Foot, Peripheral Pulses Flashcards
What are the main ligaments of the foot?
- Medial (Deltoid) Ligament
- Lateral Ligament
- Spring Ligament
- Calcaneo-Cuboid Ligaments
What ligaments make up the Medial (Deltoid) Ligament?
- Tibiocalcaneal
- Tibionavicular
- Anterior Tibiotalar
- Posterior Tibiotalar
What ligaments make up the Lateral Ligament?
- Calcaneofibular
- Anterior Talofibular
- Posterior Tibofibular
What is the other name for the Spring Ligament?
Plantar Calcaneonavicular Ligament
Where does the Spring Ligament attach?
- Anterior margin of Sustentaculum Tali
2. Inferior surface and tuberosity of Navicular
What are the functions of the Spring Ligament?
- Maintain arches of the foot
2. Stabilises the Talocalcaneonavicular Joint
What ligaments make up the Calcaneo-Cuboid Ligaments?
- Long Plantar Ligament
- Short Plantar Ligament
- Bifurcated Ligament
Where does the Long Plantar Ligament Attach?
Attaches from the underside of Calcaneus to the cuboid and the bases of the 2nd, 3rd, 4th and 5th Metatarsal bones
Where does the Short Plantar Ligament attach?
Attaches from Calcaneus to the Cuboid Bone
Where does the Bifurcated Ligament attach?
Y-shaped: Attaches from the upper surface of the calcaneus to both the cuboid and navicular
What are the bones involved in the Medial Arch of the foot?
- Calcaneus
- Talus
- 3 Cuneiforms
- 1st 3 Metatarsals
What are the supporting ligaments of the Medial Arch of the foot?
- Planrar Ligaments (Spring ligament + Calcaneo-Cuboid Ligaments)
- Medial (Deltoid) Ligament
- Plantar Aponeurosis
What are the supporting tendons of the Medial Arch of the foot?
- Tibialis Anterior
- Tibialis Posterior
- Peroneus Longus
- Flexor Digitorum Longus
- Flexor Hallucis Longus
- Intrinsic Foot Muscles
What are the bones involved in the Lateral Arch of the foot?
- Calcaneus
- Cuboid
- 2 metatarsals
What are the supporting ligaments of the Lateral Arch of the Foot?
- Plantar Ligaments (Spring ligament + Calcaneo-Cuboid Ligaments)
- Plantar Aponeurosis
What are the supporting tendons of the Lateral Arch of the foot?
- Peroneus Longus
- Flexor Digitorum Longus
- Intrinsic Foot Muscles
What are the bones involved in the Transverse Arch of the Foot?
- Junction of tarsal bones with metatarsals
- Cuboid
- 3 Cuneiforms
What are the supporting ligaments of the Transverse Arch of the foot?
- Plantar Ligaments (Spring ligament + Calcaneo-Cuboid Ligaments)
- Deep Transverse Metatarsal Ligaments
What are the supporting tendons of the Transverse Arch of the Foot?
- Fibularis Longus
2. Tibialis Posterior
Describe the movement of Inverting the foot
It is the movement of the foot so that the sole faces medially
What are the joints involved in inverting the foot?
1, Talocalcaneonavicular (Mid-tarsal) joint
2. Calcaneocuboid (Transverse-Tarsal Joint)
What are the muscles involved in inverting the foot?
- Tibialis Anterior
- Extensor Hallucis Longus
- Tibialis Posterior
Describe the movement of Everting the foot
It is the movement of the foot so the sole faces laterally
What are the joints involved in everting the foot?
1, Talocalcaneonavicular (Mid-tarsal) joint
2. Calcaneocuboid (Transverse-Tarsal Joint)
What are the muscles involved in everting the foot?
- Peroneus Longus
2. Peroneus Brevis
Describe the sole of the foot
- Thick, hairless
- Firmly found to underly deep fascia by numerous fibrous bands
- Has many sweat glands
What is the sensory nerve supply to the sole of the foot?
- Medial Plantar Nerve
2. Lateral Plantar Nerve
Describe the Plantar Aponeurosis
It is triangular in shape and occupies the centre of the sole. The apex is attached to the calcaneus and the base divides into 5 slips, each dividing into 2 and diverging around the flexor tendons
What are the functions of the sole of the foot?
- Firm attachment to the skin
- Protect neuromuscular bundle
- Assist in maintaining arches
How many layers of muscle are there in the foot?
4 layers
What are in the 1st layer of muscles in the foot?
3 muscles–> Abductors (Hallucis and Digiti Mini) and Flexor Digitorum Brevis
What are in the 2nd layer of muscles in the foot?
2 Muscles and 2 Tendons–> Lumbricals (4), Quadratus PLantae and Tendons of Flexor Haluucis Longus and Flexor Digitorum Longus
What are in the 3rd layer of muscles in the foot?
3 Muscles–> Flexor Hallucis Brevis, Flexor Digiti Minimi Brevis and Adductor Hallucis
What are in the 4th layer of muscles in the foot?
2 Muscles and 2 tendons–> Dorsal Interossei, Plantar interossei, and Tendons of Tibialis Posterior and Peroneus Longus
What is the nerve supply to the sole of the foot?
Lateral Plantar Nerve, except the 3rd layer of muscles and the 1st Lumbrical, which are supplied by the Medial Plantar Nerve
What is the arterial supply to the sole of the foot?
Medial and Lateral Plantar Arteries, which arise from Posterior Tibial Artery
What does the Medial Plantar Artery supply?
Medial side of the big toe
Describe the course of Lateral Plantar Artery
It passes deep to flexor retinaculum and muscles of the foot to form the Plantar Arch, and joins with the Dorsalis Pedis Artery in the first inter metatarsal space
Describe the venous drainage of the sole of the foot
Medial and Lateral Plantar Veins accompany their corresponding arteries and unite behind medial malleolus to form the Posterior Tibial Venae Comitantes
Describe the Motor Nerve supply of the foot
- Medial Plantar Nerve supplies Abductor Hallucis, Flexor Digitorum Brevis, Flexor Hallucis Brevis and 1st Lumbrical
- Lateral Plantar Nerve supplies the rest of the muscle
Describe the cutaneous nerve supply of the foot
Dorsal Side:
- Mainly Superficial Peroneal Nerve
- Deep Peroneal Nerve supplies first web space
- Sural nerve supplies lateral side
- Saphenous Nerve supplies medial side
Plantar side:
- Medial Plantar Nerve supplies medial 3.5 toes
- Lateral Plantar nerve supplies lateral 1.5 toes
Where would you palpate the pulse of the Femoral Artery?
- Midway between the ASIS and the pubic symphysis along the Inguinal Ligament
Where would you palpate the pulse of the Popliteal Artery?
In the Popliteal Fossa when the knee is partially flexed
Where would you palpate the pulse of the Posterior Tibial Artery?
Between the Medial Malleolus and Calcaneus
Where would you palpate the pulse of the Dorsalis Pedis Artery?
In the proximal part of the First Dorsal Metatarsal Space, between the tendons of Extensor Hallucis Longus medially and Extensor Digitorum Longus Laterally
What happens if there is fracture to the neck of the fibula?
Common Peroneal Nerve can be damaged–> Pateint presents with foot drop and inverted foot
