Lab 6-13: Plantar Surface of the Foot

Question 1

plantar aponeurosis extends from __________ to the _____ and from there via ______ slips to the digits

Answer 1

• from the calcaneal tuberosity
• ball of the foot
• five
• it is also connected to the skin via connective tissue septa

Question 2

at its origin, the plantar aponeurosis is _____ cm wide

Answer 2

1-2 cm

- it widens considerably as the fibers proceed longitudinally towards the toes

Question 3

lateral extension of the plantar aponeurosis is known as …

Answer 3

calcaneometatarsal ligament

- extending between the calcaneus to the base of the 5th metatarsal

Question 4

near the superficial ball of the foot a band of transverse fibers should be observed longitudinally. what are they?

Answer 4

superficial transverse metatarsal ligament

Question 5

what structures are you trying to expose when you clean between the digital slips?

Answer 5

• terminal branches of superficial plantar arch and its branches - superficial plantar digital arteries

Question 6

there are usually ___ superficial plantar arteries

Answer 6

three

Question 7

what artery and nerve run together emerging from the medial groove close to the ball of the foot?

Answer 7

• 1st proper plantar digital nerve

- superficial tibial plantar artery

Question 8

what artery and nerve are found in the distal part of the lateral groove?

Answer 8

• 10th proper plantar digital artery and nerve

Question 9

where is the superficial branch of the medial plantar a. located relative to the plantar aponeurosis?

Answer 9

medial side

Question 10

what are the terminal branches of the superficial branch of the medial plantar a?

Answer 10

• superficial tibial plantar a.

- common plantar digital (branch of medial plantar a.)

Question 11

at the medial side of the 1st toe, the superficial tibial plantar a. becomes the …

Answer 11

1st proper plantar digital a.

Question 12

what courses with the 1st proper plantar digital a. ?

Answer 12

1st proper plantar digital nerve.

Question 13

a large superficial tibial plantar a. often replaces the …

Answer 13

1st plantar metatarsal a.

Question 14

tracing the superficial tibial artery proximally you locate the …

Answer 14

common plantar digital a.

Question 15

the superficial plantar arch has ______ superficial plantar digital arteries branching off it

Answer 15

three

Question 16

what forms most of the superficial plantar arch?

Answer 16

common plantar digital branch of the medial plantar artery

Question 17

the superficial plantar arch is completed on the lateral side by anastomosis with ____________

Answer 17

superficial branch of the lateral plantar artery

Question 18

the superficial plantar arch is ________ to the distal end of the plantar aponeurosis and ___________ to the tendons of the flexor digitorum brevis muscle

Answer 18

• deep

- superficial

Question 19

the superficial plantar digital arteries anastomose with …

Answer 19

plantar metatarsal arteries of deep plantar arch

Question 20

at their termination, the deep layers of the digital slips blend with …

Answer 20

fibrous digital sheaths of each toe

Question 21

what divides the muscle of the sole of the foot into three compartments?

Answer 21

the two intermuscular septa of the plantar aponeurosis

Question 22

flexor retinaculum aka

Answer 22

lacinate ligament

Question 23

the flexor retinaculum extends between

Answer 23

calaneus and medial malleolus

Question 24

what n. pierces the retinaculum?

Answer 24

medial calaneal n. (branch of tibial n.)

Question 25

the flexor retinaculum is divided into 4 compartments. what is in each?

Answer 25

anterior/first = tendon of tibialis posterior second =tendon o fflexor digitorum longus third = posterior tibial vessels and tibial n. fourth = tendon of flexor hallucis longus

Question 26

what are the two terminal branches of the tibial n.?

Answer 26

medial and lateral plantar nn.

Question 27

_____ to the superior border of the flexor retinaculum identify the posterior tibial artery and its venae comitantes

Answer 27

proximal

Question 28

what are the two terminal branches of the posterior tibial artery?

Answer 28

medial and lateral plantar arteries

Question 29

which is bigger? medial or lateral plantar aa

Answer 29

lateral plantar a.

Question 30

which is bigger? medial or lateral plantar nn

Answer 30

medial plantar n.

Question 31

where is the medial calcaneal a. located?

Answer 31

- piercing the flexor retinaculum | - can also originate from the lateral plantar a and on occasion there can be more than one branch

Question 32

where is the peroneal retinaculi located?

Answer 32

- along the lateral side of the foot inferior to the lateral malleolus - there is a superior and inferior peroneal retinaculi - both are thickenings of the deep fascia of the foot

Question 33

the superior peroneal retincauli extends from ...

Answer 33

lateral malleolus to the lateral surface of the calcaneus

Question 34

the inferior peroneal retinaculum is continuous with ...

Answer 34

- the stem of the inferior extensor retinaculum

Question 35

the inferior peroneal retinaculum expands over _______ and attaches to ...

Answer 35

- over the tendons of peroneus longus and brevis - attaches to calcaneus (tarsal sinus) inferior to the tendon of peroneus longus - deep fibers of the retinaculum attach to the peroneal trochlea between the tendons of the peroneus longus and brevis

Question 36

where does the tendon of the peroneus brevis insert?

Answer 36

at the tuberosity of the 5th metatarsal

Question 37

true or false: peroneus longus and peroneus brevis share a common tendon sheath

Answer 37

true

Question 38

what are the three muscles of the first layer?

Answer 38

abductor hallucis flexor digitorum brevis abductor digiti minimi

Question 39

proximal attachment of flexor digitorum brevis

Answer 39

medial process of calcaneal tuberosity

Question 40

insertion of the tendons of flexor digitorum brevis

Answer 40

middle phalanx of lateral four toes

Question 41

which tendon of the flexor digitorum brevis might be missing?

Answer 41

tendon to the 5th toe

Question 42

nerve supply to flexor digitorum brevis

Answer 42

medial plantar nerve (enters proximal part of muscle)

Question 43

what m underlies the abductor digiti minimi?

Answer 43

flexor digiti minimi brevis

Question 44

origin of abductor digiti minimi?

Answer 44

medial and lateral processes of the calcaneal tuberosity

Question 45

insertion of abductor digiti minimi

Answer 45

proximal phalanx of 5th toe

Question 46

nerve supply to the abductor digiti minimi

Answer 46

branch of lateral plantar n.

Question 47

the medial plantar a. lies _________ to the medial plantar nerve

Answer 47

medial

Question 48

what originates from the medial plantar nerve?

Answer 48

(3) common plantar digital nerves

Question 49

what nn. arise from the first common plantar digital nerve?

Answer 49

2nd and 3rd proper plantar digital nerves

Question 50

the nerve to the first lumbrical originates from what n?

Answer 50

first common plantar digital nerve

Question 51

where does the seventh proper plantar digital n. originate from?

Answer 51

3rd common plantar digital n.

Question 52

describe the termination of the proper plantar digital nerves

Answer 52

terminate at distal ends of the toes where they curl around the tip of the toes to innervate the nail beds

Question 53

the medial calcaneal a. is a branch off of the ...

Answer 53

posterior tibial a.

Question 54

what are the main branches off the medial plantar a?

Answer 54

- superficial branch and deep branch (ramus profundus)

Question 55

what are the main branches off the superficial branch of the medial plantar a. ?

Answer 55

- common plantar digital - superficial plantar tibial branches - it also has branches to the abductor halucis and flexor digitorum brevis

Question 56

how does the common plantar digital a. end?

Answer 56

- dividing into three superficial plantar digital arteries | - each branch joins a plantar metatarsal a.

Question 57

you are carefully cleaning the are between the abductor digiti minimi and flexor digitorum brevis near the base of the 5th metatarsal - what do you identify?

Answer 57

lateral plantar artery and nerve - entering this space from the medial side of the foot

Question 58

the lateral plantar nerve lies ________ to the lateral plantar artery

Answer 58

medial

Question 59

where does the muscular branch to the abductor digiti minimi n. come from?

Answer 59

lateral plantar n. | - the lateral plantar n divides into a superficial and deep division after giving off this branch

Question 60

which division of the lateral plantar n. follow the deep plantar arterial arch?

Answer 60

deep division of lateral plantar n.

Question 61

what n. supplies the muscular branches to the flexor digiti minimi brevis?

Answer 61

superficial division of the lateral plantar n. | - it also provides branches to the most lateral plantar and dorsal interossei muscles

Question 62

starting at the proximal phalanx of the 5th toe, the superficial division of the lateral plantar nerve is known as...

Answer 62

10th proper plantar digital n.

Question 63

where does the 4th common plantar digital branch come from?

Answer 63

superficial division of the lateral plantar n.

Question 64

what are the terminal branches of the 4th common plantar digital branch of the superficial division of the lateral plantar n?

Answer 64

8th and 9th proper plantar digital nerves

Question 65

you notice that some fibers from the abductor digiti minimi attach to the fifth metatarsal, what is the part of the muscle known as?

Answer 65

abductor os metatarsi digiti minimi

Question 66

which layer is the quadratus plantae (flexor accessorius) m located in?

Answer 66

second layer

Question 67

where do the lateral and medial heads of the quadratus plantae arise from/

Answer 67

medial : medial surface of calcaneus, inferior to the groove for the flexor hallucis longus tendon lateral: lateral surface and lateral edge of the plantar surface of the calcaneus and from the long plantar ligament

Question 68

where does the quadratus platae insert?

Answer 68

into the tendon of the flexor digitorum longus

Question 69

the lateral plantar artery is _________ to the lateral plantar n. as it course obliquely from medial to lateral across the belly of the quadratus plantae

Answer 69

lateral

Question 70

what n. courses laterally across the proximal part of the quadratus plantae muscle?

Answer 70

nerve to abductor digiti minimi

Question 71

what is the origin of the four lumbricals?

Answer 71

tendon of flexorr digitroum longus

Question 72

what forms the inferior and lateral walls that house the tendons of the flexor muscles?

Answer 72

fibrous flexor sheaths

Question 73

each flexor digitorum brevis tendon splits just ______ to the metatarsophalangeal joint to surround the tendon of the flexor digitorum longus

Answer 73

proximal - the two split ends unite deep to the tendon of the flexor digitorum longus and then divide again to attach to the sides of the middle phalanx

Question 74

fibrous, membrane-like structures that connect the bony phalanges with the distal ends of the flexor digitorum longus and brevis tendons

Answer 74

short vincula - the long vincula are located proximal to the short - each vincula has a proximal and distal part - usually cord-like structures that attach to the dorsal aspect of the tendons - both the long and short carry blood vessels to the tendons

Question 75

this large branch passes laterally across the proximal end of quadratus plantae to reach the abductor digiti minimi m. near its origin

Answer 75

branch of the lateral n. that supplies the abductor digiti minimi

Question 76

this artery follows the course oft he superficial branch of the lateral plantar n.

Answer 76

superficial fibular plantar a.

Question 77

the lateral plantar a. dives deep below the _____________ as the deep plantar arch

Answer 77

oblique head of the adductor hallucis

Question 78

distal branches of the deep branch of the medial plantar artery (ramus profundus)

Answer 78

tibial and lateral branches

Question 79

at the base of the 1st metatarsal bone, the tibial branch of the ramus profundus anastomoses with...

Answer 79

1st plantar metatarsal a. | - the lateral branch of the ramus profundus will join with the deep plantar arch

Question 80

what is the innervation tot he flexor digiti quinti brevis

Answer 80

superficial division of the lateral plantar n.

Question 81

the posterior/proximal perforating branches are usually _____ in number

Answer 81

3 originate from the deep arterial arch join with the dorsal metatarsal arteries

Question 82

reflecting the oblique head of the adductor hallucis, what do you observe?

Answer 82

- deep plantar arterial arch and deep division of the lateral plantar n .

Question 83

at the 1st interosseous space, the deep plantar artery from the __________ joins with the arch to complete it

Answer 83

dorsalis pedis a | - the lateral branch of the ramus profundus joins the arch close to where the deep plantar joins the arch

Question 84

what originates from the deep plantar arterial arch?

Answer 84

four plantar metatarsal arteries and their anterior/distal perforating branches

Question 85

the plantar metatarsal arteries course ____________ to the metatarsal bones

Answer 85

distally superficial not in the interosseous spaces *** arteries remain superficial to the interosseous muscles

Question 86

distal to the anterior perforating arteries, the plantar metatarsal arteries become known as the _______

Answer 86

common plantar digital arteries

Question 87

each common plantar digital artery gives rise to ....

Answer 87

two proper plantar digital arteries

Question 88

what is the origin of the 1st proper plantar digital artery?

Answer 88

- from the superficial tibial branch of the medial plantar OR from the 1st plantar metatarsal artery

Question 89

the three plantar interossei originate from the ______ side of metatarsals _________-

Answer 89

medial side | metatarsals 3-5

Question 90

the dorsal interossei originate from _______ of metatarsals

Answer 90

adjacent sides of all metatarsal bones

Question 91

where does the tibialis posterior tendon attach? ***

Answer 91

- tuberosity of navicular bone - 2nd, 3rd, 4th metatarsals - all other tarsals EXCEPT for the talus