foot

Question 1

foot:

1. what regions are the foot subdivided into?
2. what is the superior surface of the foot called?
3. what is the inferior surface called?

Answer 1

1. it is subdivided into the tarsus (ankle), the metatarsus and the digits (toes) - hindfoot, midfoot, forefoot
2. dorsum
3. sole

Question 2

hallux:

1. what is normal angulation in the medial side of the foot?
2. if the hallux (big toe) s forced to adduct, what happens?

Answer 2

1. normally there is some angulation between 1st metatarsal and the proximal phalanx
2. if the big toe is forced to adduct, the forces acting on the joint through the tendons tend t pull the toe more laterally

Question 3

sole:

1. what type of skin does the sole have and what is it firmly attached to?
2. what is this type of deep fascia used for?
   where does it thicken?
   where does it sed septae?

Answer 3

1. The sole has thick, highly sensitive skin, very firmly attached to the Plantar Aponeurosis
2. Plantar aponeurosis:
   - is used for grip and weight bearing
   - it thickens as 5 longitudinal bands that continue with the fibrous flexor sheaths
   - it sends septae to the metatarsals to create compartments and potential spaces

Question 4

plantar muscles:

1. how are plantar muscles arranged?
2. what are the three main roles they play?
3. what are they supplied by?

Answer 4

1. plantar muscles are arranged in layers
2. • arch support
     - adjustment of balance
     - Gait, especially on uneven surfaces
3. they are supplied by the lateral r medial plantar nerves

Question 5

plantar muscles:

1. what are the three layer 1 plantar muscles (2 supplied by the medial plantar nerve, 1 by the lateral plantar nerve)
2. what are the two layer 2 muscles (both mainly suplied by the lateral plantar nerve)
3. what are the three layer 3 muscles (2 supplied by the lateral plantar nerve, 1 by the medial plantar nerve)
4. what are the two layer 4 muscles (both supplied by the lateral plantar nerve)

Answer 5

1. • (M) flexor digitorum brevis
     - (M) abductor hallicus
     - (L) abductor digiti minimi
2. • (L) lumbricals 1-4 (M supplies 1)
     - (L) quaratus plantae
3. (L) adductor hallucis
   (L) flexor digiti minimi brevis
   (M) flexor hallucis brevis
4. (L) plantar interossei
   (L) dorsal interossei

Question 6

plantar arteries
1. when does the posterior tibial artery change? and what does it change into?

2. where can the pulse of the posterior tibial artery be felt?

Answer 6

1. Posterior tibial artery becomes the medial and lateral plantar arteries after running posterior to the medial malleolus.
2. Pulse of posterior tibial artery can be felt behind the medial malleolus

Question 7

plantar nerves:

1. where does the tibial nerve pass into?
2. what does the tibial nerve divide into?

Answer 7

1. Tibial nerve passes into the sole behind medial malleolus, deep to the flexor retinaculum
2. Divides into the Medial and Lateral plantar nerves

Question 8

tarsal tunnel:

1. what are the borders of the tarsal tunnel?
2. what are the contents and order of the tarsal tunnel?

Answer 8

1. • Depression inferior to the medial malleolus
     - Talus
     - Calcaneus
     - Inferior surface of the sustentaculum tali
     - Flexor retinaculum
2. T: tibialis posterior
   D: flexor digitorum longus
   A: artery (posterior tibial)
   V: vein (posterior tibial)
   N: nerve (tibial)
   H: flexor hallucis longus

Question 9

plantar arches:

1. what are the plantar arches for?
2. what are the bones involved in the medial longitudinal arch?
3. what are the bones involved n the lateral longitudinal arch?
4. what are the bones involved in the transverse arch?

Answer 9

1. Weight bearing/distribution; shock absorption; resilience; “spring in the stride”!
2. Medial longitudinal arch: Calcaneus, talus, navicular, 3 cuneiform bones and medial 3 metatarsals
3. Lateral longitudinal arch: Calcaneus, cuboid and 4th -5th metatarsals
4. Transverse arch: Cuneiforms and cuboid; disappears near the heads of the metatarsals

Question 10

what are the 2 passive supporters of the arch?

what are the 5 ligaments?

what is an active supporter of the arches?

Answer 10

1. shape of bones and strong ligaments
2. Calcaneonavicular plantar ligament: Supports the keystone.
   Long plantar ligament
   Plantar aponeurosis
   Deltoid ligament
   Calcaneocuboid (short plantar) ligament
3. muscles (effective when contracting)

Question 11

what are the three supporters of the medial arch?

Answer 11

Deltoid ligament
Plantar aponeurosis
Spring ligament

Question 12

what are the two supporters of the lateral arch

Answer 12

Flexor digitorum longus
Lateral ligament

Question 13

dorsum of the foot:

1. how does the deep fibular nerve enter the foot?
2. what does it give rise to?
3. how does the anterior tibial artery enter?
4. where can the pulse of the dorsalis pedis be felt?

Answer 13

1. Deep fibular nerve enters the dorsum of the foot passing under the extensor retinaculum
2. it gives rise to dorsal digital nerve to toes 1-2
3. Anterior tibial artery passes under the inferior extensor retinaculum and becomes dorsalis pedis
4. Pulse of dorsalis pedis is felt in the first intermetatarsal space, between the tendons of extensor digitorum longus and extensor hallucis longus

Question 14

what is the name of tarso-metatarsal joint?

Answer 14

lisfranc joint