Foot Flashcards
Flexor Retinaculum
- Deep fascial band that passes between the medial malleolus and the medial surface of the calcaneus and forms the tarsal tunnel with tarsal bones for the tibial nerve, posterior tibial vessels, and flexor tendons.
- Holds three tendons and blood vessels and a nerve in place deep to it (from anterior to posterior): the tibialis posterior, flexor digitorum longus, posterior tibial artery and vein, tibial nerve, and flexor hallucis longus
- Provides a pathway for the tibial nerve and posterior tibial artery beneath it.
Tarsal tunnel syndrome
A complex synptom resulting from the compression of the tibial nerve or its medial and lateral plantar branches in the tarsal tunnel, with pain, numbness, and tingling sensations on the ankle, heel, and sole of the foot. It may be caused by repetitive stress with activities, flat feet, or excess weight gain.
Which muscles make up the triceps surae?
Gastrocnemius and soleus
____________ is the tendon of insertion of the triceps surae into the tuberosity of the calcaneus.
Tendon calcaneus
Avulsion or rupture of the achilles tendon
Disables the triceps surae muscles; thus, the patient is unable to plantar flex the foot.
Forced eversion of the foot
Avulse the medial malleolus or ruptures the deltoid ligament
Forced inversion of the foot
Avulses the lateral malleolus or tears the lateral collateral ligament
Ankle sprain (inversion injury)
Results from the rupture of calcaneofibular and talofibular ligaments and a fracture of the lateral malleolus caused by forced inversion of the foot.
Plantar aponeurosis
- Thick fascia inversting the plantar muscles
- Radiates from the calcaneal tuberosity toward the toes and provides attachment to the short flexor muscles of the toes
What are the three major arches of the foot?
- Medial longitudinal arch
- Lateral longitudinal arch
- Transverse Arch
- Proximal arch
- Distal arch
Medial longitudinal arch
- Formed and maintained by the interlocking of the talus, calcaneous, navicular, cuneiform, and three medial matatarsal bones
- Has, as its keystone, the head of the talus, which is located at the summut between the sustentaculum tali and the navicular bone
- Suported by the spring ligament and the tendon of the flexor hallucis longus
Lateral longitudinal arch
- Formed by the calcaneus, the cuboid bone, and the lateral two metatarsal bones.
- The keystone is the cuboid bone
- Supported by the peroneus longus tendon and the long and short plantar ligaments
Transverse arch
- Proximal (metatarsal) arch
- Formed by the navicular bone, the three cuneiform bones, the cuboid bone, and the bases of the five metatarsal bones of the foot
- Supported by the tendon of the peroneus longus
- Distal arch
- Formed by the heads of five metatarsal bones
- Maintained by the transverse head of the adductor hallucis
Ligaments of the Foot
Long plantar (plantar calcaneocuboid) Ligament
Short Plantar (Plantar Calcaneocuboid) Ligament
Spring (Plantar Calcaneonavicular) Ligament
Long Plantar Ligament
- Extends from the plantar aspect of the calcaneus in front of its tuberosity to the tuberosity of the cuboid bone and the base of the metatarsals and forms a canal for the tendon of the peroneus longus
- Supports the lateral side of the longitudinal arch of the foot
Short Plantar Ligament
- Extends from the front of the plantar surface of the calcaneus to the plantar surface of the cuboid bone
- Lies deep to the long plantar ligament and supports the lateral longitudinal arch
Spring Ligament
- Passes from the sustentaculum tali of the calcaneus to the navicular bone
- Supports the head of the talus and medial longitudinal arch
- Comtains considerable number of elastic fibers to give elasticity to the arch and spring to the foot
- Supported bu the tendon of the tibialis posterior
Flat foot
A condition of disappearance or collapse of the medial longitudinal arch with eversion and abduction of the forefoot and causes greater wear on the inner border of the soles and heels of shoes thatn on the outer border. It causes pain as a result of stretching of the plantar muscles and straining of the spring ligament and the long and short plantar ligaments.
Pes cavus
Exhibits an exaggerated height of the medial longitudinal arch of the foot
Clubfoot (talipes equinovarus)
A conginital deformity of the foot in which the foot is plantar-flexed, inverted, and adducted. It may involve a deformity in which the heel is elevated (the longitudinal arch is abnormally high) and turns medially or laterally.
Muscles in dorsum of foot
Extensor digitorum brrevis
Extensor hallucis brevis
Muscles in sole of foot
First layer
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi
Second layer
Quadratus plantae
Lumbricals (4)
Third layer
Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis
Fourth layer
Plantar interossei (3)
Dorsal interossei (4)
Extensor Digitorum Brevis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Dorsal surface of calcaneus
Insertion: Tendons of extensor digitorum longus
Nerve: Deep fibular
Action: Extends toes
Blood Supply: Dorsalis pedis artery
Extensor hallucis brevis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Dorsal surface of calcaneus
Insertion: Base of proximal phalanx of big toe
Nerve: Deep femoral
Action: Extends big toe
Blood Supply: dorsalis pedis artery
Abductor hallucis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Medial tubercle of calcaneus
Insertion: Base of proximal phalanx of big toe
Nerve: Medial plantar
Action: Abducts big toe
Blood Supply: Medial plantar artery
Flexor digitorum brevis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Medial tubercle of calcaneus
Insertion: Middle phalanges of lateral four toes
Nerve: Medial plantar
Action: Flexes middle phalanges of lateal four toes
Blood Supply: Medial and lateral plantar arteries and plantar arch, plantar metatarsal and plantar digital arteries
Abductor digiti minimi
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Medial and lateral tubercles of calcaneus
Insertion: Proximal phalanx of little toe
Nerve: Lateral plantar
Action: Abducts little toe
Blood Supply: Lateral plantar artery
Quadratus plantae
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Medial and lateral side of calcaneus
Insertion: Tendons of flexor digitorum longus
Nerve: Lateral plantar
Action: Aids in flexing toes
Blood Supply: Medial plantar artery; lateral plantar artery; deep plantar arch
Lumbricals
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Tendons of flexor digitorum longus
Insertion: Proximal phalanges, extensor expansion
Nerve: First by medial plantar, lateral three by lateral plantar
Action: Flex metatarsophalangeal joints and extend interphalangeal joints
Blood Supply: Medial and Lateral plantar arteries
Flexor hallucis brevis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Cuboid, third cuneiform
Insertion: Proximal phalanx of big toe
Nerve: Medial plantar
Action: Flexes big toe
Blood Supply: Medial plantar artery; plantar metatarsal arteries
Adductor hallucis
Origin
Insertion
Nerve
Action
Blood Supply
Origin:
- Oblique head: Bases of metatarsals 2-4
- Transverse head: Capsule of lateral four metatarsophalangeal joints
Insertion: Proximal phalanx of big toe
Nerve: Lateral plantar
Action: Adducts big toe
Blood Supply: Lateral plantar artery
Flexor digiti minimi brevis
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Base of metatarsal 5
Insertion: Promixal phalanx of little toe
Nerve: Lateral plantar
Action: Flexes little toe
Blood Supply: Lateral plantar artery; superficial branch of lateral plantar artery; lateral tarsal artery
Plantar interssei
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Medial sides of metatarsals 3-5
Insertion: Medial sides of base of proximal phalanges 3-5
Nerve: Lateral plantar
Action: Adducts toes, flex proximal, and extend distal phalanges
Blood Supply: Lateral plantar artery; deep plantar arch; plantar metatarsal arteries, proper plantar digital arteries
Dorsal interossei
Origin
Insertion
Nerve
Action
Blood Supply
Origin: Adjacent shafts of metatarsals
Insertion: Proximal phalanges of second toe (medial and lateral sides), and third and forth toes (lateral sides)
Nerve: Lateral plantar
Action: Abducs toes, flex proximal, and extend distal phalanges
Blood Supply: Arcuate artery of foot; plantar metatarsal arteries; dorsal metatarsal arteries; dorsal digital arteries of foot
March fracture
- Stress fracture
- A fatigue fracture of one of the metatarsals, which may result from prolonged walking.
