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MSK Exam I > Lecture 14: Foot > Flashcards

Lecture 14: Foot Flashcards

1
Q

What are the 2 bones that make up the hind foot?

A

Talus

Calcaneous

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2
Q

What are the 5 bones that make up the midfoot?

A

Navicular
Cuboid
3 cuneiforms

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3
Q

What are the 2 groups of bones that make up the forefoot, and how many bones are in each group?

A

Metatarsals (5)

Phalanges (14)

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4
Q

Which region of the foot contains mostly fibrous subcutaneous tissue?

A

Plantar foot

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5
Q

Which region of the foot has looser subcutaneous tissue and is most susceptible to edema?

A

Dorsum of foot

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6
Q

The fascia of the foot is called the plantar fascia. It has a thick central region and a weaker medial and lateral region. What is the central region called?

A

Plantar aponeurosis

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7
Q

Where does the plantar aponeurosis arise from?

A

Arises from calcaneus and covers the entire length of sole of foot

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8
Q

The plantar aponeurosis divides into 5 bands and encloses the digital tendons. What is its major function?

A

Supporting the longitudinal foot arches

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9
Q

What pathology associated with the plantar fascia results from overuse or high-impact aerobic activities like running?

A

Plantar fasciitis

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10
Q

Where is point tenderness usually located with plantar fasciitis? What types of movement increase the pain?

A

At the proximal attachment of the aponeurosis to the medial tubercle of the calcaneus and on the medial surface of the calcaneus.

The pain increases with passive extension of the great toe and may be further exacerbated by dorsiflexion of the ankle and/or weight bearing

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11
Q

What anatomical change might make plantar fasciitis cause pain in the medial foot when walking?

A

Protrusion of a calcaneal spur (abnormal bony process) from the medial tubercle

[usually a bursa develops at the end of the spur that may also become enflamed and tender]

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12
Q

What provides innervation to the dorsal foot muscles?

A

Deep fibular n.

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13
Q

What are the 2 muscles on the dorsal foot?

A

Extensor hallucis brevis

Extensor digitorum brevis

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14
Q

What is the origin and insertion of the dorsal foot muscles?

A

Origin: Calcaneus and talocalcaneal ligament

Insertion: phalanges

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15
Q

What 3 muscles are found in the layer 1 of the foot?

A

Abductor digiti minimi m.
Flexor digitorum brevis m.
Abductor hallucis m.

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16
Q

What 2 muscles are found in layer 2 of the foot?

A

Quadratus plantae m.

Lumbricals

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17
Q

What tendons can be seen in the first and second layers of the foot?

A

Flexor hallucis longus

Flexor digitorum longus

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18
Q

What innervates the abductor hallucis m.?

A

Medial plantar n.

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19
Q

What is the main action of abductor hallucis m.?

A

Abducts and flexes 1st digit (great toe/hallux)

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20
Q

What innervates flexor digitorum brevis m.?

A

Medial plantar n.

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21
Q

Main action of flexor digitorum brevis m.

A

Flexes lateral four digits

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22
Q

Innervation of abductor digiti minimi m.

A

Lateral plantar n.

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23
Q

Main action of abductor digiti minimi m.

A

Abduction and flexion of 5th digit

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24
Q

Innervation of quadratus plantae m.

A

Lateral plantar n.

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25
Q

Main action of quadratus plantae

A

Assists flexor digitorum longus in flexing lateral four digits

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26
Q

Innervation of lumbricals

A

Medial one: medial plantar n.

Lateral three: lateral plantar n.

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27
Q

Main action of lumbrical mm.

A

Flexion of proximal phalanges, extension of middle and distal phalange of lateral four digits

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28
Q

Innervation of flexor hallucis brevis m.

A

Medial plantar n.

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29
Q

Main action of flexor hallucis brevis m.

A

Flexion of proximal phalanx of 1st digit

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30
Q

Innervation of adductor hallucis m.

A

Deep branch of lateral plantar n.

31
Q

Main action of adductor hallucis m.

A

Traditionally said to adduct the 1st digit; assists in transverse arch of foot by metatarsals medially

32
Q

Innervation of flexor digiti minimi brevis m.

A

Superficial branch of lateral plantar n.

33
Q

Main action of flexor digiti minimi brevis m.

A

Flexes proximal phalanx of 5th digit, thereby assisting with its flexion

34
Q

Innervation of interossei mm.

A

Lateral plantar n. (Innervates both plantar and dorsal interossei muscles)

35
Q

Which includes more muscles, plantar interossei or dorsal interossei?

A

Dorsal interossei has 4

Plantar interossei has 3

36
Q

Main action of the 3 plantar interossei muscles

A

Adducts digits 3-5 and flexes metatarsophalangeal joints

37
Q

Main action of the 4 dorsal interossei muscles

A

Abducts digits 2-4 and flexes metatarsophalangeal joints

38
Q

Innervation of extensor digitorum brevis m.

A

Deep fibular n.

39
Q

Innervation of extensor hallucis brevis m.

A

Deep fibular n.

40
Q

Main action of extensor digitorum brevis m.

A

Aids the extensor digitorum longus in extending the 4 medial toes at the MTP and interphalangeal joints

41
Q

Main action of extensor hallucis brevis m.

A

Aids the extensor hallucis longus in extending the great toe at the MTP joint

42
Q

What muscles are found in the 3rd layer of the foot?

A

Adductor hallucis m.
Flexor hallucis brevis m.
Flexor digiti minimi brevis m.

43
Q

The tendons of flexor hallucis brevis m. form a tunnel around the MTP joint to keep the flexor hallucis longus tendon from being squished. What lies under the flexor hallucis longus tendon?

A

2 sesamoid bones

44
Q

What muscles are found in layer 4 of the foot?

A

Planter interossei (1, 2, and 3)

Dorsal interossei (1, 2, 3, and 4)

45
Q

Which interosseus muscles are responsible for abduction?

A

Dorsal interossei (DAB)

46
Q

Which interosseus muscles are responsible for movement toward the midline aka adduction?

A

Plantar interosseus mm. (PAD)

47
Q

Which tendons are found in layer 4 of the foot?

A

Fibularis longus tendon

Tibialis posterior tendon

48
Q

What is the action of the fibularis longus tendon?

A

Foot eversion

49
Q

What are the actions of tibialis posterior tendons?

A

Foot inversion and plantar flexion

50
Q

Which foot deformity is characterized by lateral deviation of the great toe?

A

Hallux valgus (forms bunion, may also form corns on dorsal PIPs from shoe-contact)

–surrounding tissues swell and resultant pressure and friction against shoe cause a bursa to form, a tender/inflamed bursa = bunion

51
Q

What joint deformities are associated with “hammer-toe” (usually of second digit)

A

Proximal phalanx is permanently hyperextended at MTP

Middle phalanx is plantarflexed at PIP

Distal phalanx is extended

52
Q

Hammer-toe is associated with permanent hyperetension of MTP, plantar flexion of middle phalanx PIP, and extension of DIP.

If there is flexion in that DIP, the deformity is referred to as what?

A

Mallet toe

53
Q

Hammer-toe is associated with permanent hyperetension of MTP, plantar flexion of middle phalanx PIP, and extension of DIP.

This usually occurs in the 2nd digit, but it may also occur in the large toe, what is it called when this happens?

A

Trigger toe (extension of MP, flexion of IP)

54
Q

“Claw-toe” is characterized by what joint motions in the great toe?

A

Hyperextension of MTP joint

Flexion of DIP and PIP joints

55
Q

The common fibular n. branches into superficial and deep branches. Where does the superficial branch go?

A

Superficial common fibular n. runs into lateral compartment (supplying fibularis longus m. and fibularis brevis m.), then comes out and emerges on the dorsum of the foot

56
Q

The common fibular n. branches into superficial and deep branches. Where does the deep branch go?

A

Anterior compartment of the leg; it stays deep but will come out between the first and second digits.

[note that much of the dorsum of the foot is supplied by the superficial cutaneous fibular n.]

57
Q

The tibial n. divides posterior to the medial malleolus into what 2 nerves? What do these supply?

A

Medial and lateral plantar nerves

These supply all intrinsic muscles of the foot (except 2 intrinsic dorsum muscles), supply the plantar skin

58
Q

The tibial n. leaves the posterior compartment of the leg by passing deep to the flexor retinaculum in the interval between the medial malleolus and the calcaneus. What occurs with tibial nerve entrapment?

A

Entrapment and compression occurs when there is edema and tightness of the ankle involving the synovial sheaths of the tendons of muscles in the posterior compartment of the leg. The area involved is from the medial malleolus to the calcaneus, and the heel pain results from compression of the tibial n. by the flexor retinaculum

59
Q

What is another name for tibial nerve entrapment?

A

Tarsal tunnel syndrome

60
Q

What is the larger of the 2 terminal branches of the tibial n.?

A

Medial plantar n.

61
Q

The medial plantar n. passes deep to _______ ______ m., and runs anteriorly between this muscle and and flexor digitorum brevis m.

It terminates near the metatarsal bases by dividing into _______ (sensory/motor) branches supplying the medial three and a half digits

A

Abductor hallucis

Sensory

62
Q

What is the smaller of the 2 terminal branches of the tibial n.?

A

Lateral plantar n.

63
Q

The lateral plantar n. passes deep to the _______ ________ m. and anterolaterally deep to the _______ ______ ______.

It terminates by dividing into superficial and deep branches

A

Abductor hallucis

Flexor digitorum brevis

64
Q

What muscles are innervated by the medial plantar n.?

A

Abductor hallucis m.
Flexor hallucis brevis m.
Flexor digitorum brevis m.
Medial one lumbrical m.

65
Q

What muscles are innervated by the lateral plantar n.?

A 
Abductor digiti minimi m.
Quadratus plantae m.
Lateral three lumbricals
Adductor hallucis m.
Flexor digiti minimi brevis m.
Interossei
66
Q

What is an inflammatory syndrome characterized by bone and joint disorganization due to underlying neuropathy, trauma, and perturbations of bone metabolism

Leads to loss of foot sensation, foot bones are fragile and often fractured

A

Charcot’s foot

67
Q

What is the most common etiology of Charcot’s foot?

A

Diabetic neuropathy (can be a consequence of other peripheral neuropathies)

68
Q

What are the dorsal arteries of the foot?

A

Anterior tibial a. (Gives rise to anterior lateral and medial malleolar a., lateral tarsal a., dorsalis pedis a., arcuate a., and deep plantar a.)

69
Q

What are the plantar arteries of the foot?

A

Posterior tibial a. (Gives medial plantar a., lateral plantar a.)

70
Q

What artery runs laterally across the metatarsal bases, deep to the extensor tendons, and gives rise to 2nd-5th dorsal metatarsal arteries?

A

Arcuate artery

71
Q

What artery passes through the first interosseous space, joins lateral plantar a. forming plantar arch, and gives rise to first dorsal metatarsal a.?

A

Deep plantar a.

72
Q

What artery passes distally between abductor hallucis m. and flexor digitorum brevis m. and gives rise to the medial two plantar metatarsal and plantar digital aa.?

A

Medial plantar a.

73
Q

What a. runs with the lateral plantar n. (Superficial to quadratus plantae) and terminates by joining deep plantar a., forming the plantar arterial arch?

A

Lateral plantar a.

MSK Exam I (18 decks)

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