Section 2 -- Bulk of A and P Flashcards
Tendons
Describe
What do they do? (2)
Where to tendons connect?
How many in foot?
White fibrous connective tissue – strong, non-flexible/non-contractile
Connects muscle to bone
Support the joint between muscles and bones
Connect at the end of skeletal muscles to any place of the bone
100+
What is the largest tendon?
What does it attach?
What does it facilitate?
Achilles
Attaches gastrocnemius to calcaneus
Facilitates rising up on toes when running or walking
Forefoot bones?
o Phalanges (Phalanx) o metatarsal
Midfoot bones?
What does the midfoot form?
What does this act as?
o Cuboid
o Navicular
o Cuneiform
The arch of the foot
A shock absorber
Rearfoot bones?
o Talus
o Calcaneus
What do toe tendons allow?
Toe tendons allow toes to dorsiflex or straighten
Origin
The attachment site that doesn’t move during contraction. Usually proximal relative to the the insertion.
Skeletal muscles are attached to bones on each end by tendons. The origin is the fixed attachment, while the insertion moves with contraction.
Insertion
The attachment site that does move when the muscle contracts. Usually distal.
Skeletal muscles are attached to bones on each end by tendons. The origin is the fixed attachment, while the insertion moves with contraction.
The origin of a muscle is the point where the muscle begins; it inserts by means of?
a tendon into the part that it is going to move
Three Arches
- the medial longitudinal (inside of the foot)
- the lateral longitudinal (outside of the foot)
- the transverse arch
Articulation b/w the talus and calcaneus =
the subtalar joint
Articulation of the tibia and fibula to the foot =
the ankle
What type of joint is the ankle?
What does it allow?
A hinge joint
Allows
dorsiflexion (upward movement)
and
plantar flexion (downward movement)
Function of the arches
Support the body’s weight
Provide leverage while walking
Provide flexibility to the foot which aids in shock absorption since they are not rigid, they defer as weight is applied and spring back when weight is lifted.
The bones that make up the arches are held in place by?
muscles, tendons and ligaments
Ankle bones and joints combine?
stability with flexibility
Ankle bones and joints combine stability with flexibility to allow for?
support and propulsion
Metatarsals (Metatarsal bone) 5
i)
Describe
What type of articulations? Where and for what?
shortest/strongest
plantar articulations
near the head
for tibial/fibular sesamoid bones
Metatarsals (Metatarsal bone) 5
ii)
Describe
What does it do? (2)
longest/least mobile,
bears half the body weight
and
balances pressure on metatarsal heads
Metatarsals (Metatarsal bone) 5
v)
What is at its base?
What does this serve as?
lateral prominence (styloid process)
serves as insertion site for tendon of peroneus brevis muscle
Tibial/fibular sesamoid bones
Location
embedded within the tendons of the flexor hallucis bevis muscle of the hallux
Intrinsic muscle system
Define
Originate and terminate within the foot.
Extrinsic muscle system
Begin in the leg, but cross the ankle and end in the foot.
Intrinsic muscle system function? (2)
fine motor actions of the foot such as moving the toes
support the arches of the foot
Extrinsic muscles arise from?
anterior, posterior and lateral compartments of the leg
Extrinsic muscle system function?
Control muscle movement of the foot, relative to the leg.
E.g., Plantarflexion (movement in which the top of your foot points away from your leg - standing on the tip of toes or pointing toes) and dorsiflexion (movement at the ankle joint where the toes are brought closer to the shin, curling upwards, and decreasing the angle between the dorsum of the foot and the leg) of the foot.
Ligaments
Describe
What do they do? (2)
Where to tendons connect?
How many in foot?
Yellow fibrous connective tissue – flexible and elastic to help in movements of bones
Connects one bone to another bone at a joint
Support the joints between bones
107
Articulation (or joint)
Define
What is it usually formed by?
An area where two bones are attached for the purpose of motion of body parts.
Fibrous connective tissue and cartilage.
Planta
The sole of the foot, anatomically referred to as the plantar aspect/surface. There are no hair follicles or sebaceous glands on the soles of the feet.
Dorsum
The top of the foot is called the dorsum of the foot.
Plantar Fascia
Describe
Where does it start and end
What does it do?
The thick connective tissue (aponeurosis) which supports the arch on the bottom (plantar side of the foot)
Starts at the tuberosity of calcaneus
forward to
the heads of the metatarsal bones
Connect the bones of the midfoot to the forefoot.
Metatarsal head (MTH) -
Ball(s) of the foot.
*See second metatarsal. –
longest/least mobile,
bears half the body weight
balances pressure on metatarsal heads
Metatarsal phalangeal joints (MTPJ)
Define
What type of joints are they?
Joints between the heads of the metatarsal bones of the foot and the proximal bones (proximal phalanges) of the toes.
They are condyloid joints, meaning that an elliptical or rounded surface (of the metatarsal bones) comes close to a shallow cavity (of the proximal phalanges).
When a person is standing:
%ages
First and second metatarsals support about 25% of the body weight
Third, fourth and fifth metatarsals support about 25%
50% percent of body weight (while standing) rests on the calcaneus
Primary function of the foot
AAPS
Act as a flexible and adaptable unit during ground contact – provides a stable base
Act as a rigid lever during propulsion
Provide shock absorption – flexible and absorbs forces several times greater than weight of body that occur with walking, running, jumping
Supports the entire weight of the body during walking/standing – steadiness/strength
2.3 Apply knowledge of arterial circulation to foot care
Normal toenail growth/development depends on adequate nerve/blood supply to matrix/nail bed
Arterial circulation from heart to knee
– Route > Heart through aorta branches to > Iliac arteries in the pelvis into > Femoral artery that supplies blood to the lower extremities becoming > Popliteal artery behind the knee dividing into > Anterior and posterior tibial arteries below the knee
Arterial circulation from knee to foot
POSTERIOR
> Posterior tibial artery travels down the posterior of the leg, entering the foot under the medial aspect of the ankle
branching into
Medial and lateral plantar arteries
branches of these arteries supply blood to
Plantar aspect of the foot and the toes
Arterial circulation from knee to foot
ANTERIOR
> Anterior tibial artery passes, just below the knee, through a space between the tibia and fibula and extends down the anterior of the leg. At the anterior aspect of the ankle joint
it becomes
Dorsalis pedis artery, which provides the blood supply to the dorsum of the foot and
continues to branch and ends on
Dorsum of the toes
– Pulses
Name ‘em.
Posterior tibial pulse
Dorsalis pedis pulse
> Posterior tibial pulse
Site
just behind and below the medial malleolus
> Dorsalis pedis pulse
Site
dorsum of the foot between the 1st and 2nd cuneiforms at the proximal end of the 1st metatarsal
It is not uncommon to have difficulty locating either the dorsalis pedis or the posterior tibial pulse in adults over the age of 45, but??
At least one of the pulses should be palpable in each leg.
Capillaries
Tiny blood vessels between arteries/veins. As blood travels through capillaries, nutrients/O2 move from the blood into the body cells, CO2/other wastes move from the body cells into the blood.
How to test capillary refill time?
Normal findings?
- Squeeze toenail between your fingers. After blanching, removal of the finger normally results in immediate return of normal skin color.
Acceptable filling time = < 3 seconds.
2.5 Predict the importance of the nervous system to the health of the leg and foot
Any spinal dysfunction can lead to neuropathic symptoms, such burning and tingling, in the feet
Nervous system - lower back to foot
> Lumbosacral area nerve roots
unite to form
Sciatic nerve (largest in body)
extends down
Posterior aspect of thigh to knee
where it divides into two branches:
i) Common peroneal nerve - anterior aspect of leg
which divides again
then both branches continue down the leg to the dorsum of the foot
ii) Tibial nerve - posterior aspect of leg
to enter foot
under medial aspect of ankle
it then branches again and continues branching until reaching the ends of all toes
2.4 Relate venous return to foot care
Standing motionless for long periods deprives veins of the assistance of skeletal muscle contractions.
With pro-longed periods of standing or sitting, the
walls of the veins become stretched until the
valves no longer work effectively and backflow
occurs. The veins become distended and varicosed.
Edema may be present if a deep vein becomes
occluded.
Two types of vein systems in the lower extremities?
Deep veins
Superficial veins
Deep veins
Describe
Most run parallel to arteries and share the same name
Deep veins include
Posterior/anterior tibial, popliteal, femoral
What is the longest vein in the body
GREAT saphenous vein
Describe path of GREAT saphenous vein from distal to proximal
Starts on the medial, dorsal aspect of the foot, passes in front of the medial malleolus, continues up the medial aspect of the leg and thigh
Describe path of small saphenous vein from distal to proximal
Starts at the lateral, dorsal aspect of the foot, passes behind the lateral malleolus, and continues upward on the posterior of the leg
Buddy to GREAT saphenous vein = ?
small saphenous vein
2.6 Relate the lymphatic system to lower limb health
Lymphatic dysfunction results in blockage in the system. Fluid buildup leads to swelling and serious complications such as bacterial infection of the skin (cellulitis), infection of the lymph vessels (lymphangitis).
Lymph system consists of?
organs, ducts, and nodes
Lymph system consists of organs, ducts, and nodes which?
transport lymph
Lymph is drained from the tissue in microscopic vessels called?
lymph capillaries
Capillaries = very permeable/not pressurized, therefore lymph fluid easily drains
from
tissue to capillaries to return to blood
What are the two phases of gait
stance phase and swing phase
Stance phase
Heel Strike –
Foot Flat –
Heel Off –
Toe Off
Describe walking … ummmmm
The heel touches the ground first
Followed by forefoot contact.
As weight is shifted medially across the metatarsal heads, the final propulsive phase occurs from the first metatarsal and hallux head.
One foot bears all the weight until the other heel touches the ground.
The lower limb is able to do during contact with the ground?
distribute and dissipate compressive tensile, shearing and rotary forces
Efficient force attention during contact with the grund is a combination effect of?
muscle, tendon, ligaments and bone function in the foot
Inadequate distribution of forces during contact with the ground can lead to?
abnormal movement
Inadequate distribution of forces during contact with the ground can lead to abnormal movement, which in turn, produces?
excessive stress and results in damage to connective tissue and muscle
