .1/3 on the lateral 3 digits
  2. 1/3 on the medial two digits.
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5
Q

How is weight transferred when we walk?

A

Calcaneus–> along the lateral ray to the tuberosity of the 5th metatarsal–> head of the 1st metatarsal –> distal phalanx of the great toe

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6
Q

________ is important for being a terminal lever during walking and providing strength during toe off stage

A

Big toe

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7
Q

fascia on dorsum of the foot

A

thin and continuous with the extensor retinaculum

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8
Q

Fascia on sole of the foot

A

Plantar fascia.

the middle part thickens to form plantar aponeurosis

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9
Q

Plantar aponeurosis

A

Has 5 slips that run concurrently with the tendinous sheaths of the foot and helps them slide fluidly.

Also important passive support for arches of the foot

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10
Q

CN : Plantar Fasciitis

A

Overweight patients and patients whose shoes lack arch support are more prone to Plantar Fasciitis. The arch sags and the calcaneus slides in a bursa that is just underneath the Plantar Aponeurosis. This can cause inflammation of that bursa, which can then lead to overgrowth of bone and a bone spur.
—The pain is typically worse after someone gets out of bed and improves as they stretch the plantar fascia.

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11
Q

M on dorsum

A

Extensor hallucis brevis m

Extensor digitiorum brevis m

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12
Q

Which toes does extensor digitorum brevis go to

A

2-4

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13
Q

I of m on dorsum

A

deep fibular n

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14
Q

Roles of plantar muscles

A

synergists: maintain foot arches and stand on uneven ground

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15
Q

1st layer of plantar m

A
  1. Abductor hallucis m
  2. Abductor digiti minimi m.
  3. Flexor digitorum brevis m.
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16
Q

What is quadratus plantae m analog in hand

A

does not have one

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17
Q

3rd layer of plantar m

A
  1. adductor hallucis m.
  2. flexor hallucis brevis m.
  3. flexor digiti minimi brevis m.
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18
Q

why does adductor hallucis m have 2 heads

A

because naturally the big toe wants to abduct, so it keeps it in line

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19
Q

What is special about flexor hallucis brevis m

A

Has a medial and lateral head that both have sesamoid bones that create a gap for the tendon of FHL so that you do not step on it.

The belly also protexts the 1st metarsal and t. of FHL

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20
Q

What does the 2nd digit have 2 dorsal interossei muscles

A

its the “middle” digit for determining adduction and abduction

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21
Q

Bunion

A

tender and inflamed bursa

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22
Q

Where do corns form?

A

Over proximal IP joints

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23
Q

Hallux valgus

A

Lateral dislocation of the big toe causes the

[t. of FHL] to slip out of groove created by the sesamoid bones of the FHB.

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24
Q

In general, how do toe defmorities form?

A

Lumbricals will work to keep the IP joints extended.

Toe deformities are due to shorted flexor muscles that have overriden fx of lumbricals

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25
Q

Someone with a longer 2nd or 3rd toe, compared to 1st is more likely to get what?

A

Mallet toe- flexion at the distal IP joint

26
Q

what nerve supplies all muscles muscles of the foot except the 2 dorsum

A

tibial n

27
Q

What nerve provides cutaneous sensation to medial leg

A

saphenous n

28
Q

What n provides cutaneous sensation to posterior leg an part of the lateral aspect of the foot

A

Sural n

29
Q

What n provides cutaneous sensation to the plantar foot, except fifth digit

A

Medial plantar n

30
Q

What n provides cutaneous sensation to Fifth Digit and Distal Lateral portion of the Foot

A

superficial branch of the lateral plantar n

31
Q

What n provides cutaneous sensation to the dorsal foot, except flip flop spot

A

superficial fibular n

32
Q

What n provides cutaneous sensation to the flip flop spot

A

Deep fibular n

33
Q

Tibial nerve in foot

A

–> [lateral plantar n and medial plantar n]

[lateral plantar n–> superficial branch of lateral plantar n and deep branch of lateral plantar n]

34
Q

Anterior tibial a

A

–> lateral tarsal a and dorsalis pedis a

–> forms the arcuate artery and deep plantar a

–>Arcuate a forms [dorsal metatarsal a] –> [dorsal digital a]

35
Q

What happens if we fracture our calcaneus?

A

Damage the [TALOCALCANEAL] joint, where the talus meets the calcaneus.

usually debilitating

36
Q

How can we fracture the neck of our talus?

A

severe dorsiflexion, like pressing too hard on the brake pedal during an accident.

37
Q

Dancers are more likely to damage

A

metatarsal

38
Q

How can we damage the tuberosity of the 5th metarsal?

A

tuberosity of the 5th metatarsal can be damaged during violent inversion, like ankle sprain.

The t of the fibularis brevis m. may tear it away.

39
Q

Palpation of posterior tibial pulses is important for people with what?

A

occlusive peripheral dz. absence is a sign of occlusive peripheral dz

40
Q

most common hindfoot problem in runners

A

plantar facisitis

41
Q

when is pain in plantar facitis worse

A

pain is worse in the after sitting and when you begin to walk. goes away after 5-10 min of acitibty

42
Q

When there is an infection in the foot, how is it drained?

A

incision is made on the medial side of the foot, aove the abductor hallucis

43
Q

knowing the location of the belly of EDB is important for what

A

the muscle fiber can be torn and mistaken for abnormal edema.

misdx as a severe sprain

44
Q

Plantar reflex

A

Tests L4, L5, S1 and S2 nerve roots

response: flexion

abnormal response: babinski sign; big toe dorsiflexes and other 4 fan out

45
Q

plantar reflex indicates what

A

brain dz

but the babinski sign can be seen until kids are 4

46
Q

mEdial plantar nerve entrapment

Aka
What happens
how does it occur

A

AKA: joggers foot

can cause paresthesia on medial side of sole of the foot

repetitive Eversion

47
Q

dorsalis pedis palpation

A

can be palpated with foot slightly dorsiflexed.

absence can detect vascular insufficiency

48
Q

Puncture wounds to the sole of the foot involve

A

deep plantar arch

bleeding is bad and occurs from both ends of the cut artery

49
Q

Tibial nerve entrapment

AKA
Results in:

A

Tarsal tunnel syndrome

Heel pain due to compression by flexor retinaculum

50
Q

L in vaLGus stands for

A

lateral deviation

51
Q

Club feet

A

involves the subtalar joint.

foot is inverted,
ankle is plantarflexed
forefoot is adducted

wallks on lateral side of foot

52
Q

Karen got into a car accident. When she saw the car, she pressed on the brakes really hard. What will happen to her?

A

Fracture neck of talus due to dorsiflexion

53
Q

Muscles on the Dorsum of the Foot

A

Extensor Hallucis Brevis

Extensor Digitorum Brevis

54
Q

Extensor Hallucis Brevis

I:
Axn:

A
  • Deep fibular N

- Extend hallux

55
Q

Extensor Digitorum Brevis

I:
Axn:

A
  • Deep fibular N
  • Extend digits 2-4
  • Does not send a digit to digiti minimi
56
Q

Muscles on the plantar aspect of the foot

A

4 layers

Layer 1 (3)

  1. Abductor hallucis m.
  2. Flexor Digitorum brevis m
  3. Adductor Digiti Minimi m.

Layer 2 (2)

  1. Quadratus Plantae m.
  2. Lumbricals

Layer 3 (3)

  1. Flexor hallucis brevis m.
  2. Adductor hallucis m (transverse and oblique head)
  3. Flexor digiti minimi brevis m.

Layer 4

  1. PADS
  2. DABS
57
Q

Layer 3 sends muscles where

A

1st and 3rd digit only

58
Q

What are the roles of plantar muscles?

A

they have a synergistic effect: work together to

  1. Maintain foot arch
  2. Stand on uneven ground
59
Q

Flexor Digitorum Brevis can be found ________ to the Tendons of the Flexor Digitorum Longus

A

superficial

60
Q

Roles of quadratus plantae m

A

pulls the tendons of the Flexor Digitorum Longus towards the lateral side to keep the tendons straight in order to pull the toes straight back.

61
Q

Why are the two heads of the adductor hallucis m important?

A

The two heads of the Adductor Hallucis are important because naturally the toe wants to abduct when walking, so the Adductor Hallucis muscles keep it in line

MSK Exam 2 (23 decks)

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