Foot Flashcards
Medial Longitudinal Arch
What bones make up this arch?
- Calcaneus
- Talus
- Navicular
- All three cuneiforms
- First three metatarsal bones
- First three proximal, medial, and distal phalanges
Lateral Longitudinal Arch
What bones make up this arch?
- Calcaneus
- Cuboid
- 4th and 5th metatarsal bones
- 4th and 5th proximal, medial, and distal phalanges
Transverse Arch
What bones make up this arch?
- Cuboid
- All 3 Cuneiforms
- Metatarsal Bases
Which arch of the foot comes in closest contact with the ground?
The lateral arch
What are the four places weight is transferred on the foot during walking?
Calcaneus
Tuberosity of the fifth metatarsal
Head of the first metatarsal
Distal phalanx of the great toe
Where is the ideal site of amputation of the foot, allowing the patient to still heel strike, and not lose the height of the limb?
The transverse tarsometatarsal joint
What two structures emerge from the inferior border of the extensor retinaculum?
Dorsalis Pedis Artery
Deep Fibular Nerve
What is the function of the plantar aponeurosis?
The Plantar Aponeurosis is dense connective tissue has five slips which run concurrently with the tendinous sheaths of the foot and helps them slide fluidly
The Plantar Aponeurosis is also a critically important passive support for the arches of the foot
What is Plantar Fasciiitis?
Inflammation of plantar fascia, especially at proximal attachment
What can cause a calcaneal bone spur?
The arch of the foot 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
What muscles are found on the dorsal side of the foot?
- Extensor Hallucis Brevis
- Extensor Digitorum Brevis
Extensor Hallucis Brevis Muscle
What is its attachments?
Origin: Superolateral aspect of the Calcaneus and interosseous talocalcaneal ligament
Insertion: Dorsal aspect of base of 1st proximal phalanx
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Extensor Hallucis Brevis Muscle
What is its action?
Extend big toe at metatarsophalangeal joint (MTP)
Extensor Hallucis Brevis Muscle
What is its innervation and blood supply?
Innervation: Deep Fibular Nerve
Blood Supply: Dorsalis Pedis Artery
Extensor Digitorum Brevis Muscle
What are its attachments?
Origin: Superolateral aspect of the Calcaneus and interosseous talocalcaneal ligament
Insertion: Lateral aspect Extensor Digitorum Longus Tendon
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Extensor Digitorum Brevis Muscle
What is its action?
Extend digits 2-4
Extensor Digitorum Brevis Muscle
What is its innervation and blood supply?
Innervation: Deep Fibular Nerve
Blood Supply: Dorsalis Pedis Artery
What muscles are found in the first plantar layer?
- Abductor Digiti Minimi Muscle
- Flexor Digitorum Brevis Muscle
- Abductor Hallucis Muscle
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Abductor Hallucis Muscle
What is its attachments?
Origin: Medial tubercle; calcaneal tuberosity
Insertion: Medial aspect of base of 1st proximal phalanx
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Abductor Hallucis Muscle
What is its action?
- Abduct big toe
- Flex big toe
Abductor Hallucis Muscle
What is its innervation and blood supply?
Innervation: Medial Plantar Nerve
Blood Supply: Medial Plantar Artery
Flexor Digitorum Brevis Muscle
What are its attachments?
Origin: Medial tubercle; calcaneal tuberosity
Insertion: Intermediate phalanges 2nd-5th digits
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Flexor Digitorum Brevis Muscle
What is its action?
Flex digits 2-5
Flexor Digitorum Brevis Muscle
What is its innervation and blood supply?
Innervation: Medial Plantar Nerve
Blood Supply: Medial Plantar Artery
The flexor digitorum longus tendon runs through a split in the insertion of what muscle’s tendon?
Flexor digitorum brevis
Abductor Digiti Minimi Muscle
What is its attachments?
Origin: Calcaneal tuberosity
Insertion: Lateral aspect of base of 5th proximal phalanx
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Abductor Digiti Minimi Muscle
What is its action?
- Abduct 5th toe
- Flex 5th toe
Abductor Digiti Minimi Muscle
What is its innervation and blood supply?
Innervation: Lateral Plantar Nerve
Blood Supply: Lateral Plantar Artery
What muscles are found in the second plantar layer?
- Quadratus Plantae
- Lumbricals
- Tendons of Flexor Hallucis Longus and Flexor Digitorum Longus are also found in this layer
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Quadratus Plantae Muscle
What is its attachments?
Origin: Plantar surface calcaneus
Insertion: Lateral aspect of Flexor Digitorum Longus Tendon
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Quadratus Plantae Muscle
What is its action?
Assists with flexion of digits 2-5
Quadratus Plantae Muscle
What is its innervation and blood supply?
Innervation: Lateral Plantar Nerve
Blood Supply: Lateral Plantar Artery
What muscle of the foot does not have an analogue in the hand?
Quadratus plantae
Lumbricals Muscle
What is its innervation and blood supply?
Innervation:
1st Lumbrical: Medial Plantar Nerve
2nd-4th: Lateral Plantar Nerve
Blood Supply:
1st Lumbrical: Medial Plantar Artery
2nd-4th: Lateral Plantar Artery
Lumbricals Muscle
What are its attachments?
Origin: Lateral aspect of Flexor Digitorum Longus Tendon
Insertion: Medial proximal phalanx of digits 2-5; Medial aspects of digital expansion on digits 2-5
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Lumbricals Muscle
What is its action?
- Flex MTP joint
- Extend proximal and distal interphalangeal joints
What muscles are found in the third plantar layer?
- Flexor Digiti Minimi Brevis
- Adductor Hallucis
- Flexor Hallucis Brevis
- Opponens Digiti Minimi - don’t need to know
Flexor Digiti Minimi Brevis Muscle
What is its attachments?
Origin: Base 5th metatarsal
Insertion: Base of 5th proximal phalanx
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Flexor Digiti Minimi Brevis Muscle
What is its action?
Flex proximal phalanx of 5th digit
Flexor Digiti Minimi Brevis Muscle
What is its innervation and blood supply?
Innervation: Superficial Lateral Plantar Nerve
Blood Supply: Lateral Plantar Artery
Adductor Hallucis Muscle
What is its attachments?
Origin:
Oblique head: Bases of 2nd-4th metatarsals
Transverse head: Plantar metatarsophalangeal ligament
Insertion: Lateral aspect of 1st proximal phalanx base
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Adductor Hallucis Muscle
What is its action?
Adduct hallux
Adductor Hallucis Brevis Muscle
What is its innervation and blood supply?
Innervation: Deep Lateral Plantar Nerve
Blood Supply: Medial and Lateral Plantar Arteries
Flexor Hallucis Brevis Muscle
What is its attachments?
Origin: Plantar surface of cuboid and 3rd cuneiform
Insertion: Base of 1st proximal phalanx
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Flexor Hallucis Brevis Muscle
What is its action?
Flex 1st proximal phalanx
Flexor Hallucis Brevis Muscle
What is its innervation and blood supply?
Innervation: Medial Plantar Nerve
Blood Supply: Medial Plantar Artery
What unique feature can be found in the medial and lateral head of the Flexor Hallucis Brevis?
Sesamoid bones that create a protective tunnel for the flexor hallucis longus tendon
What muscle integrates with the Oblique Head of the Adductor Hallucis?
Lateral head of Flexor Hallucis Brevis Muscle
What muscles are found in the fourth plantar layer?
How many muscles of each are there?
- 4 Dorsal Interossei Muscles (DABS)
- 3 Palmar Interossei Muscles (PADS)
- Fibularis Longus Tendon and Tibialis Posterior Tendons also in this layer
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Dorsal Interossei Muscle
What is its attachments?
Origin: Adjacent edges and bases of 1st-5th metatarsals
Insertion:
1st: Medial aspect 2nd proximal phalanx
2nd-4th: Lateral azpect bases of 2nd, 3rd, and 4th proximal phalanges
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Dorsal Interossei Muscle
What is its action?
- Abduct digits 2-4
- Flex metatarsophalangeal joint
Dorsal Interossei Muscle
What is its innervation and blood supply?
Innervation: Lateral Plantar Nerve
Blood Supply: Dorsal Digital Arteries
Plantar Interossei Muscle
What is its attachments?
Origin:
Oblique head: Bases of 2nd-4th metatarsals
Transverse head: Plantar metatarsophalangeal ligament
Insertion: Lateral aspect of 1st proximal phalanx base
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Plantar Interossei Muscle
What is its action?
- Adduct digits 3-5
- Flex MTP joint
Plantar Interossei Muscle
What is its innervation and blood supply?
Innervation: Lateral Plantar Nerve
Blood Supply: Dorsal Digital Arteries
What can happen to cause Hallux Valgus?
If you displace the Great Toe too far laterally, the Tendon of the Flexor Hallucis Longus can slip out of the groove created by the sesamoid bones of the Flexor Hallucis Brevis, causing the Great Toe to stay laterally displaced.
What is a corn of the foot?
Inflamed calluses on the medial aspect of the Metatarsophalangeal Joint
What is a bunion?
Inflammation of a bursa just over the medial aspect of the Metatarsophalangeal Joint.
What is hammer toe
Hyperextension of the Proximal Phalanx at the Metatarsophalangeal Joint
- Plantarflexion of the proximal interphalangeal joint,
- Extension of the distal interphalangeal joint
- Normally in 2nd digit*
What is claw toe?
Hyperextension of the Metatarsophalangeal joint as in Hammer Toe
-Flexion of both Interphalangeal Joints
What is mallet toe?
Flexion at the Distal Interphalangeal Joint
What nerve innervates the two muscles on the dorsum of the foot?
The lateral branch of the deep fibular nerve
What are the two main nerves of the sole of the foot?
Medial and lateral plantar nerves
Which branch of the lateral plantar nerve is involved in cutaneous (sensory) innervation, and which branch is involved in motor innervation?
The superficial branch does the cutaneous innervation
The deep branch does muscular (motor) innervation
What nerve does the lateral tarsal artery run with?
Lateral branch of the deep fibular nerve
What part of the skin of the foot is innervated by the superficial branch of the lateral plantar nerve?
The skin around and including the fifth digit of the foot
What gives rise to the medial and lateral plantar nerves?
Tibial nerve
What four muscles are innervated by the Medial Plantar Nerve?
Flexor digitorum brevis
Flexor hallucis brevis
Abductor hallucis
Medial one lumbrical
What part of the skin of the foot is innervated by the medial plantar nerve?
Plantar foot except the fifth digit
What is the primary artery to the plantar foot?
Posterior tibial artery
What does the medial plantar artery do?
Gives rise to two Plantar Metatarsal and Plantar Digital Arteries
What are the branches of dorsalis pedis?
Lateral tarsal artery
Arcuate artery
Deep plantar artery
What does the arcuate artery do?
Gives rise to the 2nd through 5th metatarsal arteries
What nerve runs with dorsalis pedis?
Medial branch of the deep fibular nerve
What does the deep plantar artery do?
Joins the lateral plantar artery to form the plantar arterial arch
Gives rise to the first metatarsal artery
What are the main branches of the posterior tibial artery in the plantar aspect of the foot?
Where does it split?
Medial and lateral plantar arteries
Deep to abductor hallucis on the medial foot
(after Tom Dick AN Harry)
What is the primary artery to the dorsum of the foot?
The anterior tibial artery
Where does the anterior tibial artery become dorsalis pedis?
When the lateral malleolar artery splits off
What does the lateral plantar artery do?
Gives rise to the 3rd through 6th Plantar Metatarsal and Plantar Digital Arteries
Terminates in an anastomosis with the deep plantar artery from the dorsalis pedis forming the plantar arterial arch