Test 5.49.50.51 Foot

Question 1

1. How many tarsals are there? Give names

Answer 1

1. Medial cuneiform
2. Intermediate cuneiform
3. Lateral cuneiform
4. Cuboid
5. Navicular
6. Talus
7. Calcaneus

Question 2

2. How many metarsals?

Answer 2

5

Question 3

3. How many phalanges?

Answer 3

14 (1st toe has only 2)

Question 4

4. Where are the sesamoid bones located?

Answer 4

Medial and lateral are in the tendons of flexor hallucis brevis muscle, on head of first metarsal

Question 5

5. Bones of hindfoot? Midfoot? Forefoot? Ball of foot?

Answer 5

Hindfoot = calcaneus, talus
Midfoot = cuboid, navicular, cuneiforms
Forefoot = phalanges and metatarsals
Ball of foot = sesamoid of 1st met and head of 2nd met

Question 6

6. Know significance of fractures of tarsal bones

Answer 6

Notepool

Question 7

7. How is the skin on the dorsal surface of the foot?

Answer 7

Thin and loose

Question 8

8. The deep fascia is continuous of what?

Answer 8

Crural fascia and fascia of the plantar surface of foot

Question 9

9. Thickening of the deep fascia forms what? What parts comprise this structure? Give the attachments for two of these parts

Answer 9

Forms inferior extensor retinaculum
Stem (frondiform ligament)
Superomedial limb – attaches at the anterior surface of medial malleolus
Inferomedial limb – attaches by blending with the plantar fascia

Question 10

10. Give the four cutaneous nerves of the foot; draw their spatial relationship to each other.

Answer 10

Saphenous nerve
Lateral dorsal cutaneous nerve
Superficial peroneal nerve
Deep peroneal nerve

Question 11

11. Where is the saphenous nerve located on the foot? How far does it go?

Answer 11

Medial side of foot, 1st metatarsal

Question 12

12. The lateral dorsal cutaneous nerve is a continuation of what nerve?

Answer 12

Sural nerve into foot

Question 13

13. What branches does the superficial peroneal nerve give off in the foot? What does it supply?

Answer 13

Medial and intermediate dorsal cutaneous nerves

Supplies middle part of the dorsum of the foot

Question 14

14. What does the deep peroneal nerve supply in the foot?

Answer 14

Skin between 1st and 2nd toes

Question 15

15. Tendons and muscles (of both leg and foot) are?

Answer 15

Extensor digitorum longus
Extensor hallucis longus
Extensor digitorum brevis
Extensor hallucis brevis

Question 16

16. What tendon(s) does the extensor digitorum longus provide? What side?

Answer 16

One tendon for each of the lateral four toes

Dorsal expansion over toes

Question 17

17. What is the only intrinsic muscle of dorsum of foot? Where does it extend?

Answer 17

Extensor digitorum brevis

Extends toe 2-4

Question 18

18. The extensor hallucis brevis is part of what muscle?

Answer 18

Extensor digitorum brevis

Question 19

19. Draw the arteries of the foot:
    a. Lateral and medial tarsal
    b. Arcuate
    Branches of dorsal metatarsal arteries, dorsal digital arteries
    (know what is the exception(s)
    Perforating arteries
    c. Deep plantar artery
    d. First dorsal metatarsal artery

Answer 19

drawing

Question 20

20. What do the perforating arteries connect?

Answer 20

Dorsal metatarsal arteries with the deep plantar arch

Question 21

21. What are the terminal branches of the dorsalis pedis?

Answer 21

Deep plantar artery and first dorsal metatarsal artery

Question 22

22. Where does the deep plantar artery go and what does it join with?

Answer 22

Goes to plantar side and joins with deep plantar arch of the lateral plantar artery

Question 23

23. What does the first dorsal metatarsal artery give rise to?

Answer 23

Three dorsal digital arteries

Question 24

24. The dorsal venous arch is made up of?

Answer 24

Dorsal metatarsal veins (4)

Dorsal digital veins

Question 25

25. Medial dorsal digital vein is part of which toe? And the lateral dorsal digital vein?

Answer 25

Medial dorsal digital vein of the 1st toe | Lateral dorsal digital vein of the 5th toe

Question 26

``` 26. Draw these veins in relation to one another: Dorsal venous arch (including branches) Medial dorsal digital vein Lateral digital dorsal digital Medial and lateral marginal veins Great saphenous vein Small saphenous vein ```

Answer 26

Drawing

Question 27

27. What is the cutaneous innervation to the plantar surface of the foot? Draw it too

Answer 27

``` Saphenous nerve Lateral dorsal cutaneous nerve Calcaneal branches of tibial nerve Medial plantar nerve Lateral plantar nerve ```

Question 28

28. The lateral dorsal cutaneous nerve is a continuation of?

Answer 28

Sural nerve

Question 29

29. What branches of the tibial nerve supply the heel area?

Answer 29

Calcaneal branches

Question 30

30. What does the medial plantar nerve supply?

Answer 30

Medial 3 ½ digits

Question 31

31. What does the lateral plantar nerve supply?

Answer 31

Lateral 1 ½ digits

Question 32

32. What is the flexor retinaculum?

Answer 32

Thickening of the plantar fascia

Question 33

33. What is the plantar aponeurosis? Describe two characteristics of it

Answer 33

Central part of plantar fascia | Very thick and strong, longitudinally arranged fibers

Question 34

34. Give two functions of the plantar aponeurosis

Answer 34

Helps to support longitudinally arranged fibers | Prevent foot injury

Question 35

35. Where does the Plantar Aponeurosis extend? Divides into how many slips? How does it divide the foot into compartments?

Answer 35

From calcaneus to the toes Divides into three compartments Vertical septa from it divide the foot into medial, lateral, and central compartments

Question 36

36. What do the four layers of intrinsic muscles of the foot do?

Answer 36

Help to maintain balance and support arches of foot

Question 37

37. Give the name of the muscles of the first layer. What are the attachments for the first layer muscles of the foot?

Answer 37

a. Abductor hallucis Tuberosity of calcaneous – base of 1st proximal phalanx b. Flexor digitorum brevis Tuberosity of calcaneous – middle phalanx of lateral 4 toes c. Abductor digiti minimi Tuberosity of calcaneous – base of 5th proximal phalanx

Question 38

38. Give the name of the muscles/tendons; and attachments (if stated) for the 2nd layer

Answer 38

Flexor digitorum longus Flexor hallucis longus Quadratus plantae: calcaneus – tendon of the flexor digitorum longus Lumbrical muscles: tendon of flexor digitorum longus – flexor sheath of lateral 4 toes

Question 39

39. Give the names of the muscles/tendons of the third layer; and their attachments

Answer 39

a. Flexor digiti minimi brevis: base of 5th plantar metatarsal – 5th proximal phalanx b. Adductor hallucis i. Oblique head: base of met. 2-4 – base 1st proximal phalanx ii. Transverse head: MP joint ligaments – base 1st proximal phalanx c. Flexor hallucis brevis: cuboid – base 1st proximal phalanx

Question 40

41. Give the muscles/tendons of the fourth layer; and attachments if stated

Answer 40

Peroneus longus tendon Tibialis posterior tendon Plantar interossei muscles (3): Base metatarsals 3-5 – base proximal phalanx of toes 3-5Dorsal interossei muscles (4): Adjacent sides 1-5 metatarsals – proximal phalanx of toes 2-4

Question 41

``` 41. Draw the following nerves and their spatial relationships: Tibial nerve Medial calcaneal n. Medial plantar n. Common plantar digital n. Two proper plantar digital nerves Lateral plantar nerve Sural Saphenous ```

Answer 41

Drawing

Question 42

42. The medial calcaneal supplies what?

Answer 42

Sensory innervation to the heel

Question 43

43. The medial plantar nerve is how big relative to lateral plantar nerve? Between what muscle layers? Passes deep to what muscle? Supplies?

Answer 43

Larger than the lateral plantar nerve Between 1st and 2nd layer Passes deep to the abductor hallucis brevis ``` Supplies cutaneous branch to 3 ½ digits Medial plantar nerve also supplies motor branches to: Abductor hallucis Flexor digitorum brevis Flexor hallucis brevis 1st lumbrical ```

Question 44

44. Lateral plantar nerve passes deep to? Provides cutaneous branches to? Provides how many common plantar digital nerves? Provides motor branches to?

Answer 44

Passes deep to the abductor hallucis Lateral 1 ½ digits One common plantar digital nerve Provides motor branches to all intrinsic muscles except the four of the medial plantar nerve

Question 45

45. Where does the sural nerve provide innervation to?

Answer 45

Sensory to lateral margin of foot and lateral side of 5th toe

Question 46

46. What is the saphenous nerve a branch of? Supplies?

Answer 46

Femoral nerve | Sensory to medial side of foot

Question 47

47. Draw and name the arteries of the sole of the foot

Answer 47

Drawing of | Medial and lateral plantar arteries

Question 48

48. What do the two branches of the posterior tibial provide blood to? Anastomoses?

Answer 48

Plantar muscles | With arteries on dorsum of foot

Question 49

49. Medial plantar artery passes through what muscles? Supplies?

Answer 49

Abductor hallucis and flexor digitorum brevis | Supplies medial side of great toe (first proper plantar digital artery)

Question 50

50. What is the course of the lateral plantar artery? Where does it pass to the medial side? Forms?

Answer 50

Obliquely across foot to lateral side At base of 5th metatarsal passes to medial side Than forms deep plantar arch

Question 51

51. What does the lateral plantar artery join with on the medial side? To make?

Answer 51

On medial side it joins with the deep plantar branch of dorsalis pedis to complete deep plantar arch

Question 52

52. Draw the following arteries showing their relation to one another

Answer 52

``` Medial plantar artery Lateral plantar artery Deep plantar arch Deep plantar branch of dorsalis pedis Deep plantar’s branches all the way to their terminus ```