The Foot Flashcards
Plantar Fasciitis
-Caused by microscopic tears at calcaneal origin
-Very common in runners and overweight patients
Clinical features:
-Pain with first steps in morning and heel pain at night
-Exam shows pain in calcaneal origin and inflexible Achilles tendon
Fascia of the foot
Plantar fascia
-Plantar aponeurosis: arises from calcaneus
-Medial plantar fascia
-Lateral plantar fascia
Dorsal fascia
Arches of the foot
Longitudinal arch
-Medial (instep)
-Lateral
Transverse arch- combination of the medial and lateral arches, includes cuneiforms as well as cuboid
Passive & Dynamic support of arches
Passive: all ligaments you have in the foot
Dynamic: tendons of muscles coming in to support the foot
Pes Planus
Pes Planus- flat foot
Can have a flexible flat foot- loose arch when you step down only
- Something wrong with one of the ligaments, loose, allowing for head of talus to drop further than it should
Rigid- step down flat, lift up flat
- Improper bone development during childhood
- Little kids have super flat feet, as they walk more they create that arch. If not developing, something wrong with bone development
Fallen arch- one point had a nice arch but for whatever reason don’t anymore
- Something happened to tibialis posterior, no longer have arch support, flattened foot all the time
-Lose of muscle, stretching of ligaments
Head of talus has fallen down, forefoot has shifted out laterally
Extensor Digitorum brevis muscle
Inn: deep fibular n.
Action(s): aids in extension of digits 2-4
Extensor hallucis brevis muscle
Inn: deep fibular n.
Action(s): extends digit 1
Arteries of the Dorsum of the Foot
Dorsalis pedis a.
-Arcuate a. : dorsal metatarsal aa, dorsal digital aa.
-First dorsal metatarsal a.
-Deep plantar a. (terminal branch)
Nerves of the food
Deep fibular n.
-Motor inn. to mm.
-Sensory to skin b/w digits 1 & 2
Superficial fibular n.
-Sensory to most skin on dorsal aspect
Sural n.
- Skin on lateral side of foot & dorsolateral surface of digit 5
Saphenous n.
-Skin medial side of proximal foot
Layer 1 muscles
abductor digiti minimi m.
flexor digitorum brevis m.
abductor hallucis m.
Abductor hallucis muscle
Inn: medial plantar n.
Action(s): abducts & flexes hallux (at MTP joint)
Flexor digitorum brevis muscle
Inn: medial plantar n.
Action(s): flexes digits 2-5 [at proximal interphalangeal (IP) joint]
Abductor digiti minimi muscle
Inn: lateral plantar n.
Action(s): abducts & flexes digit 5 (at the MTP joint)
Layer 2 muscles
Lumbricals
Quadratus plantae
Quadratus plantae muscle
Inn: lateral plantar n.
Action(s): assists flexor digitorum longus m. in flexing digits 2-5
Lumbrical muscles
Inn: medial plantar n. (lumbrical 1); lateral plantar n. (lumbricals 2-4)
Action(s): flexes MTP joint & extends IP joints of digits 2-5
Layer 3 muscles
Flexor digiti minimi brevis m.
Adductor hallucis m.
flexor hallucis brevis m.
Flexor Hallucis brevis muscle
Inn: medial plantar n.
Action(s): flexes MTP joint of hallux
Adductor hallucis muscle
Inn: lateral plantar n.
Action(s): adducts & assists in transverse arch of foot by pulling metatarsals medially
Flexor digiti minimi brevis m
Inn: lateral plantar n.
Action(s): flexes digit 5 at MTP joint
Layer 4 muscles
Dorsal interossei mm.
Plantar interossei mm.
Dorsal Interossei mm.
Inn: lateral plantar n.
Action(s): abducts digits 2-4 & flexes MTP joints
Plantar interossei mm.
Inn: lateral plantar n.
Action(s): adducts digits 3-5 & flexes MTP joints
Arteries of the sole of the foot
Posterior tibial a. –> lateral plantar a., form deep plantar arch–> branches: digital branches, plantar metatarsal aa., and perforating aa.
Medial plantar–> blood uspply to first digit
Nerves in the Sole of the foot
Tibial n.
-medial calcaneal branches
-medial plantar n.
Branches: common plantar digital nn., proper plantar digital nn.
Lateral plantar n.
Branches: superficial branch (common plantar digital nn, proper plantar digital nn.), deep branch
Bunion (halllux valgus)
-Most common deformity of the MTP joints
-Lateral deviation of the proximal phalanx
-More common in women than men (often cause by tight, pointed shoes)
-Clinical features: medial eminence pain, metatarsal head pain, deformity of toes, and inability to find shoes
-Possible limited ROM and pain with extreme ROM
