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Lower Limb Anatomy > Plantar foot > Flashcards

Plantar foot Flashcards

1
Q

Where does the superior peroneal retinaculum begin and attach?

A

begins anteriorly on posterior border of lateral malleolus and is attached posteriorly on the lateral surface of the calcaneus and the tendocalcaneus.

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2
Q

Where is the inferior peroneal retinaculum attached?

A

anteriorly to the lateral rim of the sinus tarsi and posteriorly on lateral surface of the calcaneus and to the peroneal trochlea

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3
Q

What part of the inferior peroneal retinaculum forms a tunnel? What is the tunnel for?

A

Between its attachments, the deep fibers of IPR forms a superior tunnel for the peroneus brevis tendon and inferior tunnel for peroneus longus tendon.

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4
Q

Where is the apex and the base of the flexor retinaculum attached?

A

apex: to anteromedial surface of medial malleolus
base: superior border of abductor hallucis m. and to medial process of calcaneus

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5
Q

What is the anterior and posterior border of the flexor retinaculum continuous with?

A

anterior continuous with dorsal aponeurosis

posterior continuous with deep fascia of leg

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6
Q

What are the two other names for the flexor retinaculum?

A

laciniate ligament, medial annular ligament

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7
Q

What forms the roof of the tarsal tunnel?

A

flexor retinaculum

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8
Q

What is in each compartment (4) of the tarsal tunnel?

A

first compartment: tibias posterior tendon, 2nd: FDL tendon, 3rd: posterior tibial A and tibial N, 4th: FHL tendon

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9
Q

What is the fat in the superficial fascia divided into and what divides it? What is the fat’s role?

A

divided into compartments by fibers which connect the superficial fascia to skin and to deep fascia, fat globules act as shock absorbers

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10
Q

What forms the plantar aponeurosis? What is the thickest part?

A

deep fascia forms it, central part of aponeurosis is the thickest

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11
Q

Where does the central part of the plantar aponeurosis attach? What does it divide into?

A

attaches posteriorly on medial process of calcaneal tuberosity, as it passes anteriorly becomes thinner. at the met heads, it divides into 5 processes, one for each digit

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12
Q

What is each digital process of plantar aponeurosis divided into? Where do these divisions attach?

A

Each process is divided into a deep and superficial layer. The superficial stratum attaches to the skin of transverse sulcus. The deep stratum further divides into two slips, on on each side of the flexor tendons of each digit, then blends with the tendon sheaths

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13
Q

What occurs between the digital processes of the plantar aponeurosis?

A

digital nerves, vessels and tendons of the lumbricals become superficial

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14
Q

What does the lateral part of the plantar aponeurosis lie superficial to? What happens to it?

A

superficial to abductor digiti minimi, thin distally and thick proximally where it forms a strong band between the lateral process of the calcaneal tuberosity and the base of the fifth met

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15
Q

What does the medial part of the plantar aponeurosis lie superficial to? What is its posterior attachment?

A

superficial to abductor hallucinating and its attachment is to the flexor retinaculum

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16
Q

What divides the plantar muscles into four layers?

A

two vertical intermuscular septa which pass deep into the foot from the junction between the lateral and central and medial and central parts of the aponeurosis

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17
Q

What are the muscles of the first layer of the plantar foot?

A

abductor hallucis, FDB, abductor digiti minimi

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18
Q

What does the proximal expanded part of the abductor hallucis cover?

A

the entrance of the plantar vessels and nerves into the foot-called the porta pedis

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19
Q

What is the origin of the abductor hallucis?

A

medial process of the calcaneal tuberosity, flexor retinaculum, plantar aponeurosis and the intermuscular septum between it and the FDB

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20
Q

What is the insertion of the abductor hallucis?

A

passes distally to insert via a flattened tendon on the medial side of the plantar surface of the base of the proximal phalanx of the first digit, in common with the FHB-some fibers may attach to medial sesamoid of the 1st MPJ

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21
Q

What is the innervation of abductor hallucis?

A

medial plantar nerve

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22
Q

What does FDB lie deep to? What is the deep surface of the muscle related to?

A

deep to central part of plantar aponeurosis, related to the lateral plantar vessels and N

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23
Q

What is the origin of FDB?

A

plantar aponeurosis, medial and lateral intermuscular septa and from the medial process of the calcaneal tuberosity

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24
Q

Where does the FDB insert?

A

as it passes distally it divides into 4 tendons (for lateral 4 toes), each tendon runs in the tendon sheath of FDL until it reaches base of proximal phalanx where it divides into 2 slips. The slips surround the FDL tendon. They reunite to lie deep to the FDL tendon. The slips then redivide to insert into middle phalanges of lateral 4 digits

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25
Q

What is the innervation of FDB?

A

medial plantar N

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26
Q

What is the function of FDB?

A

flexor of the proximal IPJ of the 4 lesser digits and MPJ

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27
Q

What is the origin of abductor digiti minimi?

A

lateral and medial processes of calcaneal tuberosity and from the depression between the lateral and medial processes

28
Q

What is the insertion of abductor digiti minimi?

A

as it passes towards its insertion, it lies in a groove on the plantar fifth met. it inserts into lateral side of plantar surface of the base of the proximal phalanx of the fifth digit, in common with the flexor digiti minimi brevis

29
Q

What is the innervation and function of the abductor digiti minimi?

A

lateral plantar N, abduct and flex the 5th digit

30
Q

What variations can be seen with the abductor digiti minimi?

A

may be an accessory insertion into the base of the fifth met. if present, it forms a separate muscle-the abductor os metatarsi digiti minimi

31
Q

What is found in the second layer of the plantar foot?

A

quadratous plantae, lumbricals

32
Q

What separates the two heads of origin of the quadratous plantae?

A

long plantar ligament

33
Q

What is the origin of the quadratous plantae?

A

larger medial head arises from the medial process (posteromedial) of calcaneus, lateral head arises form lateral process (posterolateral) of the calcaneus

34
Q

What is the insertion of the quadratous plantae?

A

fibers from the medial and lateral heads pass from their origins to unite and insert on the tendon of the FDL

35
Q

What is the innervation of the quadratous plantae?

A

trunk of the lateral plantar N

36
Q

What is the function of the quadratous plantae?

A

accessory flexor of the lateral 4 toes. Helps FDL by putting tension on its tendons and straightening the line of pull of the long flexor

37
Q

Where do the 2-4th lumbricals take origin from?

A

arise from adjacent sides of the FDL

38
Q

Where does the first lumbrical originate?

A

form the medial side of the most medial tendon of FDL only.

39
Q

What is the course of the lumbricals?

A

They pass distally in company with the flexor tendon which forms their lateral origin. They cross the medial side of the MPJ and continue along the medial side of digits 2-5. They all course superficial to deep transverse metatarsal ligament

40
Q

What is the insertion of the lumbricals?

A

insert into the medial surface of the extensor expansion a little dorsal to the horizontal plate, the first lumbrical inserts onto the extensor expansion of the second digit and so on. Their tendons form part of the wing of the extensor hood

41
Q

What is the innervation of the lumbricals?

A

The first is innervated by the medial plantar N, the others by the deep branch of the lateral plantar nerve

42
Q

What is the function of the lumbricals?

A

Flex the MPJ and extend the IPJ.

43
Q

What is in the third layer of the plantar foot?

A

FHB, adductor hallucis, flexor digiti minimi brevis

44
Q

What is the origin of the lateral head of the FHB?

A

lateral head arises from the cuboid near peroneal groove, from the area of the lateral cuneiform adjacent to the cuboid and occasionally from the long and short plantar ligaments

45
Q

What is the origin of the medial head of the FHB?

A

the deep fibers of medial head arise from tendon of tibias posterior, superficial fibers of medial head from intermuscular septum between the medial and central compartments

46
Q

What happens as the FHB passes toward the first digit?

A

As the M. passes toward the 1st digit, fibers from the two heads fuse briefly then divide into two bellies.

47
Q

Where does the medial head of the FHB insert?

A

medial side of the plantar surface of the base of the proximal phalanx, the medial sesamoid and the plantar pad of the hallux in common with the abductor hallucis

48
Q

Where does the lateral head of the FHB insert?

A

lateral side of the plantar surface of the base of the proximal phalanx, the lateral sesamoid and the plantar pad of the hallux in common with the adductor hallucis

49
Q

What is the innervation and function of the FHB?

A

medial plantar N, flex the first MPJ

50
Q

What is the origin of the oblique head of the adductor hallucis?

A

plantar surface of the bases of the second, third and fourth mets and from the tendon of the peroneus longus

51
Q

What is the origin of the transverse head of the adductor hallucis?

A

plantar plates, plantar MP ligaments and from the deep transverse metatarsal ligament.

52
Q

What is the insertion of the adductor hallucis?

A

in common with the lateral head of the flexor hallucis brevis

53
Q

What is the innervation and function of the adductor hallucis?

A

Deep branch of the lateral plantar N, adductor the 1st toe at the first MPJ

54
Q

What is a variation of the adductor hallucis?

A

sometimes a portion may insert into the first metatarsal forming an opponens hallucis muscle

55
Q

What is the origin of the flexor digiti minimi brevis?

A

arises from the plantar surface of the base of the fifth met and from the tendon of the peroneus longus and plantar aponeurosis

56
Q

What is the insertion of the flexor digiti minimi brevis?

A

plantar surface of the proximal phalanx of the fifth digit in common with the abductor digiti minimi of the first layer

57
Q

What is the innervation and function of the flexor digiti minimi brevis?

A

superficial branch of the lateral plantar N, flexes and abducts the fifth digit

58
Q

What is the variation with the flexor digiti minimi brevis?

A

deeper fibers may form part of a separate muscle-the opponens digiti minimi

59
Q

What are the muscles of the fourth layer of the plantar foot?

A

plantar interossei, dorsal interossei

60
Q

What is the origin of the plantar interossei?

A

the three plantar interossei arise from the bases and medial sides of the shafts of the third, fourth and fifth mets

61
Q

What is the insertion of he plantar interossei?

A

each attaches to only 1 bone-they all insert on the medial sides of the bases of the proximal phalanges, capsules of the MPJ and extensor expansions

62
Q

What is the innervation and function of the plantar interossei?

A

lateral plantar N-deep branchse serves 1st and 2nd muscles, superficial branch serves 3rd
adductors of 3rd, 4th and 5th digits

63
Q

How many dorsal and plantar interossei muscles are there?

A

4 dorsal, 3 plantar

64
Q

What is the origin of the dorsal interossei muscles?

A

arise from adjacent sides of the met bones, the 1st from the 1st and 2nd met, the 2nd from the 2nd and 3rd met, 3rd from the 3rd and 4th met, and the 4th from the 4th and 5th met

65
Q

What is the insertion of the dorsal interossei muscles?

A

insert on base of the proximal phalanx and extnesor expansions as follows: 1st dorsal IO to medial side of 2nd digit, 2nd to the lateral second digit, 3rd to lateral 3rd digit and 4th to the lateral 4th digit

66
Q

What is the innervation and function of the dorsal interossei?

A

N to all but the 4th IO is by deep branch of lateral plantar N, the 4th dorsal IO by superficial branch of lateral plantar N
fxn: abductors of digits

Lower Limb Anatomy (17 decks)

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