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429 Cards in this Set

  • Front
  • Back
Describe the skin on the dorsum of the foot
Thin hairy skin composed of an epidermis and a dermis
Describe the superficial fascia on the dorsum of the foot
Very thin fatty layer.

Absent at subcutaneous surfaces.

Contains superficial veins and cutaneous nerves
What binds down the tendons of tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius
Superior Extensor Retinaculum
What is another name for the Superior Extensor Retinaculum?
Transverse Crural Ligament
What is another name for the Transverse Crural Ligament?
Superior Extensor Retinaculum
Where does the Superior Extensor Retinaculum attach?
Attaches laterally to the distal aspect of the shaft of the fibula and medially to the distal aspect of the shaft of the tibia
What is another name for the Inferior Extensor Retinaculum?
cruciate crural ligament
What is another name for the cruciate crural ligament?
inferior extensor retinaculum
Where does the stem of the Y-shaped band of the Inferior Extensor Retinaculum attach to?
laterally to the sinus tarsi of the calcaneus
Where are the superior and inferior limbs of the Inferior Extensor Retinaculum formed?
At the medial border of EDL
What does the superior limb of the Inferior Extensor Retinaculum enclose?
tendons of extensor hallucis longus and tibialis anterior
Where does the superior limb of the Inferior Extensor Retinaculum attach to?
medial malleolus
What does the inferior limb of the Inferior Extensor Retinaculum enclose?
tendons of extensor hallucis longus and tibialis anterior
Where does the inferior limb of the Inferior Extensor Retinaculum attach to?
plantar aponeurosis
Where does the Flexor Retinaculum attach?
medial malleolus and the medial surface of the calcaneus
What are enclosed within the flexor retinaculum?
Tendon of tibialis posterior

Tendon of flexor digitorum longus

Posterior tibial artery with a vein on either side

Tibial nerve

Tendon of flexor hallucis longus
What is the common site for taking the posterior tibial pulse and for performing a tibial nerve block
Posterior to the medial malleolus
Beneath the flexor retinaculum there are individual tunnels for each of the following:
Tendon of tibialis posterior

Tendon of flexor digitorum longus

Tendon of flexor hallucis longus

Medial plantar vessels and nerve

Lateral plantar vessels and nerve
What is Tarsal tunnel syndrome?
Entrapment of the tibial nerve (or its medial plantar or lateral plantar branch) in the tunnels beneath the flexor retinaculum
What does the Peroneal Retinaculum bind?
tendons of peroneus longus and peroneus brevis
Where does the Superior Peroneal Retinaculum attach?
lateral malleolus and the lateral surface of the calcaneus
Where does the Inferior Peroneal Retinaculum attach?
lateral surface of the calcaneus including the peroneal tubercle
What is the Inferior Peroneal Retinaculum continuous with?
inferior extensor retinaculum
What is the origin of Extensor Digitorum Brevis?
Sinus tarsi of the calcaneus

Interosseous talocalcaneal ligament

Inferior extensor retinaculum
What is the course of Extensor Digitorum Brevis?
Obliquely from lateral to medial deep to the tendons of EDL and divides into four tendons
What is the insertion of the medial 1st tendon of EDB or EHB?
inserts into the dorsum of the base of the proximal phalanx of the hallux
What is the inserion for the other three tendons (second, third, and fourth) of EDB?
insert into the lateral side of the EDL tendons to the second, third, and fourth toes
What is the action of the 1st tendon of EDB or EHB?
Dorsiflex the proximal phalanx of the hallux
What is the action of the 2nd-4th tendons of EDB?
Second, third , and fourth Dorsiflex the phalanges of the second, third, and fourth
What is the only muscle on the dorsum of the foot?
Extensor Digitorum Brevis
Where do tendons of tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius course?
below the superior and inferior extensor retinaculae enclosed in synovial sheaths
What tendons have their own synovial sheaths?
tendons of tibialis anterior and
extensor hallucis longus
What tendons are enclosed within a common synovial sheath?
tendons of extensor digitorum longus and peroneus tertius
Where does the tendon of tibialis anterior insert?
medial and plantar surfaces of the first cuneiform and base of the first metatarsal (first ray)
What tendon forms the extensor hood at the first MTP?
Extensor Hallucis Longus
Where does the tendon of extensor hallucis longus insert?
dorsum of the base of the distal phalanx of the hallux
What tendon inserts onto the dorsum of the base of the distal phalanx of the hallux?
Extensor Hallucis Longus
What tendon inserts onto the medial and plantar surfaces of the first cuneiform and base of the first metatarsal (first ray)?
Tibialis Anterior
What tendons form an extensor hood at the MTP and at the head of a proximal phalanx?
Extensor Digitorum Brevis
Where does the central slip of the tendon of Extensor Digitorum Brevis insert?
dorsum of the base of a middle phalanx
Where do the 2 collateral slips of Extensor Digitorum Brevis insert?
into the dorsum of the base of a distal phalanx
What tendon inserts into the dorsum of the base of the fifth metatarsal?
Peronius Tertius
Where does the tendon of Peroneus Tertius insert?
dorsum of the base of the fifth metatarsal
To where does the extensor hood expand to?
hood extends from the head of a metatarsal to the distal aspect of a proximal phalanx
What is the proximal component of the extensor hood?
sling component
Where is the sling part of the extensor hood located?
proximal part of the extensor hood
What does the sling component of the extensor sheath encircle?
It has fibers that encircle the capsule of the MTP and blend with the plantar plate, the deep transverse metatarsal ligaments and the flexor sheaths
What is the distal component of the extensor hood?
wing component
Where is the wing part of the extensor hood located?
distal part of the extensor hood
What part of the extensor hood has fibers arranged obliquely on the sides of the digit?
wing component
Describe the fibers of the wing component of the extensor hood.
fibers arranged obliquely on the sides of the digi
What tendons contribute to the extensor hood on the lesser digits?
tendons of dorsal interossei

plantar interossei

lumbricals

second, third, and fourth tendons of EDB
What tendons contribute to the extensor hood on the hallux?
tendons of abductor hallucis

flexor hallucis brevis

adductor hallucis
What is the role of the extensor hood?
maintain the central position of the EDL tendons and the tendon of EHL
What aids in dorsiflexion of the proximal phalanx through the windlass effect?
extensor hood
Describe the skin on the plantar surface of the foot.
thick hairless skin
Describe the subcutaneous fascia on the plantar surface of the foot.
Very thick and forms distinct pads at calcaneal tuberosity, metatarsal heads and distal phalanges

Fibers pass from the dermis through the superficial fascia to the deep fascia to limit the mobility of the skin, maintain the position of the fat pads, and prevent compression of vessels and nerves
What is the role of the fibers on the plantar surface of the foot?
Fibers pass from the dermis through the superficial fascia to the deep fascia to limit the mobility of the skin, maintain the position of the fat pads, and prevent compression of vessels and nerves
Describe the deep fascia on the plantar surface of the foot.
Continuous with other regions.

Completely surrounds the
muscles.

Also called the plantar aponeurosis which is divided into a central, medial and lateral portion.

Forms intermuscular septa.

Forms flexor sheaths in the digits
What forms flexor sheaths in the digits on the plantar surface of the foot?
deep fascia
What forms intermuscular septa on the plantar surface of the foot?
deep fascia
What completely surrounds the muscle son the plantar surface of the foot?
deep fascia
In what region of the foot does the central portion of the plantar aponeurosis divide?
metatarsal shaft region
What do the superficial slips of the central portion of the plantar aponeurosis merge with?
superficial transverse metatarsal ligament
Where do the deep slips of the central portion of the plantar aponeurosis go?
divide into two slips which course on either side of the tendon of FHL, and the tendons of FDL and FDB
What do the deep slips of the plantar aponeurosis blend with?
The deep slips blend with the plantar plate and deep transverse metatarsal ligaments and then distally form the flexor sheaths
Describe the medial portion of the the deep fascia on the plantar surface of the foot.
Continuous with the other deep fascia of the foot and covers the abductor hallucis
What portion of the deep fascia covers the abductor hallucis
medial portion
Describe the lateral portion of the deep fascia on the plantar surface of the foot.
Continuous with the other deep fascia of the foot, covers the abductor digiti minimi and attaches to the lateral process of the calcaneal tuberosity
What portion of the deep fascia covers the abductor digiti minimi?
lateral portion
Where does the lateral portion of the plantar aponeurosis attach?
lateral process of the calcaneal tuberosity
What divides the foot into medial, lateral and central compartments?
A medial and lateral intermuscular septum from the deep surface of the plantar aponeurosis
What separates the central compartment from the interosseous compartment?
An interosseous septa
What tendons do the flexor sheaths enclose?
tendons of FHL, FDL, and FDB in the digits
What are continuous with the deep slips of the central portion of the plantar aponeurosis
flexor sheaths
Where do the flexor sheaths attach to?
attach to the plantar plates (MPJ’s and IPJ’s) and to the plantar aspect of the phalanges
What is the role of vincula tendinum?
carry blood vessels to the tendons within the flexor sheaths
Where are vincula brevia located?
near the insertions of the tendons within the flexor sheath
Where are vincula longa located?
along the course of the tendons within the flexor sheath
What are the 1st layer of plantar muscles?
Abductor hallucis

Flexor digitorum brevis

Abductor digiti minimi
What are the insertions for abductor hallucis?
Medial process of calcaneal tuberosity

Flexor retinaculum

Deep surface of plantar aponeurosis

Tuberosity of the navicular
What is the course of abductor hallucis?
Distally along the medial side of the foot
What do the fibers of abductor hallucis blend with?
Fibers blend with the medial tendon of FHB

medial sesamoid

plantar plate

extensor hood
What is the insertion of abductor hallucis?
medioplantar aspect of the base of the proximal phalanx of the hallux
What is the action of abductor hallucis?
Abducts and aids in plantarflexion of the hallux
What are the origins of Flexor Digitorum Brevis?
Medial process of calcaneal tuberosity

Deep surface of plantar aponeurosis
What is the course of Flexor Digitorum Brevis?
Distally and divides into four tendons, one to each lesser digit
What is the insertion of Flexor Digitorum Brevis?
The two parts unite at the head of a proximal phalanx and insert into the plantar surface of the shaft of a middle phalanx
Where does Flexor Hallucis Brevis divide into 2 parts?
base of a proximal phalanx to allow passage of a tendon of FDL
What is the action of Flexor Hallucis Brevis?
Plantarflexes the proximal and middle phalanges of the lesser digits
What are the origins of Abductor Digiti Minimi?
Lateral margin of the medial process of calcaneal tuberosity

Lateral process of the calcaneal tuberosity

Deep surface of plantar aponeurosis

Tuberosity of the base of the fifth metatarsal
What is the course for Abductor Digiti Minimi?
Distally along the lateral side of the foot
What is the insertion of Abductor Digiti Minimi?
Lateral side of the base of the proximal phalanx of the fifth toe
What is the action of Abductor Digiti Minimi?
Abducts the fifth toe
What muscle abducts the fifth toe?
Abductor Digiti Minimi
What is the second layer of plantar muscles?
Quadratus plantae (flexor accessorius)

Lumbricales (4)
The tendon of flexor hallucis longus courses in what layer of the plantar muscles?
2nd layer
Quadratus Plantae and the Lumbricals are associated with the tendons of what muscles?
flexor digitorum longus muscle
The tendon of FHL is connected to the tendon of FDL by what?
knot of Henry
What is the origin of the Medial head of Quadratus Plantae?
Medial surface of the calcaneus
What is the origin of the Lateral head of Quadratus Plantae?
Inferior surface of the calcaneus just distal to the lateral process of the calcaneal tuberosity, and long plantar ligament
The 2 heads of Quadratus Plantae are separated by what?
the long plantar ligament
What is the course of Quadratus Plantae?
The two heads join
What is the insertion of Quadratus Plantae?
Tendon of FDL
What is the action of Quadratus Plantae?
Assists FDL in plantarflexion of the lesser digits
In what interspace can the 1st Lumbrical be found in?
1st interspace
In what interspace can the 2nd Lumbrical be found in?
2nd interspace
In what interspace can the 3rd Lumbrical be found in?
3rd interspace
In what interspace can the 4th Lumbrical be found in?
4th interspace
What is the origin of the 1st Lumbrical?
Medial side of the first tendon of FDL
What is the origin of the 2nd Lumbrical?
Adjacent sides of the first and second tendons of FDL
What is the origin of the 3rd Lumbrical?
Adjacent sides of the second and third tendons of FDL
What is the origin of the 4th Lumbrical?
Adjacent sides of the third and fourth tendons of FDL
What is the course of the Lumbricals?
Distally along the medial side of the FDL tendons and inferior to the deep transverse metatarsal ligament
What is the insertion of the 1st Lumbrical?
Extensor wing and extensor trifurcation of the first tendon of EDL (of the second toe)
What is the insertion of the 2nd Lumbrical?
Extensor wing and extensor trifurcation of the second tendon of EDL (of the third toe)
What is the insertion of the 3rd Lumbrical?
Extensor wing and extensor trifurcation of the third tendon of EDL (of the fourth toe)
What is the insertion of the 4th Lumbrical?
Extensor wing and extensor trifurcation of the fourth tendon of EDL (of the fifth toe)
What is the action of the Lumbricals?
Plantarflex the proximal phalanges and extend the middle and distal phalanges of the lesser digits
What happens when the Lumbricals contract?
they tighten the wing and slacken the sling components of the extensor hood
What are the 3rd layer of plantar muscle?
Flexor hallucis brevis

Adductor hallucis

Flexor digiti minimi brevis
The tendons of peroneus longus and tibialis posterior course in what layer of the Plantar Muscles?
3rd layer
What is the origin of Flexor Hallucis Brevis?
From a Y-shaped tendon

-Lateral arm from plantar surface of the cuboid and third cuneiform

-Medial arm from the plantar component of the tendon of tibialis posterior
What is the course of Flexor Hallucis Brevis?
Towards the first metatarsal head and divides into two tendons
Describe the Medial tendon of Flexor Hallucis Brevis?
contains the medial sesamoid, blends with the plantar plate and tendon of abductor hallucis, and contributes to the extensor hood
Describe the Lateral tendon of Flexor Hallucis Brevis?
Lateral tendon contains the lateral sesamoid, blends with the plantar plate and tendon of adductor hallucis, and contributes to the extensor hood
What is the insertion of Flexor Hallucis Brevis?
The medial and lateral tendons unite and insert into the plantar surface of the base of the proximal phalanx of the hallux
What is the action of Flexor Hallucis Brevis?
Plantarflexes the proximal phalanx of the hallux
What is the origin of the Oblique head of Adductor Hallucis?
Plantar surface of the bases of the second, third, and fourth metatarsals and the tendon sheath of peroneus longus
What is the origin of the Transverse head of Adductor Hallucis?
Plantar plates of the third, fourth, and fifth MTP’s, and the deep transverse metatarsal ligaments between them
What is the transverse head of Adductor Hallucis sometimes referred to as?
transverse pedis
What is the course of Adductor Hallucis?
The two heads unite to form a conjoined tendon which courses through the split in the deep transverse metatarsal ligament
What forms the only true conjoined tendon in the foot?
Adductor Hallucis
What do the fibers of Adductor Hallucis blend with?
the lateral tendon of FHB

the lateral sesamoid

the plantar plate

and contribute to the extensor hood
What is the insertion of Adductor Hallucis?
the lateroplantar aspect of the base of the base of the proximal phalanx of the hallux
What is the action of the Oblique head of Adductor Hallucis?
Adducts and aids in plantarflexion of the hallux
What is the action of the Transverse head of Adductor Hallucis?
Adducts the hallux and assists in pulling the metatarsal heads together
What are the insertions of Flexor Digiti Minimi Brevis?
Inferior surface of the base of the fifth metatarsal

Tendon sheath of peroneus longus
What is the course of Flexor Digiti Minimi Brevis?
Distally and slightly laterally
What is the insertion of Flexor Digiti Minimi Brevis?
Lateroplantar aspect of the base of the proximal phalanx of the fifth toe
What is the action of Flexor Digiti Minimi Brevis?
Plantarflexes the proximal phalanx of the fifth toe
What are the 4th layer of Plantar muscles?
Plantar interossei

Dorsal interossei
What is the origin of the 1st Plantar Interosseous?
Inferior surface of the base and medial surface of the shaft of the third metatarsal
What is the origin of the 2nd Plantar Interosseous?
Inferior surface of the base and medial surface of the shaft of the fourth metatarsal
What is the origin of the 3rd Plantar Interosseous?
Inferior surface of the base and medial surface of the shaft of the fifth metatarsal
What interspace is the 1st Plantar Interosseous in?
2nd interspace
What interspace is the 2nd Plantar Interosseous in?
3rd interspace
What interspace is the 3rd Plantar Interosseous in?
4th interspace
What is the course of the Plantar Interossei?
Tendons course distally superior to the deep transverse metatarsal ligament
What is the insertion of the 1st Plantar Interosseous?
Medial side of the base of the proximal phalanx of the third toe and into the extensor hood (sling and wing) of the third toe
What is the insertion of the 2nd Plantar Interosseous?
Medial side of the base of the proximal phalanx of the fourth toe and into the extensor hood (sling and wing) of the fourth toe
What is the insertion of the 3rd Plantar Interosseous?
Medial side of the base of the proximal phalanx of the fifth toe and into the extensor hood (sling and wing) of the fifth toe
What is the action of the Plantar Interossei?
Adduct the third, fourth, and fifth toes
What is the origin of the 1st Dorsal Interosseous?
Adjacent sides of the shafts of the first and second metatarsals
What is the origin of the 2nd Dorsal Interosseous?
Adjacent sides of the shafts of the second and third metatarsals
What is the origin of the 3rd Dorsal Interosseous?
Adjacent sides of the shafts of the third and fourth metatarsals
What is the origin of the 4th Dorsal Interosseous?
Adjacent sides of the shafts of the fourth and fifth metatarsals
What is the course of the Dorsal Interossei?
Tendons course distally superior to the deep transverse metatarsal ligament
What Dorsal Interosseous would you find in the 1st interspace?
1st DI
In what interspace would you find the 1st Dorsal Interosseous?
1st interpsace
What Dorsal Interosseous would you find in the 2nd interspace?
2nd DI
In what interspace would you find the 2nd Dorsal Interosseous?
2nd interspace
What Dorsal Interosseous would you find in the 3rd interspace?
3rd DI
In what interspace would you find the 3rd Dorsal Interosseous?
3rd interspace
What Dorsal Interosseous would you find in the 4th interspace?
4th DI
In what interspace would you find the 4th Dorsal Interosseous?
4th interspace
What is the insertion of the 1st Dorsal Interosseous?
Medial side of the base of the proximal phalanx of the second toe and into the extensor hood (sling and wing) of the second toe
What is the insertion of the 2nd Dorsal Interosseous?
Lateral side of the base of the proximal phalanx of the second toe and into the extensor hood (sling and wing) of the second toe
What is the insertion of the 3rd Dorsal Interosseous?
Lateral side of the base of the proximal phalanx of the third toe and into the extensor hood (sling and wing) of the third toe
What is the insertion of the 4th Dorsal Interosseous?
Lateral side of the base of the proximal phalanx of the fourth toe and into the extensor hood (sling and wing) of the fourth toe
What is the action of the Dorsal Interossei?
Abduct the second, third, and fourth toes
What tendons of extrinsic muscles are found on the medial and plantar surfaces of the foot?
Tibialis posterior

Flexor digitorum longus

Flexor hallucis longus
Describe the tendon of Tibialis Posterior.
Enclosed within a synovial sheath beneath the flexor retinaculum
Describe the tendon of Flexor Digitorum Longus.
Enclosed within a synovial sheath beneath the flexor retinaculum and each tendon is enclosed in a synovial sheath within the flexor sheaths of the lesser digits
Describe the tendon of Flexor hallucis longus.
Enclosed within a synovial sheath beneath the flexor retinaculum and enclosed in a synovial sheath within the flexor sheath of the hallux
What tendons of extrinsic muscles are found on the Posterior Surface of the foot?
Gastrocnemius

Soleus

Plantaris
Describe the tendons of Gastrocnemius and Soleus.
They unite to form the tendo calcaneus which does not course beneath a retinaculum and is not enclosed in a synovial sheath. There is a bursa between the tendo calcaneus and the calcaneus (retrocalcaneal or subtendinous), and a bursa between the tendo calcaneus and the skin (subcutaneous or adventitial).
Describe the Plantaris tendon.
Does not course beneath a retinaculum and is not enclosed in a synovial sheath
What tendons are found on the Lateral Surface of the foot.
Peroneus Longus

Peroneus Brevis
Describe the tendons of Peroneus Longus and Peroneus Brevis.
Both tendons are enclosed in a common synovial sheath as they course beneath the superior and inferior peroneal retinaculae. The tendon of peroneus longus is also enclosed in a synovial sheath in the peroneal sulcus
What is the insertion of the main component of Tibialis Posterior?
Tuberosity of the navicular and plantar surface of the first cuneiform
What is the insertion of the plantar component of Tibialis Posterior?
Second and third cuneiforms; cuboid; and the second, third, and fourth metatarsal bases
What is the insertion of the recurrent component of Tibialis Posterior?
Sustentaculum tali
What is the insertion of Flexor Digitorum Longus?
inserts on the plantar surface of the base of a distal phalanx
What is the insertion of Flexor Hallucis Longus?
Plantar surface of the base of the distal phalanx of the hallux
What is the insertion of Gastrocnemius and Soleus?
Form the tendo calcaneus which inserts into the middle one-third of the posterior surface of the calcaneus
What is the insertion of Plantaris?
Medial side of the middle one-third of the posterior surface of the calcaneus
What is the insertion of Peroneus Brevis?
Tuberosity of the base of the fifth metatarsal
What is the insertion of Peroneus Longus?
Lateral and plantar surfaces of the first cuneiform and the base of the first metatarsal (first ray).
What is the key function of Quadratus Plantae during the stance phase of gait?
Convert the oblique pull of flexor digitorum longus to a more posterior pull
What is the key function of the Lumbricals, Dorsal Interossei, and Plantar Interossei during the stance phase of gait?
These muscles convert the lesser toes into rigid beams (rigid beam effect) during propulsion
What muscles convert the lesser toes into rigid beams (rigid beam effect) during propulsion?
Lumbricals

Dorsal Interossei

Plantar Interossei
What forms the sesamoid apparatus?
Abductor Hallucis

Flexor Hallucis Brevis

Adductor Hallucis

Plantar Plate

Sesamoids
What is the role of the sesamoid apparatus?
stabilizes the first metatarsal head against the ground during propulsion
What is the role of Flexor Hallucis Brevis?
stabilzes in a posterior and plantar direction
What is the role of Abductor Hallucis Brevis?
stabilizes in the direction of abduction
What is the role of Adductor Hallucis Brevis?
stabilizes in the direction of adduction
What compartment contains the abductor hallucis, tendon of FHL, and flexor hallucis brevis?
medial compartment
What does the medial compartment contain?
abductor hallucis

tendon of FHL

flexor hallucis brevis
What compartment contains the abductor digiti minimi, and flexor digiti minimi brevis?
lateral compartment
What does the lateral compartment contain?
abductor digiti minimi

flexor digiti minimi brevis
What compartment contains the flexor digitorum brevis, tendons of FDL, quadratus plantae, lumbricals, and adductor hallucis?
central compartment
What does the central compartment contain?
flexor digitorum brevis

FDL

quadratus plantae

lumbricals

adductor hallucis?
What compartment contains the dorsal and plantar interossei?
interosseous compartment
What does the interosseous compartment contain?
dorsal interossei

plantar interossei
Identify the muscle variation: Slip from the tendon of extensor hallucis longus that inserts into the capsule of the first MTP
Extensor hallucis capsularis
Identify the muscle variation: Slip from the tendon of peroneus brevis that inserts into the fifth toe
Peroneus digiti minimi
Identify the muscle variation: Originates along with the abductor digiti minimi from the lateral process of the calcaneal tuberosity and inserts on the tuberosity of the base of the fifth metatarsal
Abductor ossis metatarsi digiti minimi or Wood’s Muscle
Do the superficial veins of the foot have corresponding arteries?
They do not have corresponding arteries
How are the superficial veins of the the foot connected to deep veins?
By perforating veins
What drains the sides of the toe?
Dorsal digital veins
What do dorsal digital veins drain?
the sides of the toe
What do median digital vein drain?
center of the toe and the nail matrix
What drains the center of the toe and the nail matrix?
median digital vein
What forms a common digital vein?
Dorsal digital veins from adjacent sides of toes unite with an intercapitular vein from the plantar cutaneous venous arch
What flows into the dorsal venous arch?
Common digital veins

dorsal digital vein from the dorsomedial aspect of the hallux

dorsal digital vein from the dorsolateral aspect of the digiti minimi
What does the dorsal venous arch flow into?
Medially into the medial marginal vein

Laterally into the lateral marginal vein
Where does the dorsal venous arch lie?
in the superficial fascia at the distal aspect of the metatarsal shafts
Are superficial nerves located deep or superficial to the dorsal venous arch?
superficial
What nerve courses with the medial marginal vein?
saphenous nerve
What is the location of the medial marginal vein in relation to the medial malleolus?
runs anterior to medial malleolus
What forms the medial marginal vein?
The dorsal digital vein on the dorsomedial aspect of the hallux and the dorsal venous arch
What forms the lateral marginal vein?
The dorsal digital vein on the dorsolateral aspect of the fifth toe and the dorsal venous arch
What nerve courses with the lateral marginal vein?
lateral dorsal cutaneous nerve
Where is the position of the lateral marginal vein in relation to the lateral malleolus?
posterior to lateral malleolus
Where does the plantar cutaneous venous arch lie?
in the superficial fascia in the region of the MTP’s
The plantar cutaneous venous arch gives off how many intercapitular veins to the dorsum of the foot?
4
The plantar cutaneous venous arch receives superficial branches from where?
the toes
What is the plantar cutaneous venous arch continuous with?
continuous over the sides of the foot with the medial and lateral marginal veins
The dorsum of the foot is vascularized by what artery?
dorsalis pedis artery
The arteries are smaller on what side of the foot: dorsum or plantar?
dorsum
Where does the dorsalis pedis artery begin?
at the articular capsule of the ankle joint as a continuation of the anterior tibial artery
What is the course of the dorsalis pedis artery?
over the neck of the talus, navicular, and second cuneiform
Where does the dorsalis pedis artery terminate?
At the proximal aspect of the first interspace by dividing into the first dorsal metatarsal artery and the deep plantar artery
What artery terminates at the proximal aspect of the first interspace by dividing into the first dorsal metatarsal artery and the deep plantar artery?
dorsalis pedis artery
What artery begins at the articular capsule of the ankle joint as a continuation of the anterior tibial artery?
dorsalis pedis artery
What tendon is located on the medial side of the dorsalis pedis artery?
Extensor Hallucis Longus
Flexor Hallucis Longus runs on what side of the dorsalis pedis artery?
medial side
What tendon crosses the dorsalis pedis artery near its termination?
first tendon of extensor digitorum brevis
What are the major branches of the dorsalis pedis artery?
Artery of the sinus tarsi

Lateral tarsal artery

Medial tarsal arteries

Arcuate artery

First dorsal metatarsal artery

Deep plantar artery
What artery branches from the dorsalis pedis artery at the level of the neck of the talus (it may branch from the lateral tarsal or perforating artery)?
Artery of the sinus tarsi
What artery provides the major vascular supply to the talus?
Artery of the sinus tarsi
The artery of the sinus tarsi provides the major vascular supply to what?
talus
What artery terminates by anastomosing with the artery of the tarsal canal from the posterior tibial artery?
Artery of the sinus tarsi
How does the artery of the sinus tarsi terminate?
by anastomosing with the artery of the tarsal canal from the posterior tibial artery
What artery branches from the dorsalis pedis artery at the level of the neck of the talus or navicular?
Lateral tarsal artery
The lateral tarsal artery branches from where?
from the dorsalis pedis artery at the level of the neck of the talus or navicular
What artery courses laterally deep to EDB with the lateral terminal branch of the deep peroneal nerve?
Lateral tarsal artery
What artery vascularizes Extensor Digitorum Brevis?
Lateral tarsal artery
What does the lateral tarsal artery vascularize?
Extensor Digitorum Brevis
What artery terminates by anastomosing with the anterior lateral malleolar, perforating, and arcuate arteries (lateral malleolar network)?
Lateral tarsal artery
How does the lateral tarsal artery terminate?
by anastomosing with the anterior lateral malleolar, perforating, and arcuate arteries (lateral malleolar network)
What arteries, usually two or three branches, vascularize structures on the medial aspect of the foot and then anastomose with the medial malleolar network?
Medial tarsal arteries
What artery branches from the dorsalis pedis artery near the second metatarsal base?
Arcuate artery
What artery courses laterally over the metatarsal bases deep to the tendons of EDL and EDB?
Arcuate artery
Where does the arcuate artery branch from?
the dorsalis pedis artery near the second metatarsal base
What is the course of the arcuate artery?
laterally over the metatarsal bases deep to the tendons of EDL and EDB
What artery terminates by anastomosing with the lateral malleolar network?
Arcuate artery
How does the arcuate artery terminate?
by anastomosing with the lateral malleolar network
What are the branches of the arcuate artery?
Second, third, and fourth dorsal metatarsal arteries
What arteries course distally on its respective dorsal interosseous muscle?
Second, third, and fourth dorsal metatarsal arteries
What is the course of the second, third, and fourth dorsal metatarsal arteries?
distally on its respective dorsal interosseous muscle
How do the second, third, and fourth dorsal metatarsal arteries terminate?
by dividing into two dorsal proper digital arteries at the cleft of the toes for the adjacent sides of the digits
What arteries terminate by dividing into two dorsal proper digital arteries at the cleft of the toes for the adjacent sides of the digits?
Second, third, and fourth dorsal metatarsal arteries
What arteries receive at its distal aspect an anterior perforating artery from its respective plantar metatarsal artery?
Second, third, and fourth dorsal metatarsal arteries
What arteries receive at its proximal aspect a posterior perforating artery from the plantar arch?
Second, third, and fourth dorsal metatarsal arteries
What arteries give off a dorsal proper digital artery to the dorsolateral aspect of the fifth toe?
fourth dorsal metatarsal artery

Lateral plantar artery
What arteries are terminal branches of the dorsalis pedis artery?
First dorsal metatarsal artery

Deep plantar artery
The first dorsal metatarsal artery is a terminal branch of what artery?
dorsalis pedis artery
What artery courses distally on the first dorsal interosseous muscle?
First dorsal metatarsal artery
What is the course of the first dorsal metatarsal artery?
distally on the first dorsal interosseous muscle
What artery terminates at the cleft of the toes by dividing into two dorsal proper digital arteries to the adjacent sides of the hallux and second toe?
First dorsal metatarsal artery
How dies the first dorsal metatarsal artery terminate?
terminates at the cleft of the toes by dividing into two dorsal proper digital arteries to the adjacent sides of the hallux and second toe
What artery gives off a dorsal proper digital artery which courses deep to the tendon of EHL to the dorsomedial aspect of the hallux?
First dorsal metatarsal artery
What artery receives an anterior perforating artery from the first plantar metatarsal artery?
First dorsal metatarsal artery
What artery courses plantarly through the first dorsal interosseous muscle between the first and second metatarsal bases?
Deep plantar artery
What is the course of the deep plantar artery?
plantarly through the first dorsal interosseous muscle between the first and second metatarsal bases
What artery unites with the plantar arch portion of the lateral plantar artery to complete the plantar arch?
Deep plantar artery
What do the dorsal metatarsal arteries vascularize?
metatarsals

sesamoids

MTP’s

interossei muscles
What vascularize the metatarsals, the sesamoids, the MTP’s, and the interossei muscles?
dorsal metatarsal arteries
The dorsal proper digital arteries vascularize what?
phalanges

interphalangeal joints
What vascularize the phalanges, and interphalangeal joints?
dorsal proper digital arteries
The plantar surface of the foot is vascularized by what?
the medial and lateral plantar arteries
The medial and lateral plantar arteries vascularize what?
The plantar surface of the foot
What are the terminal branches of the posterior tibial artery?
medial and lateral plantar arteries
The medial and lateral plantar arteries are terminal branches of what artery?
the posterior tibial artery
What artery branches from the posterior tibial artery between the calcaneus and abductor hallucis muscle (porta pedis)?
Medial plantar artery
What artery courses distally between the abductor hallucis and flexor digitorum brevis muscles to the base of the first metatarsal?
Medial plantar artery
What is the course of the medial plantar artery?
distally between the abductor hallucis and flexor digitorum brevis muscles to the base of the first metatarsal
What artery terminates along the medioplantar aspect of the hallux as a plantar proper digital artery?
Medial plantar artery
How does the medial plantar artery terminate?
along the medioplantar aspect of the hallux as a plantar proper digital artery
What artery vascularizes the abductor hallucis and flexor digitorum brevis muscles?
Medial plantar artery
What does the medial plantar artery vascularize?
the abductor hallucis and flexor digitorum brevis muscles
What artery branches from the posterior tibial artery between the calcaneus and abductor hallucis muscle (porta pedis)?
Lateral plantar artery
What artery courses obliquely anteriorly and laterally between the flexor digitorum brevis and quadratus plantae muscles?
lateral plantar artery
What is the course of the lateral plantar artery?
obliquely anteriorly and laterally between the flexor digitorum brevis and quadratus plantae muscles
What artery becomes more superficially located between flexor digitorum brevis and abductor digiti minimi?
lateral plantar artery
What courses on the bases of the metatarsals between the interossei muscles and the oblique head of the adductor hallucis muscle?
Plantar arch
What terminates by uniting with the deep plantar artery in the first interspace?
Plantar arch
What are the major branches of the lateral plantar artery?
Posterior perforating arteries (3)

Plantar metatarsal arteries (4)
What artery vascularizes the abductor digiti minimi, quadratus plantae, flexor digiti minimi brevis, and oblique head of adductor hallucis?
Lateral plantar arterty
What does the lateral plantar artery vascularize?
Abductor digiti minimi

quadratus plantae

flexor digiti minimi brevis

oblique head of adductor hallucis
How many plantar metatarsal arteries are there?
4
What arteries course distally on its respective interossei muscles?
Plantar metatarsal arteries
What is the course of the plantar metatarsal arteries?
distally on its respective interossei muscles
How do the plantar metatarsal arteries terminate?
Each terminates by dividing into two plantar proper digital arteries at the cleft of the toes for the adjacent sides of the digits
What arteries vascularize the metatarsals; the sesamoids; the MTP’s; and the interossei muscles, flexor hallucis brevis, lumbricals, and transverse head of adductor hallucis?
Plantar metatarsal arteries
What do the plantar metatarsal arteries vascularize?
metatarsals

sesamoids

MTPs

interossei muscles

flexor hallucis brevis

lumbricals

transverse head of adductor hallucis
What arteries vascularize the phalanges, and interphalangeal joints?
Plantar proper digital arteries
What do the plantar proper digital arteries vascularize?
phalanges

interphalangeal joints
What artery vascularizes the metatarsals?
Plantar metatarsal arteries
What artery vascularizes the MTP’s?
Plantar metatarsal arteries
What artery vascularizes the interossei muscles?
Plantar metatarsal arteries
What artery vascularizes the flexor hallucis brevis?
Plantar metatarsal arteries
What artery vascularizes the lumbricals?
Plantar metatarsal arteries
What artery vascularizes the transverse head of adductor hallucis?
Plantar metatarsal arteries
What are the arteries in the digits of the foot?
two dorsal proper digital arteries

two plantar proper digital arteries
The two plantar proper digital arteries terminate where?
on the distal aspect of a digit by forming a terminal tuft or terminal arborization which is a major communication between these arteries
The two dorsal proper digital arteries anastomose with what?
terminal tuft
What arteries anastomose with the terminal tuft?
the two dorsal proper digital arteries
The superficial lymphatic vessels are most abundant on what side of the foot?
plantar
Describe the medial group of collecting vessels.
Larger and more numerous than the lateral group

course with the great saphenous vein up the leg and thigh

drain into the lower group (vertical group) of superficial inguinal lymph nodes
Describe the lateral group of collecting vessels.
Course anterior and posterior to the lateral malleolus

Those coursing anterior drain into the medial group and those passing posterior accompany the small saphenous vein and drain into the popliteal lymph nodes
What do the deep lymphatic vessels course with in the foot?
dorsalis pedis

medial plantar

lateral plantar arteries and veins
What do the deep lymphatic vessels course with in the leg?
anterior tibial

posterior tibial

peroneal arteries and veins
What do the deep lymphatic vessels in the leg drain into?
drain into the popliteal lymph nodes
What does the deep peroneal nerve or deep fibular nerve innervate?
innervates the anterior compartment of the leg
What nerve innervates the anterior compartment of the leg?
deep peroneal nerve or deep fibular nerve
The deep peroneal nerve or deep fibular nerve is a branch of what nerve?
Branch of the common peroneal nerve
What is the course of the deep peroneal or deep fibular nerve?
courses deep to the deep fascia with the anterior tibial vessels
What nerve courses deep to the deep fascia with the anterior tibial vessels?
deep peroneal or deep fibular nerve
What nerve follows the course of the dorsalis pedis artery?
Medial terminal branch of the deep peroneal nerve or deep fibular nerve
Medial terminal branch of the deep peroneal nerve or deep fibular nerve follows the course of what artery?
dorsalis pedis artery
What nerve becomes superficial as it pierces the deep fascia at the distal aspect of the first interspace?
Medial terminal branch of the deep peroneal nerve or deep fibular nerve
What nerve divides into two dorsal proper digital nerves for the adjacent side of the hallux and second toe?
Medial terminal branch of the deep peroneal nerve or deep fibular nerve
What nerve follows the course of the lateral tarsal artery?
Lateral terminal branch of the deep peroneal nerve or deep fibular nerve
The lateral terminal branch of the deep peroneal nerve or deep fibular nerve follows the course of what artery?
lateral tarsal artery
Lateral terminal branch of the deep peroneal nerve or deep fibular nerve innervate?
Innervates the extensor digitorum brevis
The superficial peroneal or superficial fibular nerve is a branch of what nerve?
Branch of the common peroneal (fibular) nerve
What nerve innervates the lateral compartment of the leg?
superficial peroneal or superficial fibular nerve
What does the superficial peroneal or superficial fibular nerve innervate?
the lateral compartment of the leg
What nerve pierces the deep fascia in the lower one-third of the leg and innervates the skin on the lower anterolateral aspect of the leg?
superficial peroneal or superficial fibular nerve
What nerve proximal to the malleoli it divides into a medial dorsal cutaneous nerve and an intermediate dorsal cutaneous nerve?
superficial peroneal or superficial fibular nerve
What nerve branches from the superficial peroneal (fibular) nerve in the lower leg region?
Medial dorsal cutaneous nerve
What nerve on the dorsum of the foot divides into a dorsal proper digital branch and a dorsal common digital branch?
Medial dorsal cutaneous nerve
What nerve innervates the skin on the dorsomedial aspect of the hallux?
The dorsal proper digital branch of the medial dorsal cutaneous nerve
The dorsal proper digital branch communicates with what 2 nerves?
the medial terminal branch of the deep peroneal nerve and the saphenous nerve
The dorsal common digital branch divides into two dorsal proper digital branches for the skin on the adjacent sides of what 2 toes?
the second and third toes
The dorsal common digital branch of the medial dorsal cutaneous nerve innervates what?
the skin on the dorsomedial side of the foot
The intermediate dorsal cutaneous nerve branches from what nerve?
Branches from the superficial peroneal (fibular) nerve in the lower leg region
What nerve on the dorsum of the foot divides into a medial dorsal common digital branch and a lateral dorsal common digital branch?
Intermediate dorsal cutaneous nerve
The medial dorsal common digital branch of the intermediate dorsal cutaneous nerve branch divides into two dorsal proper digital branches for the skin on the adjacent sides of what toes?
the third and fourth toes
The lateral dorsal common digital branch of the intermediate dorsal cutaneous branch divides into two dorsal proper digital branches for the skin on the adjacent sides of what toes?
the fourth and fifth toes
The lateral dorsal common digital branch communicates with what nerve?
the lateral dorsal cutaneous nerve
What does the intermediate dorsal cutaneous nerve innervate?
it innervates the skin on the dorsointermediate side of the foot
What innervates the skin on the dorsointermediate side of the foot?
the intermediate dorsal cutaneous nerve innervate
The intermediate dorsal cutaneous nerve may also branch from what 2 nerves?
the sural nerve or the lateral dorsal cutaneous nerve
The lateral dorsal cutaneous nerve is a continuation of what nerve?
the sural nerve as it courses below the lateral malleolus
What is the course of the lateral dorsal cutaneous nerve?
It courses along the dorsolateral side of the foot innervating the skin in this region
What nerves courses along the dorsolateral side of the foot innervating the skin in this region?
the lateral dorsal cutaneous nerve
What nerve terminates as a dorsal proper digital nerve to the dorsolateral side of the fifth toe?
the lateral dorsal cutaneous nerve
How does the lateral dorsal cutaneous nerve terminate?
as a dorsal proper digital nerve to the dorsolateral side of the fifth toe
The lateral dorsal cutaneous nerve communicates with what nerve?
the lateral dorsal common digital branch of the intermediate dorsal cutaneous nerve
What do some textbooks still call the lateral dorsal cutaneous nerve?
the sural nerve
The saphenous nerve is a branch of what nerve?
Branch of the femoral nerve in the thigh
What is the course of the saphenous nerve?
Courses with the great saphenous vein in the leg
How does the saphenous nerve terminate?
Terminates on the dorsum of the foot by innervating the skin on the medial side of the foot up to the first MTP
What nerve is the only nerve of the foot that is not a branch of the sciatic nerve?
saphenous nerve
The plantar and posterior aspect of the foot is innervated by what nerves?
Tibial nerve:
-Medial calcaneal nerve
-Medial plantar nerve
-Lateral plantar nerve

Sural nerve:
-Lateral calcaneal nerve
The medial plantar nerve is a branch of what nerve?
tibial nerve
What is the course of the medial plantar nerve?
Courses distally with the medial plantar vessels between the abductor hallucis and flexor digitorum brevis muscles
What nerve courses distally with the medial plantar vessels between the abductor hallucis and flexor digitorum brevis muscles?
the medial plantar nerve
What nerve as it courses distally gives off cutaneous, muscular and articular branches?
the medial plantar nerve
How does the medial plantar nerve terminate?
It terminates by dividing into a plantar proper digital and three plantar common digital branches
What nerve innervate the skin on the medioplantar aspect of the foot?
Cutaneous branches of the medial plantar nerve
What do the cutaneous branches of the medial plantar nerve innervate?
the skin on the medioplantar aspect of the foot
What nerve innervates the abductor hallucis and flexor digitorum brevis muscles before the medial plantar nerve divides into plantar proper and plantar common digital branches?
Muscular branches of the medial plantar nerve
What nerve innervates joints on the medial portion of the tarsus?
Articular branches of the medial plantar nerve
What do the articular branches of the medial plantar nerve innervate?
joints on the medial portion of the tarsus
The second plantar common digital branch of the medial plantar nerve divides into two plantar proper digital branches for the skin on the adjacent sides of what toes?
second and third toes
The third plantar common digital branch of the medial plantar nerve divides into two plantar proper digital branches for the skin on the adjacent sides of what toes?
third and fourth toes
The third plantar common digital branch of the medial plantar nerve is the common site of what?
Morton’s neuroma
What is the common site for a Morton's neuroma?
The third plantar common digital branch of the medial plantar nerve
The third plantar common digital branch of the medial plantar nerve communicates with what nerve?
the plantar common digital branch of the superficial division of the lateral plantar nerve
The lateral plantar nerve is a branch of what nerve?
the tibial nerve
What is the course of the lateral planter nerve?
Courses distally with the lateral plantar vessels
How does the lateral planter nerve terminate?
by dividing into a superficial and deep branch
What nerve innervate the skin on the lateroplantar aspect of the foot?
Cutaneous branches of the lateral plantar nerve
The cutaneous branches of the lateral plantar nerve innervate what?
the skin on the lateroplantar aspect of the foot
What nerve innervates the abductor digiti minimi and quadratus plantae muscles before the lateral plantar nerve divides into a superficial and deep branch?
Muscular branches of the lateral plantar nerve
The muscular branches of the lateral plantar nerve innervate what?
abductor digiti minimi

quadratus plantae
What is Baxter’s Nerve?
the first branch of the lateral plantar nerve
The first branch of the lateral plantar nerve is known by what other name?
Baxter’s Nerve
What nerve innervates joints on the lateral portion of the tarsus?
Articular branches of the lateral plantar nerve
The articular branches of the lateral plantar nerve innervate what?
joints on the lateral portion of the tarsus
What nerve innervates the flexor digiti minimi brevis, fourth dorsal interosseous, and third plantar interosseous muscles; and the skin on the lateroplantar aspect of the fifth toe?
Plantar proper digital branch of the superficial branch of the lateral plantar nerve
What does the plantar proper digital branch of the superficial branch of the lateral plantar nerve innervate?
flexor digiti minimi brevis

fourth dorsal interosseous

third plantar interosseous

skin on the lateroplantar aspect of the fifth toe
Plantar common digital branch of the superficial branch of the lateral plantar nerve Divides into two plantar proper digital branches for the skin on the adjacent sides of what toes?
the fourth and fifth toes
The plantar common digital branch communicates with what nerve?
the third plantar common digital branch of the medial plantar nerve
What is course of the deep branch of the lateral planter nerve?
Courses with the plantar arch portion of the lateral plantar artery
What does the deep branch of the lateral plantar nerve innervate?
adductor hallucis

second, third, and fourth lumbricals

first, second, and third dorsal interosseous

first, and second plantar interosseous muscles
The first plantar common digital branch of the medial nerve is in what interspace?
1st interspace
The second plantar common digital branch of the medial nerve is in what interspace?
2nd interspace
The third plantar common digital branch of the medial nerve is in what interspace?
3rd interspace
What nerve is in the 1st interspace on the plantar surface of the foot?
The first plantar common digital branch of the medial nerve
What nerve is in the 2nd interspace on the plantar surface of the foot?
The second plantar common digital branch of the medial nerve
What nerve is in the 3rd interspace on the plantar surface of the foot?
The third plantar common digital branch of the medial nerve
What plantar common digital branch of the lateral nerve is in what interspace?
4th interspace
What nerve on the plantar surface of the foot is in the 4th interspace?
the plantar common digital branch of the lateral nerve
The medial calcaneal nerve is a branch of what nerve?
tibial nerve
What nerve innervates the skin on the plantar and medial aspect of the heel?
medial calcaneal nerve
The medial calcaneal nerve innervates what?
the skin on the plantar and medial aspect of the heel
Entrapment of the medial calcaneal nerve is a common cause of what?
heel pain
The lateral calcaneal nerve is a branch of what nerve?
sural nerve
What nerve innervates the skin on the posterior and lateral aspect of the heel?
lateral calcaneal nerve
What does the lateral calcaneal nerve innervate?
the skin on the posterior and lateral aspect of the heel
The plantar proper digital nerves are branches of what nerves?
the medial and lateral plantar nerves
What nerve gives off cutaneous and articular branches along their respective quadrant of a digit?
Plantar proper digital nerves
What nerves terminate in the area of the ungual tuberosity by sending branches to the distal end of the digit?
Plantar proper digital nerves
Where do the plantar proper digital nerves terminate?
ungual tuberosity
At the level of what structure do the plantar proper digital nerves send branches dorsally to the structures around the nail?
the distal phalanx
What nerves are anesthetized for a digital block?
all four digital nerves
What arteries make up the lateral malleolar network?
anterior lateral malleolar arteries

perforating arteries

arcuate arteries
The dorsal metatarsal arteries course distally on what muscles?
dorsal interossei
The first dorsal metatarsal artery gives off a dorsal proper digital artery which courses deep to what tendon?
Extensor Hallucis Longus
What structures make up the porta pedis?
calcaneus

abductor hallucis muscle
The dorsum of the foot is innervated by what nerves?
Medial terminal branch of the deep peroneal nerve (deep fibular nerve)

Lateral terminal branch of the deep peroneal nerve (deep fibular nerve)

Medial dorsal cutaneous nerve which is a branch of the superficial peroneal nerve (superficial fibular nerve)

Intermediate dorsal cutaneous nerve which is a branch of superficial peroneal nerve (superficial fibular nerve)

Lateral dorsal cutaneous nerve which is a continuation of the sural nerve onto the foot

Saphenous nerve which is a branch of femoral nerve
What is the location of the medial terminal branch of the deep peroneal nerve (deep fibular nerve) compared with the dorsalis pedis artery?
medial terminal branch of the deep peroneal nerve (deep fibular nerve)is medial to the dorsalis pedis artery
What does Baxter's Nerve innervate?
the periosteum of the calcaneus