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Bloc H - Movement > June5 M3-Anatomy LL 5 > Flashcards

June5 M3-Anatomy LL 5 Flashcards

1
Q

3 groups of bones in the foot

A

back to front

  • tarsal bones
  • metatarsals
  • phalanges (proximal, middle and distal, except big toe only proximal and distal)
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2
Q

metatarsals are what

A

five tube shaped bones under the toes (metacarpals in the hand)

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3
Q

tarsal bones

A
  • calcaneus in the back of the tarsus
  • talus on top of calcaneus medially
  • cuboid (lat) and navicular (med) anterior to the calcaneus and talus
  • 3 cuneiform bones (ant to navicular medially): medial, intermediate and lateral cuneiform. medial articulates with 1st metatarsal, etc.
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4
Q

joints in the foot pahlanges

A

interphalangeal joints (DIP and PIP)

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5
Q

joint between metatarsals and proximal phalanges

A

metatarsophalangeal joints (MP joints) (in hand was MCP)

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6
Q

other joints in the foot

A
  • tarsometatarsal joints (3 joints between cuneiforms and first three metatarsals + 2 joints between cuboid and last two metatarsals)
  • cuneonavicular joint (3 joints between navicular and cuneiform bones)
  • talocalaneonavicular joint (joint between talus+calcaneus and navicular)
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7
Q

the tibia articulates with what foot bone

A

talus

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8
Q

movement of tibia needed to dorsiflex or plantar flex the foot

A

the tibia has to rub back and forth on the talus (an inward curve (concave) of the tibia accomodates for the convex curve of the talus

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9
Q

landmark on the fibula relevant to the foot (fibula is lateral to tibia)

A

lateral malleolus

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10
Q

2 ligaments connecting the talus and the fibula

A

anterior and posterior talofibular ligaments (dnm name know it’s there)
(come from lateral malleolus of fibula)

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11
Q

ligament connecting the calcaneus to the fibula (is a lateral lig)

A 
calcaneofibular ligament (dnm name know it's there)
(comes from lateral malleolus of fibula)
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12
Q

3 lateral ligaments of the ankle

A
  • anterior and post talofibular

- calcaneofibular

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13
Q

sprained ankle most common type + affected structures

A
  • sprain = to passive structures (ligaments)
  • most common = when foot inverted too much + lateral ligaments are stretched
  • most commonly affects the anterior talofibular ligament
  • 70-85% of ankle sprains are inversion injuries*
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14
Q

function of the medial ligaments of the ankle + how many

A
  • are a group of 4 ligaments forming the deltoid ligament

- attaches the tibia to the talus, calcaneus and navicular

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15
Q

4 parts of the deltoid ligament

A
  • anterior and posterior tibiotalar ligament
  • tibionavicular ligament
  • tibiocalcaneal ligament
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16
Q

how injuries to the deltoid ligament occur

A
  • eversion ankle sprain
  • rare, occurs if someone pushing on the leg (tibia) inwards and the foot is stuck on ground laterally, foot will evert
  • bc often a contact sprain, often accompanied with fracture of the fibula (the push is on the lat side to push the leg medially)
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17
Q

groups of muscles and tendons attaching on the foot (are tendons from above the foot, not muscles on the foot only)

A
  • superficial group (in the back)
  • lateral group (in the back, laterally)
  • anterior group (in the front)
  • medial group (in the back, medially)
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18
Q

superficial group of tendons on the foot

A

group of tendons forming the calcaneal tendon (Achille’s tendon) attaching in back of calcaneus (back of foot) and NOT going under foot

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19
Q

lateral group of tendons on foot (2)

A

fibularis longus (ant) and fibularis brevis (post), both pass behind the lateral malleolus. (fct = evert the foot)

  • fibularis longus to base of 1st metatarsal (so has to cross under the foot)
  • fibularis brevis to base of 5th metatarsal
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20
Q

anterior group of tendons on the foot (4)

A

medial to lateral

  • tibialis anterior (to near base of 1st metatarsal)
  • extensor hallucis longus (to big toe)
  • extensor digitorum longus (to toes)
  • fibularis tertius tendon (to base of 1st metatarsal)
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21
Q

structures stopping the foot tendons to bow out when the muscles contract to move the foot

A

-superior extensor retinaculum (post, more on leg)
-inferior extensor retinacula (ant, more on foot)
(sheaths covering the tendons attaching to the foot)

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22
Q

medial group of tendons on the foot (3) + 2 crossings over of tendons that we have to identify (one in the back and one below the foot)

A

behind medial malleolus (of tibia), front to back

  • tibialis posterior (was lat to flexor digitorum longus but goes medially to it to cross behind medial malleolus most ant and most med)
  • flexor digitorum longus (under the foot, crosses flexor hallucis longus even though is initially medial to it, to go laterally and go to the toes, and let hallucis longus go to the big toe)
  • flexor hallucis longus
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23
Q

retinaculum holding the medial group of tendons to the foot

A

flexor retinaculum

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24
Q

function of tibialis anterior (anterior group) and tibialis posterior (medial group)

A
  • tibialis post also attaches near the base of the 1st metatarsal (like tibialis ant)
  • both work to invert the foot
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25
Q

structures protecting tendons to the foot from friction on all sides (surrounding each tendon to the foot)

A

tendon sheaths (or synovium. sheath = synovium)

  • synovial like bursae but are long tubes
  • avoid rubbing of tendons on the CT bands (sup and inf extensor + flexor retinacula)
  • produce synovial fluid to keep the tendon lubricated
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26
Q

clinical relevance of tendon sheaths

A
  • inflammation of these = tenosynovitis
  • cause = mechanical irritation or straining of ligaments or infection (give Abx)
  • can get inflamed, like bursae
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27
Q

mnemonic to remember the structures passing behind the medial malleolus (the tendons and neurovascular bundle) from front to back

A

Tom, Dick and Very Nervous Harry

  • Tibialis posterior
  • flexor Digitorum longus
  • tibial Artery (POSTERIOR)
  • tibial Vein
  • tibial Nerve
  • flexor Hallucis longus
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28
Q

where to take the pulse of the posterior tibial artery

A

midway between the heel and the medial malleolus

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29
Q

movements of the toes

A
  • ABDuction and ADDuction AXIS IS on 2nd toe + ADDuction is the relaxed position
  • extension (toes towards head) and flexion (toes towards ground)
30
Q

2 muscles on the dorsum of the foot

A
  • extensor digitorum brevis (lat to talus)
  • extensor hallucis brevis (medial to it, lat to talus): only 3 tendons to toes 2,3,4 (little toe doesn’t get a brevis)
    (note: extensor digitorum longus on ant group of tendons to foot goes to toes 2,3,4,5)
31
Q

extensor expansion definition

A

lot of CT covering the dorsum of the foot, the muscles and the tendons there

32
Q

extensor digitorum brevis and extensor hallucis brevis O and trajectory and I + nerve innervating them

A
  • O: calcaneus
  • blend in the extensor expansion (CT)
  • I: toes
  • N: deep fibular nerve
33
Q

sole of foot 4 layers of muscles and tendons

A
  1. three muscles
  2. two muscles two tendons
  3. three muscles
  4. two muscles two tendons
34
Q

CT on sole of the foot name + what it is

A

plantar aponeurosis

-very tight CT, tough aponeurotic sheet

35
Q

3 muscles of first layer of muscles in sole of the foot

A

medial to lat

  • ABDuctor hallucis
  • flexor digitorum brevis
  • ABDuctor digiti minimi (like in hand)
36
Q

ABDuctor hallucis O, I, N and F

A
  • O: calcaneus
  • I: proximal phalanx of big toe
  • medial plantar nerve
  • abducts big toe
37
Q

flexor digitorum brevis O, I, N and F

A
  • O: calcaneus
  • I: middle phalanx of the four lateral toes
  • medial plantar nerve
  • flex the 4 lat toes
38
Q

ABDuctor digiti minimi O, I, N and F

A
  • O: calcaneus
  • I: proximal phalanx of 5th toe
  • lateral plantar n.
  • abduct 5th toe
39
Q

2 muscles and 2 tendons of 2nd layer of sole of the foot

A

med to lat

  • flexor hallucis longus tendon (medial group)
  • lumbricals (m) (under tendons of flexor digitorum longus)
  • flexor digitorum longus tendon (medial group)
  • quadratus plantae (square behind flexor digitorum longus tendons)
40
Q

what stops the flexor digitorum longus from flexing the toes in a crooked direction (laterally) (would expect that bc this muscle comes from the medial side)

A

quadratus plantae contracts also to keep the toes straight and not bend externally bc are pulled internally

41
Q

how tendons of the flexors interact on the sole of toes 2,3,4,5

A

flexor digitorum brevis (layer 1. inserts on medial phalanx)) splits at proximal phalanx to let flexor digitorum longus through (medial group. inserts on distal phalanx of toes 2,3,4,5)

42
Q

how tendons of the flexors interact on the sole of the big toe

A

flexor hallucis brevis (layer 3. inserts on proximal phalanx) splits to let flexor hallucis longus through (medial group. inserts on distal phalanx)

43
Q

3 muscles of the 3rd layer of muscles in sole of the foot

A

med to lat

  • flexor hallucis brevis (2 heads, transverse head lat and oblique head medially)
  • adductor hallucis (2 heads: transverse horizontal, covering the metatarsophalangeal joints. + oblique head post-lat to ant-med)
  • flexor digiti minimi
44
Q

2 muscles and 2 tendons to recognize in 4th layer of sole of the foot

A

med to lat:

  • dorsal interossei
  • plantar interossei
  • tendon of fibularis longus crossing to lat to med, under tendon of transverse head of ADDuctor hallucis to base of 1st metatarsal
  • tendon of tibialis posterior (medial group)
45
Q

longitudinal arches of the foot and their keystone

A
  • medial arch (keystone = talus)

- lateral arch (keystone = cuboid). more shallow

46
Q

transverse arch of the foot is what bones (std = look at if from front to back)

A

cuneiforms and cuboid

keystone = intermediate cuneiform

47
Q

supporting structures for the arches of the foot

A
  • long plantar lig (calcaneus to cuboid and 3 lat metatarsals (toes 3,4,5)
  • spring ligament (also called calcaneonavicular lig) (calcaneus to navicular)
48
Q

two types of anomalies in foot arches

A
  • flat feet (pes planus or fallen arches): normal. painless.

- high arch (pes cavus or high instep): hereditary or acquired. underlying neuro, orthopedic or neuromusc problem.

49
Q

innervation of muscles of 2nd layer of sole

A
  • lumbricals = medial plantar n. for 1st lumbrical, lateral plantar n. for lumbricals 2,3,4.
  • quadratus plantae = lateral plantar n.
50
Q

innervation of muscles of 3rd layer of the sole

A
  • flexor hallucis brevis: medial plantar n.
  • adductor hallucis: lateral plantar n.
  • flexor digiti minimi: lateral plantar n.
51
Q

innervation of muscles of 4th layer of the sole

A

dorsal and palmar interossei: lateral plantar n.

52
Q

lumbricals (layer 2) O, I and fct

A
  • O: tendon of flexor digitorum longus
  • I: dorsal extensors of lateral four toes
  • fct: extends toes at interphalangeal joints
53
Q

quadratus plantae (layer 2) O, I and fct

A
  • O: calcaneus
  • I: tendons of flexor digitorum longus
  • fct: aids flexor digitorum longus to flex lateral four toes (and keep the flexion straight)
54
Q

flexor hallucis brevis (layer 3) O and I

A
  • O: tarsal bones

- I: proximal phalanx of the big toe

55
Q

adductor hallucis (layer 3) O, I and fct

A
  • O: metatarsals and ligaments
  • I: proximal phalanx of big toe
  • fct: adducts the big toe
56
Q

flexor digiti minimi (layer 3) O and I

A
  • O: base of 5th metatarsal

- I: proximal phalanx of 5th toe

57
Q

dorsal interossei O, I and fct

A
  • O: metatarsals
  • I: bases of phalanges
  • fct: ABDuct the toes (2nd toe reference)
58
Q

palmar interossei O, I and fct

A
  • O: metatarsals
  • I: bases of phalanges
  • fct: ADDuct the toes (2nd toe reference)
59
Q

2 nerves in front of the tibia, run where and do what

A
  • deep fibular n. (deep branch of common fibular n.): runs on anterior surface of interosseus membrane. inn. muscles of ant compt below knee
  • superficial (branch of the common) fibular n.: emerges from between fibularis longus and brevis. sensory inn. only
60
Q

deep fibular n. innervates what in the foot

A
  • muscle: extensor hallucis brevis and extensor digitorum brevis
  • skin: skin between big toe and 2nd toe
61
Q

superficial fibular n. inn. what in the foot

A

all skin (including lateral compt of the foot most importantly), except skin posterolaterally, skin of deep fibular n. and saphenous n. (medial tibia and posteromedial foot)

62
Q

nerve in back of the tibia relevant to the foot

A

tibial nerve.

  • passes under the soleus and between superficial and poster
  • passes posterior to medial malleolus and then to sole of the foot
63
Q

tibial n. runs with what artery

A

posterior tibial a.

64
Q

divisions of tibial n. in the back of the foot + muscles inn. by each division

A
  • medial plantar n. (ABDuctor hallucis lay1, flexor digitorum brevis lay1, flexor hallucis brevis lay3, lumbricals to 1st toe lay2)
  • lateral plantar n. (ADDuctor hallucis lay3, quadratus plantae lay2, ABDuctor digiti minimi lay1, flexor digiti minimi lay3, lumbricals 2,3,4 lay2, interossei lay4)
65
Q

blood supply in back of thigh in tibia relevant to the foot

A
  • popliteal a. in back of thigh came through adductor hiatus formed by adductor magnus tendon
  • becomes anterior tibial a. which splits in poplitial tibial a. (med) and fibular a. (lat)
66
Q

fibular a. supplies what

A

lateral compt of the lower leg

67
Q

posterior tibial a. runs with what n.

A

tibial n.

68
Q

where the posterior tibial a. passes to go to the foot

A

posterior to the medial malleolus (is the A in TDAVNH) (and then goes to the sole of the foot)

69
Q

what posterior tibial a. does in sole of the foot

A
  • splits in medial plantar a. and lateral plantar a.
  • medial plantar a. goes to big toe
  • lateral plantar a. forms plantar arch which gives metatarsal aa and these become digital aa
70
Q

location of the neurovascular supply in the sole of the foot (what layer)

A

second layer (nerves, arteries) (with the long tendons, quadratus plantae and lumbricals)

Bloc H - Movement (48 decks)

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