Week 10 - The foot Flashcards
3 main areas of the foot, their names and which bones contain them
The hindfoot = talus and calcaneus
The midfoot = navicular, cuboid and cuneiforms
The forefoot = metatarsals and phalanges
Name all joints of the foot and what they articulate with
Talocrural - Fibula, Tibia with Talus
Subtalar - Talus with calcaneus, navicular and cuboid
Transverse tarsal - talonavicular & calcaneocuboid
Tarsometatarsal joint (TMT) - tarsals & metatarsals
Metatarsal phalangeal joint (MPJ) - metatarsals and phalanges
Proximal interphalangeal joint (PIPJ) - proximal phalange & middle phalange digits 2-5
Distal phalangeal joint (DPJ) - middle phalange & distal phalange digits 2-5
Interphalangeal joint (IPJ) - proximal phalanx & distal phalanx (hallux)
What type of axis is at the subtalar joint?
A diagonal axis that is about 42 degrees superiorly along the sagittal plane and 16 to 23 degrees medial along the transverse plane
What is the ligament that is made up of the Calcaneocuboid and calcaneonavicular and what action does it resist? (have a think)
Bifurcate ligament
Resists inversion of the foot
Where is the transverse tarsal joint
Calcaneocuboid joint + talonavicular joint
It divides the hindfoot and the midfoot
Where is the tarsometatarsal joint?
Between the metatarsals and the tarsals (cuboid, cuniform)
Divides the midfoot and the forefoot
Where is the axis for the tarsometatarsal joint?
Medial to lateral
Where is the proximal interphalangeal joint? (PIPJ)
Between the proximal phalangeals of digits 2-5
The hallux does not have one because there is only two phalanges so technical only an IPJ of the hallux
Where is the metatarsophalangeal joint? (MTPJ)
Between the metatarsals and phalanges (the knuckle of the foot)
What are important ligaments that help in storing energy during walking and what are their functions (2)?
Plantar calcaneonavicular ligament - spring ligament
Long plantar ligament and short plantar ligament
Both function to maintain longitudinal arches of the foot and absorb load
Intrinsic foot muscles on the dorsal surface and NS
Extensor digitorum brevis, extensor hallucis brevis
Deep fibular nerve
Where is the plantar fascia and what is its function?
Name the P & D attachments
Also known as plantar aponeurosis is located deep to the skin and superficial to the intrinsic muscles on the plantar surface of the foot.
The function is to provide support to the arches of the foot and forms a layer of protection to the deep structures.
Medial tubercle of the calcaneal and distal attaches into FDB & divides into head of metatarsal
Intrinsic foot muscles on plantar surface - 1st layer & NS
Layer 1 - abductor digiti minimi, flexor digitorum brevis, abductor hallucis
Medial & lateral plantar N
Intrinsic foot muscles on plantar surface - 2nd layer & NS
Lumbricals 1-4, flexor hallucis longus tendon, flexor digitorum longus tendons, quadratus plantae
Medial & lateral plantar N
Intrinsic foot muscles on plantar surface - 3rd layer and which joint do they move?
Flexor hallucis brevis, adductor hallucis, flexor digiti minimi
They move the MTPJs
Intrinsic foot muscles on plantar surface - 4th layer and which joint do they move?
Dorsal interossei, plantar interossei
Both flex MTPJs
PAD, DAB
How does the Quadratus Plantae assist the FDL tendon in flexion of the distal phalanges?
It inserts into the side of the FDL to align the line of pull. If this muscle wasn’t here, the FDL would be pulling posterior and more medial.
PAD, DAB?
Plantar muscles adduct, dorsal muscle abduct
Which muscles groups are not working in “curled toe” and how does this effect balance?
The intrinsic dorsal muscles are not working to extend the toes. This can impact the weight distribution throughout the foot, meaning less balance.
Medial longitudinal arch bones
Talus, calcaneum, navicular,
3 cuneiforms & medial metatarsals
Lateral longitudinal arch bones
Calcaneum, cuboid
& lateral 2 metatarsals
What is the transverse arch of the foot and where is it?
The transverse arch is the arch that runs from lateral to medial sides of the plantar surface of the foot. It runs along the transverse tarsal joint.
What is the function of the arches of the foot? (3)
The arches distribute weight over the foot, absorb shock, and act as springs during walking & jumping
Superficial fibular nerve (L4 - S1) course distribution
Fib longus, fib brevis and then turns into cutaneous nerve half way down leg and supplies skin of dorsum of foot
Deep fibular nerve supplies which muscles, what cutaneous area and which joint?
Anterior muscles, and extensor digitorum brevis and extensor hallucis brevis
Cutaneous area is a tiny spot between hallux and digit 2 (dorsum)
Proximal tibiofibular joint
Where do the medial and plantar nerves arise from, and which lower leg nerve do they branch from?
Tibial nerve, deep to the flexor retinaculum
Medial plantar nerve supplies
– abductor hallucis
– flexor digitorum brevis
– flexor hallucis brevis
– 1st lumbrical
cutaneous - medial plantar skin (big toe to middle of 4th digit)
Lateral plantar nerve supplies
– quadratus plantae
– abductor digiti minimi
– plantar & dorsal interossei
– 2nd 3rd and 4th lumbricals
– adductor hallucis
cutaneous - lateral plantar skin (5th phalange and half of 4th digit)
Calcaneal nerve supplies
Branches off tibial nerve deep to flexor retinaculum. Sensory to plantar surface of calcaneum.
What happens to the FDL tendon when it reaches the plantar surface of the foot?
It splits for the flexor digitorum brevis tendons at distal attachment
