Foot Anatomy Overview

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Questions and Answers

What is the primary action of the flexor digitorum brevis (FDB)?

  • Extend the metatarsophalangeal joint (MTPJ)
  • Abduct the fifth metatarsophalangeal joint (MTPJ)
  • Flex the proximal interphalangeal joint (PIPJ)
  • Flex both metatarsophalangeal and proximal interphalangeal joints (correct)

Which nerve innervates the abductor digiti minimi (AbDM)?

  • Superficial peroneal nerve
  • Deep peroneal nerve
  • Medial plantar nerve
  • Lateral plantar nerve (correct)

What is the insertion site for the lumbricals in the foot?

  • Lateral border of the flexor digitorum longus tendon
  • Base of the fifth proximal phalanx
  • Base of the proximal phalanx of the lesser toes and extensor hood (correct)
  • Midfoot via sesamoid bones

Which muscle acts to straighten the pull of the flexor digitorum longus (FDL)?

<p>Quadratus plantae (QP) (D)</p> Signup and view all the answers

Which of the following origins does the flexor hallucis brevis (FHB) have?

<p>Plantar aspect of the midfoot (C)</p> Signup and view all the answers

What type of muscle configuration do the plantar interossei have?

<p>Unipennate (B)</p> Signup and view all the answers

Which action is performed by the adductor hallucis (AdH)?

<p>Flex and adduct the first MTPJ (A)</p> Signup and view all the answers

What are the primary actions of the quadratus plantae (QP)?

<p>Flex both metatarsophalangeal and interphalangeal joints (B)</p> Signup and view all the answers

What is the primary action of the plantar interossei muscles on the toes?

<p>Flex and adduct MPJ (C)</p> Signup and view all the answers

Which ligament connects the calcaneus to the cuboid and supports the foot's longitudinal arch?

<p>Long plantar ligament (A)</p> Signup and view all the answers

What is the 'keystone' structure of the medial longitudinal arch?

<p>Head of talus (C)</p> Signup and view all the answers

Which structure is responsible for the windlass effect during MPJ extension?

<p>Plantar aponeurosis (A)</p> Signup and view all the answers

Which muscles are primarily responsible for abducting the metatarsophalangeal joints?

<p>Dorsal interossei (D)</p> Signup and view all the answers

What role do the 'staples' play in the support of the transverse arch?

<p>Link individual components and prevent separation (B)</p> Signup and view all the answers

Which of the following is NOT a function of the arches of the foot?

<p>Muscle relaxation (B)</p> Signup and view all the answers

Which ligaments provide passive structure to support the longitudinal arch while standing?

<p>Bones, ligaments, and fascia (C)</p> Signup and view all the answers

Which tendon supports the lateral longitudinal arch by acting as a suspension structure?

<p>Peroneus longus (B)</p> Signup and view all the answers

What establishes the 'tiebeam' structure for the medial longitudinal arch?

<p>Flexor hallucis longus (B)</p> Signup and view all the answers

What is the primary function of the plantar aponeurosis?

<p>To anchor the skin to the skeleton and contain plantar tissues (A)</p> Signup and view all the answers

The loculated fat pads in the plantar foot are primarily found under which areas during weightbearing?

<p>Under the distal phalanges and heel (A)</p> Signup and view all the answers

Which of the following correctly describes the skin on the dorsum compared to the sole of the foot?

<p>The dorsum is hairy while the sole is glaborous and thicker (C)</p> Signup and view all the answers

What structures lie between the first and second layers of muscles in the sole?

<p>Medial and lateral plantar blood vessels and nerves (B)</p> Signup and view all the answers

What is the primary action of the muscle Abductor hallucis?

<p>To abduct and flex the 1st metatarsophalangeal joint (B)</p> Signup and view all the answers

Which of the following statements about the layers of muscles in the sole is true?

<p>Muscles in more superficial layers originate further from the foot (A)</p> Signup and view all the answers

What role does the dense fibrous connective tissue (CT) have in the plantar aponeurosis?

<p>It forms boundaries for muscle compartments and provides structural integrity (B)</p> Signup and view all the answers

The medial plantar nerve supplies which of the following?

<p>Medial 3.5 toes on the plantar aspect of the foot (A)</p> Signup and view all the answers

Which of the following correctly identifies the attachments of the plantar aponeurosis?

<p>Medial tubercle of calcaneus, 5 slips to proximal phalanges, and septa to tarsals (D)</p> Signup and view all the answers

Flashcards

Flexor Digitorum Brevis (FDB)

A muscle in the foot that flexes both the metatarsophalangeal (MTP) and proximal interphalangeal (PIP) joints of the four lesser toes.

Abductor Digiti Minimi (AbDM)

A muscle that flexes and abducts the 5th toe at the MTP joint.

Layer 2 Muscles (Extrinsic)

The group of muscles that lie under the flexor retinaculum and fibrous flexor sheaths of the toes.

Lumbricals

Long, thin muscles that originate from the flexor digitorum longus (FDL) tendons. They flex the metatarsophalangeal (MP) joint and extend the interphalangeal (IP) joints of the lateral four toes.

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Quadratus Plantae (QP)

A muscle that helps flex the MP and IP joints of the toes, straightening out the pull of the FDL tendon.

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Flexor Hallucis Brevis (FHB)

A muscle that flexes the 1st metatarsophalangeal (MTP) joint, located on the plantar aspect of the midfoot.

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Flexor Digiti Minimi (FDM)

A muscle that flexes the 5th toe at the metatarsophalangeal (MTP) joint.

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Adductor Hallucis (AdH)

A muscle with two heads that flexes and adducts the 1st MTP joint.

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Plantar Aponeurosis

Thickening of deep fascia forming a strong fibrous sheet. It spans the length of the plantar surface of the foot, anchoring skin to skeleton, providing compartment boundaries, and supporting the plantar arches.

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Loculated Fat Pads

Specialized adipose tissue within the superficial fascia, divided by fibrous septa. They provide cushioning and prevent fat dispersal under weight-bearing areas.

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Layer 1 Muscles of the Sole

Outermost layer of foot muscles, responsible for toe flexion and abduction. Abductor hallucis is a key example.

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Abductor Hallucis

Muscle that abducts and flexes the 1st metatarsophalangeal joint (MTPJ). It originates from the medial calcaneal tuberosity and inserts on the proximal phalanx of the hallux.

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Plantar Foot

The sole of the foot, opposite the dorsal surface (top). It's thicker and less mobile, with numerous nerve endings and sweat glands.

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Dorsum vs. Sole

The difference in structure and function between the dorsal and plantar surfaces of the foot.

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Neurovascular Components of the Sole

The medial and lateral plantar nerves are branches of the tibial nerve, innervating the skin of the toes. The medial and lateral plantar arteries, from the posterior tibial artery, supply blood to the toes.

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Organization of the Sole Muscles

The arrangement of muscles in the sole by compartment (medial, central, lateral, deep) and by layer (4 layers, superficial to deep). Muscles in more superficial layers originate more proximally, and insert just distal to the most distal joint they act upon.

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Muscle Compartments of the Sole

A group of muscles in the foot that act together, usually on the toes.

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Four Layers of Sole Muscles

The 'four layers of sole muscles' are arranged from superficial to deep, reflecting their origin and function.

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Dorsal Interossei (D.I.O.)

Muscles responsible for flexing the metatarsophalangeal (MPJ) joint and extending the interphalangeal (IPJ) joints of the 3rd-5th toes. They are also involved in adducting the MPJ joint.

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Plantar Calcaneonavicular Ligament ('Spring' Ligament)

A thick ligament that supports the medial longitudinal arch of the foot. It acts as a 'spring' by connecting the sustentaculum tali (a bony projection on the calcaneus) to the navicular bone.

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Arches of the Foot

A structural component of the foot that distributes weight, absorbs shock, and protects underlying structures.

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Keystone of the Medial Longitudinal Arch

The highest point of the medial longitudinal arch, often formed by the talus.

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Tiebeam of a Foot Arch

A structure that links the two ends of an arch, preventing separation, and providing structural support.

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Windlass Effect of Plantar Aponeurosis

The windlass effect describes how extending the metatarsophalangeal (MPJ) joint increases the height of the longitudinal arches of the foot due to the tension created in the plantar aponeurosis.

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Muscles Supporting Medial Longitudinal Arch

Muscles that contribute to the support of the medial longitudinal arch. They act as 'tiebeams', 'staples', or 'suspension' structures.

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Muscles Supporting Lateral Longitudinal Arch

Muscles that contribute to the support of the lateral longitudinal arch. These muscles also help to stabilize the transverse arch.

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Passive Support Structures of Foot Arches

These structures, primarily ligaments and fascia, provide passive support to the arches of the foot when standing. They help maintain the shape of the arches by preventing excessive collapse.

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Active Support Structures of Foot Arches

These structures, primarily muscles, provide active support to the arches of the foot during locomotion. They help stabilize and adjust the shape of the arches during movement.

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Study Notes

Foot Anatomy

  • The plantar foot is complex, with multiple layers of structures that work together
  • Surface structures differ from the dorsal, the skin's thickness varies, with more sweat glands and nerves on the sole
  • The sole, or underside of the foot, shows features including superficial structures such as fat pads and the plantar aponeurosis
  • Muscles are organized into compartments and layers (4 in total) that work to support the arch and movement of the foot
  • There are supportive ligaments and arches in the foot
  • A network of nerves and vessels (neurovascular) supports the foot
  • The loculated fat pads provide protection and cushion the foot and are specialized for weight distribution
  • The plantar aponeurosis is a thickening of deep fascia, which runs along the sole of the foot, attaching to the calcaneus and extends to the phalanges and metatarsals
  • Structures are essential for stabilizing the skeletal components of the foot, and for containing and supporting soft tissues

Muscle Layering

  • Foot muscles are organized by compartment and layer (superficial to deep). This organization correlates to how muscles originate and insert within the layered structure of the foot
  • Layer 1 muscles include: abductor hallucis, flexor digitorum brevis, and abductor digiti minimi. These muscles have specific origins, insertions, actions, and nerve innervations.
  • Layer 2 contains the extrinsic muscles, flexor digitorum longus (FDL), flexor hallucis longus (FHL), synovial tendon sheaths. These generally originate outside and act on the digits of the foot. The muscles in this layer create tendon sheaths, which assist in movement and support of the foot.
  • Layer 3 intrinsic muscles: flexor hallucis brevis(FHB), flexor digiti minimi (FDM), adductor hallucis. These muscles act on the joints of the foot, with specific actions impacting the toes and feet.
  • Layer 4 intrinsic muscles: plantar interossei. and dorsal interossei. These muscles act to adduct or abduct the toes, affecting how they move and the alignment of the foot.

Neurovascular

  • The neurovascular components of the sole reside between the muscle layers and contain nerves and blood vessels. The tibial nerve and its branches supply cutaneous sensation and motor functions, while plantar arteries/veins supply blood to the metatarsals, toes, and the arch.

Arches and Ligaments

  • The foot has longitudinal and transverse arches, providing elasticity, shock absorption, and weight distribution.
  • Key support structures within the arches include several ligaments (e.g., plantar calcaneonavicular/spring ligament, short plantar ligament, long plantar ligament), which provide stability
  • The passive structures (bones, ligaments, fascia) support the foot under load, while active structures (muscles) regulate it during movement. The mechanisms of arch support include crucial structures and actions, such as keystone, tiebeams, and staples
  • The plantar arches' function is related to weight distribution, shock absorption, and protection of soft tissues in the foot.

Windlass Effect

  • The plantar aponeurosis demonstrates a windlass action when the metatarsophalangeal (MTPJ) joint extends
  • This increases the arch's height, enhancing the foot's stability during push-off and mid-stance phases of gait

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