Foot and Ankle

Question 1

Abductor digiti minimi S1-2

Answer 1

ATTACHMENTS- from calcaneal tuberosity to lateral side of proximal phalangeal base of 5th digit

ACTIONS- abducts & flexes 5th digit

INNERVATION- lateral plantar nerve

Question 2

Abductor hallucis L4-5, S1

Answer 2

ATTACHMENTS- from medial calcaneal tuberosity to medial side of proximal phalangeal base of great toe

ACTIONS- flexes & abducts great toe

INNERVATION- medial plantar nerve

Question 3

Adductor hallucis S1-2

Answer 3

ATTACHMENTS- from 2-4th metatarsal bases (oblique head) & distal ends of 3-5 metatarsal (transverse head) to lateral base of the proximal phalanx of great toe

ACTIONS- adducts great toe

INNERVATION- lateral plantar nerve

Question 4

Extensor digitorum brevis L4-5, S1

Answer 4

ATTACHMENTS- from anterolateral calcaneus to dorsal aspect of the base of the proximal phalanx (digit 1 for EHB) or to the lateral side of tendons of extensor digitorum longus (digits 2-4 for EDB)

ACTIONS- extension of digits 2-5 (MP & IP; EDB) and extension of digit 1 (EHB)

INNERVATION- deep fibular nerve

Question 5

Extensor hallucis brevis L4-5, S1

Answer 5

ATTACHMENTS- from extensor digitorum brevis to dorsal aspect of the base of the proximal phalanx of the hallux

ACTION- extension of great toe at metatarsophalangeal joint

INNERVATION- deep fibular nerve

Question 6

Quadratus plantae S1-2

Answer 6

ATTACHMENTS- from medial surface of calcaneus & lateral process of calcaneal tuberosity to long flexor tendons

ACTIONS- assists flexor digitorum longus

INNERVATION- lateral plantar nerve

Question 7

Flexor digitorum brevis L4-5, S1

Answer 7

ATTACHMENTS- from medial process of calcaneal tuberosity to sides of intermediate phalanges of digits 2-5

ACTIONS- flexes toes (proximal IP)

INNERVATION- medial plantar nerve

Question 8

Flexor digiti minimi S1-2

Answer 8

ATTACHMENTS- from 5th metatarsal base to proximal phalangeal base

ACTIONS- flexion of 5th digit (MP)

INNERVATION- lateral plantar nerve

Question 9

Flexor hallucis brevis L4-5, S1

Answer 9

ATTACHMENTS- from cuboid & tendon of tibialis posterior to base of the proximal phalanx of great toe

ACTIONS- flexion of great toe (MP)

INNERVATION- medial plantar nerve

Question 10

Dorsal interossei S1-2

Answer 10

ATTACHMENTS- from metatarsal shafts to proximal phalangeal bases & dorsal digital expansions of digits 2-4

ACTIONS- abducts (MP) & flexes (MP) digits 2-4

INNERVATION- lateral plantar nerve

Question 11

Plantar interossei S1-2

Answer 11

ATTACHMENTS- from plantar surface of base of metatarsals to dorsal digital expansions of digits 3-5

ACTIONS- adducts & flexes (MP) digits 3-5

INNERVATION- lateral plantar nerve

Question 12

Lumbricals

Answer 12

ATTACHMENTS- from tendons of flexor digitorum longus to medial sides of dorsal expansions of digits 2-5

ACTIONS- flexes proximal phalanges (MP), and extend IP joints

INNERVATION- 1st- medial plantar nerve & 2nd-4th- lateral plantar nerve

Question 13

What is the innervation of the 1st lumbrical?

Answer 13

L4-5

S1

Question 14

What is the innervation of 2-4th lumbricals?

Answer 14

S1-2

Question 15

what are the attachments of Talocrural fibrous capsule?

Answer 15

from the borders of the articular surfaces of tibia & malleoli to the margins of the trochlear surface of the talus

Question 16

What are the attachments and function of the Medial collateral (deltoid) ligament?

Answer 16

ATTACHMENTS- from the medial malleolus to the talus, navicular & sustentaculum tali of the calcaneus

FUNCTION- stabilizes joint & resists forced eversion

common to have secondary injuries with this sprain
strong

Question 17

What are the Lateral ligaments of the ankle?

Answer 17

1. Posterior talofibular
2. Calcaneofibular
3. Lateral talocalceneal
4. Anterior talofibular

Question 18

What are the functions of the lateral ligaments of the ankle?

Answer 18

stabilize joint & resist forced inversion

weaker

Question 19

What are the Long plantar attachments?

Answer 19

from the plantar surface of the calcaneus & cuboid to the plantar surface of the bases of the metatarsals

Question 20

What are the Plantar calcaneocuboid (aka “short plantar lig.”) attachments?

Answer 20

from calcaneus to the plantar surface of the cuboid

Question 21

What are the attachments and function of the Plantar calcaneonavicular (aka “spring lig.”)?

Answer 21

ATTACHMENTS- from the anterior margin of the sustentaculum tali to the plantar surface of the navicular

FUNCTION- supports the medial longitudinal arch of the foot

Question 22

What is the nerve supply to the foot?

Answer 22

Sciatic
Tibial: medial plantar, lateral plantar (superficial b and deep b)
common plantar
proper plantar

Question 23

What is the arterial supply to the foot?

Answer 23

popliteal

post tib: medial plantar, lat plantar (deep plantar arch)

Question 24

What is a common location to take pulse at the foot?

Answer 24

Dorsalis pedis
identify hallucis longus tendon and go lateral
tibialis anterior tendon

Question 25

What are the movements of the foot at the ankle joint?

Answer 25

plantar flexion dorsi flexion inversion eversion

Question 26

What are the movements of the toes?

Answer 26

flexion extension abduction adduction

Question 27

Where would you take the posterior tibial pulse?

Answer 27

Posterior to the medial malleolus calcaneal tendon posterior tibial artery

Question 28

Explain the Talus

Answer 28

The talus is a weight bearing structure | -mdifoot translates all forces through subtalar joint and talonavicular joint into crural joint

Question 29

Explain the fibrous joint capsule of the ankle

Answer 29

Talocrural fibrous capsule | anterior talofibular ligament- thickening of the fibrous joint capsule that is easily injured

Question 30

What is the function of the Anterior talofibular ligament?

Answer 30

resists anterior translation and inversion of talus when plantar flexed

Question 31

What is the function fo the calcaneofibular ligament?

Answer 31

resists inversion of calcaneous

Question 32

What is the function of the posterior talofibular ligament?

Answer 32

resists inversion of talus

Question 33

What is the most common ankle injury?

Answer 33

Inversion (lateral) sprain ATF usually injured first the ankle is plantar flexed and inverted which puts ATF on the most stress -many athletes do not have ATF in tact but experience no issues and mainly focus on balance and proprioception -surgery not recommended bc ankle can still function

Question 34

what does the medial longitudinal arch connect?

Answer 34

calcaneous and 1st MTP joint

Question 35

what are the supporting structures in the medial longitudinal arch?

Answer 35

-spring ligament/plantar calcaneonavicular ligament | if you tear this ligament, entire arch will collapse

Question 36

Describe metatarsophalengeal joints

Answer 36

- synovial condyloid - head of metatarsal; base of prox phalanges - collateral ligament and plantar ligament

Question 37

Describe interphalangeal joints

Answer 37

- hinge joint - flexion and extension - head of one phalanx to base of distal one

Question 38

What is the order of structures on the medial malleolus?

Answer 38

``` Tom- tibialis posterior Dick- Flexor digitorum longus And- posterior tibial artery Very- Posterior Tibial Vein Nervous- Tibial Nerve Harry- Flexor Hallucis Longus ```

Question 39

What muscles are in the 1st layer of the foot?

Answer 39

Flexor digitorum brevis Abductor hallucis Abductor digiti minimi

Question 40

What is the nerve supply to the 1st layer of the foot?

Answer 40

lateral/medial plantar nerves

Question 41

What muscles are in the 2nd layer of the foot?

Answer 41

Quadratus plantae | Lumbricals (4)

Question 42

What is the nerve supply to the 2nd layer of the foot?

Answer 42

lateral/medial plantar nerves

Question 43

What muscles are in the 3rd layer of the foot?

Answer 43

adductor hallucis flexor hallucis brevis flexor digiti minimi brevis

Question 44

What is the nerve supply to the 3rd layer of the foot?

Answer 44

lateral/medial plantar nerves

Question 45

What muscles are in the 4th layer of the foot?

Answer 45

``` planter interossei (3) dorsal interossei (4) ``` digit 2- axis for ab/aduction

Question 46

What is the nerve supply to the 4th layer of the foot?

Answer 46

lateral plantar n

Question 47

What are the muscles and innervation to the dorsal aspect of the foot?

Answer 47

extensor hallucis brevis extensor digitorum brevis innervated by deep fibular n

Question 48

What are the general actions of the first layer of the foot?

Answer 48

Flex and Abduct the toes

Question 49

Describe the branching of the medial plantar nerve

Answer 49

Medial plantar nerve gives rise to the common plantar digital nerves that innervate digits 1-3, and those give rise to the proper plantar digital nerves.

Question 50

Describe the branching of the lateral plantar nerve.

Answer 50

Lateral plantar nerve gives rise to a superficial branch that innervates the 4th and 5th digit. The superficial branch gives rise to a common plantar digital nerve. Lateral plantar nerve also gives rise to a deep branch that goes to the deeper layers of foot.

Question 51

Where would you take the medial malleolar pulse?

Answer 51

Posterior to the medial malleolus OR posterior to Flexor Hallucis longus

Question 52

Where would you take the Dorsalis pedis pulse?

Answer 52

lateral to the extensor hallucis longus tendon OR | medial to extensor digitorum longus