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