week 7 Flashcards

1
Q

leg and foot – Retinacula

A

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

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2
Q

Superior extensor retinaculum

A

Binds the tendons of TA, EHL, EDL, PT Runs horizontally above ankle

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3
Q

Inferior extensor retinaculum

A

Binds down the TA, EHL, EDL, PT
Y shaped band anterior to the talocrural ligaments

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4
Q

Superior and inferior peroneal retinacula

A

bind down the PL and PB behind the lateral malleolus

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5
Q

Flexor retinaculum

A
  • Converts the bony grooves into canals for the tendons of TP, FDL, FHL as they pass behind the medial malleolus
  • Bridges over the posterior tibial vessels and nerves
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6
Q

leg and foot – synovial sheaths

A
  • Double layer of synovial membrane surrounding each tendon as it passes under the retinacula
  • Facilitate sliding of the tendons
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7
Q

Muscles of the foot

A

Intrinsic foot muscles: origin and insertion both within the foot as opposed to extrinsic muscles – origin in leg or thigh, insertion in
foot
Plantar layers described in FOUR layers Superficial to deep

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8
Q

what are Dorsal muscles of the foot

A
  • Extensor digitorum brevis
  • Extensor hallucis brevis
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9
Q

what are the Plantar muscles of the foot – Aponeurosis/Plantar Fascia

A
  • Most superficial structure of plantar surface
  • Triangular in shape: apex at the calcaneus, base at the heads of the metatarsals
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10
Q

what are the Plantar muscles of the foot – Aponeurosis/Plantar Fascia FUNCTIONS

A
  • binds the skin of the foot
  • provides an attachment site for foot muscles
  • helps to maintain arches of the foot (more soon)
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11
Q

Plantar muscles of the foot – layer 1

A

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

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12
Q

Plantar muscles of the foot – layer 2

A

Two tendons and two muscles:
* Flexor digitorum longus
* Flexor hallucis longus
* Flexor accessorius or Quadratus plantae
* Lumbricals

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13
Q

Plantar muscles of the foot – layer 3

A

One adductor and two flexors
* Adductor hallucis
* Flexor digiti minimi
(brevis)
* Flexor hallucis brevis

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14
Q

Plantar muscles of the foot – layer 4

A

Two tendons and two muscles:
* Peroneus longus
* Tibialis posterior
* Plantar interossei
* Dorsal interossei

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15
Q

leg and foot – Dorsal digital expansion

A

Expansion of the extensor tendons as they approach the digits (toes)

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16
Q

leg and foot – Dorsal digital expansion functions

A
  • Allows all the joints of the toe to be extended simultaneously
  • Provides attachment for some of the intrinsic muscles
17
Q

Foot Functions

A
  • Weight bearing (balance)
  • Propulsion
  • Shock absorption
18
Q

when is the foot rigid

A
  • Step-off
  • Plantarflex ankle & extend MTP
    joints
  • Tightens plantar aponeurosis (Windlass mechanism/effect)
  • Raises medial longitudinal arch
  • Head of talus moves superiorly
    and subtalar joint supinates
  • Mid-tarsal joint is locked
19
Q

when is the foot flexible

A
  • Heel strike - vice versa
  • Subtalar joint pronates
  • Mid-tarsal joint unlocks
20
Q

Foot longitude Arches

A
  • Two Longitudinal – run from calcaneus to metatarsal heads
  • Medial arch
  • Lateral arch
  • Transverse – runs in coronal plane
  • Formed and supported by?
    Fit of the bones
    Joint integrity
    Ligament tightness
    Muscle tension
21
Q

what makes up Medial Longitudinal Arches of the Foot

A
  • Calcaneus
  • Talus
  • Navicular
  • Cuneiforms (all 3)
  • Metatarsals I, II, III
  • Talus is highest point (keystone)
22
Q

what are the Lateral Longitudinal Arches of the Foot

A
  • Calcaneus
  • Talus
  • Cuboid
  • Metatarsals IV, V
  • Cuboid is highest point (keystone)
23
Q

Transverse Arch

A

– At proximal end formed by
* Metatarsal bases
* Cuboid
* All 3 cuneiform bones at
proximal end
– At distal end formed by
* Head of the metatarsals

24
Q

Functions of Foot Arches

A
  • Absorb weight forces/shock
  • Efficient weight bearing – weight bearing areas of foot (hindfoot & forefoot)
  • Add to foot’s ability to adapt to changes in ground surface contour
  • Efficient propulsion - elastic recoil of arch when weight lifted off (arches flatten slightly when weight-bearing)
25
Q

Static Support for Foot Arches

A

– Shape of the bones
– Ligaments
* Plantar aponeurosis – both arches
* Long plantar ligament – lateral arch
* Short plantar ligament (plantar calcaneocuboid ligament) – lateral arch
* Spring ligament (plantar calcaneonavicular ligament) – medial arch
* All other interosseous ligaments within the medial arch – medial arch

26
Q

Ligamentous Support

A
  • Plantar aponeurosis very important
  • Thick, triangular shaped
  • Longitudinal fibres except anteriorly
  • Near metatarsal head it splits into superficial and deep
    layers
  • Toe extension increases the tension in the aponeurosis (due to attachments)
  • This raises the longitudinal arches
27
Q

Muscular (Dynamic) Support

A
  • provide dynamic support to the arch – walking, running
  • Two main ways muscle can support the arches which increase concavity
  • Bowstring or tie beam – pull the ends of the arch together
  • Sling – lift the summit upwards
28
Q

Eversion

A

Eversion (combination movement) is Dorsiflexion, Abduction, Pronation

29
Q

inversion

A

Inversion (combination movement) is Plantarflexion, Adduction, Supination
* iPADs – inversion Plantarflexion, ADduction, supination

30
Q

Dorsal Digital Expansion

A
  • Allows all the joints of the toe to be extended simultaneously
  • Important in digital sweep
31
Q

what is digital sweep

A
  • Longest possible sweep (pathway) of the tips of the digits
  • Flexion occurs at the MTP first
  • While the IP joints are maintained in extension
  • Flexion of the IP joints comes late
32
Q

what happens to allow digital sweep

A
  • Intrinsic muscles act to extend IP joints – to avoid ‘scrunching’ up toes
  • Lumbricals and interossei
33
Q

how does digital sweep occur

A
  • Interplay between extrinsic & intrinsic foot muscles
  • Intrinsic muscles modulate the extrinsic muscles
34
Q

what do lumbricals attach to and what are their actions

A
  • Attaches to the dorsal digital expansion * Action of lumbrical
  • Flex MTP joints & extend IP joints
  • Prevents toes clawing