The Foot - Plantar Flashcards
Cutaneous Innervation of plantar surface
Saphenous Lateral dorsal cutaneous Calcaneal branches Medial plantar Lateral plantar
Calcaneal branches supply
heel area
Medial plantar suplies
medial 3 1/2 digits
Lateral plantar supplies
lateral 1 1/2 digits
Deep Fascia
Thicker than dorsal side
Thickening of plantar fascia
Flexor retinaculum
Plantar aponeurosis - deep fascia
Central part of deep fascia
Very thick and strong - prevents injury and supports arches of foot
Longitudinally arranged fibers
Goes from calcaneus to toes
Plantar aponeurosis divides into
five slips - one for each toe that attaches to fibrous digital sheaths
Vertical septa from plantar aponeurosis
divide foor into 3 compartments
Medial, lateral, central
Muscles
4 layers of muscles
Help maintain balance and support arches of foot
First layer
3 muscles
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi
Abductor hallucis
First
Tuberosity of calcaneous - base of 1st proximal phalanx
Flexor digitorum brevis
First
Tuberosity of calcaneous - middle phalanx of lateral 4 toes
Abductor digiti minimi
First
Tuberosity of calcaneous - base of 5th proximal phalanx
Second layer
Flexor digitorum longus tendons Flexor hallucis longus tendon Quadratus plantae Lumbrical muscles (4)
Quadratus plantae
Second
Calc - Tendon of FDL
Lumbricals
Second
Tendon of FDL - flexor sheath of lateral 4 toes
Third Layer
Flexor digiti minimi brevis
Adductor hallucis - oblique and transverse heads
Flexor hallucis brevis
Flexor digiti minimi brevis
Third
Base of 5th metatarsl - 5th proximal phalanx
Adductor hallucis - oblique head
Third
Base of met 2-4 – base 1st prox phalanx
Adductor hallucis - transverse head
MP joint ligaments - base 1st proximal phalanx
THird
Flexor hallucis brevis
cuboid - base 1st proximal phalanx
Third
Fourth layer
Peroneus longus tendon
Tibialis post tendon
Plantar interossei muscles (3)
Dorsal interossei muscles (4)
Plantar interossei muscles
Base metatarsals 3-5 –> base proximal phalanx of toes 3-5
Fourth
Dorsal interossei muscles
Adjacent sides 1-5 metatarsals –> proximal phalanx of 2-4 toes
Nerves
Tibial
Sural
Saphenous
Tibial gives what branches
Medial calcaneal
Medial plantar nerve
Lateral plantar nerve
Medial calcaneal
supplies sensory innervation to heel
branch of tibial
Medial plantar nerve
- Larger than lateral
- btw 1st and 2nd layer
- passes deep to abductor hallucis brevis
- Divides into 3 common plantar digital nerves
- each of those gives rise to two proper plantar digital nerves
Medial plantar nerve supplies
cutaneous branch to 3 1/2 digits motor to --> abductor hallucis FDB FHB 1st lumbrical
Lateral Plantar nerve
Passes deep to abductor hallucis
Provides cutaneous branches to lateral 1 1/2 digits
Provides 1 common plantar digital nerve
Provides moto branches to rest of intrinsic muscles
Sural Nerve
Sensory to lateral margin of foot and lateral side of 5th toe
Saphenous Nerve
branch of femoral nerve
sensory to medial side of phoot
Arteries of sole of foot are from
Posterior tibial
- medial and lateral plantar arteries
- supply plantar muscles
- Anastomose with arteries of dorsum of foot
Medial Plantar Artery
smaller than lateral
passes btw abductor hallucis and FDB
Supplies medial side of great tow (first proper plantar digital artery)
Lateral Plantar Artery
Runs obliquely across foot to lateral side
At base of 5th metatarsal it passes medial side
On medial side it joins deep plantar branch of dorsalis pedis to complete plantar arch
Deep plantar artery procides
four plantar metatarsal arteries
Each plantar metatarsal artery divides into
2 proper plantar digital arteries that supply adjacent sides of each toe
The first proper plantar digital artery usally originates either from
first metatarsal or from medial plantar artery
WHat is usually terminal branch of lateral plantar artery
10th proper plantar digital