Lecture 3 Flashcards
What are the motions of the foot
Dorsiflexion/plantar flexion and pronation/supination (eversion/inversion)
What ligaments hold together the inferior tibiofibular joint
anterior tibiofibular ligament, posterior tibiofibular ligament, and the interosseus membrane
What kind of joint is the inferior tibiofibular joint
Syndesmosis
What is the ankle joint
Hinge type synovial joint between tibia, fibula, and talus
What motion does the ankle joint allow
Dorsiflexion and plantar flexion
Where is the deltoid ligament located
On the medial ankle spanning from the medial malleolus to navicular, calcaneus, and talus bones.
What is the role of the deltoid ligament
Resists eversion of the foot
Where are the anterior and posterior talofibular and calcaneofibular ligaments
They span the bones their names suggest and are all found on the lateral side of the ankle. THey work together to resists inversion of the foot
What is the most common kind of ankle sprain
Inversion sprain is most common because the lateral is more inferior that the medial malleolus and the deltoid ligament is stronger than the lateral ligaments.
What is the Talo-calcaneo-navicular joint
Head of the talus inserts between navicular and calcaneus
What is the spring ligament
Ligament between the calcaneus and navicular that prevents the talus from wedging the bones apart
What is the sub talar (talo-calcaneal) joint
The facet joint where the talus rests on the calcaneus
What motion happens at the Talo-calcaneo-navicular joint
inversion and eversion
Where is the long plantar ligament
Spans from the calcaneus to metatarsals 2-5 and forms a tunnel for the fibularis longs tendon
Where is the short plantar ligament located
From the calcaneus to the cuboid
Where is the deep transverse ligament
It spans the MTP joints to link all 5
What are the muscles of the anterior group of the leg and what innervates them
Tibialis anterior, extensor hallucis longus, exntensor digitorum longus, and fibularis tertius are all innervated by the deep fibular nerve (peroneal)
What is the origin and insertion of the tibialis anterior
O: upper 2/3 of tibia, interosseus membrane
I: 1st MT, medial cuneiform
What is the action of the tibilalis anterior
Dorsiflex and invert foot
What is the origin and insertion of extensor hallucis longus
O: fibula, interosseus membrane
I: distal phalanx hallux
What is the action of the extensor hallucis longus
extend hallux and dorsiflex foot
What is the origin and insertion of the extensor digitorum longus
O: upper 3/4 fibula, interosseus membrane
I: Middle and distal phalanges
What is the action of the extensor digitorum longus
Extend digits 2-5 and dorsiflex foot
What is the origin and insertion of the fibularis tertius
O: lower 1/3 fibula
I: 5th metatarsal
What is the action of the fibularis tertius
Dorsiflexion and eversion of foot
What is the innervation and action of the lateral group of the leg
N: Superficial fibular
A: evert and plantar flex foot
What is the origin and insertion of the fibularis longus
O: Upper 2/3 of fibula
I: 1st MT; medial cuneiform
What is the origin and insertion of the fibularis brevis
O: lower 1/3 of fibula
I: 5th MT
What is the innervation of the posterior group of the leg
Gastrocnemius, soleus, plantaris, flexors digitorum longus and hallucis longus, and tibilas posterior are all innervated by the TIbial nerve
What is the origin and insertion of the gastrocnemius
O: femoral condyles
I: Calcaneus
What is the origin and insertion of the soleus
O: upper fibula and tibia
I: Calcaneus
What is the action of the gastrocnemius
Plantar flex foot (fast) flex knee
What is the action of the soleus
Plantar flex foot (slow) maintain standing
What is the origin and insertion of the plantaris
O: Lateral supracondylar ridge
I: calcaneus
What is the action of the plantaris
Plantar flex foot
How does the body maintain upright posture
The body wants to fall forward so the soleus and erector spinae work together to pull the body posteriorly
What is the origin and insertion of the flexor digitorum longus
O: Tibia
I: distal phalanges
What is the action of the flexor digitorum longus
Flex toes and plantar flex foot
What is the origin and insertion of the flexor hallucis longus
O: Fibula
I: distal phalanx hallux
What is the action of the flexor hallucis longus
Flex hallux and plantar flex foot
What is the origin and insertion of the Tibialis posterior
O: Tibia, fibula, IO membrane
I: navicular, calcaneus, cubiod, all cuneiforms, meta tarsals 2-4
What is the action of the tibialis posterior
Invert, plantar flex foot
Which 7 muscles plantar flex the foot
Gastrocnemius, soleus, flexors digitorum longus and hallucis longus, tibialis posterior, and fibularis longus and brevis
Which 4 muscles dorsiflex the foot
Exensors digitorum longus and hallucis longus, tibialis anterior, and fibularis tertius
Which 2 muscles invert the foot
Tibialis posterior and tibialis anterior
Which 3 muscles evert the foot
Fibularis longus and brevis, and fibularis tertius
Where is the common fibular nerve
It branches from the sciatic nerve and passes around the head of the fibula through the fibularis longus
Where is the superficial fibular nerve
Branches from the common fibular and goes in the lateral compartment of leg
Where is the deep fibular nerve
Branches from the common fibular nerve and travels into the anterior compartment
What happens if the common fibular nerve is injured
Foot drop: loss of dorsiflexion and eversion
Who commonly has foot drop
Alcoholics, tertiary syphilis, and diabetics
Where is the tibial nerve
Passes between the deep and superficial posterior muscles
What are the two most tested reflexes of the lower limb
Patellar reflex to test L4 nerve root, and Achilles reflex to test S1 nerve root
Where is the extensor retinaculum
over the extensor tendons complete with synovial sheathes
Where is the flexor retinaculum
Between the tibia and calcaneus, over the flexor tendons T, D, and H
What is the plantar aponeurosis (fascia)
Continuation of achilles tendon from antero-medial calcaneus to head of metacarpals
What is plantar fasciitis
Inflammation usually localized at calcaneal attachment. Calcaneal spurs can develop
What is the origin and insertion of the extensors hallucis brevis and digitorum brevis
O: Dorsal surface of calcaneus
I: proximal phalanges
What is the innervation and action of extensors hallucis brevis and digitorum brevis
N: Deep fibular N
A: extend big toe and digits, respectively
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What is the insertion of the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi
Abductor Hallucis: Proximal phalanx of digit 1
Abductor digiti minimi: Promixal phlanx of digit 5
Flexor D.B: middle phalanx of digits 2-5
What is the innervation of the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi
Abductor hallucis and flexor DB: Med Plantar N
Aductor digiti minimi: Lateral Plantar N
What is the action of the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi
abductor hallucis: Flex, abduct digit 1
flexor digitorum brevis: flex digits 2-5
abductor digiti minimi: flex, abduct digit 5
What is the origin and insertion of the quadratus plantae
O: Calcaneus
I: tendons of Flexor digitorum longus
What is the innervation and action of the quadratus plantae
N: Lateral plantar N
A: flex digits 2-5
What is the origin and insertion of lumbricals
O: Tendons of flexor digitorum longus
I: Extensor expansions
What is the innervation and action of lumbricals
N: L1 medial plantar nerve, L2,3,4 Lateral plantar N
A: extend IP, flex MTP joints (tata!)
What is the origin and insertion of flexor hallucis brevis
O: cuboid, lateral cuneiform
I: proximal phalanx of digit 1
What is the innervation and action of the flexor hallucis brevis
N: Medial plantar nerve
A: flex 1st MTP joint
What is the origin and insertion of the adductor hallucis
O: MT for the transverse and oblique heads
I: Proximal phalanx of digit 1
What is the origin and insertion of the flexor digit minimi
O: MT 5
I: proximal phalanx of the 5th digit
What is the innervation of the adductor hallucis and flexor digit minimi
Lateral plantar nerve
What is the role of the sesamoid bones in the flexor hallucis brevis
They protect the tendon of the flexor hallucis longus
What is the origin and insertion of the plantar and dorsal interossei
O: metatarsals
I: proximal phalanx, extensor expansion
What is the innervation and action of the plantar and dorsal interossei
N: Lateral plantar nerve
A: Both Flex MTP, Ext IP joints, Plantar adducts toes and dorsal abduct toes
What is the cutaneous innervation of the foot
Medial plantar innervations 3.5 digits, lateral plantar innervates lateral 1.5 digits (Just like with the median and ulnar nerve in the hand)
Where is the acupuncture point LV3 located
1st dorsal interossei. When combined with LI 4 in the 1st dorsal interosseus of the hand, it is good for relieving headaches
What are the arches in the foot
External (lateral) longitudinal arch, Internal (medial) longitudinal arch, and the transverse (anterior) arch
What is the most inferior diaphragm in the body
Plantar fascia
What forms the medial longitudinal arch
Calcaneus, talus, navicular, 3 cuneiforms, and 3 MTs
What supports the medial longitudinal arch
4 Muscles: flexor hallucis longus, abductor hallucis, tibialis anterior and posterior
3 CT: plantar aponeurosis, spring ligament, plantar ligament
What forms the lateral longitudinal arch
Calcaneus, cuboid, lateral 2 MT
What supports the lateral longitudinal arch
4 Muscles: Abductor digiti minimi, fibularis longus, brevis, and tertius
3 CT: plantar aponeurosis, long and short plantar ligaments
What forms the transverse arch
Cuboid, cuneiforms, the 5 MT
What supports the transverse arch
2 Muscles: Fibularis longus, adductor hallucis
1 CT: deep transverse ligaments
