Week 22 - Ankle & Foot Flashcards
What is the ankle?
The transition zone between the leg and the foot.
What structures cross the anterior aspect of the ankle?
Anterior to the malleoli and in relation to the extensor retinacula.
List structures that pass superficial to the extensor retinacula from medial to lateral.
- Saphenous nerve and great saphenous vein
- Superficial fibular (peroneal) nerve (medial and lateral branches)
List structures that pass deep to or through the extensor retinacula from medial to lateral.
- Tibialis anterior tendon
- Extensor hallucis longus tendon
- Anterior tibial artery with venae comitantes
- Deep fibular (peroneal) nerve
- Extensor digitorum longus tendons
- Fibularis tertius
What surrounds each tendon that passes beneath or through the extensor retinacula?
A synovial sheath.
Which structures pass immediately anterior to the medial malleolus?
- Great saphenous vein
- Saphenous nerve
What structures cross the posterior aspect of the ankle?
Posterior to the malleoli and in relation to the flexor retinacula.
List structures that pass behind the medial malleolus deep to the flexor retinaculum from medial to lateral.
- Tibialis posterior tendon
- Flexor digitorum longus tendon
- Posterior tibial artery with venae comitantes
- Tibial nerve
- Flexor hallucis longus tendon
What surrounds each tendon that passes beneath the flexor retinaculum?
A synovial sheath.
List structures that pass behind the lateral malleolus superficial to the superior fibular retinaculum.
- The sural nerve
- Small saphenous vein
List structures that pass behind the lateral malleolus deep to the superior fibular retinaculum.
- Fibularis longus tendon
- Fibularis brevis tendon
What lies directly behind the ankle?
Fat and the large tendo calcaneus.
What is the primary function of the foot?
Supports body weight and provides leverage for walking and running.
What anatomical term refers to the foot?
Pes.
What is the top of the foot called?
Dorsum of the foot.
What is the bottom of the foot called?
Sole or plantar side.
What is the great toe also known as?
Digit #1 or hallux.
Describe the skin of the sole of the foot.
Thick and hairless, firmly bound to deep fascia.
What cutaneous nerves innervate the sole of the foot?
- Medial calcaneal branch of the tibial nerve
- Branches from the medial plantar nerve
- Branches from the lateral plantar nerve
What is the plantar aponeurosis?
A triangular thickening of the deep fascia that protects underlying nerves, blood vessels, and muscles.
What condition is characterized by pain and tenderness in the sole of the foot?
Plantar fasciitis.
List the muscles of the sole from superficial to deep.
- First layer: Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
- Second layer: Quadratus plantae, lumbricals, flexor digitorum longus tendon, flexor hallucis longus tendon
- Third layer: Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
- Fourth layer: Interossei, fibularis longus tendon, tibialis posterior tendon
What is the primary role of the muscles of the sole?
Support the arches of the foot.
Where does the flexor digitorum longus tendon enter the sole?
By passing behind the medial malleolus deep to the flexor retinaculum.
What does the flexor hallucis longus tendon cross deep to?
The flexor digitorum longus tendon.
What surrounds the tendons of the flexor hallucis longus and the flexor digitorum longus?
Synovial sheaths.
Where does the fibularis longus tendon insert?
Into the base of the first metatarsal bone and the adjacent part of the medial cuneiform.
What is the medial plantar artery?
The smaller terminal branch of the posterior tibial artery.
What does the lateral plantar artery supply?
The larger terminal branch of the posterior tibial artery.
What is the origin of the lateral plantar artery?
The lateral plantar artery arises deep to the flexor retinaculum.
Where does the lateral plantar artery pass after its origin?
It passes forward deep to the abductor hallucis and the flexor digitorum brevis.
What structure does the lateral plantar artery form at the base of the fifth metatarsal bone?
It curves medially to form the plantar arch.
What artery does the lateral plantar artery anastomose with?
It anastomoses with the deep plantar artery, a branch of the dorsalis pedis artery.
What does the plantar arch give off?
The plantar arch gives off plantar metatarsal arteries to the toes.
What veins accompany the medial and lateral plantar arteries?
Medial and lateral plantar veins accompany the corresponding arteries.
What do the medial and lateral plantar veins form behind the medial malleolus?
They unite to form the posterior tibial venae comitantes.
What does the tibial nerve divide into?
It divides into the medial and lateral plantar nerves.
What is the function of the medial plantar nerve?
It provides muscular and cutaneous branches to the medial side of the foot.
List the muscular branches of the medial plantar nerve.
- Abductor hallucis
- Flexor digitorum brevis
- Flexor hallucis brevis
- First lumbrical muscle
What areas do the cutaneous branches of the medial plantar nerve supply?
They supply the sides of the medial three and a half toes.
What is the lateral plantar nerve a branch of?
It is a terminal branch of the tibial nerve.
What does the lateral plantar nerve supply?
It supplies the lateral side of the foot and the muscles in that area.
What are the branches of the lateral plantar nerve?
- Muscular branches to quadratus plantae and abductor digiti minimi
- Cutaneous branches to the lateral part of the sole
- Muscular branches to flexor digiti minimi and interosseous muscles
- Plantar digital branches to lateral one and a half toes
What is the sensory nerve supply to the skin on the dorsum of the foot derived from?
It is derived from the superficial fibular nerve, assisted by the deep fibular, saphenous, and sural nerves.
Where does the superficial fibular nerve emerge?
It emerges from between the fibularis brevis and the extensor digitorum longus muscle.
What does the dorsal venous arch drain into?
It drains into the great saphenous vein on the medial side and the small saphenous vein on the lateral side.
What is the only intrinsic muscle on the dorsum of the foot?
Extensor digitorum brevis.
What is the action of the extensor digitorum brevis?
It extends the toes.
What artery supplies the dorsum of the foot?
Dorsalis pedis artery.
What branch of the dorsalis pedis artery supplies the big toe?
First dorsal metatarsal artery.
What is the role of the deep fibular nerve on the dorsum of the foot?
It supplies the skin of the adjacent sides of the big and second toes and the extensor digitorum brevis muscle.
Fill in the blank: The tendon of extensor digitorum longus passes deep to the _______.
[superior extensor retinaculum]
What does the extensor expansion in the toes consist of?
A central part inserted into the base of the middle phalanx and two lateral parts inserted into the base of the distal phalanx.
What surrounds the extensor digitorum longus and fibularis tertius tendons?
A common synovial sheath.
