Foot and Ankle Flashcards
Abductor digiti minimi S1-2
ATTACHMENTS- from calcaneal tuberosity to lateral side of proximal phalangeal base of 5th digit
ACTIONS- abducts & flexes 5th digit
INNERVATION- lateral plantar nerve
Abductor hallucis L4-5, S1
ATTACHMENTS- from medial calcaneal tuberosity to medial side of proximal phalangeal base of great toe
ACTIONS- flexes & abducts great toe
INNERVATION- medial plantar nerve
Adductor hallucis S1-2
ATTACHMENTS- from 2-4th metatarsal bases (oblique head) & distal ends of 3-5 metatarsal (transverse head) to lateral base of the proximal phalanx of great toe
ACTIONS- adducts great toe
INNERVATION- lateral plantar nerve
Extensor digitorum brevis L4-5, S1
ATTACHMENTS- from anterolateral calcaneus to dorsal aspect of the base of the proximal phalanx (digit 1 for EHB) or to the lateral side of tendons of extensor digitorum longus (digits 2-4 for EDB)
ACTIONS- extension of digits 2-5 (MP & IP; EDB) and extension of digit 1 (EHB)
INNERVATION- deep fibular nerve
Extensor hallucis brevis L4-5, S1
ATTACHMENTS- from extensor digitorum brevis to dorsal aspect of the base of the proximal phalanx of the hallux
ACTION- extension of great toe at metatarsophalangeal joint
INNERVATION- deep fibular nerve
Quadratus plantae S1-2
ATTACHMENTS- from medial surface of calcaneus & lateral process of calcaneal tuberosity to long flexor tendons
ACTIONS- assists flexor digitorum longus
INNERVATION- lateral plantar nerve
Flexor digitorum brevis L4-5, S1
ATTACHMENTS- from medial process of calcaneal tuberosity to sides of intermediate phalanges of digits 2-5
ACTIONS- flexes toes (proximal IP)
INNERVATION- medial plantar nerve
Flexor digiti minimi S1-2
ATTACHMENTS- from 5th metatarsal base to proximal phalangeal base
ACTIONS- flexion of 5th digit (MP)
INNERVATION- lateral plantar nerve
Flexor hallucis brevis L4-5, S1
ATTACHMENTS- from cuboid & tendon of tibialis posterior to base of the proximal phalanx of great toe
ACTIONS- flexion of great toe (MP)
INNERVATION- medial plantar nerve
Dorsal interossei S1-2
ATTACHMENTS- from metatarsal shafts to proximal phalangeal bases & dorsal digital expansions of digits 2-4
ACTIONS- abducts (MP) & flexes (MP) digits 2-4
INNERVATION- lateral plantar nerve
Plantar interossei S1-2
ATTACHMENTS- from plantar surface of base of metatarsals to dorsal digital expansions of digits 3-5
ACTIONS- adducts & flexes (MP) digits 3-5
INNERVATION- lateral plantar nerve
Lumbricals
ATTACHMENTS- from tendons of flexor digitorum longus to medial sides of dorsal expansions of digits 2-5
ACTIONS- flexes proximal phalanges (MP), and extend IP joints
INNERVATION- 1st- medial plantar nerve & 2nd-4th- lateral plantar nerve
What is the innervation of the 1st lumbrical?
L4-5
S1
What is the innervation of 2-4th lumbricals?
S1-2
what are the attachments of Talocrural fibrous capsule?
from the borders of the articular surfaces of tibia & malleoli to the margins of the trochlear surface of the talus
What are the attachments and function of the Medial collateral (deltoid) ligament?
ATTACHMENTS- from the medial malleolus to the talus, navicular & sustentaculum tali of the calcaneus
FUNCTION- stabilizes joint & resists forced eversion
common to have secondary injuries with this sprain
strong
What are the Lateral ligaments of the ankle?
- Posterior talofibular
- Calcaneofibular
- Lateral talocalceneal
- Anterior talofibular
What are the functions of the lateral ligaments of the ankle?
stabilize joint & resist forced inversion
weaker
What are the Long plantar attachments?
from the plantar surface of the calcaneus & cuboid to the plantar surface of the bases of the metatarsals
What are the Plantar calcaneocuboid (aka “short plantar lig.”) attachments?
from calcaneus to the plantar surface of the cuboid
What are the attachments and function of the Plantar calcaneonavicular (aka “spring lig.”)?
ATTACHMENTS- from the anterior margin of the sustentaculum tali to the plantar surface of the navicular
FUNCTION- supports the medial longitudinal arch of the foot
What is the nerve supply to the foot?
Sciatic
Tibial: medial plantar, lateral plantar (superficial b and deep b)
common plantar
proper plantar
What is the arterial supply to the foot?
popliteal
post tib: medial plantar, lat plantar (deep plantar arch)
What is a common location to take pulse at the foot?
Dorsalis pedis
identify hallucis longus tendon and go lateral
tibialis anterior tendon
What are the movements of the foot at the ankle joint?
plantar flexion
dorsi flexion
inversion
eversion
What are the movements of the toes?
flexion
extension
abduction
adduction
Where would you take the posterior tibial pulse?
Posterior to the medial malleolus
calcaneal tendon
posterior tibial artery
Explain the Talus
The talus is a weight bearing structure
-mdifoot translates all forces through subtalar joint and talonavicular joint into crural joint
Explain the fibrous joint capsule of the ankle
Talocrural fibrous capsule
anterior talofibular ligament- thickening of the fibrous joint capsule that is easily injured
What is the function of the Anterior talofibular ligament?
resists anterior translation and inversion of talus when plantar flexed
What is the function fo the calcaneofibular ligament?
resists inversion of calcaneous
What is the function of the posterior talofibular ligament?
resists inversion of talus
What is the most common ankle injury?
Inversion (lateral) sprain
ATF usually injured first
the ankle is plantar flexed and inverted which puts ATF on the most stress
-many athletes do not have ATF in tact but experience no issues and mainly focus on balance and proprioception
-surgery not recommended bc ankle can still function
what does the medial longitudinal arch connect?
calcaneous and 1st MTP joint
what are the supporting structures in the medial longitudinal arch?
-spring ligament/plantar calcaneonavicular ligament
if you tear this ligament, entire arch will collapse
Describe metatarsophalengeal joints
- synovial condyloid
- head of metatarsal; base of prox phalanges
- collateral ligament and plantar ligament
Describe interphalangeal joints
- hinge joint
- flexion and extension
- head of one phalanx to base of distal one
What is the order of structures on the medial malleolus?
Tom- tibialis posterior Dick- Flexor digitorum longus And- posterior tibial artery Very- Posterior Tibial Vein Nervous- Tibial Nerve Harry- Flexor Hallucis Longus
What muscles are in the 1st layer of the foot?
Flexor digitorum brevis
Abductor hallucis
Abductor digiti minimi
What is the nerve supply to the 1st layer of the foot?
lateral/medial plantar nerves
What muscles are in the 2nd layer of the foot?
Quadratus plantae
Lumbricals (4)
What is the nerve supply to the 2nd layer of the foot?
lateral/medial plantar nerves
What muscles are in the 3rd layer of the foot?
adductor hallucis
flexor hallucis brevis
flexor digiti minimi brevis
What is the nerve supply to the 3rd layer of the foot?
lateral/medial plantar nerves
What muscles are in the 4th layer of the foot?
planter interossei (3) dorsal interossei (4)
digit 2- axis for ab/aduction
What is the nerve supply to the 4th layer of the foot?
lateral plantar n
What are the muscles and innervation to the dorsal aspect of the foot?
extensor hallucis brevis
extensor digitorum brevis
innervated by deep fibular n
What are the general actions of the first layer of the foot?
Flex and Abduct the toes
Describe the branching of the medial plantar nerve
Medial plantar nerve gives rise to the common plantar digital nerves that innervate digits 1-3, and those give rise to the proper plantar digital nerves.
Describe the branching of the lateral plantar nerve.
Lateral plantar nerve gives rise to a superficial branch that innervates the 4th and 5th digit. The superficial branch gives rise to a common plantar digital nerve.
Lateral plantar nerve also gives rise to a deep branch that goes to the deeper layers of foot.
Where would you take the medial malleolar pulse?
Posterior to the medial malleolus OR posterior to Flexor Hallucis longus
Where would you take the Dorsalis pedis pulse?
lateral to the extensor hallucis longus tendon OR
medial to extensor digitorum longus
