Foot Flashcards
Name the different Intertarsal Joints
- Subtalar (talocalcaneal) joint
- Talonavicular joint
- Surgical subtalar
- Transverse tarsal
what type of joint is the Talonavicular joint?
ball and socket, synovial
What is the role of the talonavicular joint?
transfer weight from the tibia through the talus anteriorly to the balls of the feet
The surgical subtalar joint is a combination of what?
the talocalcaneal and talonavicular joint
*also called the talocalcaneonavicular joint
What ocurs at the talocalcaneonavicular (surgical subtalar) joint?
location of most movement in inversion/eversion
what is the transverse tarasl joint a combination of?
calcaneocuboid + talonavicular compound joint
what does the transverse tarsal joint allow?
rotation around a longitudinal axis contributing to inversion/eversion
what is the role of all the other intertarsal joints?
absorb shock and dissipate shock from impact of foot with ground
only give a little and don’t have appreciable movement
Tarsometatarsal joint type?
plane type synovial joint
Intermetatarsal joint type
planar synovial
Ligaments of the intermetatarsal joints
- strong capsule
- strong interosseous ligaments
- deep transverse ligament distally
role of the deep transverse ligament?
ties all 5 metatarsal together distally
what joint is at the “balls of the feet”?
mmetatarsophalangeal (MTP) joint
MTP joint type?
condyloid synovial
Ligaments of the MTP joints
- strong capsule
- collateral ligaments
- plantar ligaments
what do the plantar ligaments at the MTP joints limit?
extension
(Feet) Interphalangeal joint type?
hinge synovial
Ligaments of the interphalangeal joints?
- strong capsule
- colalteral ligaments
- plantar ligaments
What are the two types of arches at the feet?
- Longitdudinal
- Transverse
name the 2 longitudinal arches of the feet?
- Medial
- Lateral
What do the arches of the feet allow for?
distribution of body weight between heel and balls of feet for 2-point transfer to the ground
Roles of arches of feet
- Shock absorber
- Act as a springboard = provide propulsive force (recoil) during the push off part of the stance phase
which arch is the highest and most important?
Medial longitudinal arch
Name the structures of the Medial Longitudinal arch from posterior to anterior
calcaneus -> talus -> navicular -> 3 cuneiforms -> metatarsals 1-3
what significant ligament is found in the medial longitudinal arch?
Plantar calcaneonavicular (spring) ligament
describe the weight distribution of the medial longitudinal arch
from talus (high point) to calcaneus posterior and heads of metatarsals 1-3 (medial balls of foot) anterior
name the structures of the lateral longitudinal arch from posterior to anterior
calcaneus -> cuboid -> metatarsals 4 & 5
describe the weight distribution of the lateral longitudinal arch
from calcaneus (reveived weight from talus)
to cuboid (high point)
and heads of metatarsals 4 and 5 (anterior)
name the structures of the transverse arch from lateral to medial
cuboid, cuneiforms and bases of metatarsal bones
what maintains the transverse arch?
- shape of bones (broader on dorsum than plantar)
- ligaments
- tendons
- muscles
what ligaments help maintain the transverse arch?
deep and superficial transverse and plantar intermetatarsal ligaments
what tendons help maintain the transverse arch?
- fibularis longus
- tibialis posterior
what muscle helps maintain the transverse arch?
adductor hallucis
what passive factors help maintain the arches of the feet?
- plantar aponeurosis
- long plantar ligmanet
- short plantar (calcaneocuboid) ligament
- spring (calcaneonavicular) ligament
what is the plantar aponeurosis?
deep fascia running longituindally from heel to balls of feet
What muscles are in the thenar group of the intrinsic foot muscles?
- abductor hallucis
- flexor hallucis brevis
What muscles are in the hypothenar group of the intrinsic foot muscles?
- abductor digit minimi
- flexor digiti minimi
- opponens digiti minmi
What muscles support the medial longitudinal arch?
- abductor hallucis
- flexor hallucis brevis
- flexor digitorum brevis
- flexor digitorum longus
- flexor hallucis longus
What muscles support the lateral longitudinal arch?
- abductor digiti minimi
- flexor digiti minimi
- opponens digiti minimi
- flexor digitorum brevis
- flexor digitorum longus
What muscles support the transverse arch?
- fibularis longus
- tibialis posterior
- adductor hallucis
What are the zones that the foot can be divided into?
- hindfoot
- midfoot
- forefoot
what does the hindfoot consist of?
talus and calcaneus
What does the midfoot consist of?
- navicular
- cuboid
- cuneiforms
What does the forefoot consist of?
metatarsals and phalanges
what creates longitudinal compartments in the foot?
plantar fascia that has vertical septa
What are the comparments of the foot?
- medial
- central
- lateral
- interosseous
where is the medial compartment of the foot?
located in midfoot and forefoot
also called the thenar compartment
what is inside the medial compartment of the foot?
- medial intrinsic foot muscles and tendons to the hallux
- medial plantar nerve and vessels
Where is the central compartment of the foot located at?
midfoot and forefoot
what is in the central compartment of the foot?
intrinsic foot muscles and tendons to digits 1-5
lateral plantar nerves and vessels
flexor digitorum longus and brevis
where is the lateral compartment of the foot located at?
midfoot and forefoot
also called the hypothenar compartment
what does the lateral compartment of the foot contain?
intrinsic foot muscle and tendons to digit 5
Where is the interosseous compartment of the foot?
in the forefoot only
what is located within the interosseous compartment of the foot?
- metatarsals
- interosseous muscles
- deep plantar blood vessels
- PADs and DABs
what is the overall function of the instrinsic muscles of the foot?
work together to maintain the arches of the foot when weight is loaded on them during stance phase
Intrinsic foot muscles in the 1st layer
- Abductor hallucis
- Flexor digitorum brevis
- Abductor digiti minimi
Abductor hallucis prox attachment
calcaneus & plantar aponeurosis
Abductor Hallucis distal attachment
proximal phalanx digit 1 (medial side)
Abductor Hallucis action
- abduct digit 1 (limited by deep and surface transverse ligaments)
- maintain medial longitudinal arch
- provide cushioning
Abductor hallucis innervation
branch of tibial nerve = medial plantar (S2, 3)
Flexor digitorum brevis prox attachment
calcaneus and plantar aponeurosis
Flexor digitorum brevis distal attachment
middle phalanx digit 2-5 (medial and lateral sides)
split attachment similar to flexor digitorum superficialis in hand
Flexor digitorum brevis action
- flex digits 2-5
- maintain M/L longitudinal arches
- provides cushioning
- keeps flexor digitorum longus oriented
Flexor digitorum brevis innervation
branch of tibial nerve = medial plantar (S2,3)
Abductor digiti minimi prox attachment
calcaneus and plantar aponeurosis
Abductor digiti minimi distal attachment
proximal phalanx digit 5 (lateral side)
Abductor digiti minimi action
- abduct digit 5 (at MTP joint)
- maintain lateral longitudinal arch
- provide cushioning
Abductor digiti minimi innervation
branch of tibial nerve = lateral plantar (S2, 3)
Intrinsic foot muscles 2nd layer
- Quadratus plantae
- Lumbricals
Quadratus plantae prox attachment
calcaneus
Quadratus plantae distal attachment
tendon of flexor digitorum longus
Quadratus plantae action
- maintain orientation of flexor digitorum longus (straigtens line of pull of FDL)
- maintain longitudinal arch
Quadratus plantae innervation
branch of tibial nerve = medial plantar (S2, 3)
Lumbricals prox attachment
tendons of flexor digitorum longus
Lumbricals distal attachment
extensor expansion digits 2-5
Lumbricals action
- flex at MTP joints of digits 2-5
- extend at IP joints of digits 2-5
Lumbricals innervation
branch of tibial nerve = lateral and mediial plantar nerve (S2, 3)
3rd layer of intrinsic muscles
- Flexor hallucis brevis
- Adductor hallucis
- flexor digiti minimi brevis
Flexor hallucis brevis prox attachment
cuboid and lateral cuneiform
Flexor hallucis brevis distal attachment
split attachment M/L sides of proximal phalange of digit 1
onto sesamoid bones
Flexor hallucis brevis action
- maintain orientation of flexor hallucis longus
- maintain medial longitudinal arch
Flexor hallucis brevis innervation
branch of tibial nerve = medial plantar (S2, 3)
Adductor hallucis prox attachment
- oblique head = base of metatarsals 2-4
- transverse head = plantar ligment of MTP joints
Adductor hallucis distal attachment
Oblique and transverse head = lateral side base of proximal phalange of digit
Adductor hallucis action
- Main action = maintain transverse arch of foot
- adduct digit 1
- provide cushioning
Adductor hallucis innervation
branch of tibial nerve = lateral plantar (S2, 3)
Flexor digiti minimi brevis prox attachment
base of metatarsal 5
Flexor digiti minimi brevis distal attachment
base of proximal phalange 5
Flexor digiti minimi brevis action
flex digit 5
Flexor digit minimi brevis innervation
branch tibial nerve = lateral plantar (S2, 3)
Muscles in the 4th layer of intrinsic muscle
- Plantar interossei (PADs)
- Dorsal interossei (DABs)
Plantar interossei (PADs) prox attachment
metatarsals 3-5
Plantar interossei (PADs) distal attachment
extensor expansion 3-5
Plantar interossei (PADs) action
- adduct digit 3-5 (move towards digit 2 as reference)
- flex MTP joints of digits 3-5
- extend IP joints of digits 3-5
Plantar interossei (PADs) innervation
branch of tibial nerve = lateral plantar (S2, 3)
Dorsal interossei (DABs) prox attachment
metatarsals 1-5
Dorsal interossei (DABs) distal attachment
extensor expansion 2-4
digit 2 has a M/L DAB
digit 3 and 4 have lateral only
Dorsal interossei (DABs) action
- abduct digit 3-4 (away from 2)
- abd/adduct digit 2
- flex MTP joints digits 2-4
- extend IP joints digits 2-4
Dorsal interossei (DABs) innervation
branch of tibial nerve = lateral plantar (S2, 3)
What muscles are on the dorsum of the foot?
- Extensor digitorum brevis
- Extensor hallucis brevis
Extensor digitorum brevis prox attachment
calcaneus
Extensor digitorum brevis distal attachment
extensor expansion 2-4
Extensory digitorum brevis action
- extend digits 2-4
- shock absorption, raising height of arches
Extensor digitorum brevis innervation
deep fibular nerve (L5, S1)
Extensor hallucis brevis prox attachment
calcaneus
Extensor hallucis brevis distal attachment
extensor expansion of digit 1
Extensor hallucis brevis action
- extend digit 1
- shock absorption, raising height of arches
Extensor hallucis brevis innervation
deep fibular (L5, S1)
Motor nerves of the foot
- Tibial nerve
- Deep fibular nerve
Tibial nerve route and destinations
divides into M/L plantar nerves
supply intrinsic muscles on plantar surface of the foot
Deep fibular nerve route and destinations
to intrinsic foot muscles on dorsum of foot
Sensory nerves of the foot
- Sural
- Saphenous
- Fibular
- Tibial
Origin and destination of sural nerve
origin = tibial never
destination = lateral malleolus
Origin and destination of saphenous cutaneous nerve?
origin = femoral nerve
destination = medial malleolus
Destinations of cutaneous fibular nerve?
- Dorsum of hallux
- Dorsum of digit 5
- Dorsum of foot
Destinations of cutaneous tibial nerve?
- Plantar hallux
- Plantar digit 5
- Plantar foot
Arteries of the feet
- Anterior tibial artery
- Fibular artery
- Posterior tibial artery
Branches of the anterior tibial artery
dorsal pedis artery
branches of the fibular artery
perforating branches of fibular artery
what do the anterior tibial and fibular artery combine to form?
dorsal arch
Branches of hte Posterior Tibial artery
- Medial plantar artery
- lateral plantar artery
- deep plantar arch