Foot Flashcards
Height of arch importance
. Abnormally high arch is more rigid and susceptible to stress fractures than a lower arch
Pes planus
. Normal feet w/ low arches
. Could be from feet w/ high arches that have collapsed (med. arch)
. Painful bc plantar ligaments and aponeurosis are stretched
. Spring ligament can no longer support head of talus so the head is displaced inferno medially
. Results in flattening of med. longitudinal arch along w/ lat. deviation of forefoot
Plantar calcaneonavicular (spring) ligament
. Extends from sustentaculum tali to navicular tuberosity
. Important in maintaining longitudinal arch of foot
Long plantar ligament
. Passes from plantar surface of calcaneal tuberosity to groove on cuboid
. Some fibers extend to bases of metatarsals II-V forming a tunnel for the tendon of the fibularis longus
. Important for maintaining arches of foot
Plantar calcaneocuboid ligament (short plantar ligament)
. Deep to long plantar ligament
. Extends from ant. Aspect of inf. Surface of calcaneus to inf. Surface cuboid
Superficial fascia of foot
. SubQ tissue in sole more fibrous than other areas
. Fibrous septa separate subQ into fat-filled areas to make shock-absorbing pad
.septa anchor skin to underlying plantar aponeurosis
Plantar fascia
. Deep fascia that forms plantar aponeurosis
. Longitudinally arranged bands of dense fibrous CT
. Arises from calcaneus and divides into 5 bands that split to enclose digital tendons that attach to fibrous digital sheaths and Desmond bones to great toe
. Protects plantar surface of foot from injury
. Supports longitudinal arches of foot
Plantar fasciitis
. Straining and inflammation of plantar aponeurosis that may result from running and high impact aerobics
. Causes pain on plantar surface of heel and on med. aspect of foot
Extensor hallicus brevis OIAN
O: dorsal surface of calcaneus I: lateral aspect of the base of proximal phalanx of digit I A: extends 1st MTP joint N: deep fibular nerve
Extensor digitorum brevis OIAN
O: dorsal surface of calcaneus (divides into 3-4
bellies)
I: lateral sides of extensor digitorum longus
tendons to digits II-IV
A: extends MTP and proximal interphalangeal
(PIP) joints of digits II-IV
N: deep fibular nerve
Dorsalis pedis a.
Direct continuation of ant. Tibial a. . Courses w/ deep fibular n. . Pulsation can be felt as it descends btw extensor hallicus and digitorum longus mm. . Terminates as deep plantar a. . Dorsalis pedis v. Follows same course
Arcuate a.
. Course transversely across foot
. Gives rise to dorsal metatarsal aa.
. Arcuate v. Follows same path
Deep plantar a.
. Contributes to plantar arterial/venous arch
Dorsal venous arch
. Continuous w. Great (long) and small (sort) saphenous vv.
Abductor hallicus OIAN
O: (medial) calcaneal tuberosity, flexor
retinaculum, and plantar aponeurosis
I: base of proximal phalanx of 1st digit
A: abducts and flexes MTP joint of digit I
N: medial plantar nerve
Flexor digitorum brevis
O: (medial) calcaneal tuberosity, flexor retinaculum, and plantar aponeurosis
I: base of proximal phalanx of 1st digit
A: abducts and flexes MTP joint of digit I
N: medial plantar nerve
Abductor digiti minimi (quinti) OIAN
O: (lateral) calcaneal tuberosity and plantar aponeurosis
I: base of prox. phalanx of digit V
A: abducts and flexes MTP joint of digit V
N: lateral plantar nerve
Tendon of flexor digitorum longus
. Crosses flexor hallicus longus tendon superficially
. Splits into 4 tendons that insert on bases of distal phalanges II-V
. Flexes all joints of digits II-V
Quadratus plantae OIAN
O: calcaneus (plantar surface)
I: tendon of flexor digitorum longus
A: assists flexor digitorum longus muscle
N: lateral plantar nerve
Lumbricals of foot OIAN
O: tendons of flexor digitorum longus
I: medial sides of extensor expansions of digits II-V
A: weakly flexes MTP joints and extends IP joints of digits II-V
N: Medial and lateral plantar nerves
Tendon of flexor hallicus longus
. Runs to base of distal phalanx of digit I in groove inf. To sustentaculum tali
. Flexes MTP and IP joints of digit I
Flexor hallicus brevis OIAN
O: cuboid and lateral cuneiform I: Both sides of the base of prox. phalanx of digit I, Med. tendon joins abductor hallucis; the lat. tendon joins adductor hallucis . Each tendon contains a sesamoid bone that tendon of flexor hallucis longus passes btw A: flexes MTP joint of digit I N: medial plantar nerve
Adductor hallicus OIAN
O: Oblique head: base of metatarsals II-IV, transverse head: deep transverse metatarsal ligaments btw heads of
metatarsals 3-5
I: lat. side of the base of prox. phalanx of digit I
A: adducts MTP joint of digit I
N: lateral plantar nerve
Flexor digiti minimi OIAN
O: base of fifth metatarsal
I: base of prox. phalanx of digit V (often a sesamoid is present)
A: flexes MTP joint of digit V
N: lateral plantar nerve
Tendon of fibularis longus
. Crosses sole to reach base of 1st metatarsal
. Everts foot and shores up transverse arch
Tendon of tibialis posterior
. Broad insertion on navicular tuberosity, 1st cuneiform, and several adjacent bones
. Inverts foot
Interosseous mm.
3 plantar interossei
4 dorsal interossei
Plantar interossei
. 3 O: medial side of metatarsal III-V I: medial side of proximal phalanges and extensor expansions of digits III-V A: adducts MTP joints of digits III-V (plantar adduct – PAD) N: lat. plantar n.
Dorsal interossei
. 4
O: separate heads from adjacent metatarsal shafts
I: bases of proximal phalanges and extensor
expansions of digits II-IV
A: abducts MTP joints of digits II-IV (dorsal
abduct – DAB)
N: lateral plantar n.
Medial plantar n.
. Motor to abductor hallicus, flexor digitorum brevis, flexor hallicus brevis, and 1st lumbrical (digit II)
. Cutaneous: med. sole of foot and 3.5 digits
Lateral plantar n.
. Motor: abductor digiti minimi, flexor digiti minimi, adductor hallicus, quadratus plantae, lumbricals II-IV, and all interosseous
. Cutaneous: lat. sole of foot and 1.5 digit
Calcaneal nn.
. From tibial and Sural nn.
. Pass from distal part of post. Aspect of leg to skin on heel
. Cutaneous to skin over heel
Arteries on plantar side of foot
. End branches of post. tibial a./v.
. Med. plantar a./v: supplies med. portion of sole and digit I
. Lat. plantar a./v: larger than med. plantar a, supplies lat. sole and ends w/ plantar arterial arch
. Plantar metatarsals from deep plantar arch
. Plantar digital aa.: from plantar metatarsal aa. To supply sides of adjacent pedal digits
Veins on plantar side of foot
. . Plantar venous network: superficial vv. Drain into med. marginal and lat. marginal vv. That become great and small saphenous vv.
. Deeper med. and lat. plantar vv. Form post. Tibial and fibular vv. (Venae comitantes)
