LEA Plantar Foot Part 1 Flashcards
1st ray
medial cuneiform and 1st metatarsal
2nd ray
intermediate cuneiform and 2nd metatarsal
3rd ray
lateral cuneiform and 3rd metatarsal
4th ray
4th metatarsal
5th ray
5th metatarsal
Plantar Aspect of the foot
- thick skin
- thick layer of subcutaneous fat
there is a thick layer of subcutaneous at especially where
the MTP joints and calcaneus
supported by septa
the central band
Thickest, toughest part of fascia
Proximal attachment of central band
Posterior calcaneal tuberosity
distal attachment of the central band
-Divides into 5 bands near the metatarsal bases (one for each metatarsal)
at the met heads, divide into superficial and deep layers
superficial layer of central band attaches
to dermis of skin
longitudinal fibers of the superficial central band
attach to skin in the sulcus between toes and metatarsals
transverse fibers of the superficial central band
connect the digital bands together at the level of the MTP joints
Forms superficial transverse metatarsal ligament
Superficial layer of central band
Deep layer of central band splits into
medial and lateral slips that attach to bone and blend with the flexor sheaths
the deep layer of the central band divides into medial and lateral slips that attach to
- Medial and lateral base of proximal phalanges of corresponding digit
- (The 1st medial slip attaches to the sesamoid bones at the 1st MTP joint )
- Plantar MTP joint ligaments, plantar plate
- Deep transverse metatarsal ligament
Plantar aponeurosis is important in
the windlass mechanism
Windlass Mechanism: (1)
The plantar fascia simulates a cable attached to the calcaneus and the metatarsophalangeal joints
Windlass Mechanism 2: Dorsiflexion during the propulsive phase of gait
winds the plantar fascia around the head of the metatarsal.
Windlass Mechanism 3: The winding of the plantar fascia
shortens the distance between the calcaneus and metatarsals to elevate the medial longitudinal arch.
Windlass Mechanism 4: The ___ is the essence of the windlass mechanism principle.
plantar fascia shortening that results from hallux dorsiflexion
Plantar fasciitis:
inflammation of the central band at its attachment to medial process of calcaneal tuberosity
Layer 1
- Abductor hallucis
- Flexor digitorum brevis
- Abductor digiti minimi
Layer 2
- Quadratus plantae (flexor accessories)
- Lumbricals (4 of them)
- Flexor digitorum longus tendon
- Flexor hallucis longus tendon
Layer 3
-Adductor hallucis
(Transverse and oblique heads)
-Flexor hallucis brevis
-Flexor digiti minimi brevis
Layer 4
- Plantar interossei (3 of them)
- Dorsal interossei (4 of them)
- Tibialis posterior tendon
- Fibularis longus tendon
The muscles of ___ are located in the forefoot
layers 3 and 4
The lateral plantar artery/vein/nerve pass between
layers 1 and 2.
The medial plantar artery/vein/nerve pass within
layer 1, between abductor hallucis and flexor digitorum brevis. (deep to abductor hallucis)
[Some also say between layers 1 and 2]
The arteries are located ___ of the nerves.
outside
Lateral plantar artery is lateral to the
lateral plantar nerve
Medial plantar artery is medial to the
medial plantar nerve.
_ plantar compartments
9
medial muscular compartment is formed by
plantar aponeurosis,
medial intermuscular septum,
1st metatarsal
Lateral Muscular Compartment formed by
plantar aponeurosis,
lateral intermuscular septum,
5th metatarsal
Central Muscular compartment formed by
both intermuscular septa,
plantar aponeurosis,
and
inferior interosseous fascia
medial muscular compartment contains
abductor hallucis
flexor hallucis brevis,
FHL tendon,
medial plantar nerve/artery
lateral muscular compartment contains
abductor digiti minimi,
flexor digiti minimi,
lateral plantar nerve/artery
Subdivisions of central compartment are separated by
fascial layers
Superficial central compartment
FDB
lumbricals,
tendon of FDL
Deep central (adductor) compartment
found in the forefoot;
Adductor hallucis
Calcaneal (deep hindfoot) compartment
QP muscle,
lateral plantar nerve and artery
4 Interosseous compartments
dorsal and plantar interossei (4 separate compartments)
Dorsal compartment:
extensor muscles tendons
Medial intermuscular septum attaches from
calcaneus to 1st met head
Lateral intermuscular septum attaches from head
calcaneus to the 5th met
first layer has __ muscles
3, Abductor Hallucis
Flexor digitorum brevis
abductor digiti minimi (quinti)
Abductor hallucis-Visible/ palpable
- on medial side of foot
- Forms boundary for porta pedis
Abductor hallucis origin
medial tubercle of calcaneal tuberosity,
flexor retinaculum,
plantar fascia and intermuscular septum
Abductor hallucis insertion
medial tubercle base of proximal phalanx of hallux,
medial sesamoid
Abductor hallucis blood and nerve supply
medial plantar artery and nerve
Abductor hallucis function
abducts hallux, also flexes (plantarflexes) hallux
Flexor digitorum brevis origin
medial tubercle of calcaneal tuberosity,
plantar aponeurosis,
intermuscular septum
Flexor digitorum brevis insertion
planter aspect of the bases of middle phalanges 2-5
- Tendons are plantar to the FDL tendons
- Split to allow them to pass
Flexor digitorum brevis blood and nerve supply
medial plantar artery and nerve
Flexor digitorum brevis fxn
flex digits 2-5 (PIP and MTP joints)
Abductor digiti minimi (quinti) origin
medial and lateral tubercles of calcaneal tuberosity, plantar aponeurosis, intermuscular septum
Abductor digiti minimi (quinti) insertion
lateral base of proximal phalanx of 5th toe
Abductor digiti minimi (quinti) blood and nerve supply
lateral plantar artery and nerve
inferior calcaneal nerve; “Baxters nerve”
Abductor digiti minimi (quinti) function
abduct 5th toe,
flexes (plantarflexes) 5th toe
