Lab List Monday 6/23/14 Flashcards
Flexor digitorum brevis Origin, insertion, innervation, action
Origin: medial tubercle of tuberosity of calcaneous, plantar aponeurosis, intermuscular septa
Insertion: Both sides of middle phalanges of lateral four digits
Innervation: Medial plantar nerve (S2, S3)
Action: Flexes lateral four digits
Abductor hallucis Origin, Insertion, Innervation, Action
Origin: Flexor Retinaculum, Plantar aponeurosis, medial tubercle of tuberosity of calcaneous
Insertion: Medial side of base of proximal phalanx of 1st digit
Innervation: Medial plantar nerve (S2, S3)
Action: abducts and flexes 1st digit
abductor digiti minimi origin, insertion, innervation, action
origin: medial and lateral tubercles of tuberosity of calcaneous, plantar aponeurosis, intermuscular septa
Insertion: lateral side of base of proximal phalanx of 5th digits
Innervation: Lateral plantar nerve (S2, S3)
Action: abducts and flexes 5th digit
What are the muscles of the first layer of the sole of the foot? What two common origins do they share?
- abductor hallucis
- flexor digitorum brevis
- abductor digiti minimi
- they share medial tubercle of tuberosity of calcaneus and plantar aponeurosis
Quadratus plantae origin, insertion, innervation, action
Origin: medial and lateral margin of plantar surface of calcaneus
Insertion: posterolateral margin of tendon of flexor digitorum longus
Innervation: lateral plantar nerve (S2, S3)
Action: assists flexor digitorum longus in flexing lateral four digits
lumbricals origin, insertion, innervation, action
origin: tendons of flexor digitorum longus
insertion: medial aspect of expansion over lateral four digits
innervation: Medial one: Medial plantar nerve (S2, S3)
Lateral three: lateral plantar nerve (S2, S3)
action: flex proximal phalanges; extend middle and distal phalanges of lateral four digits
What are the muscles of the second layer of the sole of the foot?
- quadratus plantae
- lumbricals
What are the muscles of the third layer of the sole of the foot?
- flexor hallucis brevis
- adductor hallucis
- flexor digiti minimi brevis
What are the muscles of the fourth layer of the sole of the foot?
- plantar interossei (three muscles)
- dorsal interossei (four muscles)
Flexor hallucis brevis origin, insertion, innervatio, action
origin: plantar surfaces of cuboid and lateral cuneiform
insertion: both sides of base of proximal phalanx of 1st digit
innervation: medial plantar nerve (S2, S3)
action: flexes proximal phalanx of 1st digit
adductor hallucis origin, insertion, innervation, action
origin: oblique head: bases of metatarsals 2-4
transverse head: plantar ligaments of 3rd-5th
metatarsophalangeal joint
insertion: lateral side of base of proximal phalanx of 1st digit
innervation: deep branch of lateral plantar nerve (S2, S3)
Action: adducts 1st digit, assists in maintaining transverse arch of foot
flexor digiti minimi brevis origin, insertion, innervation, action
origin: base of 5th metatarsal
insertion: base of proximal phalanx of 5th digit
innervation: superficial branch of lateral plantar nerve (S2, S3)
action: flexes proximal phalanx of the 5th digit
Plantar interossei origin, insertion, innervatio, action
origin: bases and medial sides of metatarsals 3-5
insertion: medial sides of bases of proximal phalanges of 3rd-5th digits
innervation: lateral plantar nerve (S2, S3)
action: adducts digits 3-5 and flex metatarsophalangeal joints
dorsal interossei origin, insertion, innervation, action
origin: adjacent sides of metatarsals 1-5
insertion: first: medial side of proximal phalanx of 2nd digit
second-fourth: lateral sides of 2nd-4th digits
innervation: lateral plantar nerve (S2, S3)
action: abducts digits (2-4) and flex metatarsophalangeal joints
All of the muscles of the sole of the foot have the same segmental innervation. What is it?
S2, S3
What are the seven tarsal bones?
- calcaneous
- talus
- navicular
- medial (first) cuneiform, at base of 1st metatarsal
- intermediate (2nd) cuneiform, at base of 2nd metatarsal
- lateral (third) cuneiform, at base of 3rd metatarsal
- cuboid, most lateral in the distal row of the tarsal bones
Sustentaculum tali
projects from the superior border of the medial surface of the calcaneous and supports the head of the talus
On which tarsal bone is the groove for the tendon of fibularis longus located?
cuboid
What bony structures are in the hindfoot? The midfoot? The forefoot?
Hindfoot: - talus and calcaneous Midfoot: - navicular, cuneiforms, cuboid Forefoot: - metatarsals and phalanges
The deep fascia on the dorsum of the foot is continuous with the:
Inferior extensor retinaculum and plantar fascia and aponeurosis
What are some functions of the plantar fascia?
- hold parts of the foot together
- protect sole from injury
- passively supports longitudinal arch of foot
What forms the three compartments of the sole of the foot?
vertical intramuscular septa extending from the margins of the plantar aponeurosis
What are the contents of the medial compartment of the sole of the foot?
- abductor hallucis
- flexor hallucis brevis,
- tendon of flexor hallucis longus
- medial plantar nerve and vessels
What are the contents of the central compartment of the sole of the foot?
- flexor digitorum brevis
- flexor digitorum longus
- quadratus plantae
- lumbricals
- adductor hallucis
- tendon of flexor hallucis longus
- lateral plantar nerve and vessels
Contents of lateral compartment of sole of foot?
- abductor digiti minimi
- flexor digiti minimi brevis
The forefoot contains a fourth compartment. What are its contents?
- metatarsals
- dorsal interosseous muscles
- plantar interosseous muscles
- deep plantar and metatarsal vessels
The plantar interossei muscles 1 and the dorsal interossei 2.
1) Adduct (PAD)
2) Abduct (DAB)
Extensor digitorum brevis (EDB) and Extensor hallucis brevis (EHB, which is part of EHB). Where are they located and what functions do they serve? What nerve supplies them?
- anterior to the lateral malleolus
- aid extensor digitorum and extensor hallucis longus in extending digits one through four
- deep fibular nerve
What nerves supply the intrinsic muscles of the foot? What two muscles are an exception to this? What nerve supplies these exceptions?
- medial and lateral plantar nerves
- Extensor digitorum brevis and extensor hallucis brevis, which are supplied by the deep fibular nerve
The medial and lateral plantar nerves are accompanied by:
- medial and lateral plantar arteries and veins
The popliteal artery branches into what arteries after exit of the popliteal fossa?
- anteriorly = anterior tibial artery
- posteriorly = - posterior tibial artery
- fibular artery
The anterior tibial artery divides into:
- anterior lateral and medial malleolar arteries
- (medially) dorsalis pedis
- (laterally) lateral tarsal artery
- lateral tarsal and dorsalis pedis join to form arcuate artery just before the shafts of the metatarsal bones
- from arcuate artery, dorsal metatarsal arteries
- proper dorsal digital arteries
On the posterior leg, the popliteal artery divides into:
- posterior tibial artery (medially)
- fibular artery (laterally)
- medial and lateral malleolar arteries
- medial and lateral plantar arteries
- medial plantar divides into superficial and deep medial plantar arteries
- lateral plantar and deep medial plantar arteries come together at the beginning of the metatarsal shafts to form deep plantar arch
- plantar metatarsal arteries
- common plantar digital arteries
- proper plantar digital arteries
The sole of the foot is supplied by what artery?
posterior tibial artery
What artery supplies the muscles of the great toe and skin on the medial side of the sole?
medial plantar artery
The deep plantar arch runs between what?
The third and fourth muscle layers of the foot
The lateral four digits of the foot are supplied by what arteries?
plantar digital arteries
Deep veins of the foot 1 whereas the superficial veins 2 and 3
1) accompany all arteries internal to the deep fascia
2) are not accompanied by arteries
3) drain most of the blood from the foot
Order of veins leading to main superficial veins from the toes:
- plantar digital veins
- plantar metatarsal veins
- dorsal and plantar venous arches
- medial marginal vein; becomes great saphenous vein
- lateral marginal vein; becomes small saphenous vein
Lymph nodes of the foot follow_1_ and eventually, all lymph from the lower limb eventually passes to 2
1) veins and major vascular bundles
2) iliac lymph nodes
Subtalar (talocalcaneal) joint type, movement, blood supply, nerve
type: plane synovial
movement: inversion and eversion
blood: posterior tibial and fibular arteries
nerve: plantar aspect of medial or lateral plantar nerve, dorsal aspect of deep fibular nerve
Transverse tarsal joint: what joints, types, movements, blood supply, nerves?
Joints: talonavicular and calcaneocuboid joints
Types: - ball and socket type synovial, plane synovial
Movements: gliding and rotatory, inversion/eversion/circumduction
Blood: anterior tibial via lateral tarsal artery
Nerve: plantar aspect of medial or lateral plantar nerve and dorsal aspect of deep fibular nerve
Metatarsophalangeal joint type, movement, blood supply, nerve
Type: condyloid synovial
Movement: flexion, extension, some circumduction, abduction, adduction
Blood: lateral metatarsal arteries
Nerve: digital nerve
Interphalangeal joint type, movement, blood supply, nerve supply
Type: hinge synovial
Movement: flexion, extension
Blood: digital branches of plantar arch
Nerves: digital nerves
The arches of the foot function to:
- absorb shock
- act as springboards in walking
- transverse arch spreads weight in all directions
Medial longitudinal arch is higher and more important than lateral. What structures support it? What structures does it contain?
- tibialis posterior
- tibialis anterior
- both their tendons
- tendons of fibularis longus
- contains:
- calcaneous
- talus
- navicular
- medial 3 cuneiforms
- medial 3 metatarsals
Lateral longitudinal arch - flatter. What does it contain?
- calcaneous
- cuboid
- lateral two metatarsals
Transverse arch runs from side to side. What structures does it contain? What tendons maintain its curvature? What structures serve as its pillar?
contents:
- cuboids
- cuneiforms
- bases of metatarsals
maintain curve:
- fibularis longus and posterior tibialis tendons
pillar:
- medial and lateral parts of longitudinal arch
Passive factors supporting the arches of the feet:
- shape of united bones
- four successive layers of fibrous tissue:
- plantar aponeurosis
- long plantar ligament
- short plantar ligament
- calcaneonavicular (spring) ligament
Dynamic support for the arches of the foot? Which muscles are specific to each arch?
- reflexive, active bracing action of intrinsic foot muscles
- active and tonic contractions of these muscles
- flexor hallucis longus and flexor digitorum longus for longitudinal arch
- fibularis longus and anterior tibialis muscles for transverse arch
What muscles are in the first LAYER of the sole of the foot?
- abductor hallucis
- flexor digitorum brevis
- abductor digiti minimi
(AFA)
Muscles of 2nd LAYER of sole of foot?
- quadratus plantae
- lumbricals
(QL)
Muscles of 3rd LAYER of sole of foot?
- flexor hallucis brevis
- adductor hallucis
- flexor digiti minimi brevis
(FAF)
Fourth layer of muscles of sole of foot?
- plantar interossei
- dorsal interossei
(PD)
What two structures bear the greatest stress and greatest importance in maintaining the arches of the foot?
- plantar ligaments
- plantar aponeurosis
