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Questions and Answers
Which nerve innervates the abductor hallucis muscle?
Which nerve innervates the abductor hallucis muscle?
What is the primary artery that runs between the extensor hallucis longus and extensor digitorum longus?
What is the primary artery that runs between the extensor hallucis longus and extensor digitorum longus?
Which digits receive sensory innervation from the medial plantar nerve?
Which digits receive sensory innervation from the medial plantar nerve?
Which of the following muscles is innervated by the lateral plantar nerve?
Which of the following muscles is innervated by the lateral plantar nerve?
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What is the function of the deep plantar artery?
What is the function of the deep plantar artery?
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Which artery contributes to the formation of the deep plantar arch?
Which artery contributes to the formation of the deep plantar arch?
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Which structures are part of the medial longitudinal arch of the foot?
Which structures are part of the medial longitudinal arch of the foot?
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What role do the arches of the foot primarily serve?
What role do the arches of the foot primarily serve?
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Which tendon helps strengthen the medial longitudinal arch?
Which tendon helps strengthen the medial longitudinal arch?
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Which lymph nodes drain lymph from the lateral side of the foot?
Which lymph nodes drain lymph from the lateral side of the foot?
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Which of the following structures is NOT part of the transverse arch of the foot?
Which of the following structures is NOT part of the transverse arch of the foot?
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What is the primary function of the plantar aponeurosis?
What is the primary function of the plantar aponeurosis?
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Which veins converge to form the great and small saphenous veins?
Which veins converge to form the great and small saphenous veins?
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Which muscle is located on the dorsal side of the foot?
Which muscle is located on the dorsal side of the foot?
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Which structure does the flexor retinaculum stretch between?
Which structure does the flexor retinaculum stretch between?
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What condition arises from compression of the tibial nerve in the tarsal tunnel?
What condition arises from compression of the tibial nerve in the tarsal tunnel?
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How does the deep fascia on the plantar side support the foot?
How does the deep fascia on the plantar side support the foot?
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Which muscle is NOT part of the plantar side muscles of the foot?
Which muscle is NOT part of the plantar side muscles of the foot?
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Which bone is NOT directly associated with the tarsal tunnel?
Which bone is NOT directly associated with the tarsal tunnel?
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Which layer of the plantar side of the foot contains the adductor hallucis muscle?
Which layer of the plantar side of the foot contains the adductor hallucis muscle?
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What is the primary function of the plantar fascia?
What is the primary function of the plantar fascia?
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What is the primary role of the plantar fascia in the foot?
What is the primary role of the plantar fascia in the foot?
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Which of the following structures creates a tunnel that is important for the passing of tibial nerve and vessels in the foot?
Which of the following structures creates a tunnel that is important for the passing of tibial nerve and vessels in the foot?
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Which muscle is NOT located on the dorsal side of the foot?
Which muscle is NOT located on the dorsal side of the foot?
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What occurs in tarsal tunnel syndrome?
What occurs in tarsal tunnel syndrome?
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Which region of the foot has a thicker layer of skin with sweat glands and fat for cushioning?
Which region of the foot has a thicker layer of skin with sweat glands and fat for cushioning?
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How many layers of muscles does the plantar side of the foot contain?
How many layers of muscles does the plantar side of the foot contain?
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What is the function of the extensor retinaculum?
What is the function of the extensor retinaculum?
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Which tendons pass through the tarsal tunnel in the order from anterior to posterior?
Which tendons pass through the tarsal tunnel in the order from anterior to posterior?
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Which muscle is innervated by the medial plantar nerve?
Which muscle is innervated by the medial plantar nerve?
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Which artery runs distally between the abductor hallucis and flexor digitorum brevis?
Which artery runs distally between the abductor hallucis and flexor digitorum brevis?
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What is the sensory distribution of the lateral plantar nerve?
What is the sensory distribution of the lateral plantar nerve?
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Which arteries are classified as the main arteries of the foot?
Which arteries are classified as the main arteries of the foot?
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Which nerve runs between the first and second layers of the foot?
Which nerve runs between the first and second layers of the foot?
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Which muscle is responsible for the abduction and flexion of the fifth digit?
Which muscle is responsible for the abduction and flexion of the fifth digit?
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What is the primary function of the Quadratus Plantae muscle?
What is the primary function of the Quadratus Plantae muscle?
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Which nerve primarily innervates the Flexor Hallucis Brevis muscle?
Which nerve primarily innervates the Flexor Hallucis Brevis muscle?
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What function do the Lumbricals serve in the foot?
What function do the Lumbricals serve in the foot?
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Which muscle helps maintain the foot arches and assists in the flexion of the big toe?
Which muscle helps maintain the foot arches and assists in the flexion of the big toe?
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Which is the primary action of the Dorsal Interossei muscles?
Which is the primary action of the Dorsal Interossei muscles?
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What is the main role of the Abductor Hallucis muscle?
What is the main role of the Abductor Hallucis muscle?
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Which of the following muscles is NOT part of the 1st layer of the plantar side of the foot?
Which of the following muscles is NOT part of the 1st layer of the plantar side of the foot?
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What contributes to the formation of the deep plantar arch?
What contributes to the formation of the deep plantar arch?
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Which structure assists in maintaining the curvature of the transverse arch?
Which structure assists in maintaining the curvature of the transverse arch?
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What is the primary function of the arches of the foot?
What is the primary function of the arches of the foot?
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Which arteries primarily supply the plantar digital arteries of the hallux?
Which arteries primarily supply the plantar digital arteries of the hallux?
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Which lymph nodes drain lymph from the medial side of the foot?
Which lymph nodes drain lymph from the medial side of the foot?
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Which bones are included in the medial longitudinal arch?
Which bones are included in the medial longitudinal arch?
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Which ligaments are involved in the support of the arches of the foot?
Which ligaments are involved in the support of the arches of the foot?
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What is the role of the superficial veins of the foot?
What is the role of the superficial veins of the foot?
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Study Notes
Cutaneous Innervation
- The skin on the dorsum of the foot is thin and has hair, while the superficial fascia is thin with little fat.
- The plantar surface of the foot has thicker skin with sweat glands, thick fat providing shock absorption, especially around the heel.
- The plantar fascia bounds underlying structures firmly by fibrous connective tissue, important for weight bearing and protecting these structures
Deep Fascia of the Foot
- The flexor retinaculum stretches between the medial malleolus and calcaneus, behind which is the tarsal tunnel.
- The extensor retinaculum has two parts: a superior part above the tibiotalar joint and an inferior Y-shaped part anterior to the tibiotalar joint.
- On the plantar side, thick deep fascia known as the plantar fascia or aponeurosis, supports the longitudinal arches and divides the sole of the foot into three main compartments: medial, lateral, and central.
Tarsal Tunnel
- The tarsal tunnel contains:
- Tendon of tibialis posterior
- Tendon of flexor digitorum longus
- Posterior tibial vessels
- Tibial nerve
- Tendon of flexor hallucis longus
Tarsal Tunnel Syndrome
- Compression of the tibial nerve within the tarsal tunnel
Muscles of the Foot
-
Dorsal Side:
- Extensor digitorum brevis
- Extensor hallucis brevis
-
Plantar Side (4 Layers):
- Layer 1: Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
- Layer 2: Quadratus plantae, lumbricals
- Layer 3: Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
- Layer 4: Plantar and dorsal interossei
Arteries of the Foot
-
Main Arteries:
- Dorsalis pedis (anterior tibial)
- Plantar arteries (posterior tibial)
Dorsalis Pedis Artery
- Runs between the extensor hallucis longus and extensor digitorum longus
- In the 1st intermetatarsal space:
- Deep plantar artery
- 1st dorsal metatarsal artery
- Arcuate artery (laterally)
- Dorsal metatarsal arteries
- Dorsal digital arteries
- Perforating arteries
- Dorsal metatarsal arteries
Plantar Arteries
- Posterior tibial artery:
- Medial plantar artery
- Lateral plantar artery (underneath the abductor hallucis)
Medial Plantar Artery
- Runs distally between the abductor hallucis and flexor digitorum brevis
- Sensory branches to the medial three and a half of the fourth digits
- Motor branches to:
- Abductor hallucis
- Flexor digitorum brevis
- Flexor hallucis brevis
- Medial lumbrical (2nd digit)
Lateral Plantar Artery
- Runs between the first and second layers
- Superficial and deep branches
- Sensory branches to the fifth and a half of the fourth digits
- Motor branches to:
- Abductor digiti minimi
- Quadratus plantae
- 3rd, 4th, 5th lumbricals
- Adductor hallucis
- Flexor digiti minimi brevis
- Interossei
Superficial Veins of the Foot
- Dorsal venous arch of the foot converges laterally and medially to form the small and great saphenous veins
Lymphatics of the Foot
- Lateral side: popliteal lymph nodes
- Medial side: superficial inguinal lymph nodes
Arches of the Foot
- The tarsal and metatarsal bones form longitudinal and transverse arches of the foot, acting as shock absorbers and weight bearers, spreading the weight in all directions.
- The longitudinal and transverse arches are supported by ligaments and tendons:
-
Medial Longitudinal Arch:
- Plantar calcaneonavicular ligament (spring ligament)
- Plantar aponeurosis
- Long plantar ligament
- Calcaneus, talus, navicular, three cuneiforms, and three metatarsals
-
Lateral Longitudinal Arch:
- Calcaneus, cuboid, and lateral two metatarsals
-
Transverse Arch:
- Cuboid, cuneiforms, base of metatarsals
-
Medial Longitudinal Arch:
- Tendons help strengthen the arches:
-
Medial Longitudinal Arch:
- Tibialis anterior tendon (attaching to the first metatarsal and medial cuneiform)
- Flexor hallucis longus tendon
-
Transverse Arch:
- Peroneus longus tendon (crossing the sole of the foot obliquely)
-
Medial Longitudinal Arch:
Nerves of the Foot
-
Posterior-inferior to the medial malleolus:
- Tibial nerve
- Lateral plantar nerve
- Medial plantar nerve
- Tibial nerve
Medial Plantar Nerve
- Runs between the abductor hallucis and flexor digitorum brevis
- Sensory branches to the medial three and a half of the fourth digits
- Motor branches to:
- Abductor hallucis
- Flexor digitorum brevis
- Flexor hallucis brevis
- Medial lumbrical (2nd digit)
Lateral Plantar Nerve
- Runs between the first and second layers
- Superficial and deep branches
- Sensory branches to the fifth and a half of the fourth digits
- Motor branches to:
- Abductor digiti minimi
- Quadratus plantae
- 3rd, 4th, 5th lumbricals
- Adductor hallucis
- Flexor digiti minimi brevis
- Interossei
Cutaneous Innervation of the Foot
- Dorsum of the foot skin is thin with hair, plantar skin is thick and contains sweat glands
- Superficial fascia supports the plantar surface, containing a shock-absorbing layer of fat
Foot Bones
- Review the bones of the foot
Surface Anatomy
- The dorsum of the foot is the top
- The plantar surface is the sole
- The ball of the foot is the area where the toes join the foot
- The heel is the back part of the foot
Deep Fascia
- Flexor retinaculum and extensor retinaculum are located along the foot
- Plantar fascia is a thick deep fascia that supports the longitudinal arches of the foot
- Plantar fascia divides the sole into medial, lateral, and central compartments
Extensor Retinaculum
- Extensor retinaculum has two parts: superior and inferior
- Superior is above the tibiotalar joint
- Inferior is Y-shaped and anterior to the tibiotalar joint
Flexor Retinaculum
- Flexor retinaculum stretches from the medial malleolus to calcaneus
- The tarsal tunnel lies behind it
Tarsal Tunnel
- Contains the following from anterior to posterior:
- Tendon of tibialis posterior
- Tendon of flexor digitorum longus
- Posterior tibial vessels
- Tibial nerve
- Tendon of flexor hallucis longus
Tarsal Tunnel Syndrome
- Compression of the tibial nerve within the tarsal tunnel
Muscles of the Foot
- Dorsal Side: extensor digitorum brevis and extensor hallucis brevis
-
Plantar Side: 4 layers, including:
- 1st Layer: Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
- 2nd Layer: Quadratus plantae and lumbricals
- 3rd Layer: Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
- 4th Layer: Plantar and dorsal interossei
Muscles on the Dorsal Side
-
Extensor digitorum brevis and extensor hallucis brevis
- Extend the toes and hallux (dorsiflexion)
- Innervated by deep peroneal nerve
Muscles on the Plantar Side
-
1st Layer:
- Abductor Hallucis: Abduction and flexion of the big toe. Innervated by medial plantar nerve.
- Flexor Digitorum Brevis: Flexion of lateral four digits. Innervated by medial plantar nerve.
- Abductor Digiti Minimi: Abduction and flexion of the 5th digit. Innervated by lateral plantar nerve.
-
2nd Layer:
- Quadratus Plantae: Flexion of the lateral four digits. Innervated by lateral plantar nerve.
- Lumbricals: Flex the proximal phalanx and extend the middle and distal phalanges. Innervated by medial plantar nerve for the 2nd digit and lateral plantar nerve for the 3rd-5th digits.
-
3rd Layer:
- Flexor Hallucis Brevis: Flexion of the proximal phalanx of the hallux. Innervated by medial plantar nerve.
- Adductor Hallucis: Adducts the first digit. Innervated by lateral plantar nerve.
- Flexor Digiti Minimi Brevis: Flexion of the 5th digit. Innervated by lateral plantar nerve.
-
4th Layer:
- Plantar Interossei: Adducts (pADD) the 3rd-5th digits. Innervated by lateral plantar nerve.
- Dorsal Interossei: Abducts (dABD) the 2nd-4th digits. Innervated by lateral plantar nerve.
Nerves of the Foot
- Tibial nerve splits posterior inferior to the medial malleolus into lateral and medial plantar nerves
Medial Plantar Nerve
- Runs between abductor hallucis and flexor digitorum brevis
- Sensory branches to the medial 3 and 1/2 of the 4th digits
- Motor branches to:
- Abductor hallucis
- Flexor digitorum brevis
- Flexor hallucis brevis
- Medial lumbrical (2nd digit)
Lateral Plantar Nerve
-
Runs between the 1st and 2nd layers
-
Superficial and deep branches
-
Sensory branches to the 5th & 1/2 of the 4th digits
-
Motor branches to:
- Abductor digiti minimi
- Quadratus plantae
- 3, 4, 5 lumbricals
- Adductor hallucis
- Flexor digiti minimi brevis
- Interossei
Arteries of the Foot
-
Main arteries:
- Dorsalis pedis (from anterior tibial)
- Plantar arteries (from posterior tibial)
Dorsal Arteries
-
Dorsalis Pedis Artery: Runs between the ext. hall. longus and ext. digitorum longus tendons
-
In the 1st intermetatarsal space:
- Deep plantar artery
- 1st dorsal metatarsal artery
-
Arcuate artery (laterally)
- Dorsal metatarsal arteries
- Dorsal digital arteries
- Perforating arteries
- Dorsal metatarsal arteries
-
Plantar Arteries
- Posterior tibial artery splits into:
- Medial plantar artery
- Lateral plantar artery
- Lateral plantar artery runs underneath the abductor hallucis
Medial Plantar Artery
- Runs distally between abd. hallucis and flex. digitorum brevis
- Superficial branch contributes to 1, 2, 3 planter metatarsal arteries
- Plantar digital arteries of hallux
- Joins the deep plantar arch
Lateral Plantar Artery
- Forms the deep plantar arch with the deep plantar artery from dorsalis pedis and the terminal part of medial plantar artery
- Plantar metatarsal arteries
- Plantar digital arteries
- Perforating arteries
- Plantar metatarsal arteries
Arteries and Nerves of the Sole of the Foot
- Note the location and direction of the nerves and arteries in the sole
Superficial Veins of the Foot
- Dorsal venous arch of the foot converges laterally and medially to form the small and great saphenous veins
Lymphatics of the Foot
- Lateral side: popliteal lymph nodes
- Medial side: superficial inguinal lymph nodes
Arches of the Foot
- The foot has longitudinal and transverse arches that act as shock absorbers, weight bearers, and distribute weight
-
Medial Longitudinal Arch:
- Calcaneus, talus, navicular, three cuneiforms, and three metatarsals (bones)
- Supported by:
- Plantar calcaneonavicular ligament (spring ligament)
- Plantar aponeurosis
-
Lateral Longitudinal Arch:
- Calcaneus, cuboid, and lateral two metatarsals
- Supported by:
- Long plantar ligament
-
Transverse Arch:
- Cuboid, cuneiforms, and base of metatarsals
- Provides support and flexibility
-
Medial Longitudinal Arch:
Arches of the Foot (Ligaments and Tendons)
-
Medial Longitudinal Arch Strengthening:
- Tibialis anterior tendon attaching to the first metatarsal and medial cuneiform
- Flexor hallucis longus tendon supports the medial longitudinal arch
-
Transverse Arch Strengthening:
- Peroneus longus tendon crossing the sole of the foot obliquely
- Completes the stirrup with the tibialis anterior tendon to maintain the transverse arch curvature
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Description
Explore the intricate details of cutaneous innervation and deep fascia of the foot. This quiz covers the structure and function of the skin and fascia, as well as the tarsal tunnel's significance in foot anatomy. Test your understanding of these essential components related to foot health and biomechanics.
