The Foot

Question 1

What are the functions of the plantar aponeurosis?

Answer 1

• Grip and weight bearing.
• Thickens as 5 longitudinal bands that continue with the fibrous flexor sheaths of the toes.
• Sends septae to metatarsals to create compartments and potential spaces

Question 2

What are plantar muscles supplied by?

Answer 2

Lateral or Medial plantar nerves

Question 3

What muscles are found in layer 1 of plantar muscles and what is their nerve supply?

Answer 3

Flexor digitorum Brevis - Medial plantar.
Abductor hallucis - Medial plantar.
Abductor digiti minimi - lateral plantar

Question 4

What muscles are in layer 2 of plantar muscles and what is their nerve supply

Answer 4

Lumbricals 1-4 (lumbrical one is supplied by medial, 2-4 are supplied by lateral). 
Quadratus plantae (lateral plantar nerve)

Question 5

What muscles are in layer 3 of plantar muscles and what are their nerve supplies?

Answer 5

Adductor hallucis (lateral planter).
Flexor hallicus brevis (medial plantar N).
Flexor digiti minimi brevis (lateral plantar N)

Question 6

What muscles are in the 4th layer of plantar muscles and what is their nerve supply

Answer 6

3 Plantar interossei - adduction (lateral plantar nerve).

4 Dorsal interossei -abduction (lateral plantar nerve)

Question 7

Describe features of plantar arteries

Answer 7

The posterior tibial artery passes behind the medial malleolus and becomes the medial and lateral plantar arteries. Lateral contributes more to deep plantar arch

Question 8

What happens with a fracture of the neck of talus?

Answer 8

It will interrupt the blood supply to the head of talus causing avascular necrosis.

Question 9

Describe features of the plantar nerves

Answer 9

The tibial nerve bases behind the medial malleolus into the sole deep to the flexor retinaculum and then divides into the medial and lateral plantar nerves.

Question 10

What are the points of contacts of the foot with the flooe?

Answer 10

calcaneus and heads of all metatarsals.

Question 11

What are the functions of the arches in the feet

Answer 11

Weight bare and distribute forces, absorb shock and resilience.

Question 12

What is the medial longitudinal arch made up out of?

Answer 12

Calcaneus, talus, navicular, all 3 cuniforms and medial 3 metatarsals

Question 13

What is the lateral longitudinal arch made up out of?

Answer 13

Calcaneus, cuboid and 4th and 5th lateral metatarsals.

Question 14

What is the transverse arch made up out of?

Answer 14

Cuboid and all 3 cuniforms

Question 15

What are some passive supporters of the arches

Answer 15

1) shapes of the bones with the head of talus being the ‘keystone’ of the medial arch.
2) Strong ligaments

Question 16

What are the strong ligaments that support the arches

Answer 16

Calcaneonavicular plantar ligament (supports the keystone and is therefore the most important). 
Long plantar ligament. 
Plantar aponeurosis. 
Deltoid ligament (extends from tibia). 
Calcaneocuboid (short plantar) ligament.

Question 17

What are some active supporters?

Answer 17

Muscles when they are contracted

Question 18

What are the passive and active supporters of the medial longitudinal arch?

Answer 18

Passive - Deltoid ligament, plantar aponeurosis and spring ligament.
Active - Flexor hallucis longus, tibialis posterior and tibialis anterior.

Question 19

What are the passive and active supporters of the lateral arch

Answer 19

Passive - Short plantar ligament, long palmar ligament, lateral ligament and plantar aponeurosis.
Active - Fibularis longus tendon and flexor digitorum longus

Question 20

What are the muscles on the dorsum of the foot? what are they supplied by?

Answer 20

Extensor digitorum brevis and extensor hallucis brevis which are supplied by the deep fibular nerve

Question 21

What is the function of the extensor and flexor retinaculum ?

Answer 21

Keep the extensor and flexor tendons + neurovascular bundles held down/ in place.

Question 22

What is the tarsal tunnel?

Answer 22

The depression inferior to the medial malleolus formed by talus, calcaneus and flexor retinaculum.

Question 23

What passes through the tarsal tunnel

Answer 23

Tendons for flexor hallucis longus, flexor digitorum longus and tibialis posterior and neurovascular structures.

Question 24

What is the lisfranc joint?

Answer 24

Where the tarsals meet the metatarsals