Musculoskeletal System Of The Foot

Question 1

Describe the arches of the foot and name their key bones

Answer 1

Transverse arch
-Intermediate cuneiform

Medial longitudinal arch
-Talus

Lateral longitudinal arch
-Cuboid

Question 2

What is the function of the arches

Answer 2

Act as a spring
Weight bearing
Shock absorbers
Allows for walking and running

Question 3

What are 2 pathologies associated with arches

Answer 3

Pes planus
-arch has collapsed

Pes cavus
-overfibrosis of plantar arch

Question 4

How are the arches supported

Answer 4

Plantar aponeurosis of plantar fascia branch out and attach to each toe
Kept together by superficial transverse ligaments

Question 5

What is plantar fasciitis and what can happen as a result

Answer 5

Overstretched fascias => pain if inflammation also present

Pain in thickest part of fascia
Worse when standing
Shallow arch

Question 6

Name the ligaments present on the foot that support the arches

Answer 6

Plantar

• Spring ligament
• Long plantar
• Short plantar

Lateral

• Bifurcate
• Dorsal

Question 7

Name the tendons that support the arches

Answer 7

Lateral side

• Fibularis longus
• Fibularis brevis

Plantar side

• Tibialis posterior
• Flexor digitorum longus
• Flexor hallucis longus

Question 8

Where are the intrinsic muscles of the dorsum

Name the 2 instrinsic muscles found on the dorsum

Answer 8

Found under the extensor leg muscles (extensor digitorum longus, extensor hallucis longus)

Extensor digitorum brevis
Extensor hallucis brevis

Question 9

What are the attachments and actions of the intrinsic dorsal muscles

• Extensor digitorum brevis
• Extensor hallucis brevis

Answer 9

Extensor digitorum brevis

• Calcaneus => 4 lateral toes via long extensor tendons
• Extends 4 lateral toes

Extensor hallucis brevis

• Calcaneus => proximal phalanx of big toe
• Extends big toe

Question 10

What are the nervous innervations and blood supply of the dorsal side of the foot

Answer 10

Deep fibular nerve

Dorsalis pedis artery

Question 11

What is the function of the intrinsic plantar muscles

Answer 11

Support arches

Adds small movements to toes (flexors of the toes)

Question 12

Name the 3 muscles found the the most superficicial layer of the intrinsic plantar muscles

Answer 12

Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi

Question 13

Describe the

• Attachments
• Actions
• Nervous innervations of the 1st layer of plantar intrinsic muscles
• Abductor hallucis
• Flexor digitorum brevis
• Abductor digiti minimi

Answer 13

Abductor hallucis

• Medial tubercle of calcaneus => proximal big toe phalanx
• Abducts, flexes big toe
• Medial plantar nerve (L4-S2)

Flexor digitorum brevis

• Medial calcaneal tubercle => middle phalanx of lateral 4 toes
• Flexes 4 lateral toes
• Medial plantar nerve (L4-S2)

Abductor digiti minimi

• Med and lateral calcaneal tubercle => lateral proximal base of little toe
• Abducts, flexes small toe
• Lateral plantar nerve

Question 14

Name the 2 muscles found in the 2nd layer of intrinsic plantar muscles (under tendons of flexor digitorum longus)

Answer 14

Quadratus plantar

Lumbrical

Question 15

What is the
-attachment
-actions
-nervous innervations
Of the muscles in the 2nd layer of plantar intrinsics

• Quadratus plantar
• lumbricals

Answer 15

Quadratus plantae

• medial and lateral calacaneal surface => flexor digitorum longus tendon
• flex lateral 4 toes
• lateral plantar nerve

Lumbrical

• flexor digitorum longus tendons => lateral 4 toe i
• flex metatarsophalangeal joints, extends interphalangeal joints
• medial lumbrical => medial plantar
• 3 lateral lumbrical => lateral plantar

Question 16

What are the 4 muscles found in the 3rd layer of intrinsic plantar muscles

Answer 16

Flexor hallucis brevis
Adductor hallucis (OH)
Adductor hallucis (TH)
Flexor digiti minimi brevis

Question 17

What are the

• attachments
• actions
• nervous innervations of the 3rd layer of intrinsic plantar muscles
• flexor hallucis brevis
• adductor hallucis (OH)
• adductor hallucis (TH)
• Flexor digiti minimi brevis

Answer 17

Flexor hallucis brevis

• cuboid, cuneiform and post tibial tendon => base of phalanx great toe
• Flex big toe at metatarsophalangeal joint
• Medial plantar nerve

Adductor hallucis (OH)
-2-4th metatarsal base => lateral base of big toe phalanx

Adductor hallucis (TH)

• plantar ligaments of metatarsophalangeal joints => lateral base of big toe phalanx
• Adducts big toe
• Deep branch of lateral plantar nerve

Flexor digiti minimi brevis

• Base of M5 => base of phalanx of toe 5
• Flex proximal phalanx of toe 5
• Superficial branch of lateral plantar

Question 18

Name the 2 muscles found in the 4th layer of plantar intrinsic muscles

Answer 18

Dorsal interossei

Plantar interossei

Question 19

What are the

• attachments
• actions
• nervous innervations of the 4th layer of intrinsic plantar muscles
• dorsal interossei
• plantar interossei

Answer 19

Dorsal interossei

• sides of metatarsals 1-5 => medial side of phalanx 2 and lateral sides of phalanx 2-4
• abducts toe 2-4, flex metatarsophalangeal joints
• lateral plantar

Plantar interossei

• medial side of metatarsals 3-5 => medial side of phalanges 3-5
• adducts toes 3-5, flex metatarsophalangeal joints
• lateral plantar

Question 20

What are the causes of forefoot pathologies

Describe 4 forefoot pathologies

Answer 20

Fibrosis of long tendons
Muscle spasms
Bone fractures
SHOES

Claw toe
Mallet toe
Hammer toe
Curly toe
Hallucis vagus

Question 21

Describe the nervous pathways of the nerves in the plantar side

Answer 21

Medial and lateral plantar from post tibial nerve

Lateral plantar supplies 1 1/2 lateral toes
Medial plantar supplies 3 1/2 medial toes

Each toe gets 2 digital branches

Question 22

Describe the nervous pathway of the nerves in the dorsal side of the foot

Answer 22

Dorsal nerves from superficial and deep fibular nerves

Superficial fibular supplies 4 toes, doesn’t supply webbing between toe 1 and 2

Deep fibular supplies 1 toe, only the webbing between toe 1 and 2

Question 23

Describe the cutaneous nerve supply of the dorsal side of the foot
Describe the cutaneous nerve supply of the plantar side of the foot

Answer 23

Dorsal

• Saphenous L4 (medial side of hind foot)
• Superficial fibular L4-S2 (3 1/2 toes except half of T5 and webbing between T1 and 2)
• Deep fibular L4-S2 (webbing between T1-2)
• Sural nerve S1 (tibial branch, lateral half of T5)

Plantar

• Tibial L4-S3 (medial heel)
• Sural S1 (lateral heel)
• Saphenous L4 (medial heel)
• Lateral plantar L4-S3 (1 1/2 lateral toes)
• Medial plantar L4-S3 (3 1/2 medial toes)

Question 24

Describe the arterial blood supply to the dorsum of the foot

Describe the arterial blood supply to the plantar of the foot

Answer 24

Ant tibial
Dorsal pedis artery
Lateral tarsal artery branches off
Dorsal arch gives off dorsal metatarsal arteries => digital arteries

Post tibial
Medial and lateral plantar => plantar arch
Lateral plantar supplies 3 1/2 lateral toes
Medial plantar supplies 1 1/2 medial toes

Question 25

Describe the venous drainage of the foot

Answer 25

Sole Dorsal venous arch Medial malleolus or lateral malleolus Posterior to medial malleolus => greater Saphenous => femoral Posterior lateral malleolus => lesser Saphenous => popliteal