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Lower Extremity Anatomy > Plantar Foot: Part 2 > Flashcards

Plantar Foot: Part 2 Flashcards

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1
Q

2nd plantar layer

A
  • 5 muscles (4 lumbricals, quadratus plantae)
  • 2 tendons (FDL and FHL)
  • All muscles attach to FDL
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2
Q

Quadratus plantae (flexor accesorius)

A
  • Deep to FDB

- 2 heads (medial and lateral)

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3
Q

Quadratus plantae (flexor accesorius) origins

A
  • Medial head: medial surface of calcaneus
  • Lateral head: trigonum plantare and inferior calcaneus (distal to lateral tubercle)
  • Origins separated by long plantar ligament
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4
Q

Quadratus plantae (flexor accesorius) insertion

A
  • Heads unite

- Insert onto the FDL tendon

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5
Q

Quadratus plantae (flexor accesorius) blood supply

A
  • Medial and lateral plantar arteries
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6
Q

Quadratus plantae (flexor accesorius) innervation

A
  • Lateral plantar nerve
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7
Q

Quadratus plantae (flexor accesorius) function

A
  • Redirects line of pull of FDL

- Assists in flexing phalanges

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8
Q

Lumbricals (lumbricale muscles)

A
  • 1 is unipennate

- 2,3,4 are bipennate

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9
Q

Lumbricals (lumbricale muscles) origins

A
  • 1st: medial side of 1st tendon of FDL (tendon going to 2nd digit)
  • 2-4: adjacent tendons (e.g. 3rd lumbrical: medial side of 3rd, lateral side of 2nd; 2nd lumbrical medial side of 2, lateral side of 1)
  • Tendons pass distally plantar to the deep transverse metatarsal ligament
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10
Q

Lumbricals (lumbricale muscles) insertions

A
  • Medial aspect of extensor wing of the extensor expansion at base of proximal phalanx of digits 2-5
  • 1st lumbrical goes to 2nd digit, 2nd lumbrical to 3rd digit…
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11
Q

Lumbricals (lumbricale muscles) blood supply

A
  • Respective plantar metatarsal arteries
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12
Q

Lumbricals (lumbricale muscles) innervations

A
  • 1st: medial plantar nerve

- 2-4: deep branch of lateral plantar nerve

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13
Q

Lumbricals (lumbricale muscles) function

A
  • Flex MTP joints

- Extend PIP and DIP joints

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14
Q

3rd plantar layer muscles

A
  • FHB
  • FDMB
  • ADD Hallucis
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15
Q

Flexor hallucis brevis origins

A
  • Lateral head: plantar surface of cuboid and lateral cuneiform
  • Medial head: tibialis posterior tendon
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16
Q

Flexor hallucis brevis insertions

A
  • Medial and lateral base of proximal phalanx
  • Respective heads invest respective hallux sesamoid bones before phalangeal insertion: medial (tibial) and lateral (fibular)
  • Sesamoids
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17
Q

Flexor hallucis brevis blood supply

A
  • 1st plantar metatarsal artery
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18
Q

Flexor hallucis brevis innervation

A
  • Medial plantar nerve
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19
Q

Flexor hallucis brevis function

A
  • Flex (plantarflex) hallux MTP joint
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20
Q

Flexor hallucis brevis sesamoid insertion advantage

A
  • Increase the mechanical advantage of the FHB

- Weight bearing structures and decrease friction

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21
Q

Flexor digiti minimi brevis origin

A
  • Base of 5th metatarsal

- Tendon sheath of fibularis longus

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22
Q

Flexor digiti minimi brevis insertion

A
  • Plantar/lateral aspect of base of proximal phalanx of 5th toe
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23
Q

Flexor digiti minimi brevis bloody supply

A
  • Lateral plantar artery
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24
Q

Flexor digiti minimi brevis innervation

A
  • Superficial branch of lateral plantar nerve
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25
Flexor digiti minimi brevis function
- Flex (plantarflex) 5th digit at MTP joint
26
Adductor hallucis heads
- Transverse | - Olbique
27
Adductor hallucis transverse head origin
- Fibrous capsule - Plantar plates of digits 3-5 - Deep transverse metatarsal ligament
28
Adductor hallucis oblique head origin
- Plantar aspect of metatarsal bases 2-4 | - Fibularis longus tendon sheath
29
Adductor hallucis insertion
- Lateral sesamoid | - Lateral aspect of proximal phalanx base of 1st digit
30
Adductor hallucis blood supply
- Plantar metatarsal arteries
31
Adductor hallucis innervation
- Deep branch of lateral plantar nerve
32
Adductor hallucis function
- Adducts hallux
33
Opponens digiti minimi origin
- Base of 5th metatarsal - Long plantar ligament - FDMB
34
Opponens digiti minimi insertion
- Lateral shaft of 5th metatarsal | - Surrounding fascia
35
Opponens digiti minimi function
- Abduct and flexion 5th toe
36
4th plantar layer
- 4 dorsal and 3 plantar interossei (two muscle groups of 4th layer) - Located within the metatarsal spaces - None associated with hallux - Tendons pass dorsal to deep transverse metatarsal ligament
37
Interosseous muscle groups
- 3 plantar ADDuct | - 4 dorsal ABduct
38
2 tendons of 4th layer
- Tibialis posterior | - Fibularis longus
39
Plantar interossei muscles
- 3 in number - Associated with digits 3,4,5 - Unipennate muscles
40
Plantar interossei origins
- Base and medial aspect of shafts of metatarsals 3, 4, 5
41
Plantar interossei insertions
- Medial aspect of base of proximal phalanx - Extensor expansion of same digit - Example: 1st plantar interossei originates from the 3rd metatarsal and inserts onto the proximal phalanx and extensor expansion of 3rd digit. - 2nd plantar interossei – 4th digit; 3rd – 5th digit
42
Plantar interossei blood suply
- Plantar metatarsal arteries 2-4
43
Plantar interossei innervation
- Lateral plantar nerve - Superficial branch innervates 3rd plantar interossei - Deep branch innervates 1st and 2nd plantar interossei
44
Plantar interossei functon
- Adduct digits 3-5 toward foot midline - Flex (plantarflex) 3-5 MTP joint - Extend (dorsiflex) IP joints of digits 3-5
45
Dorsal interossei
- 4 in number - Associated with digits 2-4 - Digit 2 has 2 dorsal interossei muscles inserting - Bipennate muscles located within the intermetatarsal space
46
Dorsal interossei origins
- Adjacent metatarsal shafts - Example: 1st dorsal interossei originates lateral aspect of 1st metatarsal shaft and medial aspect of 2nd metatarsal shaft
47
Dorsal interossei insertions
- 1st dorsal interossei: medial aspect of base of proximal phalanx and extensor expansion of 2nd digit - 2nd-4th dorsal interossei: lateral aspect of base of proximal phalanx and extensor expansion of corresponding digit
48
Dorsal interossei blood supply
- Corresponding dorsal metatarsal artery
49
Dorsal interossei innervation
- Lateral plantar nerve - Deep branch of lateral plantar nerve innervates 1st-3rd - Superficial branch of lateral plantar nerve innervates 4th - 1st and 2nd also receives innervation from deep fibular nerve
50
Dorsal interossei function
- Abducts digits 2-4 - Flex (plantarflex) MTP joints - Extend (dorsiflex) IP joints
51
Intermetatarsal spaces
- 1st: 1st dorsal interosseous - 2nd: 2nd dorsal, 1st plantar - 3rd: 3rd dorsal, 2nd plantar - 4th : 4th dorsal, 3rd plantar
52
Flexor sheath
- Fibrous - Keeps the tendons anchored to the bone - FHL, FDB and FDL are surrounded by a synovial sheath to reduce friction - Vincula brevia and vincula longa
53
Extensor expansion
- Tendinofibroaponeurotic structure | - Involved in the extensor function of the digits
54
Extensor expansion formed by
- Extrinsic muscles - Intrinsic muscles - Stabilizing ligaments
55
Extrinsic muscles contributing to extensor expansion
- EDL | - EHL
56
Intrinsic muscles contributing to extensor expansion
- EDB - Lumbricals - Interossei
57
Stabilizing ligaments contributing to extensor expansion
- Sling and wing | - Triangular lamina
58
Sling
- Proximally located - Transversely oriented fibers - Pass around the MTP joint - Interossei insert into the sling - Anchors EDL allowing it to extend all digits
59
Sling attachment points
- Plantar plate | - Deep transverse metatarsal ligament
60
Wing
- Distal portion of extensor expansion - Fibers are oriented obliquely (triangular shaped) - Located at the proximal phalanx - Lumbricals insert into the medial side of the wing
61
EDL tendons
- Forms the central axis of extensor expansion - Stabilized by the sling at the MTP joint - Divides into 3 slips (trifurcates) at the MTP joint (some say proximal phalanx)
62
3 slips of EDL tendons attachment points
- Medial/lateral slips: extend over dorsum of middle phalanx, insert into base of distal phalanx as a terminal tendon - Middle slip: inserts into base of middle phalanx
63
Triangular lamina
- Found between lateral slips of EDL - Function is not known - Believed to anchor medial and lateral slips - Keeps them from sliding plantarward
64
EDB and EHB tendons]
- EDB joins the EDL tendon - EDB tendons can form lateral slip instead of EDL - EHB attaches to base of proximal phalanx
65
Lumbrical tendons
- Pass plantar to deep transverse metatarsal ligament - Insert into wing - This allows them to flex MTP joint and extend IP joints - Can form medial slip
66
Interosseous tendons
- Pass dorsal to deep transverse metatarsal ligament - Insert into base of proximal phalanx at the tubercle - Insert into extensor apparatus at the sling - Disputed by some

Lower Extremity Anatomy (35 decks)

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