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Exam 3 Clinical anatomy > Foot region > Flashcards

Foot region Flashcards

1
Q

the foot consists of what four types of bones?

A

tarsus, metatarsus, phalanges, and sesamoids

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2
Q

seven tarsal bones

A

calcaneus, cuboid, lateral cuneiform, navicular, intermediate cuneiform, medial cuneiform

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3
Q

metatarsal bones

A

first through fifth

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4
Q

phalanges

A

proximal, 1 through 5

distal, 1 through 5

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5
Q

sesamoids

A

medial and lateral sesamoids located in the tendons of flexor hallucis brevis inferior to the first metatarsal head

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6
Q

what can cause fracture of the sesamoids?

A

repeated pounding of the foot such as in running or if a heavy object falls on the big toe

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7
Q

bones of medial portion of arch

A

calcaneus, talus, navicular, three cuneiforms, first, second and third metatarsals with their respective phalanges, and the constant sesamoids

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8
Q

bones of lateral portion of arch

A

calcaneus, cuboid, fourth and fifth metatarsals with their respective phalanges

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9
Q

surgical division of feet

A

forefoot
midfoot
rearfoot

forefoot: metatarsals, phalanges, and sesamoids
midfoot: navicular, cuboid, and three cuneiforms
rearfoot: calcaneus and talus

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10
Q

what is joint between rearfoot and midfoot? midfoot and forefoot?

A

rearfoot/midfoot: midtarsal joint (transverse tarsal joint or chopart’s joint)
midfoot/forefoot: lisfranc’s joint or tarsometatarsal joint

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11
Q

structures of talus

A

body, neck and head

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12
Q

structures of calcaneus

A

calcaneal tuberosity, sustentaculum tali, and fibular or peroneal tubercle (fibular or peroneal trochlea)

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13
Q

navicular structure

A

tuberosity of navicular

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14
Q

cuboid structures

A

tuberosity of the cuboid, and fibular or peroneal ridge

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15
Q

fifth metatarsal structures

A

tuberosity of the fifth metatarsal base

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16
Q

two types of accessory bones:

A

ossicles and sesamoids

ossicles are a result of anomalous devt.
sesamoids are found in tendons and joint capsules and usually present to reduce friction of a tendon or alter the pull of a tendon

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17
Q

fractures of the calcaneus are caused by? result in?

A

by some type of fall

result in a comminuted fracture that disrupts the subtalar joint

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18
Q

heel spurs

A

bony projection from the medial process of the calcaneal tuberosity

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19
Q

talar neck fractures

A

result of severe dorsiflexion such as when pressing on brakes

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20
Q

metatarsal fractures

A

common when heavy object falls on the foot or when the foot is run over by a heavy object

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21
Q

how is ankle joint formed? what kind of joint is it?

A

it is a synovial joint.
formed by malleolar fork or ankle mortice
(lateral surface of medial malleolus, inferior surface of distal extremity of tibia and medial surface of the lateral malleolus) articulating with the body of the talus (medial, superior and lateral surfaces of body of the talus or talar dome)

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22
Q

major ligaments of ankle joint are

A

articular capsule
lateral ankle ligaments
medial ankle ligaments or deltoid ligament

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23
Q

lateral ankle ligaments (3)

A

anterior talofibular
posterior talofibular
calcaneofibular

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24
Q

medial ankle ligaments or deltoid ligament

A

superficial deltoid

deep deltoid

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25
Q

superficial deltoid ligaments

A

tibionavicular
calcaneotibial
and posterior talotibial

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26
Q

deep deltoid ligament

A

anterior talotibial

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27
Q

ankle sprains due to? damage consists of?

A

usually due to an inversion injury which involves twisting of the weightbearing foot
damage usually consists of straining and/or tearing of the anterior talofibular and calcaneofibular ligaments. there may also an avulsion fracture of the tuberosity of the fifth metatarsal base

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28
Q

ankle fractures are due to ? how are they classified?

A

due to indirect trauma such as in twisting motions of the ankle with the foot
fractures are usually classified by the malleoli involved (univalleolar, bimalleolar, and trimalleolar) or the foot position and talar movement at time of injury (lauge-hansen)

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29
Q

subtalar joint. formed by. important in. major ligaments are.

A

formed by the three articular areas on the talus articulating with the corresponding areas on the calcaneus
subtalar joint motion is important in supination and pronation
major ligaments are: anterior talocalcaneal and interosseous talocalcaneal

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30
Q

midtarsal joint (transverse tarsal joint)
what
why important
major ligaments

A

talonavicular and calcaneocuboid joints function together as the midtarsal joint
midtarsal joint important in supination and pronation
major ligaments are:
spring (plantar calcaneonavicular)
bifurcate
short plantar
long plantar

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31
Q 
longitudinal arch of foot
posterior / anterior base
body of arch
lateral part
medial part
A

posterior: tuberosity of calcaneus
anterior: metatarsal heads and sesamoids
body: metatarsal and tarsal bones with talus the keystone or highest point
lateral part: calcaneus, cuboid, lateral two metatarsals and their phalanges
medial part: calcaneus, talus, navicular, cuneiforms, medial three metarsals with their phalanges and sesamoids

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32
Q

transverse arch of the foot

what forms it? what is highest point

A

cuboid, cuneiforns, and bases of the metatarsals form transverse arch.
highest point of arch lies at the second cuneiform and base of the second metatarsal

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33
Q

intrinsic vs extrinsic

A

intrinsic muscles originate and insert in the foot
extrinsic muscles originate outside of the foot and insert in the foot
intrinsic divided into dorsal and plantar

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34
Q

Dorsum of foot made up of

A

skin, superficial and deep fascia

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35
Q

dorsum of foot: muscles 2

A

extensor hallucis brevis and extensor digitorum brevis

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36
Q

dorsum of foot: tendons of extrinsic muscles

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
fibularis tertius

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37
Q

how are plantar foot muscles organized?

A

in four layers from superficial to deep, or into compartments: medial, lateral, central, and interosseous

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38
Q

why is knowledge of plantar compartments important clinically?

A

in spread and treatment of infections

39
Q

what is plantar aponeurosis?

A

deep fascia of plantar foot

40
Q

plantar fascitis ?

A

an inflammation at the attachment of the central portion of the plantar aponeurosis to the medial process of the calcaneal tuberosity.

41
Q

first layer of plantar muscle

A

abductor hallucis
flexor digitorum brevis
abductor digiti minimi

42
Q

second layer of plantar muscles

A 
quadratus plantae (flexor accessorius)
lumbricales
43
Q

what is the knot of Henry?

A

fibrous cord that connects tendon of FDL to tendon of flexor hallucis longus

44
Q

third layer of plantar muscles

A

flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis

45
Q

in what layer of plantar foot do tendons of fibularis longus and tibialis posterior course?

A

third layer

46
Q

fourth layer of plantar muscles

A

plantar interossei

dorsal interossei

47
Q

how many plantar interossei? function?

A

three/ adduct

48
Q

how many dorsal interossei? function?

A

four and they abduct

49
Q

where do the muscles of the dorsum of foot originate?

A

calcaneus

50
Q

what innervates the muscles of the dorsum of foot?

A

deep fibular (peroneal) nerve

51
Q

extensor hallucis brevis, insertion and action

A

base of proximal phalanx of the hallux

dorsiflex of the proximal phalanx of the hallux

52
Q

Extensor digitorum brevis, insertion and action

A

lateral side of the second, third, fourth tendons of textensor digitorum longus
dorsiflex the phalanges of digits 2, 3 and 4

53
Q

which muscle in first plantar layer is not innervated by medial plantar nerve?

A

abductor digiti minimi, which makes sense since it is lateral. it is innervated by the lateral plantar nerve.

54
Q

abductior hallucis, origin, insertion, action, innervation

A

o: calcaneal tuberosity, tuberosity of the navicular
i: medial sesamoid and then into the base of the proximal phalanx of the hallux
a: abducts and plantarflexes hallux
n: medial plantar nerve

55
Q

flexor digitorum brevis, OIAN

A

o: calcalneal tuberosity
i: middle phalanges of lesser digits
a: plantarflexes middle and proximal phalanges of lesser digits
n: medial plantar nerve

56
Q

abductor digiti minimi: oia

A

o: calcaneal tuberosity, tuberosity of the fifth metatarsal base
i. lateral side of the proximal phalanx of fifth toe
a: abducts and plantarflexes the fifth toe

57
Q

quadratus plantae oian

A

o: medial head; medial surface of calcaneus/ lateral head plantar surface of calcaneus
i: tendon of flexor digitorum longus
a: assist flexor digitorum longus
n: lateral plantar nerve

58
Q

lumbricals

A

o: tendons of flexor digitorum longus
i: medial side of extensor hoods of lesser digits
a. plantarflex proximal phalanges/ extend middle and distal phalanges
n. first medial plantar nerve
2-4 lateral plantar nerve

59
Q

what third plantar muscles does lateral plantar nerve innervate?

A

adductor hallucis and flexor digiti minimi brevis

60
Q

flexor hallucis brevis oian

A

o: plantar surface of cuboid, third cuneiform, tendon of tibialis posterior
i: medial and lateral sesamoids and then into the plantar surface of the base of the proximal phalanx of the hallux
a: plantarflexes the hallux
n. medial plantar nerve

61
Q

adductor hallucis oia

A

o: oblique head: bases of metatarsals 2-4. transverse head: plantar ligaments of lesser MPJ’s
i. lateral sesamoid and then into the lateral surface of the base of the proximal phalanx of the hallux
a. adducts and plantarflexes the hallux

62
Q

flexor digiti minimi brevis

A

origin: plantar surface base of the fifth metatarsal
inserts: lateral surface of the base of the proximal phalanx of the fifth toe
action: plantarflex the fifth toe

63
Q

what nerve innervates the muscles of the fourth plantar layer?

A

lateral plantar nerve

64
Q

dorsal interossei o,i, a

A

o: adjacent sides of metatarsal shafts
i. 1st: medial side of the base of the proximal phalanx of the second toe
2nd-4th: lateral sides of the bases of the proximal phalanges of the second to fourth toes
action: abduct 2nd to fourth toes. plantarflex proximal phalanges

65
Q

plantar interossei, oia

A

o: bases and medial sides of metatarsal shafts
i: medial sides of the bases of the proximal phalanges of the lesser digits and then into extensor hood
action: adduct 3rd to 5th toes.
plantarflex proximal phalanges

66
Q

tendons of extrinsic muscles on plantar, medial, lateral and posterior aspects of the foot:

A 
tibialis posterior (on tibial side)
flexor digitorum longus (medial)
flexor hallucis longus 
tendo calcaneus (achilles)
fibularis (peroneus) longus ( on fibular side)
fibularis (peroneus) brevis
67
Q

what do superficial veins of the digits flow into?

A

the dorsal venous arch

68
Q

what does dorsal venous arch flow into?

A

medially into the medial marginal vein which courses anterior to the medial malleolus to become the great saphenous vein
laterally into lateral marginal vein which courses posterior to lateral malleolus to become small saphenous vein

69
Q

what artery vascularizes the dorsum of the foot?

A

the dorsalis pedis artery

70
Q

what is the trajectory of the dorsalis pedis artery?

A

begins at the articular capsule of the ankle joint as a continuation of the anterior tibial artery; courses over the dorsum of the foot to the proximal aspect of the first interspace.
terminates by dividing into the first dorsal metatarsal artery and the deep plantar artery

71
Q

major branches of dorsalis pedis artery

A 
lateral tarsal artery
medial tarsal artery
arcuate artery
first dorsal metatarsal artery
deep plantar artery
72
Q

where is dorsalis pedis pulse palpated?

A

lateral to the tendon of EHL and is important in determining the vascular supply to the dorsum of the foot

73
Q

arcuate artery gives off:

A

second, third, and fourth dorsal metatarsal arteries

74
Q

dorsal metatarsal arteries (first, second , third and fourth) give off?

A

dorsal proper digital arteries to the digits (two to each digit) (dorsal common are superior to dorsal proper, it seems)

75
Q

what vascularizes the plantar surface of the foot?

A

medial and lateral plantar arteries, which are branches of the posterior tibial artery

76
Q

how is posterior tibial artery palpated?

A

posterior to the medial malleolus bet. the tendons of FDL and FHL and is important in determining the vascular supply to the plantar surface of the foot

77
Q

trajectory of medial plantar artery

A

branches from posterior tibial artery, courses distally between the abductor hallucis and flexor digitorum brevis muscles to the base of the first metatarsal and terminates along the medioplantar aspect of the

78
Q

what is trajectory of lateral plantar artery?

A

branches from posterior tibial artery
courses obliquely twd base of the fifth metatarsal
gives off a plantar proper digital artery to the fifth toe
turns medially as deep plantar arch or plantar arch portion of the lateral plantar artery

79
Q

major branches of the plantar arch are

A

four plantar metatarsal arteries that give off remaining plantar proper digital arteries to the digits

80
Q

how many dorsal proper digital arteries does each digit receive? plantar proper digital arteries?

A

two of each

81
Q

dermatomes involved in cutaneous innervation of right foot

A

L4, L5, S1 and S2
dorsum of foot, l4, medial side, half of toe, l5, lateral half of toe to fourth digit. s1. digiti minimi
plantar :s2 handles back of foot, heel

82
Q

cutaneous nerves that innervate foot (look at notes for graphics)

A 
saphenous
superficial fibular
deep fibular
lateral dorsal (sural)
medial plantar
lateral plantar
medial calcaneal
83
Q

muscular innervation of foot

A

deep fibular n
medial plantar n
lateral plantar n

84
Q

what happens when one taps tendon to a muscle?

A

results in an afferent impulse to the spinal cord that synapses either directly or indirectly on alpha motor neurons. motor neurons generate an efferent impulse to the muscle causing contraction.

85
Q

patellar or quadriceps reflex

A

tap ligamentum patellae which results in leg extention (L3 and L4 via femoral nerve)

86
Q

achilles, tendo calcaneus or triceps surae reflex

A

tap tendon achilles which results in plantarflexion of the foot (S1 via tibial nerve)

87
Q

how do superficial reflexes work?

A

stimulation of receptors in the skin generates an afferent impulse to a level of the spinal cord that results in stimulation of alpha motor neurons causing contraction of muscles innervated by that same level

88
Q

plantar reflex

A

stroking the sole of the foot from the heel, along the lateral side and then across the metatarsal heads results in plantarflexion of the toes

89
Q

what is a babinski sign?

A

a pathological sign (usually an upper motor neuron lesion) that consists of dorsiflexion of the hallux and fanning of the lesser toes

90
Q

what do lymphatic vessels of lower extremity consist of?

A

superficial and deep vessels

91
Q

how are lymphatic vessels distributed?

A

similarly to superficial and deep veins

92
Q

how do lymphatic vessels communicate?

A

both sets of vessels have valves and communicate with each other

93
Q

what do lymphatic vessels drain into?

A

the popliteal and inguinal lymph nodes

Exam 3 Clinical anatomy (1 decks)

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