Neck and Foot Flashcards
Extensor Digitorum Brevis (foot)
Origin:
1. superolateral calcaneus
Insertion:
1. base of proximal phalanx of great toe
2. EDL tendons, toes 2-4
Action:
1. Extends toes 2-4
Innervation:
1. deep perineal (fibular) S1, S2
Abductor Hallicus (foot)
Origin:
1. medial calcaneal tuberosity
Insertion:
1. base of proximal phalanx of great toe
Action:
1. Abducts, flexes 1st MTP
Innervation:
1. medial plantar S2,S3
Flexor Digitorum Bervis (foot)
Origin:
1. medial calcaneal tuberosity
2. Plantar aponeurosis
Insertion:
1. middle phalanges 2-5 (bifurcate)
Action:
1. flexes PIP joint lateral 4 toes
Innervation:
1. medial plantar S2, S3
Abductor Digiti Minimi (foot)
Origin:
1. calcaneal tuberosity
Insertion:
1. base of proximal phalanx of toe #5
Action:
1. abducts 5th toe
Innervation:
1. lateral plantar S2,S3
Lumbricals of the foot
Origin:
1. tendon of flexor digitorum longus (foot)
Insertion:
1. extensor expansion lateral 4 toes (run medially)
Action:
1. flexes MTP
2. extends IP joints of toes 2-5
Innervation:
1. 1st: medial plantar S2,S3
2. 2nd, 3rd, 4th lateral plantar S2,S3
Quadratus Plantae
Origin:
1. medial calcaneus
2. lateral calcaneal tuberosity
Insertion:
1. lateral side of Flexor digitorum longus tendon in proximal foot
Action:
1. Flexes lateral toes
Innervation:
1. lateral plantar S1-S3
Adductor hallucis
Origin:
1. transverse head: plantar MTP ligaments of lateral 3 toes
2. oblique head: bases of 2nd, 3rd and 4th metatarsals
Insertion:
1. base of proximal phalanx 1st toe
Action:
1. Adducts 1st toe
Innervation:
1. lateral plantar S2,S3
Flexor Digiti Minimi Brevis (foot)
Origin:
1. Base of 5th metatarsal
Insertion:
1. base of proximal phalanx 5th toe
Action:
1. Flexes 5th MTP joint
Innervation:
1. lateral plantar S2, S3
Flexo Hallucis Brevis
Origin:
1. lateral head: cuboid
2. medial head: tendon of tibialis posterior
Insertion:
1. lateral and medial sides of proximal phalanx of great toe
Action:
1. Flexes 1st MTP joint
Innervation:
1. medial plantar nerve S1, S2
Dorsal/plantar interrossei of the foot
Origin:
1. Sides of metatarsals
Insertion
1. extensor expansions
Action:
1. abduct toes 2-4 (dorsal)
2. adduct toes 3-5 (plantar)
Innervation:
1. All = lateral plantar S2-S3
2. 1st and 2nd: also deep perneal
Sternocleidomastoid
Origin:
1. sternal head: manubrium
2. clavicular head: medial 1/3 of clavicle
Insertion:
1. lateral 1/2 of superior nuchal line
2. mastoid process
Action:
1. unilateral: ipsilateral neck lateral flexion and contralateral rotation
2. bilateral: draw head forward
Innervation:
1. accessory CN XI
2. Anterior rami of C2, C3
Stylohyoid
origin:
1. styloid process
Insertion:
1. hyoid
Action:
1. elevate the hyoid of swallowing
Innervation:
1. cranial nerves
Diagastric
Origin:
1. anterior belly - inside of mandible
2. posterior belly: mastoid process
Insertion:
1. hyoid (held on by sling of CT)
Action:
1. elevate the hyoid of swallowing
Innervation:
1. cranial nerves
Mylohyoid
Origin:
1. mandible
Insertion:
1. hyoid
Action:
1. elevate the hyoid of swallowing
Innervation:
1. cranial nerves
Geniohyoid
origin:
1. inner surface of mandible
Insertion:
1. hyoid
Action:
1. elevate the hyoid of swallowing
Innervation:
1. cranial nerves
Sternohyoid
Origin:
1. posterior S-C joint
2. manubrium
Insertion:
1. hyoid
Action:
1. depress hyoid
Innervation:
1. ventral rami C1-C3
Omohyoid
Origin:
1. Superior border of scapula
2. medial to supra scapular notch
Insertion:
1. hyoid
Action:
1. depress hyoid
Innervation:
1. ventraal rami C1-C3
Sternothyroid
Origin:
1. manubrium
Insertion:
1. thyroid cartilage
Action:
1. depress hyoid
Innervation:
1. ventraal rami C1-C3
Thryohyoid
Origin:
1. thyroid cartilage
Insertion:
1. hyoid
Action:
1. depress hyoid
Innervation:
1. ventraal rami C1-C3
Scalenes
Origin:
1. Cervical TP
Insertion:
1. 1 or 2 rib
Action:
1. elevates 1st o 2nd rib (accessory breathing)
Innervation:
1. anterior rami of cervical nerves
Prevertebral muscles
- name them
- action
- innervation
- longus capties
- longus colli
- rectus capitis anterior
- rectus capitis lateralis
action:
1. flex the head
Innervation:
1. cervical spinal roots
Suprahyoid muscles
- stylohyoid
- digastric
- mylohyoid
- geniohyoid
Infrahyoid muscles
- Sternohyoid
- omohyoid
- sternothryoid
- thyrohyoid
Anterior triangle
borders:
- SCM
- mandible
- midline
Contents:
- common carotid
Posterior triangle of the neck
borders:
- SCM
- clavicle
- trap
Contents:
- scalenes
- brachial plexus
Congential muscular torticollis
- contraction o fibrosis of SCM
- etiology rermains unknown; possible ischemia, birth tauma, intrauterine position
- may have bony changes but mostly just soft tissue
- right sided torticollis = side bent right and rotated left
Congential muscular torticollis
PT intervention
- Neck PROM
- Neck and trunk AROM
- development of symmetrical movement
- environmental adaptations
- parent/caregive education
- may need to put toys so that babay looks other way/football stretch
Congential muscular torrticollis
DC pt when these 5 things are met
- PROM within 5ºof the non-affected side
- symmetrical active movement patterns
- age appopiate motor development
- no visable head tilt
- the parents/caregivers understand what to monitor as the child grows
need to reassess child 3-12 months after DC of PT
Plantar nerves of the foot
medial cutaneous:
- cutaneous to medial plantar heel
Medial plantar:
- cutaneous: medial plantar 3 medial toes and 1/2 of 4th toe
- motor: 1st lumbrical, FHB, Abductor hallucis, FDB
Lateral plantar
- cutaneous: lateral plantar surface lateral 1/2 of 4th toe and little tow
- motor: abducot digiti minimi, quadratus plantae, 2-4 lumbricals, adducto hallucis, FDMB, dorsal and planatar interossei
Dorsal nerves of the foot
Superficial peroneal nerve
- cutaneous to dosum of foot
Deep peroneal:
- cutaneous between 1st and 2 digit
- motor: Extensor hallucis brevis and extensor digitoum brevis
Saphenous nerve
- cutaneous to medial foot and leg
Nerve entrapment:
Morton’s neuroma
- most common location between 3d and 4th MT heads
- compression/entrapment of a nerve
Mortons neuroma
causes
- micrrotrauma to intermetatarsal plantar digital nerves
- compression between deep transverse MT ligament and plantar soft tissue stuctuers
- women more common - shoe wear
morton’s neuroma
treatment
- coticosteriod injections and manipulation/mobilization have strong evidence
- neurolysis
- neuroectomy
blood supply to
the foot
- posterior tibial artery: lateral plantar and medial plantara
- anterior tibial artery: dorsalis pedis ends in 1st intermetatarsal space and becomes deep plantar
turf toe
- sprain of ligaments and capsule of 1st MTP joint
- prognosis: good depends on degree of sprain (3days-6weeks recovery/rest)
turf toe
what other possible injuries
- collateral ligament sprain/tear
- tendon sprain/tearr
- osteochondral injury
- dipartite sesmoid diastasis
- sesamoid and metatarsal factures
- capsular instability
Presentation of turf toe
- antalgic gait
- increased supination
- antalgic gait to pain at first toe with push off
- hypermobility ot MTP
- inability to ambulate distances of 1 mile seconday to pain
differential diagnosis of
turf toe
- dislocation of the MTP
- halluc valgus
- sesamoiditis
- halluc rigidus
- gout
- osteochondrodtic lesion of the first MT head
- osteochondritis dissecans
- metatarsalgia
- metatarsal stress fracture
interventions
turf toe
- rest
- taping to stabilize and limiti extension
- cast shoe
- orthotics with firm extension to the toe to limit toe ROM until pain has resolved
- donut pad to offload pressure on the sesamoid
- address, swelling, pain, mobility strength
Plantar fascitis
interventions
Strongly recommended:
- manual therapy
- stretching
- taping
- night splints
Moderate:
- low level laser in comibination with otherrs
- lifestyle modifcations for weight loss
- ther ex and neuromuscular re-education
- dry needling
