Foot

Question 1

Flexor Retinaculum

Answer 1

• Deep fascial band that passes between the medial malleolus and the medial surface of the calcaneus and forms the tarsal tunnel with tarsal bones for the tibial nerve, posterior tibial vessels, and flexor tendons.
• Holds three tendons and blood vessels and a nerve in place deep to it (from anterior to posterior): the tibialis posterior, flexor digitorum longus, posterior tibial artery and vein, tibial nerve, and flexor hallucis longus
• Provides a pathway for the tibial nerve and posterior tibial artery beneath it.

Question 2

Tarsal tunnel syndrome

Answer 2

A complex synptom resulting from the compression of the tibial nerve or its medial and lateral plantar branches in the tarsal tunnel, with pain, numbness, and tingling sensations on the ankle, heel, and sole of the foot. It may be caused by repetitive stress with activities, flat feet, or excess weight gain.

Question 3

Which muscles make up the triceps surae?

Answer 3

Gastrocnemius and soleus

Question 4

____________ is the tendon of insertion of the triceps surae into the tuberosity of the calcaneus.

Answer 4

Tendon calcaneus

Question 5

Avulsion or rupture of the achilles tendon

Answer 5

Disables the triceps surae muscles; thus, the patient is unable to plantar flex the foot.

Question 6

Forced eversion of the foot

Answer 6

Avulse the medial malleolus or ruptures the deltoid ligament

Question 7

Forced inversion of the foot

Answer 7

Avulses the lateral malleolus or tears the lateral collateral ligament

Question 8

Ankle sprain (inversion injury)

Answer 8

Results from the rupture of calcaneofibular and talofibular ligaments and a fracture of the lateral malleolus caused by forced inversion of the foot.

Question 9

Plantar aponeurosis

Answer 9

• Thick fascia inversting the plantar muscles
• Radiates from the calcaneal tuberosity toward the toes and provides attachment to the short flexor muscles of the toes

Question 10

What are the three major arches of the foot?

Answer 10

• Medial longitudinal arch
• Lateral longitudinal arch
• Transverse Arch
  
  • Proximal arch
  • Distal arch

Question 11

Medial longitudinal arch

Answer 11

• Formed and maintained by the interlocking of the talus, calcaneous, navicular, cuneiform, and three medial matatarsal bones
• Has, as its keystone, the head of the talus, which is located at the summut between the sustentaculum tali and the navicular bone
• Suported by the spring ligament and the tendon of the flexor hallucis longus

Question 12

Lateral longitudinal arch

Answer 12

• Formed by the calcaneus, the cuboid bone, and the lateral two metatarsal bones.
• The keystone is the cuboid bone
• Supported by the peroneus longus tendon and the long and short plantar ligaments

Question 13

Transverse arch

Answer 13

• Proximal (metatarsal) arch
  
  • Formed by the navicular bone, the three cuneiform bones, the cuboid bone, and the bases of the five metatarsal bones of the foot
  • Supported by the tendon of the peroneus longus
• Distal arch
  
  • Formed by the heads of five metatarsal bones
  • Maintained by the transverse head of the adductor hallucis

Question 14

Ligaments of the Foot

Answer 14

Long plantar (plantar calcaneocuboid) Ligament

Short Plantar (Plantar Calcaneocuboid) Ligament

Spring (Plantar Calcaneonavicular) Ligament

Question 15

Long Plantar Ligament

Answer 15

• Extends from the plantar aspect of the calcaneus in front of its tuberosity to the tuberosity of the cuboid bone and the base of the metatarsals and forms a canal for the tendon of the peroneus longus
• Supports the lateral side of the longitudinal arch of the foot

Question 16

Short Plantar Ligament

Answer 16

• Extends from the front of the plantar surface of the calcaneus to the plantar surface of the cuboid bone
• Lies deep to the long plantar ligament and supports the lateral longitudinal arch

Question 17

Spring Ligament

Answer 17

• Passes from the sustentaculum tali of the calcaneus to the navicular bone
• Supports the head of the talus and medial longitudinal arch
• Comtains considerable number of elastic fibers to give elasticity to the arch and spring to the foot
• Supported bu the tendon of the tibialis posterior

Question 18

Flat foot

Answer 18

A condition of disappearance or collapse of the medial longitudinal arch with eversion and abduction of the forefoot and causes greater wear on the inner border of the soles and heels of shoes thatn on the outer border. It causes pain as a result of stretching of the plantar muscles and straining of the spring ligament and the long and short plantar ligaments.

Question 19

Pes cavus

Answer 19

Exhibits an exaggerated height of the medial longitudinal arch of the foot

Question 20

Clubfoot (talipes equinovarus)

Answer 20

A conginital deformity of the foot in which the foot is plantar-flexed, inverted, and adducted. It may involve a deformity in which the heel is elevated (the longitudinal arch is abnormally high) and turns medially or laterally.

Question 21

Muscles in dorsum of foot

Answer 21

Extensor digitorum brrevis

Extensor hallucis brevis

Question 22

Muscles in sole of foot

Answer 22

First layer

Abductor hallucis

Flexor digitorum brevis

Abductor digiti minimi

Second layer

Quadratus plantae

Lumbricals (4)

Third layer

Flexor hallucis brevis

Adductor hallucis

Flexor digiti minimi brevis

Fourth layer

Plantar interossei (3)

Dorsal interossei (4)

Question 23

Extensor Digitorum Brevis

Origin

Insertion

Nerve

Action

Blood Supply

Answer 23

Origin: Dorsal surface of calcaneus

Insertion: Tendons of extensor digitorum longus

Nerve: Deep fibular

Action: Extends toes

Blood Supply: Dorsalis pedis artery

Question 24

Extensor hallucis brevis

Origin

Insertion

Nerve

Action

Blood Supply

Answer 24

Origin: Dorsal surface of calcaneus

Insertion: Base of proximal phalanx of big toe

Nerve: Deep femoral

Action: Extends big toe

Blood Supply: dorsalis pedis artery

Question 25

**Abductor hallucis** Origin Insertion Nerve Action Blood Supply

Answer 25

Origin: Medial tubercle of calcaneus Insertion: Base of proximal phalanx of big toe Nerve: Medial plantar Action: Abducts big toe Blood Supply: Medial plantar artery

Question 26

**Flexor digitorum brevis** Origin Insertion Nerve Action Blood Supply

Answer 26

Origin: Medial tubercle of calcaneus Insertion: Middle phalanges of lateral four toes Nerve: Medial plantar Action: Flexes middle phalanges of lateal four toes Blood Supply: Medial and lateral plantar arteries and plantar arch, plantar metatarsal and plantar digital arteries

Question 27

**Abductor digiti minimi** Origin Insertion Nerve Action Blood Supply

Answer 27

Origin: Medial and lateral tubercles of calcaneus Insertion: Proximal phalanx of little toe Nerve: Lateral plantar Action: Abducts little toe Blood Supply: Lateral plantar artery

Question 28

**Quadratus plantae** Origin Insertion Nerve Action Blood Supply

Answer 28

Origin: Medial and lateral side of calcaneus Insertion: Tendons of flexor digitorum longus Nerve: Lateral plantar Action: Aids in flexing toes Blood Supply: Medial plantar artery; lateral plantar artery; deep plantar arch

Question 29

**Lumbricals** Origin Insertion Nerve Action Blood Supply

Answer 29

Origin: Tendons of flexor digitorum longus Insertion: Proximal phalanges, extensor expansion Nerve: First by medial plantar, lateral three by lateral plantar Action: Flex metatarsophalangeal joints and extend interphalangeal joints Blood Supply: Medial and Lateral plantar arteries

Question 30

**Flexor hallucis brevis** Origin Insertion Nerve Action Blood Supply

Answer 30

Origin: Cuboid, third cuneiform Insertion: Proximal phalanx of big toe Nerve: Medial plantar Action: Flexes big toe Blood Supply: Medial plantar artery; plantar metatarsal arteries

Question 31

**Adductor hallucis** Origin Insertion Nerve Action Blood Supply

Answer 31

Origin: * Oblique head: Bases of metatarsals 2-4 * Transverse head: Capsule of lateral four metatarsophalangeal joints Insertion: Proximal phalanx of big toe Nerve: Lateral plantar Action: Adducts big toe Blood Supply: Lateral plantar artery

Question 32

**Flexor digiti minimi brevis** Origin Insertion Nerve Action Blood Supply

Answer 32

Origin: Base of metatarsal 5 Insertion: Promixal phalanx of little toe Nerve: Lateral plantar Action: Flexes little toe Blood Supply: Lateral plantar artery; superficial branch of lateral plantar artery; lateral tarsal artery

Question 33

**Plantar interssei** Origin Insertion Nerve Action Blood Supply

Answer 33

Origin: Medial sides of metatarsals 3-5 Insertion: Medial sides of base of proximal phalanges 3-5 Nerve: Lateral plantar Action: Adducts toes, flex proximal, and extend distal phalanges Blood Supply: Lateral plantar artery; deep plantar arch; plantar metatarsal arteries, proper plantar digital arteries

Question 34

**Dorsal interossei** Origin Insertion Nerve Action Blood Supply

Answer 34

Origin: Adjacent shafts of metatarsals Insertion: Proximal phalanges of second toe (medial and lateral sides), and third and forth toes (lateral sides) Nerve: Lateral plantar Action: Abducs toes, flex proximal, and extend distal phalanges Blood Supply: Arcuate artery of foot; plantar metatarsal arteries; dorsal metatarsal arteries; dorsal digital arteries of foot

Question 35

March fracture

Answer 35

* Stress fracture * A fatigue fracture of one of the **metatarsals,** which may result from prolonged walking.