Anatomy Block III- Foot
part of foot contacting the ground
what is the plantar
dorsal (superior) surface of the foot
what is the dorsum
sole of foot under calcaneous
what is the heel
some of foot under medial two metatarsals
what is the ball of the foot
ball of the foot
what is the last part of the foot contacting the ground when walking
a to b. medial, intermediate, and lateral cuneiform bones
c. navicular bone
d. talus bone
e. calcaneus bone
f. cuboid bone
g. metatarsals
h. proximal, intermediate, distal phalanges
a. metatarsals
b. medial cuneiform
c. navicular
d. talus
e. calcaneus
f. metatarsal
g. cuboid
h. talus
calcaneus
1st toe big, great toe
toes 2-5, fifth toe is pinky toe
what are the orders of the toe numbers
tarsals
metatarsals
phalanges
sesamoid bones
what are the general categories of bones of the foot
calcaneous
talus
navicular
cuboid
cuneiform (medial, intermediate, lateral)
what are the tarsal bones
tarsals
what bones make up the hindfoot and midfoot
tarsals
what bones make up the ankle joints
calcaneous
what bone forms large bony protrusion posteriorly
calcaneous
what does the calcaneal tendon attach to (tarsal bone)
talus
what is the domed superior tarsal bone
talus
what bone wedges between tibia and fibula
talus
what tarsal makes up the large portion of the ankle joint
navicular
what bone articulates with the talus
navicular
what tarsal is a crescent shaped bone
navicular
what bone is proximal to the cuneiform
cuboid
what is the most lateral tarsal
distal to the navicular
where is the cuneiform relative to the navicular
medial (first)
intermediate (second)
lateral (third)
what are the different cuneiform bones
five
how many metatarsals are there
a. fibularis longus
b. tibialis posterior
- plantar calcaneonavicular ligament is ligament behind it
c. tibialis anterior
d. short plantar ligament
e. long plantar ligament
f. plantar aponeurosis
g. intrinsic plantar muscles
- flexor hallucis longus is muscle that wraps around ankle and goes to toe
metatarsals
what are the long boes that make up the arch/body of the foot
14
two off big toe, three off each of the rest
how many phalanges are tehre
proximal and distal of big toe
proximal intermediate distal off the rest of the toes 2-5
what are the phalanges
sesamoid bones
what are the two odd bones in the muscle tendon at the head of the first metatarsal on plantar surface
sesamoid bones
what bones are buried in tendons of flexor hallucis brevis tendons
general frictional forces and change up the angle that flexor hallucis brevis inserts on big toe, giving it more of a mechanical advantage
what is the purpose of the sesamoid bones
major supportive structure that bears weight whenever we stand up or use locomotion
what is important about the foot's general role
three arches
what is the support function of the foot based on
act as shock absorbers
help support/distribute body weight
protect BVs
propel body when moving
what do the arches of the foot do?
nerves and arteries bothered and pinched
why do people with flat feet have problems
medial longitudinal arch
lateral longitudinal arch
transverse arch
what are the arches of the foot
runs on medial longitudinal border of the foot
where is the medial longitudinal arch
medial longitudinal arch
which arch of the foot does not make a footprint
on lateral longitudinal border of the foot, not as high as medial longitudinal arch so it makes a footprint
where is the lateral longitudinal arch
arrangement of the metatarsal bones themselves
where is the transverse arch of the foot
due to how they are shaped and interlock structurally
how do the bones of the arch provide passive support
plantar aponeurosis
long plantar ligament
short plantar ligament
plantar calcaneonavicular ligament
what are the layers of fibrous tissue that provide passive support to the arches of the feet
protects underlying tendons, muscles, nerves, BVs
has arch support function
what is the function of the plantar aponeurosis
thickened portion of plantar fascia
functions to provide firm attachment for skin and thus improve grip
what is the plantar aponeurosis
calcaneus to heads of metatarsals and base of proximal phalanx
where does plantar aponeurosis run
from calcaneous to metatarsals
where does the long plantar ligament run
both longitudinal arches
what arches does the long plantar ligament support
short plantar ligament
what layer of the fibrous tissue runs deep to the long plantar ligament
short plantar ligaments
what layer of fibrous tissue runs from the calcaneous to cuboid tarsal bones
inflammation of plantar fascia that makes weight bearing difficult
what is plantar fasciitis
close to calcaneus
where does pain in plantar fasciitis usually originate
heel spur
what can sometimes develop in plantar fasciitis
exercise and stretching of gastroc and soleus
severe cases: corticosteroids but this can wear it away too so be careful
how can plantar fasciitis be helped
plantar calcaneonavicular ligament
what layer of fibrous tissue provides the main support to the medial longitudinal arch
plantar calcaneonavicular
which ligament is considered the spring ligament
which layer of fibrous tissue are stretched out over the course of the day
intrinsice muscles
active contractions of muscles
what provides dynamic support to the arch
tibialis anterior
fibularis longus
which muscles actively contract to support the arch
supports medial longitudinal arch
what is the function of the tibialis anterior relative to the dynamic support of the arch
cuts across transverse arch and wraps under plantar aspect of foot and supports that transverse arch
what is the function of the fibularis longus relative to dynamic support of the arch
pes planus
pes cavus
what are two types of foot shapes
flat feet
what is pes planus
yes, one reason that people are exempt from army
is pes planus common?
supple
rigid
what are two types of pes planus
when foot not weight bearing, their arch looks normal; when weight bearing it flattens out as passive and active supports give way
what is supple pes planus like
bone alignment fitting a certain way
what is rigid pes planus due to
abnormally high arch
due to tight dynamic support
what is pes cavus and what is it from
pain in other joints/muscles that usually do not bear stress
where do problems in the feet often manifest themselves
extend the toes
what do the muscles on the dorsum of the foot do
deep fibular nerve
what are the muscles of the dorsum of the foot innervated by
dorsalis pedis artery
what artery supplies the dorsum of the foot
femoral to popliteal to anterior tibial to dorsalis pedis artery
what eventually becomes the dorsalis pedis artery
big toe extensor
what is the action of the extensor hallucis brevis
extensor of toes 2-5
what is the action of the extensor digitorum brevis
central axis of the foot, bisects 2nd toe and goes to calcaneus
what is an important division line on the plantar side of the foot
medial and lateral plantar nerve
what are two terminal branches of the tibial nerve
medial and lateral plantar nerves
what nerves supply the plantar side of the food
a. extensor digitorum brevis
b. extensor hallucis brevis
two abductors and a flexor
what is in the first (superficial) layer of muscles of the plantar side of the foot made of
abductor hallucis
flexor digitorum brevis
abductor digiti minimi
what is included in the first layer of muscles on the plantar side of the foot
a. abductor digiti minimi
b. flexor digitorum brevis
c. abductor hallucis
medial plantar nerve
what innervates the abductor hallucis
medial plantar nerve
what innnervates the flexor digitorum brevis
lateral plantar nerves
what innervates the abductor digiti minimi
plantar nerves and plantar BVs
what is between the first and second layer of plantar muscles
two muscles, two tendons
what is within the second layer of plantar side foot muscles
quadratus plantae
lumbricals
what muscles are within the second layer of plantar side foot muscles
a. lumbricals
b. quadratus plantae
c. tendon of flexor digitorum longus
d. tendon of flexor hallucis longus
flexor digiti minimi (3rd layer, looks out of place)
tendon of flexor hallucis longus
tendon for flexor digitorum longus
what tendons are within the second layer of plantar side foot muscles
LPN
what innervates the quadratus plantae
MPN
what innervates the first lumbrical
LPN
what innervates the 2-5 lumbricals
flex proximal phalanges and extend intermediate and distal phalanges
what do the lumbricals do
from heel to tendons of flexor hallucis longus
where does the quadratus plantae run
only in lower limb because quadratus plantae pulls on toes so that they don't curl at an angle but straightforward
what is interesting abuot quadratus plantae
flexor digitorum tendons, run to digits
what do the lumbricals attach to
wormlike
what do lumbricals mean
from leg
where are the tendon of flexor hallucis longus and tendon of flexor digitorum longus from
one adductor, two flexors
what is in the third layer of plantar muscles of the foot
flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis
what are teh msucles in the third layer of plantar muscles in the foot
a. transverse head of adductor hallucis
b. oblique head of adductor hallucis
c. flexor hallucis brevis
flexes proximal phalanx of first toe
what is the role of the flexor hallucis brevis
active during pushoff phase of gait
pulls toes 2-5 and holds transverse arch stable
what is the action of the adductor hallucis
two sesamoid bones
where does the flexor hallucis brevis insert
MPN
what innervates the flexor hallucis brevis
has two muscle heads, looks like a 7
what is interesting about the adductor hallucis
LPN
what innervates the adductor hallucis
LPN
what innervates the flexor digiti minimi brevis
many short muscles and two tendons
what is included in the fourth layer of the plantar side of the foot
a. plantar interossei
b. dorsal interossei
adduction of toes
what is the action of the plantar interossei
3
how many plantar interossei are there
unipennate
are the plantar interossei unipennate or dipennate
abduction of toes
whta is the actin of the dorsal interossei
4
how many dorsal interossei are tehre
bipennate
are dorsal interossei unipennate or dipennate
interossei
what are the short muscles that run in between the metatarsals
three
how many plantar interossei are there
four
how mnay dorsal interossei are there
tendon of fibularis longus
tendon of tibialis posterior
what are the two tendons of fourth layer of the plantar side of the foot
plantar and dorsal interossei
what are the muscles that are in the fourth layer of the plantar side of the foot
dorsalis pedis artery
what artery supplies the dorsum of the foot
arcuate artery
what areter does the dorsalis pedis artery give off distally
anterior tibial artery
what does the dorsalis pedis artery come off of
deep plantar artery that passes to plantar aspect of foot and small digital branches
what comes off the arcuate artery
a. deep plantar artery
b. dorsalis pedis artery
c. anterior tibial artery
goes between toes 1 and 2
what is the path of the deep plantar artery
anterior tibial artery
where is the dorsalis pedis artery from
sends branch to plantar side of foot, anastamoses with some plantar BVs and terminates between first and second toe
what is the course of the dorsalis pedis artery
distal to extensor retinaculum and just laeral to tendon for extensor hallucis longus
where is the palpable dorsalis pedis pulse
arterial insufficiency
what is the dorsalis pedis artery checked for
10%
how much of the populatin have a weak or absent dorsalis pedis artery
medial plantar artery
what is the smaller branch of the posterior tibial artery
medial plantar side of foot
what does the medial plantar artery supply
lateral plantar artery
what is the larger branch of the posterior tibial artery
a. deep plantar artery
b. plantar arch
c. medial plantar artery
d. lateral plantar artery
e. posterior tibial artery
lateral plantar artery
what supplies most of the plantar side of the foot
lateral plantar artery and deep plantar artery (from dorsalis pedis)
what is the plantar arterial arch a union of
plantar arterial arch
what gives off the digital arteries
nope
does the cutaneous information of the foot follow the central axis rule
medial side of dorsum to first metatarsal
what does the saphenous nerve supply
dorsum of foot and parts of digits
what does the superficial fibular nerve supply
between first and second digits
what does the deep fibular nerve supply
medial plantar side of foot and first 3.5 digits
what does the medial plantar nerve supply
lateral plantar side of foot and last 1.5 digits
what does the lateral plantar nerve supply
very lateral side of foot
what does the sural nerve supply
skin of heel
what does the tibial nerve supply
a. sural nerve
b. deep fibular nerve
c. superficial fibular nerve
d. deep fibular nerve
e. sural nerve
f. saphenous nerve
a. tibial nerve
b. sural nerve
c. lateral plantar nerve
d. medial plantar nerve