Plantar Surface of the Foot PDF

Preview

Summary

Plantar Surface of the Foot...

Description

Plantar Surface of the Foot Bones of the Foot

Deep Fascia and Plantar Aponeurosis;  Deep Fascia: o Thick central portion o Weaker medially and laterally  Plantar Aponeurosis: o Superficial Ligament formed by central portion of deep fascia o Proximal attachment to Calcaneus o Divides into 5 bands distally – continuous with fibrous digital sheaths o Vertical intermuscular septae: o Medial, Central and Lateral compartments Compartment of the Foot;  Muscles of Dorsum of Foot o Extensor Digitorum Brevis o Extensor Hallucis Brevis

 Lateral Compartment o Muscles of the little toe: o Abductor Digiti Minimi o Flexor Digiti Minimi Brevis

 Central Compartment o Flexor Digitorum Brevis o Lumbricals and Quadratus plantae o Adductor Hallucis

 Medial Compartment o Muscles of the great toe: o Abductor Hallucis o Flexor Hallucis Brevis

 Interossei o Plantar and Dorsal interossei

Foot – Layer 1 – All Insert @ Medial Tubercle of Calcaneus;  Abductor Hallucis (1); o O - Medial Tubercle of Calcaneus; Flex. Retinaculum o I - Med. Base proximal Phalanx  Flexor Digitorum Brevis (2); o O - Medial Tubercle of Calcaneus o I - Middle Phalanges of lateral 4 toes  Abductor Digiti Minimi (3); o O - Med. and Lat. Tubercle of Calcaneus o I - Lat. Base proximal Phalanx

Foot – Layer 2;  Long flexor tendons to the toes: FDL and FHL  Lumbricals * o O - Tendons of FDL o I - Med. side of dorsal tendon expansion (wrap around)  Quadratus Plantae (QP) o O - Med. and Lat. surfaces of Calcaneus o I - Lateral side of FDL tendon

Foot – Layer 3;  Flexor Hallucis Brevis o O - Cuboid and Lat. Cuneiform o I - Both sides base Proximal Phalanx of Hallux  Adductor Hallucis o O - Transverse Head: Plantar ligament of MTPJoints o O - Oblique Head: Base metatarsals 2-4 o I - Lat. side base Proximal Phalanx of Hallux  Flexor Digiti Minimi Brevis* o O - Base 5th Metatarsal o I - Base Proximal Phalanx of 5th digit

Foot – Layer 4;  3x Plantar Interossei o O- Bases and Med. side of Metatarsals 3-5 (unipennate) o I - Med. side of proximal phalanx of 3rd -5th digit o A - PAD – Plantar Adduct  4x Dorsal Interossei  O - Adjacent sides of Metatarsals 1-5 (bipennate)  I - 1st on med. side proximal phalanx of 2nd digit  I - 2nd-4th on lat. side proximal phalanx of 2nd -4th digits  A - DAB – Dorsal ABduct

Plantar Nerves;  Terminal branches of Tibial nerve deep to flexor retinaculum  Enter foot deep to Abductor Hallucis  Medial Plantar Nerve (BLACK) - Between Abductor Hallucis and FDB  Lateral Plantar Nerve (BLUE): o Between Layers 1&2 o Deep and Superficial branches

o

Deep branch between Layers 3&4

Innervation of Muscles of Foot;  Medial Plantar Nerve: o Abductor Hallucis o Flexor digitorum brevis o 1st Lumbrical o Flexor hallucis brevis  Lateral Plantar Nerve: o All other muscles  S2, 3

Cutaneous Innervation of the Foot;

Plantar Arteries;  Terminal branches of Posterior Tibial artery deep to flexor retinaculum  Enter foot deep to Abductor Hallucis  Medial Plantar artery: o Muscles of hallux and overlying skin o Occasionally: Superficial Plantar Arch  Lateral Plantar artery: o Initially between Layers 1 and 2 o Deep Plantar Arch between Layers 3 and 4 – giving metatarsal aa. o Deep Plantar a. from Dorsalis Pedis o Plantar Metatarsal and Digital aa....