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Flashcards in Plantar Foot Deck (69):
1

plantar fascia

tough connective tissue layer of deep fascia continuous wit that of dorsum of foot attached laterally and medially to 5th and 1st metatarsal respectively

2

plantar aponeurosis?

thickened central portion of plantar fascia

3

superficial layer of plantar aponeurosis

longitudinally oriented fibers attaching proximally to tuberosity of calcaneous

distally provide slips which fuse with and reinforce fibrous digital sheaths

4

deep layer of plantar aponeurosis

transversely oriented fibers attached to heads of metactarsals forming superficial transverse metatarsal ligament

5

transverse fasciculi

transverse oriented bundles of deep fascia which reinforce webs of toes

6

fibrous digital sheaths

specializations of deep fascia
anchored to phalanges
form fibro-osseous canal that prevents bowstring of flexor tendons

7

synovial digital sheath

line the fibrous digital sheaths to lubricate them

8

intermuscular septa in plantar foot?

lateral and medial
extend from lateral and medial edges of plantar aponeurosis to attach to 1st and 5th metatarsal

delineate two compartments

9

two compartments of plantar foot?

medial compartment - great toe
lateral compartment - 5th toe

10

contents of medial compartment?

flexor and abductor for great toe
tendon of flexor hallucis longus and medial plantar vessel and nerves

11

contents of lateral compartment?

contains abductor and flexor muscle of digiti minimi

12

central compartment?

deep to plantar aponeurosis and contains flexor digitorum brevis, lumbricals, quadratus plantae, adductor hallucis longus, tendons of flexor digitorum longus, lateral plantar vessels and nerves

13

interosseous compartment

defined as existing between layers of plantar and dorsal interosseous fascia and contains the interosseous muscles

14

layers of muscle in foot?

four
3-2-3-2

15

plane of reference in foot?

2nd toe!

16

muscles of first layer

abductor hallucis
abductor digiti minimi
flexor digitorum brevis

17

attachments of abductor hallucis?

origin:
calcaneus

insertion:
medial side of base of proximal phalanx of great toe

18

action of abductor hallucis

abducts great toe

19

innervation of abductor hallucis

medial plantar nerve

20

attachment of abductor digiti minimi

origin:
calcaneus

insertion:
lateral side of base of proximal phalanx of fifth digit

21

action of abductor digiti minimi

abducts 5th digit

22

innervation of abductor digiti minimi?

lateral plantar nerve

23

attachments of flexor digitorum brevis

origin:
calcaneus

insertion:
middle phalanges of four small toes

24

actions of flexor digitorum brevis?

flexes middle and proximal phalanges of four small toes

25

innervation of flexor digitorum brevis

medial plantar nerve

26

tendons of flexor digitorum brevis?

bifurcate!

allows passage of tendons from flexor digitorum longus to reach distal phalanges

27

posterior tibial artery and nerve?

divide to lateral and medial plantar branches

deep to proximal abductor hallucis and pass forward between muscles of 1st and 2nd layers

28

muscles of second layer?

quadratus plantae
lumbricals

29

what tendons pass through second layer?

flexor hallucis longus and flexor digitorum longus

30

attachments of quadratus plantae

origin:
calcaneus

insertion:
tendon of flexor digitorum longus

31

actions of quadratus plantae

pulls on tendons of flexor digitorum longus to direct force of its action directly posterior

32

innervation of quadratus plantae

lateral plantar nerve

33

attachments of lumbricals

origin:
tendons of flexor digitorum longus

insertion:
medial side of metatarsophalangeal joints via extensor tendons

34

action of lumbricals?

flex MP joint
extend distal phalanges

35

innervation of lumbricals

first - medial plantar nerve
2,3,4 - lateral plantar nerve

36

muscles of third layer?

flexor hallucis brevis
flexor digiti minimi
adductor hallucis

37

attachments of flexor hallucis brevis?

origin:
plantar surface of cuboid and lateral cuneiform

insertion:
lateral and medial sides of base of proximal phalanx of great toe

38

action of flexor hallucis brevis

flexes great toe

39

innervation of flexor hallucis brevis

medial plantar nerve

40

flexor hallucis brevis heads?

has two heads

lateral - adductor hallucis muscle attachment
medial - abductor hallucis muscle attachment

tendon of flexor hallucis longus passes between the two heads

41

attachments of flexor digiti minimi?

origin:
base of 5th metatarsal

insertion:
lateral side of base of proximal phalanx of small toe

42

action of flexor digiti minimi

flexes and abducts small toe

43

innervation of flexor digiti minimi?

lateral plantar nerve

44

attachments of adductor hallucis?

origin:
oblique head - base of 2nd 3rd and 4th metatarsal
transverse head - lateral four plantar ligaments of MP joints

insertion: lateral side of base of proximal phalanx of great toe

45

action of adductor hallucis

adducts and flexes great toe

46

innervation of adductor hallucis?

lateral plantar nerve

47

muscles of fourth layer

plantar interossei
dorsal interossei

48

attachments of plantar interossei?

origin:
medial side plantar surfaces of 3rd, 4th, 5th metatarsals (3x)

insertion:
medial side of bases of proximal phalanx of digits 3,4,5 as well as to extensor expansions of same digits

49

action of plantar interossei?

adducts digits 3,4,5, flexes MP and extends proximal and distal IP joints of same digits

50

innervation of plantar interossei?

lateral planter nerves

51

attachments of dorsal interossei?

origin:
adjacent sides of all metatarsals

insertion:
1st to medial side of base of proximal phalanx of second toe
2,3,4 to lateral side to base of proximal phalanx of 2,3,4 digits as well as extensor expansion of same digits

52

action of dorsal interossei

abducts digits 2,3,4, flexes MP joints, and extends proximal and distal IP joints of same digits

53

innervation of dorsal interossei?

lateral plantar nerve

54

where can you view the attachments of the fibularis longus and tibialis posterior?

between 3rd and 4th layers

55

posterior tibial artery?

courses beneath flexor retinaculum and goes deep to abductor hallucis

bifurcates into lateral and medial plantar arteries

56

lateral plantar artery

larger of two terminal arteries of posterior tibial artery

passes under abductor hallucis to course between 1st and 2nd muscular layers

obliquely lateralward to gain lateral edge of flexor digitorum brevis and parallels to base of 5th metatarsal

dives deep between 3rd and 4th muscle layers and arches medially across heads of 2,3,4 metatarsals - forms plantar arterial arch

57

plantar arterial arch

distal portion of lateral plantar artery

provides three plantar metatarsal arteries

terminates in the 1st metatarsal space
-anastomose with deep plantar branch of dorsalis pedis muscle

58

branches of lateral plantar artery?

calcaneal
muscular
cutaneous
articular
plantar metatarsal arteries x3 (from arch)
-between 2,3,4 toes

59

proper plantar digital arteries

at webs of digits

branching of plantar metatarsal arteries

60

perforating branches of dorsal metatarsal arteries?

anastomose with planter arterial arch and with plantar metatarsal arteries of 2,3,4 intermetarsal spaces

lateral most proper plantar artery of 5th digit is supplied directly by lateral plantar artery
-prior to formation of arch

61

medial plantar artery

smaller of two branches of posterior tibial artery

courses along medial plantar surface between abuctor hallucis and flexor digitorum brevis

medial to head of 1st metatarsal, anastomoses with digital branch of 1st dorsal metatarsal artery (dorsalis pedis) and terminates by forming 1st proper plantar digital artery

62

branches of medial plantar artery?

second, third, fourth plantar digital arteries which anastomose with plantar metatarsal arteries to provide plantar proper digital arteries

63

tibial nerve?

after exits beneath flexor retinaculum passes deep to adductor hallucis and bifurcates:

-medial and lateral plantar nerves

64

medial plantar nerve

homologue of median nerve in hand

larger of two branches
-passes forward with medial plantar artery and vein in medial intermuscular septum where it provides muscular branches to abductor hallucis and flexor digitorum brevis

65

plantar cutaneous nerve

branch from medial plantar nerve
perforate underlying deep fascia and innervate the skin of medial portion of sole

66

termination of medial plantar nerve?

proper digital branch for medial surface of great toe and muscular branch to flexor hallucis brevis

common digital nerves (3) which provide proper digital nerves at webs between 1,2,3 toes and muscular branch of 1st lumbricals

67

muscles innervated by medial plantar nerve?

1st lumbrical
abductor hallucis
flexor hallucis brevis
flexor digitorum brevis

68

lateral plantar nerve

homolog of ulnar nerve in hand

branch from tibial nerve deep to abductor hallucis muscle and parallels path of lateral plantar artery across sole of foot between layers 1 and 2

69

termination of lateral plantar nerve?

superficial branch - courses laterally on surface of flexor digiti minimi to provide branches to surrounding muscles, proper digital nerve to lateral surface of 5th digit, and a common digital nerve which supplies proper digital nerves to 4th and 5th digits

deep branch - accompanies plantar arterial arch on surface of interosseous muscles where it provides branches to surrounding muscularture