Lecture 21 Flashcards
What are the 3 rows of tarsal bones?
Three rows
1 – calcaneus and talus
2 – navicular and cuboid
3 – cuneiforms
What are all of the tarsal bones?
Navicular
Boat
Tuberosity for TP tendon (plantar side)
Cuboid
Tuberosity of cuboid
Fibialaris longus maintains transverse arch
Cuneiforms
Three - medial, intermediate and lateral
Intermediate is tightly wedged and fairly immobile
Sesamoids – variable, usually 2 exist on the plantar side.
How many metatarsals and phalanges are there?
5 Metatarsals
14 Phalanges
2 on hallux
3 in each digit
Can be fused in the 5th digit
What are the features of the calcaneus?
Calcaneal tuberosity
Peroneal tubercle – fibialis longus and brevis
Sustentaculum tali - sustains/takes weight off the talus, flexor hallucis longus
Talar articular surfaces (three)
Cuboid articular surface (lateral side)
Calcaneal sulcus (groove) - has corresponding groove on talus (salcul talus), together they create a tunnel called the sinus tarsi.
Lots of little bony projections = fractures.
What are the features of the talus?
Makes contact with navicular Articular surface for navicular Head Neck Articular surface with distal end of tibia Articular surface with medial malleolus Groove for flexor hallucis longus Medial tubercle Lateral tubercle Anterior calcaneal surface Articular surface for calcanonavicular ligament Middle calcaneal surface Posterior calcaneal surface
Where and how does a tarsal fracture occur?
No muscle attachments to talus (which direct blood vessels to bone)
Supply via:
Dorsalis pedis (branch of anterior tibial artery, dorsal)
Fibular (lateral)
Posterior tibial (plantar)
Form a vascular sling under sinus tarsi (artery of tarsal canal) = site of fracture of talus
May lead to avascular necrosis.
Where do fractures occur in the metatarsals?
2nd metatarsal
March fracture
Pressure, tight
5th metatarsal
Long
Sticks out
Tarsal coalition
Congenital
Often navicular and talus fuse – affects mobility
Epiphyseal fractures
Ballet dancers on point
Potts fracture
What types of retinaculae are found at the ankle?
Lateral Superior extensor retinaculum Inferior extensor retinaculum Superior fibular retinaculum Inferior fibular retinaculum
Medial Flexor retinaculum Encloses: TP FDL Posterior tibial artery and vein Posterior tibial nerve FHL
What are the intrinsic dorsum muscles of the foot?
Extensor hallucis brevis
Base of proximal phalanx at extensor expansion
Extends big toe
Extensor digitorium brevis
2nd, 3rd and 4th phalanx
What are the intrinsic sole layer 1 muscles of the foot and their nerve supply?
Abductor hallucis brevis
Flexor digitorium brevis
Abductor digiti minimi
Nerve supply:
Medial plantar nerve - Abductor hallucis brevis and flexor digitorum brevis
Lateral plantar nerve - Abductor digiti minimi
What are the intrinsic sole layer 2 muscles of the foot and their nerve supply?
Tendons of FDL and FHL Quadratus plantae Flexor accessorius Originate on FDL tendons. Nerve supply: Lateral plantar nerve 4 lumbricals Originate FDC Nerve supply: Medial plantar nerve – lumbrical 1 Lateral plantar nerve – lumbrical 2-4
What are the intrinsic sole layer 3 muscles of the foot and their nerve supply?
Flexor hallucis brevis
Adductor hallucis
Flexor digit minimi
Nerve supply:
Medial plantar nerve – flexor hallucis brevis
Lateral plantar nerve – adductor hallucis, flexor digiti minimi
Note: deep plantar metatarsal ligaments link all volar plates, thus no opposition or precision possible.
What are the intrinsic sole layer 4 muscles of the foot and their nerve supply?
Interossei 4 dorsal 3 plantar (lateral) Nerve supply: Lateral plantar nerve
What clinical conditions occur in feet?
Hallux valgus Old age Tight shoes Bunions Claw toes Flexors of toes can't work Jogger's foot
