Plantar Foot: Part 1 Flashcards
(60 cards)
1
Q
1st ray
A
- Medial cuneiform
- 1st metatarsal
2
Q
2nd ray
A
- Intermediate cuneiform
- 2nd metatarsal
3
Q
3rd ray
A
- Lateral cuneiform
- 3rd metatarsal
4
Q
4th ray
A
- 4th metatarsal
5
Q
5th ray
A
- 5th metatarsal
6
Q
Rays of the foot (toe units)
A
- Rays 1-5
- Some consider the phalanges as part of the rays
7
Q
Plantar aspect of the foot
A
- Thick skin
- Thick layer of subcutaneous fat (especially over MTP joints and calcaneus)
- Supported by septa
8
Q
Deep Fascia/Plantar Aponeurosis (Fascia)
A
- Attaches to skin, bone and muscles
- 3 Bands (slips)
- Important in Windlass mechanism
9
Q
3 bands (slips) of plantar fascia
A
- Medial band
- Lateral band
- Central band
10
Q
Windlass Mechanism
A
- Plantar fascia simulates a cable attached to the calcaneus and the metatarsophalangeal joints
- Dorsiflexion during propulsion winds plantar fascia around the head of the metatarsal
- Winding shortens distance between calcaneus and metatarsals to elevate the medial longitudinal arch
- PF shortening that results from hallux dorsiflexion is the essence of the windlass mechanism principle
11
Q
Plantar fasciitis
A
- Inflammation of the central band at its attachment to medial process of calcaneal tuberosity
12
Q
Medial band
A
- Thinnest portion
- Covers abductor hallucis muscle
13
Q
Medial band proximal attachment
A
- Medial tubercle of calcaneal tuberosity
14
Q
Medial band distal attachment
A
- Not bony
- Blends with fascia (fascia dorsalis pedis, inferior band of cruciate crural ligament, and central band of plantar fascia)
15
Q
Lateral band
A
- Covers abductor digiti minimi and flexor digiti minimi brevis
16
Q
Lateral band proximal attachment
A
- Lateral tubercle of calcaneal tuberosity
17
Q
Lateral band distal attachment
A
- Deep fascia (fascia dorsalis pedis and central band)
- Styloid process of 5th metatarsal (calcaneometatarsal ligament)
18
Q
Central band
A
- Thickest, toughest part of fascia
19
Q
Central band proximal attachment
A
- Posterior calcaneal tuberosity
20
Q
Central band distal attachment
A
- Divides into 5 bands near the metatarsal bases (one for each metatarsal)
- At the met heads: divide into superficial and deep layers
21
Q
Central band distal attachment of superficial layer
A
- Dermis of skin
- Longitudinal fibers
- Transverse fibers
22
Q
Transverse metatarsal ligament is formed by
A
- Longitudinal fibers
- Transverse fibers
23
Q
Longitudinal fibers (central band superficial layer distal attachment)
A
- Attach to skin in the sulcus between toes and metatarsals
24
Q
Transverse fibers (central band superficial layer distal attachment)
A
- Connect the digital bands together at the level of the MTP joints
25
Central band distal attachment of deep layer
- Splits into medial and lateral slips (attach to bone and blend with flexor sheaths)
- Medial and lateral base of proximal phalanges of corresponding digit
- Plantar MTP joint ligaments, plantal plate
- Deep transverse metatarsal ligament
26
The 1st medial slip (central band deep layer)
- Attaches to the sesamoid bones at the 1st MTP joint
27
Plantar foot layer 1 muscles
- Abductor hallucis
- Flexor digitorum brevis
- Abductor digiti minimi (quinti)
28
Plantar foot layer 2 muscles
- Quadratus plantae (flexor accessories)
- Lumbricals (4 of them)
- Flexor digitorum longus tendon
- Flexor hallucis longus tendon
29
Plantar foot layer 3 muscles
- Adductor hallucis
- Transverse and oblique heads
- Flexor hallucis brevis
- Flexor digitorum brevis
30
Plantar foot layer 4 mucsles
- Plantar interossei (3 of them)
- Dorsal interossei (4 of them)
- Tibialis posterior tendon
- Fibularis longus tendon
31
The muscles of layers 3 and 4 are located
- In the forefoot
32
The lateral plantar artery/vein/nerve pathway
- Pass between layers 1 and 2
33
The medial plantar artery/vein/nerve pathway
- Pass within layer 1
- Between abductor hallucis and flexor digitorum brevis
- Deep to abductor hallucis
- Some also say between layers 1 and 2
34
The arteries are located outside of the nerves
- Lateral plantar artery is lateral to the lateral plantar nerve
- Medial plantar artery is medial to the medial plantar nerve
35
Muscular compartments of plantar foot (9)
- Medial
- Lateral
- Central
- Interosseous (4)
- Dorsal
36
Medial plantar compartment formed by
- Plantar aponeurosis
- Medial intermuscular septum
- 1st metatarsal
37
Medial plantar compartment contains
- Abductor hallucis
- Flexor hallucis brevis
- FHL tendon
- Medial plantar nerve/artery
38
Lateral plantar compartment formed by
- Plantar aponeurosis
- Lateral intermuscular septum
- 5th metatarsal
39
Lateral plantar compartment contains
- Abductor digiti minimi
- Flexor digiti minimi
- Lateral plantar nerve/artery
40
Central plantar compartment formed by
- Both intermuscular septa
- Plantar aponeurosis
- Inferior interosseous fascia
41
Subdivisions of central compartment
- Separated by fascial layers
- Superficial central
- Deep central (adductor)
- Calcaneal (deep hindfoot)
42
Superficial central compartment contains
- FDB
- Lumbricals
- Tendon of FDL
43
Deep central (adductor) compartment contains
- Found in the forefoot
| - Adductor hallucis
44
Calcaneal (deep hindfoot) compartment contains
- QP muscle
| - Lateral plantar nerve & artery
45
Interosseous compartments
- Formed by dorsal and plantar interossei (4 separate compartments)
- Contain associated nerves and vessels
46
Dorsal plantar compartment contains
- Tendons of extensor muscles
47
Intermuscular septum attachment points
- Medial: from calcaneus to 1st met head
- Lateral: from calcaneus to the 5th met head
- Both attach to other tarsal bones
48
Abductor hallucis
- Visible/ palpable on medial side of foot
| - Forms boundary for porta pedis
49
Abductor hallucis origin
- Medial tubercle of calcaneal tuberosity
- Flexor retinaculum
- Plantar fascia
- Intermuscular septum
50
Abductor hallucis insertion
- Medial tubercle base of proximal phalanx of hallux
| - Medial sesamoid
51
Abductor hallucis blood supply/innervation
- Medial plantar artery and nerve
52
Abductor hallucis function
- Abduct hallux
| - Flex (plantarflex) hallux
53
Flexor digitorum brevis origin
- Medial tubercle of calcaneal tuberosity
- Plantar aponeurosis
- Intermuscular septum
54
Flexor digitorum brevis insertion
- Plantar aspect of bases of middle phalanges 2-5
- Tendons are plantar to the FDL tendons
- Split to allow them to pass
55
Flexor digitorum brevis blood supply/innervation
- Medial plantar artery and nerve
56
Flexor digitorum brevis function
- Flex digits 2-5 (PIP and MTP joints)
57
Abductor digiti minimi (quinti) origin
- Medial and lateral tubercles of calcaneal tuberosity
- Plantar aponeurosis
- Intermuscular septum
58
Abductor digiti minimi (quinti) insertion
- Lateral base of proximal phalanx of 5th toe
59
Abductor digiti minimi (quinti) blood supply/innervation
- Lateral plantar artery and nerve
| - Also called inferior calcaneal nerve (Baxters nerve)
60
Abductor digiti minim (quinti) function
- Abduct 5th toe
| - Flex (plantarflex) 5th toe
