The Foot

Question 1

What are the branches of the anterior tibial artery in the foot? Where do they arise?

Answer 1

• Dorsalis Pedis (arise on dorsum of foot)
• Anterior lateral & anterior medial malleolar arteries (arise above ankle)
• Contribute to collateral circulation of ankle

Question 2

What are the branches of Dorsalis Pedis?

Answer 2

• Arcuate artery: becoming common dorsal digital arteries supplies toes
• Deep plantar artery: Supplies sole of foot passing between toes 1&2

Question 3

Describe the ankle joint

Answer 3

• Synovial hinge joint
• Between distal fibula, tibia & talus
• Weakest ant & post

Question 4

What movements are possible at the ankle? What muscles produce them?

Answer 4

• Dorsiflexion-most stable, ant leg muscles
• Plantarflexion, post leg muscles
• Inversion (supination + adduction)
• Eversion (pronation + abduction + dorsiflexion)

Question 5

What ligaments help to strengthen the ankle joint?

Answer 5

• Deltoid/medial (tibiocalcaneal, tibionavicular, ant&post tibiotalar)
• Distal part of interosseous membrane
• Calcaneal (Achilles tendon)
• Flexor retinaculum
• Anterior & Posterior tibiofibular
• Ant (weakest) &post talofibular
• Calcaneofibular

Question 6

What are the important inter tarsal joints? How are they formed?

Answer 6

• Subtalar= Talus & calcaneus bones

- Transverse talar= 2 articulations between calcaneus & cuboid bones and navicular & talus bones

Question 7

What movements are possible at the subtalar joint?

Answer 7

Supination

Pronation

Question 8

Describe the arches of the foot. What is their function?

Answer 8

• Transverse= cuboid, 3 cuneiform & 5met
• Medial longitudinal=calcaneus, talus, navicular, 3cun, med 3met, highest, weight transmitted from talus->calcaneus->met
• Lateral longitudinal= calcaneus, cuboid, lat 2met
• Shock absorbers, weight distribution & flexibility of foot

Question 9

What is pes planus?

Answer 9

Flat foot- longitudinal arch has flattened out/ not developed properly/lowered

Question 10

Name the intrinsic extensor muscles of the foot

Answer 10

Extensor hallucis brevis
Extensor digitorum brevis
Located on lateral dorsum of foot

Question 11

What nerves supply the medial & lateral ankle?

Answer 11

M= saphenous nerve
L= Sural nerve

Question 12

Name the muscles & vasculature & the layers they reside in in the plantar aspect of the foot

Answer 12

1) Superficial,FDB, abdH & abdDmi trunks of medial & lateral plantar nerves &arteries
2) Tendons of FHL, FDL & attached lumbricals and quadrates plantae
3) FHB, FDmiB, addH, arterial arch
4) Deepest, 4dorsal & 3plantar interossei

Question 13

What is the function of the plantar aponeurosis?

Answer 13

• Supports longitudinal arches of foot
• Protects deep structures in the sole
• Found superficial to first layer of muscles in the foot

Question 14

Describe the interossei

Answer 14

• 3 plantar & 4 dorsal
• Attached to & occupy space between metatarsal bones
• Adduct or abduct about 2nd toe axis

Question 15

What does the deep fibular nerve give rise to on the dorsum of the foot?

Answer 15

• Motor branches to extensor digitorum brevis & extensor hallucis brevis
• Ends as cutaneous branch to skin between great & 2nd toe

Question 16

What are the cutaneous arteries and nerves of the dorsum of the foot and what do they supply?

Answer 16

• Deep peroneal nerve= Supply skin between great toe and adjacent toe
• Superficial peroneal nerve= Supplies skin of the dorsum of the foot & toes
• Dorsalis Pedis artery

Question 17

Where is the tibial nerve & posterior tibial artery located? What do they divide into?

Answer 17

• Deep to the attachment of the abductor hallucis muscle at calcaneus
• Medial & lateral plantar nerve & vessels

Question 18

What vessels form the plantar arch?

Answer 18

• Deep plantar branch of dorsalis pedis

- Deep branch of lateral plantar

Question 19

What muscles allow eversion & inversion?

Answer 19

• E= Fibularis longus & brevis

- I=Tibialis anterior & posterior

Question 20

What is Pott fracture-dislocation?

Answer 20

• Eversion injury
• Pulls on strongest medial lig causing avulsion of medial malleolus
• Talus rotates laterally fracturing fibula

Question 21

How are the arches of the foot supported?

Answer 21

• Passive= ligaments & shape of bones. Plantar aponeurosis & ligaments.
• Dynamic= intrinsic muscles contract & brace arch & extrinsic muscles. TA supported by FL & TP act as stirrup