Foot Flashcards
Give a brief overview of the foot
The region of the lower limb distal to the ankle joint.
It is subdivided into the ankle, the metatarsus, and the digits
Hindfoot, midfoot and forefoot
The foot has a dorsum (superior surface of foot) and a sole (inferior surface)
Describe the plantar aponeurosis
- for grip and weight
bearing - thickens as 5 longitudinal bands that continue with the fibrous flexor sheaths
- sends septae to the metatarsals to create compartments and potential spaces
Describe the skin on the sole of the foot
The sole has thick, highly sensitive skin, very firmly attached to the Plantar Aponeurosis
Describe the plantar muscles
Plantar muscles are arranged in layers
Their actions are implied by the names, but they play important
roles in
− arch support
− adjustment of balance
− Gait, especially on uneven surfaces
They are supplied by the lateral or medial plantar nerves
- The Medial Plantar is the equivalent of the Median Nerve
- The Lateral Plantar is the equivalent of the Ulnar Nerve
What actions do the plantar muscles play a role in?
− arch support
− adjustment of balance
− Gait, especially on uneven surfaces
What are the important plantar muscles to know?
Abductor digiti minimi Flexor digitorum brevis Abductor hallucis Lumbricals 1 4 Quadratus plantae Flexor digiti minimi brevis Adductor hallucis Flexor hallucis brevis Plantar interossei Dorsal interossei
What are the plantar muscles that are innervated by the lateral plantar nerve?
Abductor digiti minimi Lumbricals 4 Quadratus plantae Flexor digiti minimi brevis Adductor hallucis Plantar interossei Dorsal interossei
What are the plantar muscles that are innervated by the medial plantar nerve?
Flexor digitorum brevis
Abductor hallucis
Lumbricals 1
Flexor hallucis brevis
What does the posterior tibial artery become in the foot?
Posterior tibial artery becomes the medial and lateral plantar arteries after running posterior to the medial malleolus.
What artery precedes the medial and lateral plantar arteries after running posterior to the medial malleolus?
Posterior tibial artery
Where can the pulse of posterior tibial artery be felt?
Behind the medial malleolus
What injuries may interrupt blood supply to the talus?
Fractures of the neck of the talus often interrupt the blood supply to the talus
Where does the tibial nerve pass into the foot?
Tibial nerve passes into the sole behind medial malleolus, deep to the flexor retinaculum
What does the tibial nerve become after passing into the sole behind the medial malleolus?
Divides into the Medial and Lateral plantar nerves
give an overview of the plantar arches
3 points of contact (?)
Arches between points of contact as a result of shapes and arrangements of the bones of the foot
Weight bearing/distribution; shock absorption; resilience; “spring in the stride”!
What bones make up the plantar arches?
Medial longitudinal arch: Calcaneus, talus, navicular, 3 cuneiform bones and medial 3 metatarsals
Lateral longitudinal arch: Calcaneus, cuboid and 4th -5th metatarsals
Transverse arch: Cuneiforms and cuboid; disappears near the heads of the metatarsals
What bones make up the medial longitudinal plantar arch?
Calcaneus, talus, navicular, 3 cuneiform bones and medial 3 metatarsals
What bones make up the lateral longitudinal plantar arch?
Calcaneus, cuboid and 4th -5th metatarsals
What bones make up the transverse plantar arch?
Cuneiforms and cuboid; disappears near the heads of the metatarsals
What are the passive supporters of all the plantar arches?
Shape of bones (forms bridge “keystone” at navicular bone)
Strong ligaments
Muscles (effective when contracting)
What strong ligaments support the plantar arches
Calcaneonavicular plantar ligament: Supports the keystone. Long plantar ligament Plantar aponeurosis Deltoid ligament Calcaneocuboid (short plantar) ligament
What are the supporters of the medial plantar arch?
Deltoid ligament
Plantar aponeurosis
Spring ligament
What are the supporters of the lateral arch?
Flexor digitorum longus Lateral ligament (Peroneus longus tendon, short plantar ligament long plantar ligament plantar aponeurosis)*
Where does the deep fibular nerve enter the dorsal of the foot?
Deep fibular nerve enters the dorsum of the foot passing under the extensor retinaculum
What does the deep fibular nerve give rise to?
dorsal digital nerve to toes 1-2
What gives rise to the dorsal digital nerve to toes 1-2?
The deep fibular nerve
Where does the anterior tibial artery pass into the foot?
Anterior tibial artery passes under the inferior extensor retinaculum and becomes dorsalis pedis
Where can one feel the pulse go dorsalis pedis?
Pulse of dorsalis pedis is felt in the first intermetatarsal space, between the tendons of extensor digitorum longus and extensor hallucis longus
What are the retinacula around the ankle important for?
Keeping the tendons flush to the body, same as in the wrist
Describe the location and borders of the tarsal tunnel
Depression inferior to the medial malleolus
Talus
Calcaneus
Inferior surface of the sustentaculum tali
Flexor retinaculum
What is contained within the tarsal tunnel?
From posterior to anterior: Tendon of flexor hallucis longus Tibial nerve Posterior tibial artery Tendon of flexor digitorum longus Tendon of tibialis posterior
What tendons are found in the tarsal tunnel?
Tendon of flexor hallucis longus
Tendon of flexor digitorum longus
Tendon of tibialis posterior
Where is the Lisfranc joint?
Between the metatarsals and the tarsals - not a straight line as joint between the intermediate cuneiform bone is slightly superior (remember axis - proximal)
