13_Anatomy Block 4.3 The Foot

Front 1

What is the medical term for bunyons?

Back 1

Hallux Valgus

Front 2

Hammer toe is caused by:

Back 2

An extension of the metatarsophalangeal joint.

Front 3

What causes bunions?

Back 3

It's a varus deviation of the 5th toe at the metatarsophalangeal joint - protrusion of the joint causes greater contact with the insides of shoes, leading to irritation and discomfort.

Front 4

What causes/is Morton's Neuroma?

Back 4

Light shoes squeeze the bonds of the feet and cause compression of a branch of the plantar nerve. The condition is often a perineural fibrosis rather than a true tissue mass.

Front 5

Review N500 re Femoral Artery branches.
1. What does the popliteal artery into after it branches off of the femoral artery?
2. How do they course and what does it supply?

Back 5

1. Anterior tibial artery and the Posterior Tibial Artery.
2. Anterior: Courses through the interosseous membrane to supply the anterior tissues of the lower leg.
Posterior: Continues more distally in the posterior side of the leg.

Front 6

What does the Posterior Tibial Artery branch into?

Back 6

Fibular (peroneal) artery and the posterior tibial artery.

Front 7

What is unusual about the Fibular artery?

Back 7

It's in the posterior compartment but it supplies the lateral compartment

Front 8

At the knee, femoral artery become the:

Back 8

popliteal artery

Front 9

What are the two pulses typically checked on the foot?
(N522)

Back 9

Dorsalis Pedis Pulse
Posterior Tibial Pulse

Front 10

Clinical Q: Where is an embolism if there's a dorsalis pedis pulse but no posterior tibial pulse? (N500, N518, N520)

Back 10

Somewhere between the Popliteal/Anterior Tibial artery branch point and the Posterior Tibial Artery

Front 11

The Dorsal Venous Arch can drain in two directions, laterally and medially. Where does lateral drain into and what does medial drain into?

Back 11

Lateral = Small saphenous vein and then ultimately into the DEEP popliteal vein. (N471, 3)
Medial = Great saphenous vein.

Front 12

What happens if someone gets a clot in the Anterior or Posterior Tibial Vein or Popliteal Vein?

Back 12

Deep Vein Thrombosis

Front 13

What happens if someone gets a clot in the superficial veins in the leg?

Back 13

Superficial Thrombophlebitis

Front 14

Label/circle the different compartments.

Back 14

A. Anterior Compartment
B. Lateral Compartment
C. Posterior Compartment
D. Deep Section of the Posterior Compartment

Front 15

Label
**What muscles does B supply? Why is this unusual?

Back 15

A. Anterior tibial artery and veins and deep fibular nerve
B. Fibular vessels
C. Posterior tibial arterya nd veins and tibial nerve
**Supply muscles in the lateral chamber. This is unusual because these vessels are in the posterior chamber!

Front 16

What is each area innervated by? (N510 and N529)

Back 16

Red = Sural
*Yellow = Lateral
*Green = Medial Calcaneal
*Blue = Saphenous
Pink = Medial Plantar
* = All tibial n. Notice how these three make up the center of the foot and the two "S" areas innervate the lateral parts - Sural and Saphenous. Note also how the Tibial nerves make sense...lateral, medial, and calcaneal)

Front 17

Where are three areas where you find lymph nodes in the leg?

Back 17

1. Deep Inguinal
2. Superficial Inguinal
3. Popliteal Lymph Nodes (behind knee)

Front 18

Anterior Compartment muscles of the leg include (3):

Back 18

1. Tibialis anterior m
2. Extensor hallucis longus m
3. Extensor digitorum longus

Front 19

What is Jones' Fracture?

Back 19

Fracture at the base of the 5th metatarsal - often due to tear-off of the Fibularis brevis tendon.

Fracture of the diaphysis of the 5th metatarsal.

Front 20

On extensor side of the foot (top), describe where the veins that reach toes come from.

Back 20

Anterior Tibial Artery to Arcuate Arch to Tarsal Arteries to Phalangeal arteriers

Front 21

On plantar side of the foot, describe where the veins that reach the toes come from. (N519, 523)

Back 21

Dorsalis pedis artery (remember, posterior medial aspect of foot) to plantar artery supply/branch into the medial plantar artery and lateral plantar arch that supplies the plantar metatarsal and the the digital arteries.

Front 22

What muscles does the Common fibular (peroneal) n supply?

Back 22

Deep peroneal (fibular) nerve supplies:
1. Anterior compartment muscles.
2. Leg muscles
3. Extensor digitorum brevis muscles

Front 23

The Tibial n becomes the medial and lateral plantar nerves and the medial plantar n supplies these (4) muscles (N529):

Back 23

1. Abductor hallisus
2. Flexor hallisus brevis
3. Flexor digitorum brevis
4. Most medial lumbricals

Front 24

What does the Lateral Planter n supply?

Back 24

With the Medial planter n, the lateral planter supplies a of the remaining intrinsic foot muscles.

Front 25

What is the only flexor foot muscles?

Back 25

Extensor digitorum brevis

Front 26

What are the Plantar Layers?

Back 26

1. Skin
2. Plantar Aponeurosis (fasciatis occurs here)
3. Abductor hallicis
4. Flexor digitorum brevis
5. Abductor digiti minim

Front 27

Describe the origin/insertion, vessel, and nerves of the Abductor Hallucis

Back 27

1. Originates at calcaneous, inserts at the proximal phalynx of the great toe.
2. Motor n = medial plantar n, helping to flex the big toe

Front 28

Describe the origin/insertion of the flexor digitorum brevis.

Back 28

It splits or spreads toes.
In originates at the calcaneous and inserts into the middle phalanx of digits 4-5.

Front 29

Describe the origin and innervation of the Abductor digiti minimi

Back 29

Originates from calcaneous
N = lateral plantar n
Allows you to abduct small toe and helps with flexion a bit too

Front 30

Describe the 2nd layer of the foot msucles:

Back 30

1. Quadratus Plantae muscle
2. Lumbricals

Front 31

Describe where the Quadratus Plantae Muscle

Back 31

1. Originates from the calcaneous
2. Inserts into the posterior margin of the flexor digitorum longus before it splits
3. It adjusts the pull of the flexor digitorum
4.

Front 32

Look at N522. Notice that the tend for the flexor digitorum longus runs medially. If this muscle that's attached and directly posterior to the tendon didn't exist, the toes would be pulled medially. This muscle aligns the flexion more anterior-posteriorily.

Back 32

Quadratus Plantae m

Front 33

1. What digits does the Lumbricles attach to?
2. Where do they originate?
3. Where do they insert?
4. (Don't memorize) How are they innervated?

Back 33

1. Digits 2-5
2. Originate from the tends of the flexor digitorum longus
3. Insert on the expansions of the extensor digitorum longus on the medial side
4. Motor nerve supply toes 2 medial plantar n; 3-5 lateral plantar n. (don't memorize)

Front 34

Describe the 3rd layer of foot muscles.

Back 34

1. Flexor hallucis brevis
2. Adductor hallucis muscle
3. Flexor digiti minimi brevis

Front 35

N523
1. Does the flexor hallucis brevis muscle do?
2. Where does it originate
3. Where does it insert?
4. How is it innervated?

Back 35

1. Helps flex the big toe
2. Originates from the cuboid and the lateral cuniform bones
3. Splits/Inserts at the sesmoid bones
4. Medial plantar n

Front 36

1. Where does the Adductor hallucis originate?
2. Where does it insert?
3. What does it do?

Back 36

1. Originates from the 2-4 metatarsals
2. Inserts at proximal phalynx of great toe.
3. It pulls the big toe back, adducting it.

Front 37

NN523)
1. Describe where the flexor digiti minimi brevis originates.
2. Where it inserts
3. What it's innervated by
4. What it allows you to do.

Back 37

1. Originates at the 5th metatarsal
2. Inserts on the proximal phalynx of the 5th toe
3. Innervated by lateral plantar
4. Allows you to flex little toe

Front 38

How does the axis of abduction/adduction differ in the foot vs hand?

Back 38

In Hand it's around 3rd digit.
In foot, it's around 2nd

Front 39

What are the muscles of the 4th layer? How do they move the toes?

Back 39

1.Plantar Interosseus (Remember PAD - Plantar Interosseus mm Are ADductors)
2. Dorsal Interosseus (Dorsal interosseus mm are ABductors)