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ANAT101 > Topic 7: Muscles of the Leg and Foot > Flashcards

Topic 7: Muscles of the Leg and Foot Flashcards

1
Q

Tibialis Anterior Proximal attachment

A
  • lateral proximal 2/3 of tibia

- adjacent interosseous membrane

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2
Q

Tib Ant Distal Attachment

A
  • plantar surface of the medial cuneiform

- base of metatarsal 1

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3
Q

Tib Ant Actions

A
  • Ankle dorsiflexion

- ankle inversion

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4
Q

Tib Ant nerve supply

A

deep peroneal nerve

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5
Q

Extensor Hallucis Longus (anterior part of foot) proximal attachments

A
  • middle 1/2 anterior fibula

- adjacent interosseus membrane

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6
Q

Extensor Hallucis Longus (anterior part of foot) distal attachments

A
  • dorsal surface of base of digital phalanx of digit 1
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7
Q

Extensor Hallucis Longus (anterior part of foot) actions

A
  1. ankle dorsi

2. Metatarsophalangeal, PIP, DIP, toe extension

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8
Q

Extensor Hallucis Longus (anterior part of foot) nerve supply

A

deep peroneal nerve

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9
Q

Extensor Digitorum Longus (anterior part of foot) proximal attachments

A
  1. Proximal 2/3 of anterior fibula
  2. adjacent interosseus membrane
  3. lateral condyle of tibia
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10
Q

Extensor Digitorum Longus (anterior part of foot) distal attachments

A

Bases of Middle and distal phalanges of digits 2-5 via dorsal digital expansion (extensor aponeurosis/ hood)

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11
Q

Extensor Digitorum Longus (anterior part of foot) actions

A
  1. ankle dorsi

2. MTP, PIP, DIP, Toe ext ( same as EHL)

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12
Q

Extensor Digitorum Longus (anterior part of foot) nerve supply

A

Deep peroneal nerve

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13
Q

Peroneus (fibularis) Tertius (anterior) proximal attachments

A
  1. Anterior distal 1/4 of fibula

2. adjacent interosseous membrane

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14
Q

Peroneus (fibularis) Tertius (anterior) distal attachments

A

Dorsal surface of base of metatarsal 5

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15
Q

Peroneus (fibularis) Tertius (anterior) actions

A
  1. ankle dorsi

2. ankle evers

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16
Q

Peroneus (fibularis) Tertius (anterior) nerve supply

A

Deep peroneal nerve

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17
Q

Peroneus (fibularis) Longus (lateral) proximal attachments

A
  • lateral surface proximal 2/3 and head of fibula
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18
Q

Peroneus (fibularis) Longus (lateral) distal attachments (same as tib ant)

A
  1. medial cuneiform

2. base of metatarsal 1

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19
Q

Peroneus (fibularis) Longus (lateral) actions

A
  1. ankle plantarflexion

2. ankle eversion

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20
Q

Peroneus (fibularis) Longus (lateral) nerve supply

A

superficial peroneal nerve

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21
Q

Peroneus (fibularis) Brevis (lateral) proximal attachments

A

Lateral Surface surface distal 2/3 of fibula

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22
Q

Peroneus (fibularis) Brevis (lateral) distal attachments

A

Tuberosity on base of metatarsal 5

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23
Q

Peroneus (fibularis) Brevis (lateral) actions

A
  1. ankle plant

2. ankle evers

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24
Q

Peroneus (fibularis) Brevis (lateral) nerve supply

A

Superficial Peroneal nerve

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25
Q

Gastrocnemius Proximal attachments

A
  1. posterior aspect of the medial and lateral femoral condyle
  2. capsule of knee joint
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26
Q

Gastrocnemius Distal attachments

A

Posterior Calcaneus via tendocalcaneus

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27
Q

Gastrocnemius actions

A
  1. knee flex

2. ankle plant

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28
Q

Gastrocnemius nerve supply

A

Tibial Nerve

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29
Q

Soleus Proximal attachments

A
  1. soleal line and posterior surface of the tibia

2. posterior surface upper third of fibula

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30
Q

Soleus Distal attachments

A

Posterior calcaneus via tendocalcaneus

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31
Q

Soleus actions

A

ankle plant

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32
Q

Soleus nerve supply

A

Tibial Nerve

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33
Q

Plantaris proximal attachments

A
  1. lateral supracondylar ridge of the femur

2. knee joint capsule

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34
Q

Plantaris distal attachments

A

Posterior calcaneus

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35
Q

Plantaris actions

A

ankle plant

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36
Q

Plantaris nerve supply

A

tibial nerve

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37
Q

Popliteus proximal attachments

A
  1. Lateral condyle of the femur

2. lateral meniscus of the knee

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38
Q

Popliteus distal attachments

A

posterior tibia above the soleal line

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39
Q

Popliteus actions

A
  1. knee flex

2. knee IR

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40
Q

Popliteus nerve supply

A

Tibial Nerve

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41
Q

Tibialis Posterior (posterior) proximal attachments

A
  1. proximal half of the posterior tibia below the soleal line
  2. proximal two/3 of the fibula
  3. adjacent interosseus membrane
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42
Q

Tibialis Posterior (posterior) distal attachments

A
  1. tubercle of the navicular

2. tendinosus expansions connect to all tarsal bones (except the talus) and the bases of the middle 3 metatarsals

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43
Q

Tibialis Posterior (posterior) actions

A
  1. ankle plantar

2. ankle inversion

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44
Q

Tibialis Posterior (posterior) nerve supply

A

tibial nerve

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45
Q

Flexor Digitorum Longus (posterior) proximal attachments

A

Proximal half of the medial tibia below the soleal line

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46
Q

Flexor Digitorum Longus (posterior) distal attachments

A

Plantar surface of the base of the distal phalanx of digits 2-5

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47
Q

Flexor Digitorum Longus (posterior) actions

A
  1. Ankle plant

2. MTP, PIP, DIP, Toe flex

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48
Q

Flexor Digitorum Longus (posterior) nerve supply

A

tibial nerve

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49
Q

Flexor Hallucis Longus (posterior) proximal attachments

A

Lower 2/3 of the posterior fibula

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50
Q

Flexor Hallucis Longus (posterior) distal attachments

A

Plantar Surface of the base of the distal phalanx of digit 1

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51
Q

Flexor Hallucis Longus (posterior) actions

A
  1. ankle plant

2. MTP, IP, Big Toe flex

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52
Q

Flexor Hallucis Longus (posterior) nerve supply

A

tibial nerve

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53
Q

Extensor Digitorum Brevis (dorsal) proximal attachments

A

Upper surface of the calcaneus

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54
Q

Extensor Digitorum Brevis (dorsal) distal attachments

A

Dorsal digital expansion digits 2-4

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55
Q

Extensor Digitorum Brevis (dorsal) actions

A

MTP, DIP, IP, Toes 2-4 ext

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56
Q

Extensor Digitorum Brevis (dorsal) nerve supply

A

Deep Peroneal nerve

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57
Q

Extensor Hallucis Brevis (dorsal) proximal attachments

A

Upper surface of the calcaneus

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58
Q

Extensor Hallucis Brevis (dorsal) distal attachments

A

Dorsal digital expansion digit 1

59
Q

Extensor Hallucis Brevis (dorsal) actions

A
  1. ankle dorsi

2. MTP, IP, Big toe flex

60
Q

Extensor Hallucis Brevis (dorsal) nerve supply

A

Deep peroneal nerve????

61
Q

LAYER 1

Flexor Digitorum Brevis (plantar/ sole) proximal attachments

A

medial tubercle of the calcaneus

62
Q

LAYER 1

Flexor Digitorum Brevis (plantar/ sole) distal attachments

A

plantar surface of the base of the middle phalanx of digits 2-5

63
Q

LAYER 1

Flexor Digitorum Brevis (plantar/ sole) actions

A

MTP, PIP, Flex Toes

64
Q

LAYER 1

Flexor Digitorum Brevis (plantar/ sole) nerve supply

A

medial plantar nerve

65
Q 
LAYER 1 
Abductor Hallucis (sole) proximal attachments
A

Medial tubercle of the calcaneus

66
Q 
LAYER 1 
Abductor Hallucis (sole) distal attachments
A

Medial aspect of the base of the proximal phalanx of digit 1 (with FHB)

67
Q 
LAYER 1 
Abductor Hallucis (sole) actions
A

MTP Big Toe Abd

68
Q 
LAYER 1 
Abductor Hallucis (sole) nerve supply
A

medial plantar nerve

69
Q

LAYER 1

Abductor digiti minimi (sole) proximal attachments

A

Medial and lateral tubercles of the calcaneus

70
Q

LAYER 1

Abductor digiti minimi (sole) distal attachments

A

lateral aspect base of proximal phalanx digit 5

71
Q

LAYER 1

Abductor digiti minimi (sole) actions

A

5th MTP Abd

72
Q

LAYER 1

Abductor digiti minimi (sole) nerve supply

A

Lateral plantar nerve

73
Q 
LAYER 2 (SOLE)
Flexor Accessorius (quadratus plantae) proximal attachments
A

Medial and lateral tubercles of the calcaneus

74
Q 
LAYER 2 (SOLE)
Flexor Accessorius (quadratus plantae) distal attachments
A

Tendon of FDL (flexor digitorum longus)

75
Q 
LAYER 2 (SOLE)
Flexor Accessorius (quadratus plantae) actions
A

MTP, PIP, DIP toe flex

76
Q 
LAYER 2 (SOLE)
Flexor Accessorius (quadratus plantae) nerve supply
A

lateral plantar nerve

77
Q 
LAYER 2 (SOLE)
Lumbricals proximal attachments
A

Adjacent sides of the tendon of FDL

78
Q 
LAYER 2 (SOLE)
Lumbricals distal attachments
A

Base of proximal phalanx via dorsal digital expansion of digit 2-5

79
Q 
LAYER 2 (SOLE)
Lumbricals actions
A
  1. MTP, Toe flex

2. PIP, DIP Toe ext

80
Q 
LAYER 2 (SOLE)
Lumbricals nerve supply
A

Lateral Plantar Nerve

81
Q 
LAYER 3 (SOLE)
Flexor Hallucis Brevis proximal attachments
A

Plantar surface of the cuboid and adjacent lateral cuneiform

82
Q 
LAYER 3 (SOLE)
Flexor Hallucis Brevis distal attachments
A

medial and lateral aspects of the proximal phalanx of digit 1

83
Q 
LAYER 3 (SOLE)
Flexor Hallucis Brevis actions
A

MTP Big Toe flex

84
Q 
LAYER 3 (SOLE)
Flexor Hallucis Brevis nerve supply
A

Medial Plantar nerve

85
Q 
LAYER 3 (SOLE)
Adductor Hallucis proximal attachments
A
  1. Oblique head from the bases of metatarsals 2,3, and 4

2. Transverse head from plantar surface of MTP joints 3,4, and 5

86
Q 
LAYER 3 (SOLE)
Adductor Hallucis distal attachments
A

lateral aspect of the base of the proximal phalanx of digit 1 (with FHB)

87
Q 
LAYER 3 (SOLE)
Adductor Hallucis actions
A

MTP Big Toe Add

88
Q 
LAYER 3 (SOLE)
Adductor Hallucis nerve supply
A

Lateral plantar nerve

89
Q 
LAYER 3 (SOLE)
Flexor Digiti Minimi Brevis proximal attachments
A

Plantar surface of the base of metatarsal 5

90
Q 
LAYER 3 (SOLE)
Flexor Digiti Minimi Brevis distal attachments
A

Plantar surface of the proximal phalanx digit 5

91
Q 
LAYER 3 (SOLE)
Flexor Digiti Minimi Brevis actions
A

MTP 5th Toe flex

92
Q 
LAYER 3 (SOLE)
Flexor Digiti Minimi Brevis nerve supply
A

lateral plantar nerve

93
Q 
LAYER 4 (SOLE) 
Dorsal Interossei proximal attachments
A

Proximal half of adjacent metatarsals

94
Q 
LAYER 4 (SOLE) 
Dorsal Interossei distal attachments
A

side of the proximal phalanx of digits 2,3, and 4

95
Q 
LAYER 4 (SOLE) 
Dorsal Interossei actions
A

MTP Toe flex

MTP Toe Abd

96
Q 
LAYER 4 (SOLE) 
Dorsal Interossei nerve supply
A

Lateral plantar nerve

97
Q 
LAYER 4 (SOLE) 
Plantar Interossei proximal attachments
A

Base and proximal half of the shaft of metatarsals

98
Q 
LAYER 4 (SOLE) 
Plantar Interossei distal attachments
A

Base of proximal phalanx digits 3,4,and 5

99
Q 
LAYER 4 (SOLE) 
Plantar Interossei actions
A
  1. MTP Toe flex

2. MTP Toe Add

100
Q

Superior Extensor Retinaculum

A

Binds the tendons of TA, EHL, EDL, PT

Runs horizontally above the ankle

101
Q

Inferior extensor retinaculum

A 
Binds down the:
	TA
	EHL
	EDL
	PT
o	Y shaped band anterior to the talocrural ligaments
102
Q

Peroneal Retinacula

A

Superior and inferior peroneal retina

o Bind down the PL and PB behind the lateral malleolus

103
Q

Flexor Retinaculum

A
  • Converts the bony grooves into canals for the tendons of the TP, FDL, FHL as they pass behind the medial malleolus
  • Bridges over the posterior tibial vessels and nerves
104
Q

Synovial Sheaths at the ankle and in the foot

A
  • Double layer of synovial membrane surrounding each tendon as it passes under the retinacula
  • Facilitate sliding of the tendons
105
Q

Plantar Aponeurosis

A

• Most superficial structure of plantar surface of foot, immediately under the skin
• Triangular in shape: apex at the calcaneus, base at the heads of the metatarsals
Functions:
o binds the skin of the foot
o provides an attachment site for foot muscles
o helps to maintain arches of the foot

106
Q

Maintaining Foot Arches

Static features

A
  • shape of the bones
  • ligaments
  • plantar aponeurosis
  • long plantar ligament
  • short plantar ligament (plantar calcaneocuboid ligament)
  • spring ligament (plantar calcaneonavicular ligament)
107
Q

Maintaining Foot Arches

Dynamic features

A
  • Intrinsic foot muscles
  • Extrinsic muscles
    Longitudinal arch
  • flexor hallucis Longus
  • Flexor Digitorum Longus
    Transverse arch
  • fibularis Longus
  • tibialis Posterior
  • active and tonic contraction
108
Q

Plantar Ligaments – maintaining foot arches

A
  • Ligaments provide passive support to the arch – effective when foot is not moving (e.g. standing)
  • Long plantar ligament
  • Short plantar ligament
    o (plantar calcaneocuboid ligament)
  • Spring ligament
    o (plantar calcaneonavicular ligament)
109
Q

Maintaining foot arches - ligamentous support

A
  • Plantar aponeurosis very important
  • Thick, triangular shaped
    o Longitudinal fibres except anteriorly
    o Near metatarsal head it splits into superficial and deep layers
    o toe extension increases the tension in the aponeurosis (due to attachments)
    o This raises the longitudinal arches
     Windlass effect
     Occurs during propulsion phase of gait
  • Medial arch
  • Plantar calcaneonavicular (spring) ligament
  • All other interosseous ligaments within the medial arch
  • Lateral arch
  • Long and short plantar ligaments
110
Q

Dynamic Support of maintaining foot arches (TENDONS)

A
  • provide dynamic support to the arch – walking, running
  • tie beams or bowstrings – pull the ends of the arch together and so increase concavity
  • attach to the summit, or run under the summit and pull the summit upwards thus increasing concavity
111
Q

Digital Sweep

A
  • longest possible sweep (pathway) of the tips of the digits
  • flexion occurs at the MTP first
    o while the IP joints are maintained in extension
     flexion of the IP joints comes late
112
Q

How does digital sweep occur

A

o interplay between extrinsic & intrinsic foot muscles

o intrinsic muscles modulate the extrinsic muscles

113
Q

What is Digital Sweep?

A

o Intrinsic muscles act to extend IP joints – to avoid ‘scrunching’ up toes
o Lumbricals and interossei

114
Q

Clawing of the Toes– Loss of Intrinsic Muscle Action

A
  • means that the long flexor/FDL and long extensor/EDL work unopposed
  • multi-joint muscles tend to move their most distal joint first
    o the FDL pulls the interphalangeal joints into flexion
    o the EDL pulls the MTP joints into hyperextension
  • creates a new, abnormal position of rest
115
Q

Dorsal Digital Expansion

A

• Expansion of the extensor tendons as they approach the digits (toes)
• Functions:
o Allows all the joints of the toe to be extended simultaneously
o Provides attachment for some of the intrinsic muscles
(look at diagram on page 69 for where it is)

116
Q

Lumbricals Function (muscles)

A
  • Flex MTP joints & maintains extension of IP joints

- -> Prevents toes clawing

117
Q

Posterior Group– superficial leg muscles

A
  1. Gastrocs
  2. Soleus
  3. Plantaris
    * gastrocs + soleus can be referred to as triceps surae
118
Q

Posterior Group– deep leg muscles

A

o Tibialis posterior
o Flexor hallucis longus
o Flexor digitorum longus

119
Q

Lateral Group leg muscles

A
  1. Peroneus Longus

2. Peroneus Brevis

120
Q

Anterior Group Leg muscles

A
  1. Tibialis Anterior
  2. Extensor Hallucis Longus
  3. Extensor Hallucis Brevis
  4. Peroneus Tertius
121
Q

Tendons of Anterior + Lateral groups

A

look at diagram

122
Q

Retinacula function

A

Act to hold the tendons in place and to prevent bow-stringing

123
Q

Intrinsic Foot muscles

A

Origin and insertion both within the foot

124
Q

Extrinsic Foot muscles

A

Origin in leg or thigh, insertion in foot

125
Q

Dorsal Muscles of the Foot

A
  1. extensor digitorum brevis

2. extensor hallucis brevis

126
Q

Plantar Muscles of foot - layer 1

A

One flexor and two abductors:
• Flexor digitorum brevis
• Abductor hallucis
• Abductor digit minimi

127
Q

Layer 2 muscles

A
  1. Flexor Accessorius/ quadratus plantae

2. Lumbricals

128
Q

Layer 2 tendons

A
  1. Flexor Digitorum Longus tendon

2. flexor hallucis longus tendon

129
Q

Layer 3

A
  1. adductor hallucis
  2. flexor digit minimi brevis
    3, flexor hallucis brevis
130
Q

Layer 4 muscles

A
  1. 4 DAB (dorsal interossei)
    - MTP toe abduction
  2. 3 PAD (plantar interossei)
    - MTP toe adduction
131
Q

Layer 4 tendons

A
  1. Peroneus Longus

2. Tibialis Posterior

132
Q

Foot Functions

A
  • Important that there is an entire health profession dedicated to foot health and function
  • Weight bearing (balance)
  • Propulsion
  • Shock absorption
133
Q

Foot Arches

A
  • 2 longitudinal – run from calcaneus to metatarsal heads
    o Medial arch (higher)
    o Lateral arch (flatter + more rigid)
  • Transverse—runs in coronal plane
    1. medial arch, lateral arch, transverse arch
134
Q

Foot arches formed and supported by

A

o Fit of the bones (congruence)
o Joint integrity
o Ligament tightness
o Muscle tension

135
Q

Transverse foot arch proximal end formed by:

A

o Metatarsal bases
o Cuboid
o All 3 cuneiform bones at proximal end

136
Q

Transverse arch distal end formed by:

A

Head of the metatarsals

137
Q

Foot Movements

A 
1. Abduction & Adduction 
o	Around long axis of leg
2. Pronation & supination 
o	Around foot’s longitudinal axis 
Foot movements:
1. Are not pure
2. Are combined
Adduction always accompanied by supination – called inversion 
Abduction always accompanied by pronation—called eversion
138
Q

Eversion

A

Dorsiflexion, abduction, pronation

139
Q

Inversion

A

Plantarflexion, adduction, supination

140
Q

Rigid vs Flexible Foot

Step- Off

A

o Plantarflex ankle & extend MTP joints
o Tightens plantar aponeurosis (windlass mechanism/ effect)
o Raises medial longitudinal arch
o Head of talus moves superiorly and subtalar joint supinates
o Mid-tarsal joint = locked
o Foot = rigid

141
Q

Rigid vs Flexible Foot

Heel strike- vice versa

A

o Subtalar joint pronates
o Mid-tarsal joint unlocks
o Foot = flexible

142
Q

Rigid vs flexible foot matter because:

A

For different stages of gait cycle:

  1. a rigid foot = efficient at propulsion
  2. a flexible foot = good at passing forces through it
    - and for keeping the foot firmly on the ground even when surfaces are not level
    - aids change of direction
143
Q

Functions of Foot arches

if feet were rigid

A

o Each step/ ground contact would generate very large forces to send through the skeleton
o The feet = flexible + ABSORB much of these shocks

144
Q

Functions of Foot Arches

Arches

A

o Absorb weight forces/ shock
o Efficient weight bearing—weight bearing areas of foot (hindfoot & forefoot)
o Add to foot’s ability to adapt to changes in ground surface contour
o Efficient propulsion – elastic recoil of arch when weight lifted off (arches flatten slightly when weight bearing)

ANAT101 (7 decks)

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