Lecture 11: Foot Flashcards

1
Q

Medial Longitudinal Arch

What bones make up this arch?

A
  • Calcaneus
  • Talus
  • Navicular
  • All three cuneiforms
  • First three metatarsal bones
  • First three proximal, medial, and distal phalanges
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2
Q

Lateral Longitudinal Arch

What bones make up this arch?

A
  • Calcaneus
  • Cuboid
  • 4th and 5th metatarsal bones
  • 4th and 5th proximal, medial, and distal phalanges
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3
Q

Transverse Arch

What bones make up this arch?

A
  • Cuboid
  • All 3 Cuneiforms
  • Metatarsal Bases
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4
Q

Which arch of the foot comes in closest contact with the ground?

A

The lateral arch

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5
Q

What are the four places weight is transferred on the foot during walking?

A

Calcaneus

Tuberosity of the fifth metatarsal

Head of the first metatarsal

Distal phalanx of the great toe

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6
Q

Where is the ideal site of amputation of the foot, allowing the patient to still heel strike, and not lose the height of the limb?

A

The transverse tarsometatarsal joint

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7
Q

What two structures emerge from the inferior border of the extensor retinaculum?

A

Dorsalis Pedis Artery

Deep Fibular Nerve

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8
Q

What is the function of the plantar aponeurosis?

A

The Plantar Aponeurosis is dense connective tissue has five slips which run concurrently with the tendinous sheaths of the foot and helps them slide fluidly

The Plantar Aponeurosis is also a critically important passive support for the arches of the foot

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9
Q

What is Plantar Fasciiitis?

A

Inflammation of plantar fascia, especially at proximal attachment

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10
Q

What can cause a calcaneal bone spur?

A

The arch of the foot sags and the calcaneus slides in a bursa that is just underneath the Plantar Aponeurosis.

This can cause inflammation of that bursa, which can then lead to overgrowth of bone and a bone spur

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11
Q

What muscles are found on the dorsal side of the foot?

A
  • Extensor Hallucis Brevis
  • Extensor Digitorum Brevis
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12
Q

Extensor Hallucis Brevis Muscle

What is its attachments?

A

Origin: Superolateral aspect of the Calcaneus and interosseous talocalcaneal ligament

Insertion: Dorsal aspect of base of 1st proximal phalanx

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13
Q

Extensor Hallucis Brevis Muscle

What is its action?

A

Extend big toe at metatarsophalangeal joint (MTP)

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14
Q

Extensor Hallucis Brevis Muscle

What is its innervation and blood supply?

A

Innervation: Deep Fibular Nerve

Blood Supply: Dorsalis Pedis Artery

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15
Q

Extensor Digitorum Brevis Muscle

What are its attachments?

A

Origin: Superolateral aspect of the Calcaneus and interosseous talocalcaneal ligament

Insertion: Lateral aspect Extensor Digitorum Longus Tendon

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16
Q

Extensor Digitorum Brevis Muscle

What is its action?

A

Extend digits 2-4

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17
Q

Extensor Digitorum Brevis Muscle

What is its innervation and blood supply?

A

Innervation: Deep Fibular Nerve

Blood Supply: Dorsalis Pedis Artery

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18
Q

What muscles are found in the first plantar layer?

A
  • Abductor Digiti Minimi Muscle
  • Flexor Digitorum Brevis Muscle
  • Abductor Hallucis Muscle
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19
Q

Abductor Hallucis Muscle

What is its attachments?

A

Origin: Medial tubercle; calcaneal tuberosity

Insertion: Medial aspect of base of 1st proximal phalanx

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20
Q

Abductor Hallucis Muscle

What is its action?

A
  1. Abduct big toe
  2. Flex big toe
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21
Q

Abductor Hallucis Muscle

What is its innervation and blood supply?

A

Innervation: Medial Plantar Nerve

Blood Supply: Medial Plantar Artery

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22
Q

Flexor Digitorum Brevis Muscle

What are its attachments?

A

Origin: Medial tubercle; calcaneal tuberosity

Insertion: Intermediate phalanges 2nd-5th digits

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23
Q

Flexor Digitorum Brevis Muscle

What is its action?

A

Flex digits 2-5

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24
Q

Flexor Digitorum Brevis Muscle

What is its innervation and blood supply?

A

Innervation: Medial Plantar Nerve

Blood Supply: Medial Plantar Artery

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25
Q

The flexor digitorum longus tendon runs through a split in the insertion of what muscle’s tendon?

A

Flexor digitorum brevis

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26
Q

Abductor Digiti Minimi Muscle

What is its attachments?

A

Origin: Calcaneal tuberosity

Insertion: Lateral aspect of base of 5th proximal phalanx

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27
Q

Abductor Digiti Minimi Muscle

What is its action?

A
  1. Abduct 5th toe
  2. Flex 5th toe
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28
Q

Abductor Digiti Minimi Muscle

What is its innervation and blood supply?

A

Innervation: Lateral Plantar Nerve

Blood Supply: Lateral Plantar Artery

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29
Q

What muscles are found in the second plantar layer?

A
  • Quadratus Plantae
  • Lumbricals
  • Tendons of Flexor Hallucis Longus and Flexor Digitorum Longus are also found in this layer
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30
Q

Quadratus Plantae Muscle

What is its attachments?

A

Origin: Plantar surface calcaneus

Insertion: Lateral aspect of Flexor Digitorum Longus Tendon

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31
Q

Quadratus Plantae Muscle

What is its action?

A

Assists with flexion of digits 2-5

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32
Q

Quadratus Plantae​ Muscle

What is its innervation and blood supply?

A

Innervation: Lateral Plantar Nerve

Blood Supply: Lateral Plantar Artery

33
Q

What muscle of the foot does not have an analogue in the hand?

A

Quadratus plantae

34
Q

Lumbricals Muscle

What is its innervation and blood supply?

A

Innervation:

1st Lumbrical: Medial Plantar Nerve

2nd-4th: Lateral Plantar Nerve

Blood Supply:

1st Lumbrical: Medial Plantar Artery

2nd-4th: Lateral Plantar Artery

35
Q

Lumbricals Muscle

What are its attachments?

A

Origin: Lateral aspect of Flexor Digitorum Longus Tendon

Insertion: Medial proximal phalanx of digits 2-5; Medial aspects of digital expansion on digits 2-5

36
Q

Lumbricals Muscle

What is its action?

A
  1. Flex MTP joint
  2. Extend proximal and distal interphalangeal joints
37
Q

What muscles are found in the third plantar layer?

A
  • Flexor Digiti Minimi Brevis
  • Adductor Hallucis
  • Flexor Hallucis Brevis
  • Opponens Digiti Minimi - don’t need to know
38
Q

Flexor Digiti Minimi Brevis Muscle

What is its attachments?

A

Origin: Base 5th metatarsal

Insertion: Base of 5th proximal phalanx

39
Q

Flexor Digiti Minimi Brevis ​Muscle

What is its action?

A

Flex proximal phalanx of 5th digit

40
Q

Flexor Digiti Minimi Brevis ​Muscle

What is its innervation and blood supply?

A

Innervation: Superficial Lateral Plantar Nerve

Blood Supply: Lateral Plantar Artery

41
Q

Adductor Hallucis Muscle

What is its attachments?

A

Origin:

Oblique head: Bases of 2nd-4th metatarsals

Transverse head: Plantar metatarsophalangeal ligament

Insertion: Lateral aspect of 1st proximal phalanx base

42
Q

Adductor Hallucis Muscle

What is its action?

A

Adduct hallux

43
Q

Adductor Hallucis Brevis Muscle

What is its innervation and blood supply?

A

Innervation: Deep Lateral Plantar Nerve

Blood Supply: Medial and Lateral Plantar Arteries

44
Q

Flexor Hallucis Brevis Muscle

What is its attachments?

A

Origin: Plantar surface of cuboid and 3rd cuneiform

Insertion: Base of 1st proximal phalanx

45
Q

Flexor Hallucis Brevis Muscle

What is its action?

A

Flex 1st proximal phalanx

46
Q

Flexor Hallucis Brevis Muscle

What is its innervation and blood supply?

A

Innervation: Medial Plantar Nerve

Blood Supply: Medial Plantar Artery

47
Q

What unique feature can be found in the medial and lateral head of the Flexor Hallucis Brevis?

A

Sesamoid bones that create a protective tunnel for the flexor hallucis longus tendon

48
Q

What muscle integrates with the Oblique Head of the Adductor Hallucis?

A

Lateral head of Flexor Hallucis Brevis Muscle

49
Q

What muscles are found in the fourth plantar layer?

How many muscles of each are there?

A
  • 4 Dorsal Interossei Muscles (DABS)
  • 3 Palmar Interossei Muscles (PADS)
  • Fibularis Longus Tendon and Tibialis Posterior Tendons also in this layer
50
Q

Dorsal Interossei Muscle

What is its attachments?

A

Origin: Adjacent edges and bases of 1st-5th metatarsals

Insertion:

1st: Medial aspect 2nd proximal phalanx

2nd-4th: Lateral azpect bases of 2nd, 3rd, and 4th proximal phalanges

51
Q

Dorsal Interossei Muscle

What is its action?

A
  1. Abduct digits 2-4
  2. Flex metatarsophalangeal joint
52
Q

Dorsal Interossei Muscle

What is its innervation and blood supply?

A

Innervation: Lateral Plantar Nerve

Blood Supply: Dorsal Digital Arteries

53
Q

Palmar Interossei Muscle

What is its attachments?

A

Origin:

Oblique head: Bases of 2nd-4th metatarsals

Transverse head: Plantar metatarsophalangeal ligament

Insertion: Lateral aspect of 1st proximal phalanx base

54
Q

Palmar Interossei Muscle

What is its action?

A
  1. Adduct digits 3-5
  2. Flex MTP joint
55
Q

Palmar Interossei Muscle

What is its innervation and blood supply?

A

Innervation: Lateral Plantar Nerve

Blood Supply: Dorsal Digital Arteries

56
Q

What can happen to cause Hallux Valgus?

A

If you displace the Great Toe too far laterally, the Tendon of the Flexor Hallucis Longus can slip out of the groove created by the sesamoid bones of the Flexor Hallucis Brevis, causing the Great Toe to stay laterally displaced.

57
Q

What is a corn of the foot?

A

Inflamed calluses on the medial aspect of the Metatarsophalangeal Joint

58
Q

What is a bunion?

A

Inflammation of a bursa just over the medial aspect of the Metatarsophalangeal Joint.

59
Q

What is hammer toe

A

Hyperextension of the Proximal Phalanx at the Metatarsophalangeal Joint

  • Plantarflexion of the proximal interphalangeal joint,
  • Extension of the distal interphalangeal joint
  • Normally in 2nd digit*
60
Q

What is claw toe?

A

Hyperextension of the Metatarsophalangeal joint as in Hammer Toe

-Flexion of both Interphalangeal Joints

61
Q

What is mallet toe?

A

Flexion at the Distal Interphalangeal Joint

62
Q

What nerve innervates the two muscles on the dorsum of the foot?

A

The lateral branch of the deep fibular nerve

63
Q

What are the two main nerves of the sole of the foot?

A

Medial and lateral plantar nerves

64
Q

Which branch of the lateral plantar nerve is involved in cutaneous (sensory) innervation, and which branch is involved in motor innervation?

A

The superficial branch does the cutaneous innervation

The deep branch does muscular (motor) innervation

65
Q

What nerve does the lateral tarsal artery run with?

A

Lateral branch of the deep fibular nerve

66
Q

What part of the skin of the foot is innervated by the superficial branch of the lateral plantar nerve?

A

The skin around and including the fifth digit of the foot

67
Q

What gives rise to the medial and lateral plantar nerves?

A

Tibial nerve

68
Q

What four muscles are innervated by the Medial Plantar Nerve?

A

Flexor digitorum brevis

Flexor hallucis brevis

Abductor hallucis

Medial one lumbrical

69
Q

What part of the skin of the foot is innervated by the medial plantar nerve?

A

Plantar foot except the fifth digit

70
Q

What is the primary artery to the plantar foot?

A

Posterior tibial artery

71
Q

What does the medial plantar artery do?

A

Gives rise to two Plantar Metatarsal and Plantar Digital Arteries

72
Q

What are the branches of dorsalis pedis?

A

Lateral tarsal artery

Arcuate artery

Deep plantar artery

73
Q

What does the arcuate artery do?

A

Gives rise to the 2nd through 5th metatarsal arteries

74
Q

What nerve runs with dorsalis pedis?

A

Medial branch of the deep fibular nerve

75
Q

What does the deep plantar artery do?

A

Joins the lateral plantar artery to form the plantar arterial arch

Gives rise to the first metatarsal artery

76
Q

What are the main branches of the posterior tibial artery in the plantar aspect of the foot?

Where does it split?

A

Medial and lateral plantar arteries

Deep to abductor hallucis on the medial foot

(after Tom Dick AN Harry)

77
Q

What is the primary artery to the dorsum of the foot?

A

The anterior tibial artery

78
Q

Where does the anterior tibial artery become dorsalis pedis?

A

When the lateral malleolar artery splits off

79
Q

What does the lateral plantar artery do?

A

Gives rise to the 3rd through 6th Plantar Metatarsal and Plantar Digital Arteries

Terminates in an anastomosis with the deep plantar artery from the dorsalis pedis forming the plantar arterial arch