Lab 6-13: Plantar Surface of the Foot Flashcards

1
Q

plantar aponeurosis extends from __________ to the _____ and from there via ______ slips to the digits

A
  • from the calcaneal tuberosity
  • ball of the foot
  • five
  • it is also connected to the skin via connective tissue septa
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2
Q

at its origin, the plantar aponeurosis is _____ cm wide

A

1-2 cm

- it widens considerably as the fibers proceed longitudinally towards the toes

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3
Q

lateral extension of the plantar aponeurosis is known as …

A

calcaneometatarsal ligament

- extending between the calcaneus to the base of the 5th metatarsal

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4
Q

near the superficial ball of the foot a band of transverse fibers should be observed longitudinally. what are they?

A

superficial transverse metatarsal ligament

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5
Q

what structures are you trying to expose when you clean between the digital slips?

A
  • terminal branches of superficial plantar arch and its branches - superficial plantar digital arteries
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6
Q

there are usually ___ superficial plantar arteries

A

three

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7
Q

what artery and nerve run together emerging from the medial groove close to the ball of the foot?

A
  • 1st proper plantar digital nerve

- superficial tibial plantar artery

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8
Q

what artery and nerve are found in the distal part of the lateral groove?

A
  • 10th proper plantar digital artery and nerve
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9
Q

where is the superficial branch of the medial plantar a. located relative to the plantar aponeurosis?

A

medial side

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10
Q

what are the terminal branches of the superficial branch of the medial plantar a?

A
  • superficial tibial plantar a.

- common plantar digital (branch of medial plantar a.)

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11
Q

at the medial side of the 1st toe, the superficial tibial plantar a. becomes the …

A

1st proper plantar digital a.

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12
Q

what courses with the 1st proper plantar digital a. ?

A

1st proper plantar digital nerve.

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13
Q

a large superficial tibial plantar a. often replaces the …

A

1st plantar metatarsal a.

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14
Q

tracing the superficial tibial artery proximally you locate the …

A

common plantar digital a.

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15
Q

the superficial plantar arch has ______ superficial plantar digital arteries branching off it

A

three

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16
Q

what forms most of the superficial plantar arch?

A

common plantar digital branch of the medial plantar artery

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17
Q

the superficial plantar arch is completed on the lateral side by anastomosis with ____________

A

superficial branch of the lateral plantar artery

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18
Q

the superficial plantar arch is ________ to the distal end of the plantar aponeurosis and ___________ to the tendons of the flexor digitorum brevis muscle

A
  • deep

- superficial

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19
Q

the superficial plantar digital arteries anastomose with …

A

plantar metatarsal arteries of deep plantar arch

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20
Q

at their termination, the deep layers of the digital slips blend with …

A

fibrous digital sheaths of each toe

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21
Q

what divides the muscle of the sole of the foot into three compartments?

A

the two intermuscular septa of the plantar aponeurosis

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22
Q

flexor retinaculum aka

A

lacinate ligament

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23
Q

the flexor retinaculum extends between

A

calaneus and medial malleolus

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24
Q

what n. pierces the retinaculum?

A

medial calaneal n. (branch of tibial n.)

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25
Q

the flexor retinaculum is divided into 4 compartments. what is in each?

A

anterior/first = tendon of tibialis posterior
second =tendon o fflexor digitorum longus
third = posterior tibial vessels and tibial n.
fourth = tendon of flexor hallucis longus

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26
Q

what are the two terminal branches of the tibial n.?

A

medial and lateral plantar nn.

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27
Q

_____ to the superior border of the flexor retinaculum identify the posterior tibial artery and its venae comitantes

A

proximal

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28
Q

what are the two terminal branches of the posterior tibial artery?

A

medial and lateral plantar arteries

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29
Q

which is bigger? medial or lateral plantar aa

A

lateral plantar a.

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30
Q

which is bigger? medial or lateral plantar nn

A

medial plantar n.

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31
Q

where is the medial calcaneal a. located?

A
  • piercing the flexor retinaculum

- can also originate from the lateral plantar a and on occasion there can be more than one branch

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32
Q

where is the peroneal retinaculi located?

A
  • along the lateral side of the foot inferior to the lateral malleolus
  • there is a superior and inferior peroneal retinaculi
  • both are thickenings of the deep fascia of the foot
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33
Q

the superior peroneal retincauli extends from …

A

lateral malleolus to the lateral surface of the calcaneus

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34
Q

the inferior peroneal retinaculum is continuous with …

A
  • the stem of the inferior extensor retinaculum
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35
Q

the inferior peroneal retinaculum expands over _______ and attaches to …

A
  • over the tendons of peroneus longus and brevis
  • attaches to calcaneus (tarsal sinus) inferior to the tendon of peroneus longus
  • deep fibers of the retinaculum attach to the peroneal trochlea between the tendons of the peroneus longus and brevis
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36
Q

where does the tendon of the peroneus brevis insert?

A

at the tuberosity of the 5th metatarsal

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37
Q

true or false: peroneus longus and peroneus brevis share a common tendon sheath

A

true

38
Q

what are the three muscles of the first layer?

A

abductor hallucis
flexor digitorum brevis
abductor digiti minimi

39
Q

proximal attachment of flexor digitorum brevis

A

medial process of calcaneal tuberosity

40
Q

insertion of the tendons of flexor digitorum brevis

A

middle phalanx of lateral four toes

41
Q

which tendon of the flexor digitorum brevis might be missing?

A

tendon to the 5th toe

42
Q

nerve supply to flexor digitorum brevis

A

medial plantar nerve (enters proximal part of muscle)

43
Q

what m underlies the abductor digiti minimi?

A

flexor digiti minimi brevis

44
Q

origin of abductor digiti minimi?

A

medial and lateral processes of the calcaneal tuberosity

45
Q

insertion of abductor digiti minimi

A

proximal phalanx of 5th toe

46
Q

nerve supply to the abductor digiti minimi

A

branch of lateral plantar n.

47
Q

the medial plantar a. lies _________ to the medial plantar nerve

A

medial

48
Q

what originates from the medial plantar nerve?

A

(3) common plantar digital nerves

49
Q

what nn. arise from the first common plantar digital nerve?

A

2nd and 3rd proper plantar digital nerves

50
Q

the nerve to the first lumbrical originates from what n?

A

first common plantar digital nerve

51
Q

where does the seventh proper plantar digital n. originate from?

A

3rd common plantar digital n.

52
Q

describe the termination of the proper plantar digital nerves

A

terminate at distal ends of the toes where they curl around the tip of the toes to innervate the nail beds

53
Q

the medial calcaneal a. is a branch off of the …

A

posterior tibial a.

54
Q

what are the main branches off the medial plantar a?

A
  • superficial branch and deep branch (ramus profundus)
55
Q

what are the main branches off the superficial branch of the medial plantar a. ?

A
  • common plantar digital
  • superficial plantar tibial branches
  • it also has branches to the abductor halucis and flexor digitorum brevis
56
Q

how does the common plantar digital a. end?

A
  • dividing into three superficial plantar digital arteries

- each branch joins a plantar metatarsal a.

57
Q

you are carefully cleaning the are between the abductor digiti minimi and flexor digitorum brevis near the base of the 5th metatarsal - what do you identify?

A

lateral plantar artery and nerve - entering this space from the medial side of the foot

58
Q

the lateral plantar nerve lies ________ to the lateral plantar artery

A

medial

59
Q

where does the muscular branch to the abductor digiti minimi n. come from?

A

lateral plantar n.

- the lateral plantar n divides into a superficial and deep division after giving off this branch

60
Q

which division of the lateral plantar n. follow the deep plantar arterial arch?

A

deep division of lateral plantar n.

61
Q

what n. supplies the muscular branches to the flexor digiti minimi brevis?

A

superficial division of the lateral plantar n.

- it also provides branches to the most lateral plantar and dorsal interossei muscles

62
Q

starting at the proximal phalanx of the 5th toe, the superficial division of the lateral plantar nerve is known as…

A

10th proper plantar digital n.

63
Q

where does the 4th common plantar digital branch come from?

A

superficial division of the lateral plantar n.

64
Q

what are the terminal branches of the 4th common plantar digital branch of the superficial division of the lateral plantar n?

A

8th and 9th proper plantar digital nerves

65
Q

you notice that some fibers from the abductor digiti minimi attach to the fifth metatarsal, what is the part of the muscle known as?

A

abductor os metatarsi digiti minimi

66
Q

which layer is the quadratus plantae (flexor accessorius) m located in?

A

second layer

67
Q

where do the lateral and medial heads of the quadratus plantae arise from/

A

medial : medial surface of calcaneus, inferior to the groove for the flexor hallucis longus tendon
lateral: lateral surface and lateral edge of the plantar surface of the calcaneus and from the long plantar ligament

68
Q

where does the quadratus platae insert?

A

into the tendon of the flexor digitorum longus

69
Q

the lateral plantar artery is _________ to the lateral plantar n. as it course obliquely from medial to lateral across the belly of the quadratus plantae

A

lateral

70
Q

what n. courses laterally across the proximal part of the quadratus plantae muscle?

A

nerve to abductor digiti minimi

71
Q

what is the origin of the four lumbricals?

A

tendon of flexorr digitroum longus

72
Q

what forms the inferior and lateral walls that house the tendons of the flexor muscles?

A

fibrous flexor sheaths

73
Q

each flexor digitorum brevis tendon splits just ______ to the metatarsophalangeal joint to surround the tendon of the flexor digitorum longus

A

proximal
- the two split ends unite deep to the tendon of the flexor digitorum longus and then divide again to attach to the sides of the middle phalanx

74
Q

fibrous, membrane-like structures that connect the bony phalanges with the distal ends of the flexor digitorum longus and brevis tendons

A

short vincula

  • the long vincula are located proximal to the short
  • each vincula has a proximal and distal part
  • usually cord-like structures that attach to the dorsal aspect of the tendons
  • both the long and short carry blood vessels to the tendons
75
Q

this large branch passes laterally across the proximal end of quadratus plantae to reach the abductor digiti minimi m. near its origin

A

branch of the lateral n. that supplies the abductor digiti minimi

76
Q

this artery follows the course oft he superficial branch of the lateral plantar n.

A

superficial fibular plantar a.

77
Q

the lateral plantar a. dives deep below the _____________ as the deep plantar arch

A

oblique head of the adductor hallucis

78
Q

distal branches of the deep branch of the medial plantar artery (ramus profundus)

A

tibial and lateral branches

79
Q

at the base of the 1st metatarsal bone, the tibial branch of the ramus profundus anastomoses with…

A

1st plantar metatarsal a.

- the lateral branch of the ramus profundus will join with the deep plantar arch

80
Q

what is the innervation tot he flexor digiti quinti brevis

A

superficial division of the lateral plantar n.

81
Q

the posterior/proximal perforating branches are usually _____ in number

A

3
originate from the deep arterial arch
join with the dorsal metatarsal arteries

82
Q

reflecting the oblique head of the adductor hallucis, what do you observe?

A
  • deep plantar arterial arch and deep division of the lateral plantar n .
83
Q

at the 1st interosseous space, the deep plantar artery from the __________ joins with the arch to complete it

A

dorsalis pedis a

- the lateral branch of the ramus profundus joins the arch close to where the deep plantar joins the arch

84
Q

what originates from the deep plantar arterial arch?

A

four plantar metatarsal arteries and their anterior/distal perforating branches

85
Q

the plantar metatarsal arteries course ____________ to the metatarsal bones

A

distally superficial
not in the interosseous spaces ***
arteries remain superficial to the interosseous muscles

86
Q

distal to the anterior perforating arteries, the plantar metatarsal arteries become known as the _______

A

common plantar digital arteries

87
Q

each common plantar digital artery gives rise to ….

A

two proper plantar digital arteries

88
Q

what is the origin of the 1st proper plantar digital artery?

A
  • from the superficial tibial branch of the medial plantar OR from the 1st plantar metatarsal artery
89
Q

the three plantar interossei originate from the ______ side of metatarsals _________-

A

medial side

metatarsals 3-5

90
Q

the dorsal interossei originate from _______ of metatarsals

A

adjacent sides of all metatarsal bones

91
Q

where does the tibialis posterior tendon attach? ***

A
  • tuberosity of navicular bone
  • 2nd, 3rd, 4th metatarsals
  • all other tarsals EXCEPT for the talus