Lower Limb 5: The Foot Flashcards
Describe the osteology of the foot
7 Tarsals (Talus, Calcaneus, Cuboid, Navicular, Cuneiform x3) 5 Metatarsals 5 Phalanges (x3)
What movements are possible at the ankle joint?
Dorsiflexion
Plantarflexion
Inversion
Eversion
Name the ligaments that strengthen the ankle joint
6 ligaments: Posterior Tibiotalar Posterior Talofibular Posterior Tibiofibular Calcaneofibular Tibulocalcaneal Deltoid Ligament
What joints are present at the foot and which bones are involved?
Subtalar: Talus and calcaneus
Transverse talar: - calcaneus and cuboid
- navicular and talus
What provides passive support to the longitudinal arch of the foot?
Plantar aponeurosis
Plantar ligaments - short plantar, long plantar, calcaneonavicular
What provides active support to the longitudinal arch of the foot?
small intrinsic muscles and FHL, FDL
What provides passive support to the transverse arch of the foot?
shape of the bones
wedge shaped cuneiforms
What provides active support to the transverse arch of the foot?
fibularis longus + tibialis posterior tendons
What is pes planus?
Flat feet: due to loose/degenerative ligaments
may lead to infero-medial displacement of talus
What is located on the dorsum of the foot?
2 Muscles:
Extensor Hallucis Brevis
Extensor Digitorum Brevis
+ dorsalis pedis artery
What is the common origin of the intrinsic extensors of the foot?
Superolateral surface of calcaneus
talocalcaneal ligament
What is the innervation of the intrinsic extensors of the foot?
Deep fibular nerve L4, L5, S1
Where does extensor hallucis brevis insert?
Base of proximal phalanx of big toe
Where does extensor digitorum brevis insert?
Lateral sides of tendons of EDL of toes 2-4
At what joint do EHB and EDB extend the toes?
Metatarsophalangeal joint
What nerve innervates most of the skin of the dorsum of the foot?
Superficial Fibular Nerve
Which nerves are involved in the innervation of the foot?
Deep fibular
Superficial fibular
Sural nerve (lateral side)
Saphenous nerve (medial side)
What muscles are located in the first layer of the plantar compartment?
Flexor Digitorum Brevis
Abductor Hallucis
Abductor Digiti Minimi
This layer is the most superficial to the sole
What is the common origin of the muscles in the 1st layer of the plantar foot?
Calcaneal tuberosity
What is the insertion of flexor digitorum brevis?
Middle phalanges of toes 2-4
What is the insertion of Abductor Digiti Minimi and of Abductor Hallucis?
ADM: lateral proximal phalanx of little toe
AH: medial proximal phalanx of big toe
What is the purpose of the plantar aponeurosis?
Passive support to the longitudinal arches of the foot
protect structures in the sole of the foot
What muscles and tendons are in the second layer of the plantar foot?
2 muscles, 2 tendons:
Lumbricals
Quadratus Plantae
Tendon of Flexor Hallucis Longus
Tendon of Flexor Digitorum Longus
What is the origin and insertion of quadratus plantae?
Origin: medial surface of calcaneus and lateral calcaneal tuberosity
Insertion: lateral side of tendon of flexor digitorum longus (attaches to toe tendon)
What muscles are in the third layer of the plantar foot?
Flexor Hallucis Brevis
Flexor Digiti Minimi Brevis
Adductor Hallucis (transverse and oblique head)
What muscles are found in the fourth (deepest) layer of the plantar foot?
The Dorsal and Plantar Interossei
3 PLANTAR - PAD - Palmar ADduct
4 DORSAL - DAB - Dorsal ABduct
Describe the formation of the deep plantar arch?
Anterior Tibial enters foot»_space; Dorsalis Pedis Artery
meanwhile, Posterior Tibial enters from post compartment of the leg
Post Tibial divides into Lateral and Medial Plantar Arteries
Dorsalis Pedis anastomoses with the Lateral Plantar Artery to form the Deep Plantar Arch
Which nerves contribute to the innervation of the sole of the foot?
Medial Plantar - most, toes 1-3.5, medial sole
Lateral Plantar - toes 3.5-5, lateral sole,
Saphenous nerve - postero-medial sole
Medial Calcaneal Nerve - postero-lateral sole
Sural Nerve - Heel
