L18: Musculo-neuro-vascular systems of lateral leg and foot Flashcards

(72 cards)

1
Q

lateral compartment of leg; muscles [2], nerve

A
  1. fibularis [peroneus] longus
  2. fibularis [peroneus] brevis

nerve: superficial fibular [peroneal] nerve

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2
Q

lateral compartment of leg actions

A

principally evertors of foot
especially active during plantarflexion
- walking on toes
- pushing off with great toe

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3
Q

fibularis [peroneus] longus; origin

A

head and superior two thirds of lateral surface of fibula

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4
Q

fibularis [peroneus] longus; insertion

A

base of 1st metatarsal and medial cuneiform

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5
Q

fibularis [peroneus] longus; innervation + actions

A

innervation: superficial fibular [peroneal] nerve
action: eversion of foot and weak ankle plantarflexion

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6
Q

course of tendon of fibularis [peroneus] longus:

A
  • swings under the foot to cross the sole of foot and insert into the base of the 1st metatarsal and medial cuneiform
  • acts as a stirrup to support the arches of the foot
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7
Q

arches of foot formed by:

A

tarsal and metatarsal bones

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8
Q

Fibularis (peroneus) brevis; origin

A

lies deep to fibularis longus
origin: lower two thirds of lateral surface of fibula

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9
Q

Fibularis (peroneus) brevis; insertion

A

dorsal surface of tuberosity on lateral side of base of 5th metatarsal

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10
Q

Fibularis (peroneus) brevis; innervation + action

A

innervation: superficial fibular [peroneal] nerve
action: eversion of foot and weak ankle plantarflexion

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11
Q

lateral compartment nerves:

A

superficial fibular [peroneal] nerve
- terminal branch of common fibular nerve
- continues as cutaneous nerve, supplying skin on:
- distal anterior surface of leg
- most of dorsum of foot

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12
Q

lateral compartment blood vessels

A
  • does not contain a major artery
  • perforating branch arteries and veins
    • perforating branches of anterior tibial artery
    • perforating branches of fibular artery
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13
Q

bones of the foot

A

tarsals : talus, calcaneus, navicular, medial/intermediate/lateral cuneiform, cuboid
metatarsals
phalanges

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14
Q

joints of foot

A

ankle [talocrural] joint
joints of foot:
- subtalar
- transverse tarsal joint : talocalcaneonavicular, calcaneocuboid
- intertarsal joints
- tarsometatarsal joints
- metatarsophalangeal joints
- interphalangeal joints

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15
Q

movements of metatarsophalangeal joints:

A

flexion
extension
abduction
adduction

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16
Q

movements of interphalangeal joints:

A

flexion
extension

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17
Q

foot: deep fascia

A
  • dorsal fascia continuous with inferior extensor retinaculum
  • plantar fascia:
    • thick central part: plantar aponeurosis
    • weaker medial and lateral parts
  • 3 compartments
    1. medial compartment
    2. central compartment
    3. lateral compartment
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18
Q

extrinsic muscles

A

extrinsic muscles from compartments of leg (anterior, lateral and posterior leg compartments)
- plantarflexion and dorsiflexion
- inversion and eversion

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19
Q

intrinsic muscles

A

intrinsic muscles originate an insert in the foot
20 muscles
- dorsum of foot [2]
- sole of foot (plantar) [14, 4 muscle layers]
- intermediate (4 dorsal interossei)

important in:
- propulsion of foot [gait]
- adjustment to uneven ground
- fixing foot or increasing pressure in different regions of foot to maintain balance

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20
Q

sole [plantar aspect] of foot

A
  • covered with thick layer of skin and fatty superficial fascia
  • plantar aponeurosis [deep fascia]
  • muscles, nerves and vessels lie deep to the plantar aponeurosis
  • muscles of the sole supplied by:
    • medial and lateral plantar nerves (branches of tibial nerve)
    • medial and lateral plantar arteries
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21
Q

sole [plantar aspect] of foot; intrinsic muscles function + innervation

A

10 intrinsic muscles located in the sole if the foot
function: control individual movement of the digits, stabilise the arches of the foot
all are innervated by branches of the tibial nerve:
- medial plantar nerve
- lateral plantar nerve
The muscles of the plantar aspect are described in 4 layers (superficial to deep)

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22
Q

plantar muscles layer 1 (3)

A

most superficial to the sole
located immediately underneath plantar fascia
1. abductor hallucis
2. flexor digitorum brevis
3. abductor digiti minimi

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23
Q

abductor hallucis; origin

A

medial tubercle of tuberosity of calcaneus, flexor retinaculum, plantar aponeurosis

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24
Q

abductor hallucis; insertion

A

medial side of bade of proximal phalanx of great toe

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25
abductor hallucis; innervation
medial plantar nerve
26
abductor hallucis; action
abducts and flexes great toes [ hallux ]
27
flexor digitorum brevis; origin
medial tubercle of tuberosity of calcaneus, plantar aponeurosis, intermuscular septs
28
flexor digitorum brevis; insertion
both sides of middle phalanges of digits 2-5
29
flexor digitorum brevis; innervation
medial plantar nerve
30
flexor digitorum brevis; actions
flexes lateral 4 digits
31
abductor digiti minimi; origin
medial and lateral tubercles of tuberosity of calcaneus, plantar aponeurosis, intermuscular septa
32
abductor digiti minimi; insertion
lateral side of base of proximal phalanx of digit 5
33
abductor digiti minimi; innervation
lateral plantar nerve
34
abductor digiti minimi; action
abducts and flexes little toe
35
plantar muscles: layer 2
2 muscles tendons of the extrinsic muscle flexor digitorum longus also pass through this layer 1. quadratus plantae 2. lumbricals
36
quadratus plantae; origin
medial surface and lateral margin of plantar surface if calcaneus
37
quadratus plantae; insertion
posterolateral margin of tendon of flexor digitorum longus
38
quadratus plantae; innervation + action
innervation: lateral plantar nerve actions: assists flexor digitorum longus (FDL) in flexing toes 2-5
39
lumbricals (x4); origin
tendons of flexor digitorum longus
40
lumbricals; insertion
medial aspect of expansion over digits 2-5
41
lumbricals; innervation + action
innervation: medial 1(1st): medial plantar nerve, Lateral 3 (2nd -4th): lateral plantar nerve actions: flex proximal phalanges, extend middle and distal phalanges of digits 2-5
42
plantar muscles: layer 3 (3)
3 muscles associated with movements of the great toe [hallux] and little toe 1. flexor hallucis brevis 2. adductor hallucis 3. flexor digiti minimi
43
flexor hallucis brevis; origin
plantar surface of cuboid and lateral cuneiform
44
flexor hallucis brevis; insertion
both sides of base of proximal phalanx of great toe
45
flexor hallucis brevis; innervation + action
innervation: medial plantar surface action: flexes proximal phalanx of great toe tendon contains 2 sesamoid bones
46
adductor hallucis; origin
- oblique head: bases of metatarsals 2-4 - transverse head: plantar ligament of metatarsophalangeal (MTP) joints
47
adductor hallucis; insertion
lateral side of base of proximal phalanx of big toe
48
adductor hallucis; innervation + action
innervation: deep branch of lateral plantar nerve action: adducts great toe, assists in transverse arch of foot by pulling metatarsals medially
49
flexor digiti minimi; origin
base of metatarsal 5
50
flexor digiti minimi; insertion
base of proximal phalanx 5
51
flexor digiti minimi; innervation + action
innervation: superficial branch of lateral plantar nerve action: flexes proximal phalanx of little toe, assisting with flexion
52
plantar muscles: layer 4
2 muscle groups associated with abduction and adduction movements of the toe 1. plantar interossei (x3) 2. dorsal interossei (x4)
53
plantar interossei; origin
plantar aspect of medial sides of metatarsals 3-5
54
plantar interossei; insertion
medial sides of bases of proximal phalanges 3-5
55
plantar interossei; innervation + action
innervation: lateral plantar nerve action: adducts toes 3-5, and flex metatarsophalangeal joints PAD: Planter interossei ADuct
56
dorsal interossei; origins
adjacent sides of metatarsals 1-5
57
dorsal interossei; insertion
1st: medial side of proximal phalanx of 2nd digit 2nd-4th: lateral sides of digits 2-4
58
dorsal interossei; innervation + action
innervation: lateral plantar nerve action: abduction of toes 2-4 and flex metatarsophalangeal joints DAB: Dorsal interossei ABduct
59
dorsum of foot; 2 muscles
-many of the extrinsic muscles attach to the dorsum of the foot - 2 connected muscles: - extensor digitorum brevis (EDB) - extensor hallucis brevis (EHB) - mainly responsible for assisting the extrinsic extensor muscles - innervated by the deep fibular (peroneal) nerve
60
extensor digitorum brevis (EDB); origin
calcaneus [floor of tarsal sinus]: interosseus talocalcaneal ligament, stem of inferior extensor retinaculum
61
extensor digitorum brevis (EDB); insertion
tendons of extensor digitorum 2-4
62
extensor digitorum brevis (EDB); innervation
deep fibular [peroneal] nerve
63
extensor digitorum brevis (EDB); actions
aids extensor digitorum longus [EDL] in extending toes 2-4 at metatarsophalangeal and interphalangeal joints
64
extensor hallucis brevis (EHB); origin
common with the extensor digitorum brevis
65
extensor hallucis brevis (EHB); insertion
dorsal aspect of base of proximal phalanx of great toe
66
extensor hallucis brevis (EHB); innervation
deep fibular nerve [peroneal]
67
extensor hallucis brevis (EHB); actions
aids extensor hallucis longus [EHL] in extending great toe at the metarsophalangeal joint
68
nerves of the foot
cutaneous
69
arteries of the foot
terminal branches of anterior and posterior tibial arteries - dorsal pedis - plantar arteries: medial and lateral
70
dorsalis pedis artery
- dorsal artery of foot - continuation of anterior tibial artery - continuations: - deep plantar artery [deep plantar arch] - lateral tarsal artery - 1st dorsal metatarsal artery - arcuate artery - 2nd, 3rd, 4th dorsal metatarsal arteries - dorsal digital arteries
71
arteries of sole of foot
- posterior tibial artery continues as medial and lateral plantar arteries - medial plantar artery - smaller terminal branch - lateral plantar artery - larger terminal branch - deep plantar arch - joins deep plantar artery [branch of dorsalis pedis] - plantar metatarsal arteries - plantar digital arteries
72
venous drainage of foot
- superficial and deep veins - deep venous drainage: paired veins accompanying arteries - superficial veins are subcutaneous and unaccompanied by arteries - dorsal venous arch