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Y1 - LEA- Quiz 7/8 > Q8-3. Fascia of the Foot > Flashcards

Q8-3. Fascia of the Foot Flashcards

1
Q

What is the difference between the superficial fascia on the dorsum and that on the sole?

A

Dorsum: little fat

Sole: thick, fat-filled in key weight-bearing areas (toes, ball of foot, lateral side, and heel)

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2
Q

where are the areas of thicker superficial fascia on the plantar foot?

what do these spaces correlate to?

A
  1. thicker SF:
    • lateral margin of heel
    • proceeds to MT5, then medial MTs,
    • lateral toes and hallux
  2. correlate w/ the pressure distribution during gait
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3
Q

what separates superficial fascia (SF) on dorsum from SF on the sole?

A

fusion of the deep fascia (DF) to the dermis

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4
Q

what is continuous with the deep fascia of the foot?

A

crural fascia

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5
Q

the deep fascia of the foot and the crural fascia contributes to the formation of what?

A

retinacula

(a band around tendons that holds them in place)

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6
Q

name of the deep fascia on the dorsum of the foot?

A

fascia dorsalis pedis

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7
Q

*between which layers are the TA, EHL, EDL, and FT?

A

between superficial and deep layers of the deep fascia

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8
Q

the deep layer of the deep fascia splits to enclose which muscles?

A
  1. extensor digitorum brevis and
  2. extensor hallucis brevis
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9
Q

what contents run between the deep fascia and the bone?

A
  • dorsalis pedis artery
  • terminal branches of deep fibular nerve
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10
Q

What is the deep fascia called on the sole of the foot?

A

plantar fascia/

plantar aponeurosis

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11
Q

what are the divisons of the plantar aponeurosis?

A

medial,

central,

lateral

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12
Q

medial plantar aponeurosis:

prox and distal attachments

A
  • prox:
    • continuous w/ flexor retinaculum, & (?) medial process of calcaneal tuberosity
  • distal:
    • medially: fascia dorsalis pedis
    • laterally: central plantar aponeurosis
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13
Q

lateral PA:

prox and distal attachments

A
  • proximal:
    • lateral process of calcaneal tuberosity
  • distal:
    • medially: central plantar aponeurosis
    • laterally: fascia dorsalis pedis
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14
Q

calcaneometatarsal ligament:

define

A

thick band of lateral plantar aponeurosis;

passes from lateral process of calcaneus to MT 5 tuberosity

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15
Q

which division of the plantar aponeurosis is the strongest?

A

central PA

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16
Q

central plantar aponeurosis:

attachments and divisions

A
  1. prox: medial process of calcaneal tuberosity
  2. divisions *@ midtarsal level
    • linked via transverse extensions of connective tissue to keep them properly aligned w/ each other and long axis of foot
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17
Q

at level of the MT head, each digitation splits into a…

A
  1. superficial slip/tract
  2. deep slip/tract
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18
Q

superficial slip/tract:

define

A
  • contributes to the formation of the superficial transverse metatarsal ligament (STML)
  • then attaches to the dermis
19
Q

deep slip/tract:

define

A
  • Divides into 2 parts that lie on either side of the flexor tendons (forming flexor sheaths of lateral toes; attaching to sesamoids of hallux)
  • Pass deep/dorsally to connect to the:
    • plantar metatarsophalangeal ligament/plantar pad or plate
    • deep transverse MT ligament
    • base of proximal phalanx
20
Q

what simple machine is the plantar aponeurosis compared to?

in what ways does it act like this machine?

A
  • compared to windlass/pulley system
  • actions
    • initated by heel rise
    • MTPJs passively dorsiflex
    • w/ passive dorsiflexion –> deep digital slips attached to the bases of the PPs are wound around their respective MT heads
    • winding tightens the PA, causing osseous compression in the midfoot –> raising the MLA and creating midfoot joint stability needed for propulsion on weight-bearing foot
21
Q

the medial plantar aponeurosis both covers and provides partial origin to which muscle?

A

abductor hallucis

22
Q

The central plantar aponeurosis both covers and provides partial origin to which muscle?

A

flexor digitorum brevis (FDB)

23
Q

The lateral plantar aponeurosis both covers and provides partial origin to which muscle?

A

abductor digiti minimi (ADM)

24
Q

what separates the 3 portions of the plantar aponeurosis?

A

grooves created by septa running between plantar aponeurosis and bone;

  • medial intermuscular septum
  • lateral intermuscular septum
25
Q

characteristics of the intermuscular septa running between plantar aponeurosis and bone?

A
  • septa are relatively thin, irregular sheets perforated for the passage of tendons and neurovascular structures
26
Q

what are the components creating the 3 major osteofascial compartments?

A
  • bones
  • plantar aponeurosis
  • septa
27
Q

intrinsic muscles of foot:

medial compartment

A
  1. abductor hallucis
  2. flexor hallucis brevis (*could be in central compartment)
28
Q

intrinsic muscles of foot:

central compartment

A
  • Flexor Digitorum Brevis
  • Quadratus plantae
  • Lumbricals
  • Adductor hallucis
29
Q

intrinsic muscles of foot:

lateral compartment

A
  • Abductor digiti minimi
  • Flexor digiti minimi brevis
30
Q

what separates the deeper/more superior interosseous compartment from the central compartment?

A

interosseous fascia

31
Q

contents of the interosseous compartment of the plantar foot

A
  • 4 dorsal interossei (DABs)
  • 3 plantar interossei (PADs)
32
Q

although there are many variations of compartments of extrinsic muscles, what was the one example Dr. G provided?

A

5 compartments

  • medial compartment of sole
  • central compartment of sole
  • lateral compartment of sole
  • interosseous compartment of foot
  • dorsal compartment of foot
33
Q

extrinsic muscles of:

medial compartment (example)

A
  • abductor hallucis
  • flexor hallucis brevis
  • FHL tendon
  • medial planar nerve & vessels
34
Q

extrinsic muscles of:

central compartment (example)

A
  • Flexor Digitorum Brevis
  • FHL tendon
  • FDL tendon
  • Quadratus plantae
  • Lumbricals
  • Adductor hallucis
  • Lateral Plantar Nerve & Vessels
35
Q

extrinsic muscles of:

lateral compartment

A
  • Abductor digiti minimi brevis
  • Flexor digiti minimi brevis
36
Q

extrinsic muscles of:

interosseous compartment

A
  • MTs
  • Dorsal & Plantar Interossei
  • Deep plantar & MT vessels

*note, interosseous compartment is located in the forefoot only

37
Q

extrinsic muscles of:

dorsal compartment

A
  • Extensor hallucis brevis
  • Extensor digitorum brevis
  • Branches of the dorsalis pedis & deep fibular/peroneal nerve

*Draves (1986) subdivides this compartment into 3 layers based on splitting of the deep fascia as detailed on slide 4 of this conference

38
Q

a puncture wound or perforating ulcer can penetrate where and cause what?

A

can penetrate deep central plantar spaces,

leading to abscess/ deep infection of the foot

39
Q

CC: deep infections of the foot

symptoms and sequelae if left untreated

A
  • sxs, esp along instep:
    • swelling
    • pain
    • erythema (redness, rash)
  • if untreated –>
    • can spread proximally to the posterior compartment of the leg
40
Q

extrinsic muscles of:

central compartment

A
  • Flexor Digitorum Brevis
  • FHL tendon
  • FDL tendon
  • Quadratus plantae
  • Lumbricals
  • Adductor hallucis
  • Lateral Plantar Nerve & Vessels
41
Q

CC: compartment syndrome of foot;

diagnosis

A
  • sxs
    • increasing pain, exaggerted by toe stretching
    • swelling w/ loss of skin wrinkling
    • neurovascular deficits
  • May use needle stick measurements in unconscious patients
42
Q

CC: compartment syndrome of foot;

treatment, and sequelae if left untreated

A
  • treatment: emergeny fasciotomy to release interosseous compartments
  • sequelae if left untreated:
    • chronic pain
    • numbness
    • deformities like rigid claw and hammer toes
    • plantar muscle atrophy
    • callus formation
    • cavus foot
43
Q

CC: compartment syndrome of foot;

cause

A

high energy injuries to the foot;

can also lead to compartment syndrome of the leg (e.g. calcaneal fracture)

Y1 - LEA- Quiz 7/8 (9 decks)

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