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Flashcards in Fascia of Plantar Foot Deck (18):
1

Peroneal retinacula

Located laterally
- Superior peroneal retinacula
- Inferior peroneal retinacula

2

Superior peroneal retinacula

- Crosses superficial to peroneus longus and brevis
- Originates at the posterior border of the lateral malleolus (of fibula)
- inserts into the lateral surface of the calcaneus and the tendocalcaneus (Achilles)

3

Inferior peroneal retinacula

- Originates at the lateral rib of sinus tarsi
- Inserts into the lateral surface of the calcaneus and the peroneal trochlea
- Forms two tunnels between the origin and insertion
- Superior tunnels encloses the peroneus brevis tendon
- Inferior tunnel encloses the peroneus longus tendon

NOTE: ONLY deep fibers form the tunnels, superficial fibers lie flat over teh ligaments

4

Flexor retinaculum

Located medially
- Recall that the peroneal retinacula is located laterally
- AKA lacinate ligament or medial annular ligament
- Triangular in shape

5

Attachment sites of flexor retinaculum

- Anteromedial surface of the medial malleolus
- Continuous with deep fascial of the leg
- Continuous with dorsal aponeurosis of the foot
- Superior border of the abductor hallucis
- Medial process of calcaneal tuberosity (FFA)

6

Description of flexor retinaculum formation

Flexor retinaculum forms one tunnel with 4 compartments

NOTE: the flexor retinaculum is the "roof" of the tarsal tunnel or the talocalcaneal tunnel

7

Compartments of flexor retinaculum

- Compartment 1 = Tibialis posterior
- Compartment 2 = Flexor digitorum longus
- Compartment 3 = Posterior tibial artery and nerve
- Compartment 4 = Flexor hallucis longus

NOTE: tibialis posterior is found directly posterior to the medial malleolus and it continues back from there

REMEMBER: Tom (1), Dick (2), Very Nervous (3), Harry (4)

8

Plantar aponeurosis

- Formed by the deep fascia of the plantar foot
- Thickens where the foot contacts the floor
- Fat globules are found superficial to the aponeurosis and are considered to be shock absorbers

9

3 parts of the plantar aponeurosis

- Central
- Lateral
- Medial

10

Central part of plantar aponeurosis

- Thickest of the three parts
- The central portion becomes thinner as it passes anteriorly

11

Attachments of central plantar aponeurosis

- Posterior attachment = medial process of calcaneal tuberosity ("P" of LAP)
- Anterior attachment = 5 processes to the 5 digits
- Digital processes attach to the skin, tendon sheath
- Superficial stratum attaches to the skin of the transverse sulcus
- Deep stratum divides into two slips, one on each side of the flexor tendons) then blends with the tendon sheath
- Between the digital processes of the central plantar aponeurosis we see digital nerves, vessels and lumbrical tendons

12

Lateral part of plantar aponeurosis

- Found superficial to abductor digiti minimi muscle of the 1st layer
- Thicker proximally, thins out distally (same as central portion)
- Creates a strong band between the lateral process of the calcaneal tuberosity and the base of the 5th metatarsal

13

Attachments of lateral part of plantar aponeurosis

- Posterior attachment = lateral process of calcaneal tuberosity ("P" in LAP)
- Anterior attachment = base of 5th metatarsal

14

Medial part of plantar aponeurosis

- Lies superficial to abductor hallucis (1st layer)
- Attaches posterior to the flexor retinaculum

15

Intermuscular septa

- There are two vertical septa which dive deep into the foot
- They are formed by the junction of the lateral and central parts of the plantar aponeurosis
- Creates 3 compartments (medial, lateral, central)

16

Medial compartment

Contains intrinsic muscles of the 1st digit

17

Lateral compartment

Contains intrinsic muscles of the 5th digit

18

Central compartment

Contains quadratus plantae, flexor digitorum brevis, lumbricals and interosseous muscles