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MSK exam 3 AP lower limb > plantar foot > Flashcards

plantar foot Flashcards

1
Q

plantar fascia

A

tough connective tissue layer of deep fascia continuous wit that of dorsum of foot attached laterally and medially to 5th and 1st metatarsal respectively

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2
Q

plantar aponeurosis?

A

thickened central portion of plantar fascia

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3
Q

superficial layer of plantar aponeurosis

A

longitudinally oriented fibers attaching proximally to tuberosity of calcaneous

distally provide slips which fuse with and reinforce fibrous digital sheaths

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4
Q

deep layer of plantar aponeurosis

A

transversely oriented fibers attached to heads of metactarsals forming superficial transverse metatarsal ligament

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5
Q

transverse fasciculi

A

transverse oriented bundles of deep fascia which reinforce webs of toes

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6
Q

fibrous digital sheaths

A

specializations of deep fascia

anchored to phalanges

form fibro-osseous canal that prevents bowstring of flexor tendons

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7
Q

synovial digital sheath

A

line the fibrous digital sheaths to lubricate them

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8
Q

intermuscular septa in plantar foot?

A

lateral and medial

extend from lateral and medial edges of plantar aponeurosis to attach to 1st and 5th metatarsal

delineate two compartments

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9
Q

two compartments of plantar foot?

A

medial compartment - great toelateral compartment - 5th toe

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10
Q

contents of medial compartment?

A

flexor and abductor for great toetendon of flexor hallucis longus and medial plantar vessel and nerves

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11
Q

contents of lateral compartment?

A

contains abductor and flexor muscle of digiti minimi

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12
Q

central compartment?

A

deep to plantar aponeurosis and contains flexor digitorum brevis, lumbricals, quadratus plantae, adductor hallucis longus, tendons of flexor digitorum longus, lateral plantar vessels and nerves

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13
Q

interosseous compartment

A

defined as existing between layers of plantar and dorsal interosseous fascia and contains the interosseous muscles

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14
Q

layers of muscle in foot?

A

four

3-2-3-2

this numbering system designates the number of muscles which originate in each layer

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15
Q

plane of reference in foot for abduction and adduction?

A

2nd toe!

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16
Q

muscles of first layer 3

A

abductor hallucis
abductor digiti minimi
flexor digitorum brevis

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17
Q

attachments of abductor hallucis?

A

origin: calcaneus
insertion: medial side of base of proximal phalanx of great toe

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18
Q

action of abductor hallucis

A

abducts great toe

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19
Q

innervation of abductor hallucis

A

medial plantar nerve

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20
Q

attachment of abductor digiti minimi

A

origin: calcaneus
insertion: lateral side of base of proximal phalanx of fifth digit

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21
Q

action of abductor digiti minimi

A

abducts 5th digit

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22
Q

innervation of abductor digiti minimi?

A

lateral plantar nerve

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23
Q

attachments of flexor digitorum brevis

A

origin:calcaneusinsertion:middle phalanges of four small toes

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24
Q

actions of flexor digitorum brevis?

A

flexes middle and proximal phalanges of four small toes

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25
Q

innervation of flexor digitorum brevis

A

medial plantar nerve

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26
Q

tendons of flexor digitorum brevis?

A

bifurcate

!allows passage of tendons from flexor digitorum longus to reach distal phalanges

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27
Q

posterior tibial artery and nerve? where do they divide?

A

divide to lateral and medial plantar branches

deep to proximal abductor hallucis and pass forward between muscles of 1st and 2nd layers

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28
Q

muscles of second layer?

A

quadratus plantae

lumbricals

29
Q

what tendons pass through second layer?

A

flexor hallucis longus and flexor digitorum longus

flexor digitorum longus tendon is with whic hthe muscles of the second layer have an intimate relationship

quadratus plantae actually attaches onto the flexor digitorum longus tendon and the lumbricals have their origin on this tendon

30
Q

attachments of quadratus plantae

A

origin:calcaneusinsertion:tendon of flexor digitorum longus

31
Q

actions of quadratus plantae

A

pulls on tendons of flexor digitorum longus to direct force of its action directly posterior

32
Q

innervation of quadratus plantae

A

lateral plantar nerve

33
Q

attachments of lumbricals

A

origin: tendons of flexor digitorum longus
insertion: medial side of metatarsophalangeal joints via extensor tendons

34
Q

action of lumbricals?

A

flex MP joint

extend distal phalanges

35
Q

innervation of lumbricals

A

first - medial plantar nerve

2,3,4 - lateral plantar nerve

36
Q

muscles of third layer?

A

flexor hallucis brevis

flexor digiti minimi

adductor hallucis

37
Q

attachments of flexor hallucis brevis?

A

origin: plantar surface of cuboid and lateral cuneiform
insertion: lateral and medial sides of base of proximal phalanx of great toe

38
Q

action of flexor hallucis brevis

A

flexes great toe

39
Q

innervation of flexor hallucis brevis

A

medial plantar nerve

40
Q

flexor hallucis brevis heads?

A

has two heads

lateral - adductor hallucis muscle attachment

medial - abductor hallucis muscle attachment

tendon of flexor hallucis longus passes between the two heads

41
Q

attachments of flexor digiti minimi?

A

origin: base of 5th metatarsal
insertion: lateral side of base of proximal phalanx of small toe

42
Q

action of flexor digiti minimi

A

flexes and abducts small toe

43
Q

innervation of flexor digiti minimi?

A

lateral plantar nerve

44
Q

attachments of adductor hallucis?

A

origin:oblique head - base of 2nd 3rd and 4th metatarsal

transverse head - lateral four plantar ligaments of MP jointsinsertion: lateral side of base of proximal phalanx of great toe

45
Q

action of adductor hallucis

A

adducts and flexes great toe

46
Q

innervation of adductor hallucis?

A

lateral plantar nerve

47
Q

muscles of fourth layer and how many muscles of each?

A

plantar interossei 3

dorsal interossei 4

48
Q

attachments of plantar interossei?

A

origin:medial side plantar surfaces of 3rd, 4th, 5th metatarsals

(3x)

insertion:medial side of bases of proximal phalanx of digits 3,4,5 as well as to extensor expansions of same digits

49
Q

action of plantar interossei?

A

adducts digits 3,4,5, flexes MP and extends proximal and distal IP joints of same digits

50
Q

innervation of plantar interossei?

A

lateral planter nerves

51
Q

attachments of dorsal interossei?

A

origin:adjacent sides of all metatarsals

insertion:
1st to medial side of base of proximal phalanx of second toe

2,3,4 to lateral side to base of proximal phalanx of 2,3,4 digits as well as extensor expansion of same digits

52
Q

action of dorsal interossei

A

abducts digits 2,3,4, flexes MP joints, and extends proximal and distal IP joints of same digits

53
Q

innervation of dorsal interossei?

A

lateral plantar nerve

54
Q

where can you view the attachments of the fibularis longus and tibialis posterior?

A

between 3rd and 4th layers

the fibularis longus is attaching to the base of the 1st metatarsal and the medial cuneiform

the tibialis posterior (explosive attachment) is attaching to:
the plantar surface of metatarsals 2,3 and 4
navicular
medial cuneiform (Mainly)
but also to all other tarsals except the talus

55
Q

posterior tibial artery?

A

courses beneath flexor retinaculum and goes deep to abductor hallucis

bifurcates into lateral and medial plantar arteries

56
Q

lateral plantar artery

A

larger of two terminal arteries of posterior tibial artery

passes under abductor hallucis to course between 1st and 2nd muscular layers

runs obliquely lateralward to gain lateral edge of flexor digitorum brevis and parallels to base of 5th metatarsal

dives deep between 3rd and 4th muscle layers and arches medially across heads of 2,3,4 metatarsals - forms plantar arterial arch

57
Q

plantar arterial arch

A

distal portion of lateral plantar artery

provides three plantar metatarsal arteries

terminates in the 1st metatarsal space-anastomose with deep plantar branch of dorsalis pedis muscle

58
Q

branches of lateral plantar artery?

A

calcaneal

muscular

cutaneous

articular

plantar metatarsal arteries x3 (from arch)-between 2,3,4 toes

59
Q

proper plantar digital arteries

A

at webs of digits

branching of plantar metatarsal arteries

60
Q

perforating branches of dorsal metatarsal arteries?

A

anastomose with planter arterial arch and with plantar metatarsal arteries of 2,3,4 intermetarsal spaces

lateral most proper plantar artery of 5th digit is supplied directly by lateral plantar artery-prior to formation of arch

61
Q

medial plantar artery

A

smaller of two branches of posterior tibial artery

courses along medial plantar surface between abuctor hallucis and flexor digitorum brevis

medial to head of 1st metatarsal, anastomoses with digital branch of 1st dorsal metatarsal artery (dorsalis pedis) and terminates by forming 1st proper plantar digital artery

62
Q

branches of medial plantar artery?

A

second, third, fourth plantar digital arteries which anastomose with plantar metatarsal arteries to provide plantar proper digital arteries

63
Q

tibial nerve?

A

after exits beneath flexor retinaculum passes deep to adductor hallucis and bifurcates:-medial and lateral plantar nerves

64
Q

medial plantar nerve

A

homologue of median nerve in handlarger of two branches-passes forward with medial plantar artery and vein in medial intermuscular septum where it provides muscular branches to abductor hallucis and flexor digitorum brevis

65
Q

plantar cutaneous nerve

A

branch from medial plantar nerve

perforate underlying deep fascia and innervate the skin of medial portion of sole

66
Q

termination of medial plantar nerve?

A

proper digital branch for medial surface of great toe and muscular branch to flexor hallucis breviscommon digital nerves (3) which provide proper digital nerves at webs between 1,2,3 toes and muscular branch of 1st lumbricals

67
Q

muscles innervated by medial plantar nerve?

A

1st lumbricalabductor hallucisflexor hallucis brevisflexor digitorum brevis

68
Q

lateral plantar nerve

A

homolog of ulnar nerve in handbranch from tibial nerve deep to abductor hallucis muscle and parallels path of lateral plantar artery across sole of foot between layers 1 and 2

69
Q

termination of lateral plantar nerve?

A

superficial branch - courses laterally on surface of flexor digiti minimi to provide branches to surrounding muscles, proper digital nerve to lateral surface of 5th digit, and a common digital nerve which supplies proper digital nerves to 4th and 5th digitsdeep branch - accompanies plantar arterial arch on surface of interosseous muscles where it provides branches to surrounding muscularture

MSK exam 3 AP lower limb (15 decks)

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