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Lower Extremity Anatomy > Plantar Foot: Part 2 > Flashcards

Plantar Foot: Part 2 Flashcards

1
Q

2nd plantar layer

A
  • 5 muscles (4 lumbricals, quadratus plantae)
  • 2 tendons (FDL and FHL)
  • All muscles attach to FDL
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2
Q

Quadratus plantae (flexor accesorius)

A
  • Deep to FDB

- 2 heads (medial and lateral)

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3
Q

Quadratus plantae (flexor accesorius) origins

A
  • Medial head: medial surface of calcaneus
  • Lateral head: trigonum plantare and inferior calcaneus (distal to lateral tubercle)
  • Origins separated by long plantar ligament
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4
Q

Quadratus plantae (flexor accesorius) insertion

A
  • Heads unite

- Insert onto the FDL tendon

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5
Q

Quadratus plantae (flexor accesorius) blood supply

A
  • Medial and lateral plantar arteries
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6
Q

Quadratus plantae (flexor accesorius) innervation

A
  • Lateral plantar nerve
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7
Q

Quadratus plantae (flexor accesorius) function

A
  • Redirects line of pull of FDL

- Assists in flexing phalanges

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8
Q

Lumbricals (lumbricale muscles)

A
  • 1 is unipennate

- 2,3,4 are bipennate

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9
Q

Lumbricals (lumbricale muscles) origins

A
  • 1st: medial side of 1st tendon of FDL (tendon going to 2nd digit)
  • 2-4: adjacent tendons (e.g. 3rd lumbrical: medial side of 3rd, lateral side of 2nd; 2nd lumbrical medial side of 2, lateral side of 1)
  • Tendons pass distally plantar to the deep transverse metatarsal ligament
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10
Q

Lumbricals (lumbricale muscles) insertions

A
  • Medial aspect of extensor wing of the extensor expansion at base of proximal phalanx of digits 2-5
  • 1st lumbrical goes to 2nd digit, 2nd lumbrical to 3rd digit…
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11
Q

Lumbricals (lumbricale muscles) blood supply

A
  • Respective plantar metatarsal arteries
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12
Q

Lumbricals (lumbricale muscles) innervations

A
  • 1st: medial plantar nerve

- 2-4: deep branch of lateral plantar nerve

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13
Q

Lumbricals (lumbricale muscles) function

A
  • Flex MTP joints

- Extend PIP and DIP joints

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14
Q

3rd plantar layer muscles

A
  • FHB
  • FDMB
  • ADD Hallucis
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15
Q

Flexor hallucis brevis origins

A
  • Lateral head: plantar surface of cuboid and lateral cuneiform
  • Medial head: tibialis posterior tendon
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16
Q

Flexor hallucis brevis insertions

A
  • Medial and lateral base of proximal phalanx
  • Respective heads invest respective hallux sesamoid bones before phalangeal insertion: medial (tibial) and lateral (fibular)
  • Sesamoids
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17
Q

Flexor hallucis brevis blood supply

A
  • 1st plantar metatarsal artery
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18
Q

Flexor hallucis brevis innervation

A
  • Medial plantar nerve
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19
Q

Flexor hallucis brevis function

A
  • Flex (plantarflex) hallux MTP joint
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20
Q

Flexor hallucis brevis sesamoid insertion advantage

A
  • Increase the mechanical advantage of the FHB

- Weight bearing structures and decrease friction

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21
Q

Flexor digiti minimi brevis origin

A
  • Base of 5th metatarsal

- Tendon sheath of fibularis longus

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22
Q

Flexor digiti minimi brevis insertion

A
  • Plantar/lateral aspect of base of proximal phalanx of 5th toe
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23
Q

Flexor digiti minimi brevis bloody supply

A
  • Lateral plantar artery
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24
Q

Flexor digiti minimi brevis innervation

A
  • Superficial branch of lateral plantar nerve
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25
Q

Flexor digiti minimi brevis function

A
  • Flex (plantarflex) 5th digit at MTP joint
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26
Q

Adductor hallucis heads

A
  • Transverse

- Olbique

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27
Q

Adductor hallucis transverse head origin

A
  • Fibrous capsule
  • Plantar plates of digits 3-5
  • Deep transverse metatarsal ligament
28
Q

Adductor hallucis oblique head origin

A
  • Plantar aspect of metatarsal bases 2-4

- Fibularis longus tendon sheath

29
Q

Adductor hallucis insertion

A
  • Lateral sesamoid

- Lateral aspect of proximal phalanx base of 1st digit

30
Q

Adductor hallucis blood supply

A
  • Plantar metatarsal arteries
31
Q

Adductor hallucis innervation

A
  • Deep branch of lateral plantar nerve
32
Q

Adductor hallucis function

A
  • Adducts hallux
33
Q

Opponens digiti minimi origin

A
  • Base of 5th metatarsal
  • Long plantar ligament
  • FDMB
34
Q

Opponens digiti minimi insertion

A
  • Lateral shaft of 5th metatarsal

- Surrounding fascia

35
Q

Opponens digiti minimi function

A
  • Abduct and flexion 5th toe
36
Q

4th plantar layer

A
  • 4 dorsal and 3 plantar interossei (two muscle groups of 4th layer)
  • Located within the metatarsal spaces
  • None associated with hallux
  • Tendons pass dorsal to deep transverse metatarsal ligament
37
Q

Interosseous muscle groups

A
  • 3 plantar ADDuct

- 4 dorsal ABduct

38
Q

2 tendons of 4th layer

A
  • Tibialis posterior

- Fibularis longus

39
Q

Plantar interossei muscles

A
  • 3 in number
  • Associated with digits 3,4,5
  • Unipennate muscles
40
Q

Plantar interossei origins

A
  • Base and medial aspect of shafts of metatarsals 3, 4, 5
41
Q

Plantar interossei insertions

A
  • Medial aspect of base of proximal phalanx
  • Extensor expansion of same digit
  • Example: 1st plantar interossei originates from the 3rd metatarsal and inserts onto the proximal phalanx and extensor expansion of 3rd digit.
  • 2nd plantar interossei – 4th digit; 3rd – 5th digit
42
Q

Plantar interossei blood suply

A
  • Plantar metatarsal arteries 2-4
43
Q

Plantar interossei innervation

A
  • Lateral plantar nerve
  • Superficial branch innervates
    3rd plantar interossei
  • Deep branch innervates 1st and 2nd plantar interossei
44
Q

Plantar interossei functon

A
  • Adduct digits 3-5 toward foot midline
  • Flex (plantarflex) 3-5 MTP joint
  • Extend (dorsiflex) IP joints of digits 3-5
45
Q

Dorsal interossei

A
  • 4 in number
  • Associated with digits 2-4
  • Digit 2 has 2 dorsal interossei muscles inserting
  • Bipennate muscles located within the intermetatarsal space
46
Q

Dorsal interossei origins

A
  • Adjacent metatarsal shafts
  • Example: 1st dorsal interossei originates lateral aspect of 1st metatarsal shaft and medial aspect of 2nd metatarsal shaft
47
Q

Dorsal interossei insertions

A
  • 1st dorsal interossei: medial aspect of base of proximal phalanx and extensor expansion of 2nd digit
  • 2nd-4th dorsal interossei: lateral aspect of base of proximal phalanx and extensor expansion of corresponding digit
48
Q

Dorsal interossei blood supply

A
  • Corresponding dorsal metatarsal artery
49
Q

Dorsal interossei innervation

A
  • Lateral plantar nerve
  • Deep branch of lateral plantar nerve innervates 1st-3rd
  • Superficial branch of lateral plantar nerve innervates 4th
  • 1st and 2nd also receives innervation from deep fibular nerve
50
Q

Dorsal interossei function

A
  • Abducts digits 2-4
  • Flex (plantarflex) MTP joints
  • Extend (dorsiflex) IP joints
51
Q

Intermetatarsal spaces

A
  • 1st: 1st dorsal interosseous
  • 2nd: 2nd dorsal, 1st plantar
  • 3rd: 3rd dorsal, 2nd plantar
  • 4th : 4th dorsal, 3rd plantar
52
Q

Flexor sheath

A
  • Fibrous
  • Keeps the tendons anchored to the bone
  • FHL, FDB and FDL are surrounded by a synovial sheath to reduce friction
  • Vincula brevia and vincula longa
53
Q

Extensor expansion

A
  • Tendinofibroaponeurotic structure

- Involved in the extensor function of the digits

54
Q

Extensor expansion formed by

A
  • Extrinsic muscles
  • Intrinsic muscles
  • Stabilizing ligaments
55
Q

Extrinsic muscles contributing to extensor expansion

A
  • EDL

- EHL

56
Q

Intrinsic muscles contributing to extensor expansion

A
  • EDB
  • Lumbricals
  • Interossei
57
Q

Stabilizing ligaments contributing to extensor expansion

A
  • Sling and wing

- Triangular lamina

58
Q

Sling

A
  • Proximally located
  • Transversely oriented fibers
  • Pass around the MTP joint
  • Interossei insert into the sling
  • Anchors EDL allowing it to extend all digits
59
Q

Sling attachment points

A
  • Plantar plate

- Deep transverse metatarsal ligament

60
Q

Wing

A
  • Distal portion of extensor expansion
  • Fibers are oriented obliquely (triangular shaped)
  • Located at the proximal phalanx
  • Lumbricals insert into the medial side of the wing
61
Q

EDL tendons

A
  • Forms the central axis of extensor expansion
  • Stabilized by the sling at the MTP joint
  • Divides into 3 slips (trifurcates) at the MTP joint (some say proximal phalanx)
62
Q

3 slips of EDL tendons attachment points

A
  • Medial/lateral slips: extend over dorsum of middle phalanx, insert into base of distal phalanx as a terminal tendon
  • Middle slip: inserts into base of middle phalanx
63
Q

Triangular lamina

A
  • Found between lateral slips of EDL
  • Function is not known
  • Believed to anchor medial and lateral slips
  • Keeps them from sliding plantarward
64
Q

EDB and EHB tendons]

A
  • EDB joins the EDL tendon
  • EDB tendons can form lateral slip instead of EDL
  • EHB attaches to base of proximal phalanx
65
Q

Lumbrical tendons

A
  • Pass plantar to deep transverse metatarsal ligament
  • Insert into wing
  • This allows them to flex MTP joint and extend IP joints
  • Can form medial slip
66
Q

Interosseous tendons

A
  • Pass dorsal to deep transverse metatarsal ligament
  • Insert into base of proximal phalanx at the tubercle
  • Insert into extensor apparatus at the sling
  • Disputed by some

Lower Extremity Anatomy (35 decks)

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