Foot and Ankle Flashcards

1
Q

What is fascia?

A

Thick connective tissue

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2
Q

What is the fascia on the sole of the foot?

A

Plantar fascia

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3
Q

What is the central thickest part of the plantar fascia that runs longitudinally down the foot called?

A

Plantar aponeurosis

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4
Q

Origin and function of plantar aponeurosis

A

O: Posterior calcaneus
Function: support the longitudinal foot arches

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5
Q

What is plantar fascitis?

A

Inflammation of the plantar aponeurosis at the proximal attachment to the calcaneus

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6
Q

What causes plantar fascitis and when is the pain severe?

A

Causes: overweight, bad shoes, high impact exercise, running

Pain is more severe after sitting and when getting out of bed

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7
Q

What can plantar fascitis lead to?

A

Heel spur syndrome - bony spur around medial tubercle of calcaneus

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8
Q

What are the dorsum foot muscles?

A

Extensor hallucis brevis and Extensor digitorum brevis

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9
Q

Origin, insertion, action, innervation of extensor hallucis brevis

A

O: Superolateral calcaneus and interosseous talocalcaneal L.
I: Base of 1st proximal phalynx
Innvervation: Deep fibular nerve
Action: extend hallux (big toe) at metatarsophalangeal joint

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10
Q

Origin, insertion, action, innervation of extensor digitorum brevis

A

O: superolateral calcaneus and interosseous talcalcaneal L.
I: Extensor digitorum longus tendon
Action: Extend digits 2-4 (not pinky toe)
Innervation: Deep fibular nerve

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11
Q

What are the muscles in the first layer of the plantar aspect?

A

Abductor digiti minimi, flexor digitorum brevis, abductor hallucis

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12
Q

How many layers of muscles are there in the plantar aspect of the foot?

A

4

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13
Q

Origin, insertion, action, innervation of abductor digiti minimi

A

O: Calcaneal tuberosity
I: Base of 5th proximal phalanx
Action: ABduct and flex 5th digit
Innervation: Lateral plantar n.

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14
Q

Origin, insertion, action, innervation of flexor digitorum brevis

A

O: calcaneal tuberosity
I: 2-5 intermediate phalanges
Action: flex digits 2-5
Innervation: medial plantar n.

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15
Q

Origin, insertion, action, innervation of abductor hallucis

A

O: calcaneal tuberosity
I: 1st proximal phalanx
Action: ABduct and flex hallux
Innervation: Medial plantar n.

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16
Q

What are the muscles in layer 2 of the plantar foot?

A

Quadratus plantae and lumbricals

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17
Q

Origin, insertion, action, innervation of quadratus plantae

A

O: Plantar surface of calcaneus
I: Flexor digitorum longus Tendon
Innervation: Lateral plantar n.
Action: Help flex digits 2-5

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18
Q

Origin, insertion, action, innervation of lumbricals

A

O: Flexor digitorum longus tendon
I: Proximal phalanx of digits 2-5 and medial aspects of digital expansion
Innvervation: 1st lumbrical = medial plantar nerve
2-4th lumbricals = lateral plantar nerve
Action: Flex MP joint and extend PIP and DIP joints

19
Q

What does MP stand for

A

Metatarsophalangeal joint

20
Q

What does PIP stand for

A

Proximal interphalangeal joint

21
Q

What does DIP stand for

A

Distal interphalangeal joint

22
Q

What are the muscles in layer 3 of the plantar foot?

A

Flexor digiti minimi brevis, adductor hallucis, flexor hallucis brevis

23
Q

Origin, insertion, action, innervation of flexor digiti minimi brevis

A

O: Base of 5th metatarsal
I: 5th proximal phalanx
Innervation: Superficial lateral plantar n.
Action: Flex proximal phalanx of 5th digit

24
Q

Origin, insertion, action, innervation of adductor hallucis

A
O: Transverse head: MP joints
Oblique head: Bases of 2-4 metatarsals
I: Lateral base of 1st proximal phalanx
Innervation: Deep lateral plantar n. 
Action: ADduct hallux
25
Q

Origin, insertion, action, innervation of flexor hallucis brevis

A

O: plantar surface of cuboid and lateral cuneiform
I: 1st proximal phalanx - medial and lateral heads
Innervation: Medial plantar n.
Action: Protect 1st metatarsal head and FHL tendon when walking/standing, have sesamoid bones as well

26
Q

What are the muscles in layer 4 of the plantar foot?

A

Plantar and Dorsal interossei

27
Q

Origin, insertion, action, innervation of plantar interossei

A

O: medial bases of 3-5 metatarsals
I: Medial aspects of 3-5 proximal phalanges
Innervation: Lateral plantar nerve
Action: PAD - ADDduct digits 3-5

28
Q

Origin, insertion, action, and innervation of dorsal interossei

A

O: Bases of 1st - 5th metatarsals
I: Lateral aspects of 2 - 4 proximal phalanges and medial aspect of 2nd proximal phalanx as well
Innervation: lateral plantar nerve
Action: DAB - ABduct digits 2-4

29
Q

What is hallux valgus

A

Lateral deviation of the great toe

30
Q

What is a tender and inflamed bursa

A

Bunion

31
Q

What is an inflamed area of thick skin over proximal IP joint called?

A

Corn

32
Q

List 4 toe deformities

A

Hammer toes, claw toes, mallet toes, trigger toe

33
Q

How do hammer toes arise?

A

Proximal phalanx hyperextended, distal phalanx plantar flexed at PIP joint, distal phalanx extended

34
Q

How do claw toes arise?

A

Proximal phalanx hyperextended at MP joint, flexion of distal and proximal IP joints

35
Q

What usually causes toe deformities?

A

Shortened flexor muscles that override lumbrical function

36
Q

How do mallet toes arise?

A

Only flexion at the distal IP joint

37
Q

How does a trigger toe arise?

A

Only flexion at the IP joint of the big toe

38
Q

How does the tibial nerve innervate the foot?

A

It splits into the medial plantar nerve and the lateral plantar nerve, the lateral plantar nerve has a deep and superficial branch

39
Q

What 4 muscles does the medial plantar nerve innervate?

A

Abductor hallucis, flexor digitorum brevis, medial one lumbrical, flexor hallucis brevis
Lateral plantar nerve innervates the REST!!!!

40
Q

Cutaneous innervation of the top of the foot?

A

Medial dorsal cutaneous (superficial fibular nerve)

41
Q

Cutaneous innervation using the deep fibular nerve?

A

Lateral cuteanous nerve of the big toe and medial cutaneous nerve of the 2nd toe

42
Q

What 4 ligaments make up the deltoid (medial) L?

A

Anterior and posterior tibiotalar, tibionavicular, tibiocalcaneal

43
Q

What 3 ligaments make up the lateral L?

A

Anterior and posterior talofibular, calcaneofibular

44
Q

What is the dorsum fascia of the foot continuous with?

A

Extensor retiniculum