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LEA > Muscles of the foot > Flashcards

Muscles of the foot Flashcards

1
Q

does epriderms have blood vessels ?

A

There are no blood vessels in the epidermis..nutrients and wastes are via diffusion

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2
Q

Does dermis have vascularization?

A

yes it contains vascular supply for dermis and epidermis and vareity of nerve endings

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3
Q

dermis is divided into

A
  1. Papillary layer

2. Reticular layer

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4
Q

sebacous glands on the dorsum of the foot

A

secrete sebum into the hair follicle to waterproof and moisturize the hair

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5
Q

skin appendages are derived from

A

epidermis

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6
Q

skin appendages on the dorsum of the foot includes

A
  1. hair follicle
  2. sebaceous glands,
  3. sweat glands
  4. nails
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7
Q

arrector pili muscles and bundle of smooth muscles attaching to the hair follicles are derived from

A

dermis

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8
Q

superficial fascia on the dorsum of the foot is absent at what level

A

subcutaneous surface

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9
Q

deep fascia on the dorsum of the foot forms ——–around the ankle

A

Retinacula

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10
Q

deep fascia on the dorsum of the foot forms

A
  1. Superior extensor retinaculum ( transverse crural ligament)
  2. inferior extensor retinaculum ( cruciate crural lig)
  3. flexor retinaculum (laciniate ligament)
  4. fibular retinaculum
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11
Q

Superior extensor retinaculum

A

attaches laterally to the dostal aspect of the shaft of fibula and medially to the distal aspect of shaft of tibia

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12
Q

Superior extensor retinaculum binds down the tendons of

A
  1. tibialis anterior
  2. EHL
  3. EDL
  4. Fibularis tertius
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13
Q

Inferior extensor retinaculum is attached laterally to

A

sinus tarsi of the calcaneous

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14
Q

Inferior extensor retinaculum is a Band courses medially as a double layer enclosing the tendons of

A
  1. Fibularis tertius

2. EDL

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15
Q

where is superior and inferior limb of Inferior extensor retinaculum formed

A

at the medial border of EDL

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16
Q

The superior limb of inferior extensor retinaculum encloses the tendons of

A
  1. EHL

2. Tibialis Anterior

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17
Q

The inferior limb of inferior extensor retinaculum encloses the tendons of

A
  1. EHL

2. tibialis anterior

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18
Q

Where does the superior limb of inferior extensor retinaculum attach to

A

medial malleolus

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19
Q

Where does the inferior limb of inferior extensor retinaculum attach to

A

plantar apeoneurosis

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20
Q

flexor retinaculum attaches to

A

medial malleolus and medial surface of the calcaneous

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21
Q

posterior to medial malleolus the following are arranged from medial to lateral just before they pass into tunnels that are formed deep to flexor retinaculum

A
  1. tendon of tibialis posterior
  2. tendon of FDL
  3. posterior tibial artery with veins on either side
  4. tibial nerve
  5. tendon of FHL
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22
Q

where is the common site for taking posterior tibial pulse and performing tibial nerve block

A

posterior to medial malleolus

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23
Q

what is tarsal tunnel syndrome?

A

Entrapment of tibial nerve or its (medial plantar /lateral plantar branch) in the tunnel beneath the flexor retinaculum

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24
Q

beneath the flexor retinaculum there are individual tunnes for each of the following

A
  1. tendon of tibialis posterior
  2. tendon of FDL
  3. Tendon of FHL
  4. medial plantar vessles and nerves
  5. lateral plantar vessles and nerves
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25
Q

superior and inferior portion of fibular retinaculum bind down the tendons of

A

fibularis longus

fibularis brevis

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26
Q

superior fibular retinaculum attached to

A

lateral malleolus and lateral surface of the calcaneous

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27
Q

inferior fibular retinaculum attaches to

A

lateral surface of calcaneous including fibular tubercle

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28
Q

fibular retinaculum is continuous with

A

inferior extensor retinaculum

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29
Q

tendons of lumbricales and interossei course along the side of the digits and are continuous with

A

Extensor hood

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30
Q

interdigital infections can spread along interossei and lumbrecales tendons and go to

A

plantar surface of the foot

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31
Q

name 2 intrinsic muscles on the dorsum of the foot?

A
  1. EHB

2. EDB

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32
Q

origin of EHB

A
  1. sinus tarsi of calcaneous
    2interosseious talocalcaneal lig
  2. inferior extensor retinaculum
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33
Q

course of EHB

A

obliquely from lateral to medial deep to tendon of EHL

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34
Q

insertion of EHB

A

dorsum of the base of the proximal phalanx of the hallux

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35
Q

action of EHB

A

dorsiflex the proximal phalanx of the hallux

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36
Q

origin of EDB

A
  1. sinus tarsi of calcaneous
  2. interosseous talocalcaneal lig
  3. inferior extensor retinaculum
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37
Q

course of EDB?

A

obliquely from lateral to medial deep to tendons of EDL and divides into 3 tendons

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38
Q

insertion of EDB?

A

into the lateral side of EDL tendons of the 2nd, 3rd, 4th toes at the level of base of the proximal phalanges and contribute to the extensor hood

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39
Q

Action of EDB?

A

dorsiflex the proximal phalanges of 2nd, 3rd and 4th toes

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40
Q

what are the extrinsic muscles on the dorsum of the foot

A
  1. tibialis anterior
  2. EHL
  3. EDL
  4. fibularis tertius
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41
Q

TA insert into

A

medial and plantar surfaces of the 1st cuneiforms and the bases of the first metatarsal (1st ray)

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42
Q

EDL trifurcate at what level?

A

at the head of the proximal phalanx

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43
Q

the central slip of the EDL inserts into

A

dorsum of the base of the middle phalanx

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44
Q

the 2 collateral slips unite at

A

the head of the middle phalanx

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45
Q

the 2 collateral insert into the

A

dorsum of the base of distal phalanx

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46
Q

FT insert into

A

dorsum of 5th metatarsal base

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47
Q

what tendons form the extensor hood

A
  1. EDL

2. EHL

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48
Q

the extensor hood extends from the

A

head of the metatarsal to the distal aspect of proximal phalanx

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49
Q

the proximal component of teh extensor hood is

A

sling portion

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50
Q

fibers of sling portion

A

encircle the capsule of MTP

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51
Q

fibers of sling portion of extensor hood blend with

A
  1. Plantar plate
  2. deep transverse metatarsal ligaments
  3. flexor sheaths
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52
Q

distal component of the hood is

A

wing portion

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53
Q

fibers of wing portion are arranged

A

obliquely on the sides of the digits

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54
Q

what contribute to the extensor hood on lesser digits

A

tendons of

  1. dorsal interossei
  2. plantar interossei
  3. lumbricales
  4. 1st,2nd,3rd tendons of EDB
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55
Q

what contribute to the extensor hood on hallux

A

tendons of

  1. abductor hallucis
  2. flexor hallucis brevis
  3. adductor hallucis
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56
Q

what FORMS the extensor hood?

A

tendons of

  1. EHL
  2. EDL
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57
Q

what is the action of the extensor hood?

A

dorsiflexion of the proximal phalanx through the sling mechanisms

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58
Q

what is the function of extensor hood?

A

helps maintain the central position of the EDL tendons and the tendon of EHL

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59
Q

EHL and TA

A

have their own synovial sheaths

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60
Q

EDL and FT

A

have a common synovial sheath

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61
Q

the skin on plantar surface of the foot

A

thick, hairless, composed of an epidermis and a dermis

62
Q

differences between plantar and dorsum of the foot

A

the epidermis on the plantar surface has an additional layer statrum lucidum and all layaers are much more thicker

The only skin appendages present on the plantar surface is sweat glands

63
Q

what is the natural orientation of collagen fibers in the DICT of the dermis called?

A

langer’s lines, cleavage lines, or relaxed skin tension lines

64
Q

what are these langer’s lines important for?

A

they are important for surgical incisions. they also represent the natural tension created on the skin from underlying structures

65
Q

superficial fascia on the plantar surface of the foot forms distinct pad at

A

calcaneal tuberosity, metatarsal heads and distal phalanges

66
Q

the fat pad over the calcaneal tuberosity might be compressed resulting in

A

heel bruise or stone bruise (periostitis)

67
Q

deep fascia on the plantar surface of the foot is also called

A

plantar aponeurosis or plantar fascia

68
Q

plantar aponeurisis divided into 3 portions

A

central
medial
lateral

69
Q

central portion of plantar aponeurosis

A

triangular shaped with base attached to medial process of calcaneal tuberosity

70
Q

At what region the central portion of plantar aponeurosis divide into 5 slips?

A

at metatarsal shaft

each slip then divide into deep and superficial slip

71
Q

the superficial slips are connected togethere by

A

transverse metatarsal lig

72
Q

The deep slips divide into 2 slips which course on either side of the tendons of

A

FHL, FDL, FDB

73
Q

the deep slips then blend with

A
  1. plantar plate
  2. deep transverse metatarsal lig
  3. and distally with the flexor sheaths
74
Q

plantat fascitis

A

inflammation of the attachment of central portion of plantar aponeurosis to medial process of calcaneal tuberosity

75
Q

what is the windlass effect of the central portion of plantar aponeurosis

A

dorsiflexion of the toes winds the plantar aponeurosis around the metatarsal heads

76
Q

medial portion of the deep fascia on the plantar surface covers

A

the abductor hallucis

77
Q

lateral portion of deep fascia on the plantar surface covers

A

the abductor digiti minimi

78
Q

lateral portion of deep fascia on the plantar surface attach to

A

lateral process of calcaneal tuberosity

79
Q

an interoseous septa separates the central compartment from

A

interosseous compartment

80
Q

1st layer of plantar muscles

A
  1. abductor hallucis
  2. abductor digiti minimi
  3. flexor digitorum brevis
81
Q

2nd layer of plantar muscles

A
  1. lumbricales
  2. quadratus pantea
  3. flexor hallucis longus
  4. Flexor digitorum longus
82
Q

FHL is connected to FDL by a fibrous cord called

A

knot of Henry

83
Q

3rd layer of plantar muscles

A
  1. flexor hallucis brevis
  2. Adductor hallucis
    3.flexor digiti minimi brevis
    tendon of tibialis posterior and fibularis longus are also in this layer
84
Q

4th layer of plantar muscles

A

3 plantar interossei

4 dorsal interosssei

85
Q

varus

A

bent toward the midline of the body

86
Q

valgus

A

bent away from the midline of the body

87
Q

Abductor Hallucis

A

O: Medial process of calcaneal tuberosity
flexor retinaculum
deep surface of flexor retinaculum
tuberosity of the navicular
Course: distally along the medial side of the foot
I: Fibers blend with the medial tendon of FHB , the medial sesamoid , the plantar plate and the extensor hood
tendons then insert onto the medioplantar aspect of the proximal phalanx of the hallux
Action: abducts and aids in plantarflexion of teh hallux

88
Q

origin of Flexor digitorum brevis

A

medial process of calcaneal tuberosity

deep surface of the plantar aponeruosis

89
Q

course of Flexor digitorum brevis

A

ditally and it divides into 4 tendons for lesser digits, the tendon to the 5th toe may be absent

90
Q

Insertion of Flexor digitorum brevis

A

Each tendon divides into 2 parts at the base of the proximal phalanx to allow the passage of tendon of FDL, the 2 parts then reunite at the head of the proximal phalanx and insert onto the plantar surface of the shaft of the middle phalanx

91
Q

Action of Flexor digitorum brevis

A

plantarflex the proximal and middle phalanges of the lesser digits

92
Q

origin of abductor digiti minimi

A

lateral margin of the medial process of calcaneal tuberosity
lateral process of calcaneal tuberosity
deep surface of plantar aponeurosis
tuberosity of base of the 5th metatarsal

93
Q

Course of the abductor digiti minimi

A

distally along the lateral side of the foot

94
Q

insertion of the abductor digiti minimi

A

lateral side of the base of proximal phalanx of the 5th toe

95
Q

action of abductor digiti minimi

A

abduction of the 5th toe

96
Q

entrapment od muscular branch of lateral plantar nerve to abductor digiti minimi causes

A

heel pain

97
Q

origin of quadratus plantae

A

medial head: medial surface of the calcaneous
lateral head: inferior surface of the calcaneous just distal to the lateral process of the calcaneal tuberosity , and long plantar lig
the 2 head are seoerated by long plantar ligament and either head may be reduced or absent

98
Q

insertion of quadratus plantae

A

FDL tendon

99
Q

Action of quadratus plantae

A

assists FDL in plantar flexion of lesser digits

100
Q

origin of lumbrical muscles

A

1st: medial side of the 1st tendon of FDL
2nd: adj side of 1st and 2nd tendo of FDL
3rd: adj side of the 2nd and 3rd tendon of FDL
4th: adj side of the 3rd and 4th tendon of FDL

101
Q

course of lumbrical muscles

A

distally along the medial side of the FDL tendons and inferior to deep transverse metatarsal lig

102
Q

insertion of lumbrical muscles

A

1st: extensor wing and extensor trifurcation of the 1st tenon of EDL ( of the 2nd toe)
2nd: extensor wing and extensor trifurcation of the 2nd tendon of EDL ( of the 3rd toe)
3rd: extensor wing and extensor trifurcation of the third tendon of EDL (of the 4th toe)
4th: extensor wing and extensor trifurcation of the 4th tendon of EDL ( of the 5th toe)

103
Q

action of lumbrical muscles

A

plantar flex the proximal phalanges and extend the middle and distal phalanges of the lesser digits

104
Q

origin of flexor hallucis brevis

A

form a Y shaped tendon
lateral arm from plantar surface of the cuboid and 3rd cuneiform
medial arm from the plantar portion of tendon of tibialis posteior

105
Q

course of the flexor hallucis brevis

A

toward the 1st metatarsal ehad and divides into 2 tendons

106
Q

insertion of the flexor hallucis brevis

A

medial tendon contains the medial sesamoid, blends with the plantar plate and tendon of abductor hallucis and contributes to the extensor hood
lateral tendon contains the lateral sesamoid, bend with the plantar plate and conjoined tendon of adductor hallucis and contribute to the extensor hood
the tendons then unite and insert into the plantar surface of the base of the proximial phalanx of hallux

107
Q

action of the flexor hallucis brevis

A

plantar flex the proximal phalanx of the hallux

108
Q

origin of Adductor hallucis muscle

A

oblique head:plantar surface of the base of 2nd , 3rd and 4th metatarsals and the tendon sheath of fibularis longus
Transverse head: plantar plates of the 3rd, 4th and 5th MTP’s and the deep transverse metatarsal ligament between them. the transverse head is sometimes referred to as transverse pedis

109
Q

course of Adductor hallucis muscle

A

the 2 heads unite to form a conjoined tendon which courses through the split in the deep transverse metatarsal lig

110
Q

inseriotn of the Adductor hallucis muscle

A

fibers blend with the lateral tendon of FHB and lateral seasomid, the plantar plate and contribute to the extensor hood
Tendon then insert into the lateroplantar aspect of the base of proximal phalanx of hallux

111
Q

Action of Adductor hallucis muscle

A

adducts and aids in plantarflexion of the hallux.

Assists in pulling the metatarsal heads tohgether

112
Q

seasomid apparatus is composed of

A
  1. planar plate of MTP
  2. Medial and Lateral sesamoids
  3. abductor hallucis
  4. flexor hallucis brevis
  5. adductor hallucis
113
Q

origin of flexor digiti minimi brevis

A
  • inferior surface of the base of 5th metatarsal

- tendon sheath of fibularis longus

114
Q

course of flexor digiti minimi brevis

A

distally and slightly laterally

115
Q

insertion of flexor digiti minimi brevis

A

lateroplantar aspect of the base of proximal phalanx of 5th toe

116
Q

action of flexor digiti minimi brevis

A

plantarflexes the proximal phalanx of the 5th toe

117
Q

Origin of plantar interossei muscle

A

1st: inferior surface of the base and medial surface of the shaft of 3rd metatarsal
2nd: inferior surface of the base and medial surface of the shaft of 4th metatarsal
3rd: inferior surface of the base and medial surface of the shaft of the 5th metatarsal

118
Q

course of the plantar interossei muscle

A

tendons course distally, superior to deep transverse metatarsal lig

119
Q

insertion of plantar interossei muscle

A

1st: medial side of the base of the proximal phalanx of the 3rd toe and into the extensor hood (sling and wing) of the 3rd toe
2nd: medial side of the base of the proximal phalanx of the 4th toe and into the extensor hood (sling and wing) of the 4th toe
3rd: medial side of the base of the proximal phalanx of the 5th toe and into the extensor hood (sling and wing) of the 5th toe

120
Q

action of plantar interossei muscle

A

adducts the 3rd, 4th, 5th toes

121
Q

origin of dorsal interossei muscles

A

1st: adj sides of the shafts of the 1st and 2nd metatarsals
2nd: adj side of shaft of 2nd and 3rd meatarsals
3rd: adj side of the shaft of 3rd and 4th metatarsals
4th: adj side of the shaft of 4th and 4th metatarsals

122
Q

course of dorsal interossei muscles

A

tendons course distally, superior to deep transverse metatrsal lig

123
Q

insertion of dorsal interossei muscles

A

1st: MEDIAL side of the base of the proximal phalanx of the 2nd toe and into the extensor hood (sling and wing) of the 2nd toe
2nd: LATERAL side of the base of the proximal phalanx of the 2nd toe and into the extensor hood (sling and wing) of the 2nd toe
3rd: LATERAL side of the base of the proximal phalanx of the 3rd toe and into the extensor hood (sling and wing) of the 3rd toe
4th: LATERAL side of the base of the proximal phalanx of the 4th toe and into the extensor hood (sling and wing) of the 4th toe

124
Q

Action of dorsal interossei mucles

A

abducts the 2nd, 3rd, 4th toes

125
Q

extrinsic muscles on the plantar, medial, lateral and posterior surfaces of the foot

A
  1. tibialis posterior
    2.FDL
  2. FHL
    4.gastroc
  3. soleus
    6.plantaris
  4. Fibularis brevis
    8;Fibularis longus
126
Q

insertion of the main component of tibialis posterior

A

tuberosity of navicular and plantar surface od the 1st cuneiform

127
Q

insertion of the plantar component of tibialis posterior

A

2nd, 3rd cuneiforms
cuboid
2nd, 3rd, 4th metatarsal bases

128
Q

insertion of the recurrent portion of tibilais posterior

A

sustentaculum tali

129
Q

FDL

A

from posterior surface to medial surface and then to the plantar surface where it divides to 4 tendons for the lesser digits
each tendon courses through the split in the tendon of FDB in the shaft of a proximal phalanx and then inserts on the plantar surface of the base of the distal phalanx

130
Q

FHL

A

tendon courses from posterior surface to medial surface and then to the plantar surface where it inserts on the plantar surface of the base of the distal phalanx of the hallux

131
Q

Gastroc and soleus

A

form the tendocalcaneous on the posteior surface which inserts into the middle 1/3rd of the posterior surface of the calcaneous

132
Q

plantaris

A

course on the posterior side to insert on the medial side of the middle 1/3rd pf the posterior surface of the calcaneaous

133
Q

Fibularis Brevis

A

course on the lateral surface to insert on the tuberosity of base of the 5th metatarsal

134
Q

Fibularis Longus

A

courses on the lateral surface to the plantar surface where it courses the foot to insert on the lateral side of 1st cuneiform and the base of the 1st metatarsal (1st ray)

135
Q

synovial sheath of tibialis posterior

A

beneath the flexor retinaculum

136
Q

synovial sheath of FDL

A

beneath the flexor retinaculum

each tendon within the flexor sheaths of lesser digits

137
Q

synovial sheath of FHL

A

beneath the flexor retinaculum

and enclosed in a synovial sheath within the flexor sheath of hallux

138
Q

synovial sheath of gastrocnemius and soleus

A

they unite to form a tendo calcaneous which does not course beneath a retinaculum and is not enclosed in a synovial sheath

139
Q

bursa between tendocalcaneous and calcaneous

A

Retrocalcaneal/subtendinous

140
Q

bursa between tendocalcaneous and skin

A

subcutaneous/adventitial

141
Q

synovial sheath of plantaris

A

does not course benath a retinaculum and is not enclosed in a synocial sheath

142
Q

synovial sheath of fibularis longus and brevis

A

both tendons are enclosed in a common synovial sheath as they coarse beneath the superior and inferior fibular retinaculae
The tendon of fibularis longus is also enclosed in a synovial sheath in the fibular sulcus

143
Q

The synovial sheaths have connections to the long and short flexor tendons what are those connection called?

A

vincula tendinum which carry blood vessles to the tendons

144
Q

vincula brevia are locatd

A

near the insertion of tendons

145
Q

vinvula longa are located

A

along the course of the tendons

146
Q

all of the intrinsic muscles function in ———-phase of gait

A

stance

147
Q

biomechanical function of quadratus plantae

A

convert the oblique pull of FDL to a more posterior pull

148
Q

biomechanical function of sesamoid apparatus

A

stablizes the 1st metatarsal head against the ground during propulsion

149
Q

biomechanical function of lumbricals, dorsal interossei and plantar interossei

A

These muscles convert the lesser toes into rigid beams during propulsion. (rigid beam efect)

150
Q

fibularis digiti minimi ( variation)

A

slip from fibularis brevis that inserts inti the 5th toe

151
Q

Extensor hallucis capsularis ( variation(

A

slip from the tendon of EHL that insert into the capsule of 1st MTP

LEA (10 decks)

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