Foot

Question 1

bones of foot

Answer 1

1. tarsals
2. metatarsals (1/digit)
3. phalanges (proximal/middle/distal)

Question 2

tarsal bones

Answer 2

1. calcaneus (heel)
2. talus
3. cuneiform (lateral + intermediate + medial)
4. cuboid
5. navicular

my insanely large cucumber never touches carrots

Question 3

sesamoids

Answer 3

@sole/plantar foot, MT1

2 of them-forms within tendons of flexor hallucis brevis muscle

Question 4

foot divisions

Answer 4

1. forefoot (phalanges + MTs)
2. midfoot (cuneiforms + cuboid + navicular)
3. hindfoot = calcaneus + talus
4. tarsus = all tarsals (midfoot + hindfoot)

Question 5

joints

Answer 5

tarsometatarsal/lisfranc = div fore/mid foot

trasverse tarsal/midtarsal = div mid/hintfoot

Question 6

talus structure

Answer 6

head
neck
trochlea “pulley”

Question 7

calcaneus bony features

Answer 7

calacneal tuberosity = achilles tendon insert, most weight bearing

articular surfaces= for cuboid bone and talas (@post, middle, anterior)
-sustentaculum tali/talar shelf: support head of talus and has groove for flexor hallucis longus tendon

Question 8

superficial fascia + skin

Answer 8

thin + loose CT fascia

dorsum = not much fat, thin skin, fewer lymph vessels
sole = fat lobules in compartments separated by dense CT,

dorsum is more susceptible to edema than sole near lat malleolus

Question 9

deep fascia

Answer 9

aka dorsalis fascia

cont w/ crural and plantar fascia

very thin except where extensor retinacula

tendons/arteries/nerves from ant leg run deep to dorsalis fascia

Question 10

compartments

Answer 10

1. dorsal
2. interosseous
3. medial (sole)
4. central (sole)
5. lateral (sole)

Question 11

interosseous compartment

Answer 11

boundaries: surrounded by dorsal + plantar interosseous fascia

has MT bones + dorsal and plantar interosseous muscles + deep plantar and deep MT vessels

Question 12

dorsal compartment

Answer 12

boundaries: dorsal fascia + tarsal bones + dorsal interosseous fascia of mid/forefoot

contents: muscles + neurovasculature

Question 13

foot muscles

intrinsic

Answer 13

20 intrinsic (og on foot > in distally on foot)
- 2 dorsal
- 4 intermediate
- 14 plantar/sole

Question 14

extrinsic muscles

Answer 14

1. extensor hallucis longus (will split 3 ways)
2. extensor digitorum longus

extend toes + assist dorsiflexion

og @ant leg > cross ankle > insert on foot so only tendons in dorsum/sole

both og in anterior compartment

Question 15

intrinsic dorsum muscles

Answer 15

1. extensor hallucis brevis (distally)
2. extensor digitorum brevis (II-IV proximally)

both og @ superolateral surface of calcaneus > EDB will insert on EDL

inn by deep fibular N
blood by dorsalis pedis A (+branches= arcuate, lateral tarsal, fibular A)

Question 16

deep fibular nerve

Answer 16

sciatic > common fib > deep fibular/peroneal N
-lateral branch (motor only) + medial branch (motor and cut, runs w/ dorsalis pedis A and MT1 A)

supplies muscles of anterior leg then cross under extensor retinacula to supply both intrinsic and extrinsic dorsum muscles

Question 17

cutaneous innervation

Answer 17

1. saphenous N (from femoral, medial ankle)
2. lateral dorsal cutaneous (from sural N)
3. superficial fibular (from common fib, majority of dorsum, flip flops)
4. deep fibular (from common fib, flip flop triangle b/t I and II)

Question 18

superficial fibular N

Answer 18

branches into medial + intermediate dorsal cut N > common > proper dorsal digital N

motor = fibularis longus and brevis, eversion bc @lateral leg

cutaneous = distal 1/3 @anterolateral leg and most dorsum

Question 19

dermatome testing

Answer 19

L4/L5/S1 test on medial/middle/lateral respectively with filament

also test cutaneous superficial fibular nerve same way

Question 20

arteries

Answer 20

anterior tibial A > dorsalis pedis A as cross ankle

branches:
-1 lateral tarsal A (big guy)
-2 medial tarsal A
-arcuate A (big, ARCs across to join lateral)
-deep plantar (to sole, deep plantar arch)
-1st dorsal metatarsal A

Question 21

1st dorsal metatarsal A

Answer 21

to medial side of digit I

ends by splitting into 2nd and 3rd dorsal digital As

Question 22

arcuate A branches

Answer 22

1. 3 dorsal metatarsal As > each give off 2 dorsal digital As (digits II-IV)
2. 10th dorsal digital A to lat side of digit V

anastomoses w/ 3 perforating branches of deep plantar arch

terminates in anastomosis w/ lateral tarsal A

Question 23

dorsalis pedis pulse

Answer 23

runs lateral to EHL tendon but not easy to find

weak/absent can suggest blockage of anterior tibial or vascular insufficiency from peripheral arterial disease

Question 24

5 P’s of acute arterial occlusion

Answer 24

1. pain
2. pallor
3. paraesthesia
4. paralysis
5. pulselessness

Question 25

deep veins

Answer 25

deep to dorsalis fasica in accompanying vein form flow greatly improves when walking or moving feet

Question 26

superficial veins

Answer 26

superficial to dorsalis fascia but not paired 1.10 dorsal digital > 2.4 dorsal metatarsal > 3.dorsal venous arch > 4.medial marginal (>great saph) + lateral marginal (>lesser saph) dorsal venous network highly variable

Question 27

lymphatic drainage