Foot and ankle region- muscles and functions Flashcards
4 fascial compartments
anterior compartment, lateral compartment, posterior compartment (deep and superficial), little information between them
Superior posterior compartment- muscles
gastrocnemius, soleus, plantaris
Superior posterior compartment- link between muscles
all muscles insert into the calcaneus via the tendocalcaneus, all PF foot, all muscles are supplied by tibial nerve
Origin and insertion of gastrocnemius
Origin- Lat head- posterior head of the lateral femoral condyle, Med head- posterior aspect of the medial femoral condyle
insertion- posterior surface of calcaneus via the tendocalcaneus
actions and nerve routes of gastrocnemius
powerful PF of foot, knee flexion
tibial nerve- S1, S2
Soleus origin and insertions
origin- soleal line posterior surface of tibia, posterior surface of upper 1/3 of fibula, incl head
insertion- fuses with tendon of gastrocnemius to form upper part of tendocalcaneus into post surface of calcaneus
Soleus action and nerve
insignificant PF of foot and weak knee flexor,
tibial nerve S1-S2
Deep posterior compartment- muscles
popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
Deep posterior compartment- link between muscles
all muscles are supplied by tibial nerve, all muscle except popliteus assist in PF
flexor digitorum muscle explained
flexor= flexion, digitorum= flexion of digits- toes, longus= outside of foot, brevis= short muscle intrinsic within the foot
popliteus muscle origin and insertion
origin- outer surface of lateral femoral condyle, below epicondyle
insertions- posterior surface of proximal tibia, above soleal line
popliteus muscle- action and nerve
action- inversion of foot, assists PF, assists in support of medial longitudinal arch
tibial nerve L4-L5
Tibialis posterior (Tom) origin and insertion (medial and lateral)
Origin- medial part- posterior surface of tibia and interosseous membrane, lateral part- proximal posterior surface of fibula,
insertion- tubercle on medial side of navicular and plantar surface of medial cuneiform, slips to plantar surfaces of all tarsal bones except talus
Tibialis posterior (Tom) action and nerve
action- inversion of foot, assists PF at ankle, assists in support of medial longitudinal arch
tibial nerve L4-5
Flexor digitorum longus (Dick) origin and insertion
origin- medial aspect, posterior surface of tibia
insertion- 4 tendons to plantar aspect of the base of distal phalanges
Flexor digitorum longus (Dick) action and nerve
flexion of toes 2-5 at DIP, PIP and MTP joint, assist in plantar flexion
tibial nerve- L5, S1-S2
Flexor hallucis longus (Harry) origin and insertions
origin- lower 2/3 of posterior surface of fibula and interosseous membrane
insertion- plantar surface of the base of the distal phalanx of the great toe
Flexor hallucis longus (Harry)action and nerve
action assists in PF of the foot at ankle joint, flexion of all joints in the great toe
nerve- tibial nerve S1-S2
how do tibialis posterior, flexor digitorum longus, flexor hallucis longus relate to each other
they join in the tarsal tunnel in that order (Tom, Dick, Harry), helps to remember order of tendons as they pass through the tarsal tunnel
what is the tarsal tunnel contents
Muscles- tibialis posterior, flexor digitorum longus, flexor hallucis longus, posterior tibial artery, tibial nerve
, the ceiling of the tunnel is the flexor retinaculum- tough band of CT from medial malleolus to medial wall of calcaneus
what does the flexor retinaculum do
it prevents the tendons flicking around- it holds them in place
order of contents of tarsal tunnel
Tom, Dick, bloody, nervous, harry
muscles of the anterior compartment
tibialis anterior, extensor digitorum longus, extensor hallucis longus, peroneus tertius
anterior compartment- muscles linked
all muscles are supplied by the deep peroneal nerve, all dorsiflex
tibialis anterior- origin and insertion
origin- upper 1/2 to 2/3 lateral surface of tibia and adjacent interosseous membrane
insertion- medial surface of medial cuneiform and base of 1st MT, insertion blends with that of peroneus longus
tibialis anterior- action and nerve
DF ankle, inversion of foot,
nerve- deep peroneal nerve L4/5
Extensor digitorum longus- origin and insertion
origin- upper 2/3 ant surface of fibula, upper part of interosseous membrane, lateral tibial condyle
insertion- extensor hood (dorsal digital expansion), base of middle and distal phalanges of toes 2-5
extensor digitorum longus- action and nerve
action- extension of lateral 4 toes at MTP joint, expansion at IP joint, assists in DF,
nerve- deep peroneal nerve L5,S1
what is the dorsal digital expansion (extensor hood)
divides the extensor tendon into 2 slips which terminate at the base of the distal phalanx, allows- extend distal phalanx and proximal phalanx and metatarsal phalangeal joints
extensor hallucis longus- origin and insertion
origin- middle 1/2 of anterior surface of fibula and adjacent interosseous membrane
insertion- Base of distal phalanx of great toe
extensor hallucis longus- action and nerve
action- extend all joints of great toe, mainly MTP joints, powerful DF
Deep perineal nerve L5,S1
Peroneus tertius- origin and insertion
part of EDL (not always present), origin- lower 1/4 medial fibula and adjacent interosseous membrane,
insertion- base of 5th MT, medial and dorsal aspect
peroneus tertius- action and nerve
weak DF, weak evertor of foot
deep peroneal nerve L5, S1
muscles in the lateral compartment
peroneus (fibularis) longus, peroneus (fibularis) brevis
muscles in lateral compartment- link
PL and PB supplied by superficial peroneal nerve
peroneus longus- origin and insertions
origin- lateral tibial condyle (with EDL), upper 2/3 lateral surface of fibula, lateral side of fibula head
insertion- 2 slips- base of first MT and medial cuneiform
peroneus longus- action and nerve
eversion of the foot, PF at ankle
superficial peroneal nerve L5, S1
peroneus brevis- origin and insertions
origin- lower 2/3 of lateral surface of fibula (anterior to PL),
insertion- tubercle on the lateral side of base of 5th MT
peroneus brevis- action and nerve
action- eversion of foot, PF at ankle
nerve- superficial peroneal nerve L5, S1
muscles on dorsum of foot
extensor digitorum brevis
extensor digitorum brevis- origin and insertion
origin- anterior part of calcaneus, inferior extensor retinaculum
insertion- medial tendon- to base, proximal phalanx of great toe, tendons 2-4 to lateral side of extensor hood
extensor digitorum brevis- action and nerve
action- extension at MTP joints, assists lumbricals to extend IP joints
nerve- deep peroneal nerve L5, S1
tendon sheaths of ankle region
wherever tendons have to go round a corner, prevents friction
plantar aponeurosis
inserts into the medial process of the calcaneal tuberosity and extends to the head of MT, tight and inelastic tissue that supports medial and lateral arches, covers intrinsic muscles on foot
what muscles produce and assists inversion
tibialis anterior/ posterior, extensor and flexor hallucis longus
ROM and limited by inversion
45- 60°, limited. y dorsal talonavicular ligament
what muscles produce and assist in eversion
peroneus longus, brevis and tertius
ROM and limited by eversion
25°, impact of talus on floor of sinus tarsi, plantar calcaneocuboid ligament