Sole of the foot - third and fourth layers, vessels and nerves (dave's notes)

Question 1

List the contents of the third layer of the foot. What is the collective term for these?

Answer 1

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi
Together - the three short metatarsal muscles.

Question 2

What is the origin and insertion of flexor hallucis brevis?

Answer 2

Arises from the under surface of the cuboid and lies against the undersurface of the first metatarsal bone til the deges split, develop sesamoid bones, and pass to the medial and lateral sides of the plantar surface of the proximal phalanx, great toe.

Question 3

What is the action and innervation of flexor hallucis brevis?

Answer 3

Action is to flex the proximal phalanx of the big toe.

Innevation is the medial plantar nerve.

Question 4

What is the origin and insertion of adductor hallucis?

Answer 4

Adductor hallucis has a large oblique head (from the long plantar ligament and the 2nd, 3rd, and 4th metatarsals, and a small transverse head (from deep transverse ligament and lateral 4 MTP joints.

Question 5

What is the action and innervation of adductor hallucis?

Answer 5

Action: Draws great to toward the axis.

Innervation is the deep branch of the lateral plantar nerve.

Question 6

What is the origin and insertion of flexor digiti minimi?

Answer 6

Arises from the 5th metatarsal and peroneus longus to be inserted into the base of the proximal phalanx.

Question 7

What makes up the fourth layer of the sole of the foot?

Answer 7

The interossei and intermetatarsal spaces.

Question 8

What is the action of the interossei?

Answer 8

PAD DAB - plantar adduct and dorsal abduct

Question 9

What do the plantar and dorsal interossei arise from?

Answer 9

The plantar arise from the metatarsal bone of its own toe

the dorsal interosseous arises by two heads from the second metatarsal on either side.

Question 10

What is the longitudinal axis of the foot?

Answer 10

The longitudinal axis lies along the second toe

Question 11

What three toes require adductors? In what direction to they adduct?

Answer 11

The three plantar adducting muscles adduct towards teh second toe (only the three lateral toes require adductors).

Question 12

What toes have abductors? In what direction do they abduct?

Answer 12

The four dorsal abducting muscles adbuct away from the second toe. The 1st adn 5th each posses their own abductor. The 2nd toe requires one on either side. The 3rd and 4th require a single muscles each to abduct the digit laterally.

Question 13

Where are the dorsal abductors located? What is their innervation?

Answer 13

They are crowded into the intermetatarsal space. All are supplied by the lateral plantar nerve.

Question 14

What tendon crosses the sole of the foot? How? Where does it insert?

Answer 14

The tendon of peroneus longus crosses teh sole obliquely to be inserted at the base of the first metatarsal.

Question 15

Where does the tendon of tibialis posterior insert? What does it give off?

Answer 15

Into the tuberosity of the navicular, giving off many strong fibres.

Question 16

What inserts into the base of the first metatarsal?

What inserts into the tuberosity of the navicualr?

Answer 16

Peroneus longus into the base of the 1st metatarsal

Tibialis posterior into the tuberosity of the navicular

Question 17

What are the vessels and nerves of the sole of the foot derived from? Where is the neurovascular plane of the foot?

Answer 17

Derived from the tibial neurovascular bundle in the calf. The NV plane lies between the first and second layers of the sole of the foot.

Question 18

What does the posterior tibial artery divide into? Where?

Answer 18

Divides into medial and lateral plantar branches under the cover of the flexor retinaculum (M<L)???

Question 19

What does the medial branch of the posterior tibial artery give rise to?

Answer 19

Many branches, but does not contribute to teh arch

Question 20

What does the lateral branch of the posterior tibial artery give rise to?

Answer 20

Crosses teh sole obliquely giving off branches with the main trunk forming the plantar arch and is joined by the PDA (???).

Question 21

Where are the nerves and veins of the sole of the foot located?

Answer 21

These follow the arteries. Arteries run marginal to the nerves, where they cross the nerve is closer to the skin.