Ankle and Foot

What is the flexor retinaculum of the ankle continuous with?

Deep fascia of leg and foot

What does the Flexor retinaculum of the ankle form?

Tarsal tunnel

What does the Flexor retinaculum run from?

From medial malleolus to calcaneus (inferomedial)

What does the flexor retinaculum enclose (Anterior to posterior)

Tom, Dick, and Very Nervous harry:

Tibialis posterior tendon

Flexor digitorum longus tendon

Posterior tibial artery and vein

Tibial nerve

Flexor Hallicus longus tendon

What does the superior extensor retinaculum of the ankle run between?

Distal, anterior borders of tibia and fibula superior to ankle joint

What does the superior extensor retinaculum of the ankle enclose?

Extensor digitorum longus

Fibularis (peroneus) tertius

Anterior tibial artery and vein

Extensor hallucis longus

Tibialis anterior

What shape is the inferior extensor retinaculum?

Y shaped

What is lateral superior surface of the base of the calcaneus?

Inferior extensor retinaculum

Where do the two bands of the inferior extensor retinaculum of the ankle go to?

One band: medial malleolus

Other band: wraps around to medial side of plantar aponeurosis

What does the inferior extensor retinaculum of the ankle enclose?

Extensor digitorum longus

Fibularis (peroneus) tertius

Anterior tibial artery and vein

Extensor hallucis longus

Tibialis anterior

What are the two types of Fibularis (peroneal) retinaculum?

Superior Fibular retinaculum

Inferior fibular retinaculum

What does the Fibularis retinaculum enclose?

Fibularis (peroneus) longus tendon

Fibularis (peroneus) brevis tendon

What are the dorsal muscles of the foot?

Extensor digitorum brevis muscle

Extensor hallucis brevis muscle

What are the OIANs of the dorsal muscles of the foot?

REVIEW

What type of connective tissue is Plantar aponeurosis?

Dense connective tissue

What is the plantar aponeurosis anchored to?

Calcaneous

What does Plantar aponeurosis fan out to and interconnect?

Fans out to the digits and interconnects to superficial transverse metatarsal ligament: running at metatarsophalangeal (MTP joints)

What is the function of Plantar aponeurosis?

Supports longitudinal arch

Protects structures in sole of foot

What makes up the first layer of plantar muscles of the foot?

Abductor hallucis muscle

Flexor digitorum brevis muscle

Abductor digiti minimi muscle

What is the OIANs for the 1st layer of plantar muscles

REVIEW

What makes up the second layer of the plantar muscles of the foot?

Quadratus plantae muscle

Lumbrical muscles

What tendons are found in the second layer of the plantar muscles of the foot?

Tendons of flexor digitorum longus muscle

Tendons of flexor hallucis longus

What is the OIANs of the second layer of plantar muscles of the foot?

REVIEW

What makes up the third layer of the plantar muscles of the foot?

Flexor digit minimi muscle

Flexor hallucis brevis muscle

Adductor hallucis muscle

What are the OIANs of the third layer of the plantar muscles?

REVIEW

What makes up the fourth layer of the Plantar muscles of the foot?

Plantar interossei

Dorsal interossei

What type of muscles are the 3 plantar interossei muscles?

Unipennate

What type of muscles are the 4 dorsal interossei muscles?

Bipennate

What are the OIANs of the fourth layer of plantar muscles of the foot?

REVIEW

What is the function of the arches of the foot?

Shock absorption via arrangement of bones, ligaments, and tendons

Resilience with weight bearing

Spring board for locomotion

What makes up the medial longitudinal arch?

Calcaneus

Talus

Navicular

Medial cuneiform

Metatarsal #1

What makes up the Lateral longitudinal arch?

Calcaneus

Cuboid

Metatarsal #5

What is trait of the lateral longitudinal arch?

Flatter, it rests on ground when standing

What bones make up the transverse arch?

Cuboid

Cuneiforms

What tendons provide dynamic support for the transverse arch?

Tendons of posterior Tibialis

And Fibularis longus muscles

What do the tendons of posterior Tibialis and Fibularis (peroneus) longus muscles do to provide support?

Cross under sole of foot

What are passive factors influencing arches?

1. Fit of the bones
2. Plantar aponeurosis
3. Long plantar ligament
4. Plantar calcaneocuboid ligament (short plantar)
5. Plantar calcaneonaviicular ligament (spring)

What are the dynamic factors influencing arches?

1. Active bracing of foot by instrinsic muscle
2. Active and tonic branching of extrinsic muscles via tendons attaching to foot

What kind of joint is the Proximal Tibiofibular joint?

Synovial: gliding joint

What is the articulation of the proximal tibiofibular joint?

Lateral condyle of tibia with head of fibula

What are the ligaments of the Proximal Tibiofibular joint?

Anterior superior tibiofibular ligament

Posterior superior tibiofibular ligament

What kind of joint is the Distal Tibiofibular joint?

Fibrous: Syndesmosis

Is the distal tibiofibular joint movable?

No

What is the articulation of the Distal tibiofibular joint?

Fibular notch of tibia with fibula

What are the ligaments of the distal tibiofibular joint?

Anterior inferior tibiofibular ligament

Posterior inferior tibiofibular ligament

Transverse tibiofibular ligament

What do the fibers of the interosseous membrane run to?

Runs down from tibia to fibula

What kind of joint is the ankle joint (talocrucal joint)

Synovial: Hinge joint

What axis is the ankle joint and what does it go through?

Transverse axis through malleoli

What is the articulation of the ankle joint (talocrural joint)

Trochlea of talus with medial and lateral malleoli of tibia and fibula

What are the four parts of the Medial collateral ligament (deltoid ligament) of the ankle joint?

Anterior tibiotalar ligament

Posterior tibiotalar ligament

Tibionavicular ligament

Tibiocalcaneal ligament

What are the three parts of the lateral collateral ligament of the ankle joint?

Calcaneofibular ligament

Anterior talofibular ligament

Posterior talofibular ligament

What is the subtalar joint between?

Talus and Calcaneus

What motion does the subtalar joint contribute to?

Inversion and Eversion

What kind of joints exist in the intertarsal joints?

Synovial: Plane

What kind of joint is between the cuboid and navicular?

Fibrous

Where is limited movement in the intertarsal joints?

Between cuneiforms

Between cuneiforms and navicular bone

What is the transverse tarsal joint formed by?

Talocalcaneonavicular joint

Calcaneocuboid joint?

What are the movements of the transverse tarsal joint?

Inversion and Eversion

What kind of joint is the talocalcaneonavicular joint (of transverse tarsal joint)

Synovial: Gliding, rotation

What are the movements of the Talocalcaneonavicular joint?

Inversion/Eversion

What are the ligaments of the Talocalcaneonaviucalar joint?

Interosseous talocalcaneal ligament

Talonavicular ligament

Plantar calcaneonavicular (spring) ligament

What are the ligaments of the Calcaneocuboid joint?

Bifurcate ligament

Plantar calcaneocuboid (short plantar) ligament

Long plantar ligament

What type of joints are in the Tarsometatarsal joints?

Synovial: Plane and Gliding joints

What is the articulation of the tarsometatarsal joints?

Between base of metatarsals and cuboid and cuneiform bones

What are the ligaments of the Tarsometatarsal joint?

Dorsal, Plantar, and interosseous ligaments

What types of joints are the intermetatarsal joints?

Synovial: Plane and Gliding joints

Is their very little movements at bases in the intermetatarsal joint?

Yes

Wha are the ligaments of the intermetatarsal joints?

Dorsal, Plantar and Interosseous ligaments

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Superficial/Deep transverse metatarsal ligament (distal heads)

What kind of joints are the metatarsophalangeal joints?

Synovial: Condyloid joints

What is the articulation of the Metatarsophalangeal joint?

Between metatarsal heads and base of proximal phalanges

What are the movements of the metatarsophalangeal joints?

Flexion/extension

abduction/adduction

Circumduction

What are the ligaments of the metatarsophalangeal joints?

Medial/Lateral collateral ligaments

Plantar ligaments

What kind of joint is the interphalangeal joints?

Synovial: Hinge

What movements are in the interphalangeal joints of the foot?

Flexion/Extension

What are the ligaments of the interphalangeal joints?

Collateral ligaments

Plantar ligaments

What are the branches of the Dorsalis Pedis artery

Arcuate artery

First dorsal metatarsal artery

What direction does the arcuate artery run?

Medial to lateral

What kind of arteries does the arcuate artery have?

Dorsal metatarsal arteries

Dorsal digital arteries

What does the dorsal digital arteries go to?

To great and 2nd toes

What does the deep plantar artery travel between?

Heads of 1st dorsal interosseous muscle then joins deep plantar arch

What is the dorsalis pedis artery lateral to?

Tendon of the extensor hallucis longus muscle

What is the deep fibular nerve lateral to?

Dorsalis pedis artery

What does the medial side of the dorsal venous arch drain into?

The great saphenous vein

What does the lateral side of the dorsal venous arch drain into?

The small saphenous vein

W

What does the branches of the lateral plantar artery form?

Deep plantar arch artery

How many plantar metatarsal arteries are there in the lateral plantar artery?

3-4

What does the plantar metatarsal arteries divide into?

Plantar digital branches

How many perforating arteries between metatarsals 2-5 to anastomose with dorsal arteries

3

What does the lateral plantar artery terminated by?

Joining deep plantar artery branch of big toe

What does the superficial branch of the medial plantar artery divide into for the great toe?

Plantar digital arteries

What does the deep branch (if present) join?

Deep plantar arch artery

What is cutaneous innervation of the foot?

Tibial nerve

Sural nerve

Medial Plantar nerve

Lateral plantar nerve

Saphenous nerve

Deep Peroneal nerve

Deep fibular nerve

Superficial peroneal nerve

Superficial fibular nerve

What is superficial to the retinacula?

Superficial fibular nerve and saphenous nerve

What runs deep to the extensor retinacula?

Deep fibular nerve

What is the major sensory nerve to the plantar surface?

Medial plantar nerve

How many intrinsic muscles of the foot does the medial plantar nerve innervate?

4

What muscle does the medial plantar nerve travel deep to?

Abductor hallucis muscle

What does the medial plantar nerve branches into?

Three common plantar digital branches between digits 1-4 that divide into proper plantar digital nerves

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Plantar digital branch to great toe