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Trace a general somatic afferent impulse between the appropriate regions of the spinal cord lateral side of the 1st digit. Indicate the start and end points.
Starting point: lateral side of first digit / deep fibular nerve / common fibular nerve / sciatic nerve / anterior rami of L4-S2 / spinal nerves of L4-S2 / posterior roots of L4-S2 / posterior while columns (L4-S2) / posterior grey horns (L4-S2)
List the tarsal bones and state whether they participate in the medial arch (MA), lateral arch (LA), transverse arch (TA), or none of the above.
- Talus: MA
- Calcaneus: MA, LA
- Navicular: MA
- Cuboid: LA, TA
- Medial cuneiform: MA, TA
- lateral cuneiform: MA, TA
- intermediate cuneiform: MA, TA
State which muscles support each arch of the foot and which arch each supports.
- Tibialis anterior: medial arch
- Tibialis posterior: medial arch
- Fibularis longus: lateral arch & transverse arch
Which bone is the keystone of the medial longitudinal arch?
Which joint is described below:
(minimally) supported by:
anterior tibiotalar ligament
posterior talofibular ligament
The tibiotalar joint
What is wrong with the following statement?
The patient was unable to invert the ankle at the tibiotalar joint, indicating a ligament tear on the medial side.
Inversion does not occur at the tibiotalar joint. It occurs at the intertarsal joints.
List the parts of the deltoid ligament (AKA medial collateral ligament of the ankle)
- Tibionavicular part
- tibiocalcaneal part
- posterior tibiotalar part
- anterior tibiotalar part
Which joints make up the transverse tarsal joint?
Calcaneocuboid joint and talocalcaneonavicular joint
Which of the four intertarsal joints we studied receives the body's mass during mid-stance and terminal stance of the walking gait?
which structures pass through the tarsal tunnel?
- Tibialis posterior
- flexor digitorum longus
- flexor hallucis longus
- tibial nerve
- posterior tibial artery
- posterior tibial vein
True or False: The deep fibular nerve contributes to the innervation of the intrinsic plantar muscles in the foot. Explain your answer.
True, Deep fibular nerve innervates extensor digitorum brevis and the 1st and 2nd dorsal interossei muscles. The latter are in the plantar aspect of the foot.
True or False: fibularis longus and fibularis brevis pass deep to the flexor retinaculum and posterior to the lateral malleolus.
False: they pass deep to the superior and inferior fibular retinacula.
True or false: the lateral plantar nerve participates in the innervation of all of the muscles in the sole of the foot.
False: the medial plantar nerve supplies four (or three and a portion) muscles in the sole of the foot (abductor hallucis, flexor digitorum brevis, flexor hallucis brevis and the 1st lumbrical)
Trace the path of the arcuate artery back to the abdominal aorta and give the relevant landmarks for along the path.
Arcuate artery / dorsalis pedis (becomes DP as it crosses anterior to the ankle) / anterior tibial artery (passes through superior aperture of the interosseous membrane) / popliteal artery (becomes popliteal after passing through the adductor hiatus, travels through popliteal fossa and bifurcates close to inferior margin of popliteus muscle) / femoral artery (passes deep to inguinal ligament to enter anterior thigh, travels within femoral sheath within femoral triangle and continues into adductor canal) external iliac artery / common iliac artery (bifurcates at SI joint) abdominal aorta (bifurcates at L4)
Describe the function of abductor hallucis as a function of its origin, insertion, placement and path in the body.
Abductor hallucis is an intrinsic muscle of the foot in the 1st layer of the foot. It originates on the medial process of the calcaneal tuberosity and runs along the medial inferior border of the foot. The muscle belly fibers transition to tendon around the base of the 1st MT and the tendon inserts onto the medial side of the base of the 1st proximal phalanx. Because it runs on the medial plantar surface of the foot and across the MTP joint it can abduct the 1st digit at the MTP joint: contraction of the fibers will pull posteriorly and medially at the base of the 1st MTP, inducing abduction. It can flex the first digit at the MTP joint because it also runs somewhat inferiorly and across the 1st MTP joint. This is primarily a flexor muscle despite its name.
With which tendon are the muscles of the second layer of the foot intimately associated?
the tendon of flexor digitorum longus
Through which toe doe the axis around which the toes abduct and adduct run?
The 2nd toe
list all of the muscles in the lower limb that flex ANY of the pedal digits at the MTP joint or the IP joints.
- flexor digitorum longus
- flexor hallucis longus
- flexor digitorum brevis
- abductor hallucis
- abductor digiti minimi
- Quadratus plantae
- the lumbircals
- flexor digiti minimi
- flexor hallucis brevis
- dorsal interossei
- plantar interossei
In which position is the ankle joint the most stable?
What are the primary spinal levels of the muscles of the 1st layer of the foot?
S1, S2, S3
If your tibial nerve failed to function, would you be able to extend your toes? Explain your response.
Yes because the muscles in the anterior compartment of the leg and on the dorsal surface of the foot are responsible for toe extension and they are innervated by the deep fibular nerve. But you'd still have major problems other than toe extension.
Do any of the intrinsic muscles of the foot run under the superior extensor retinaculum?
No, it is located superior to the ankle joint making the intrinsic muscles inferior to the superior extensor retinaculum.
On which bone is the sustentaculum tali found?
A patient presents with loss of sensation on a small portion of the skin between the 1st and 2nd digits on the dorum of the foot. Which nerve may be compromised?
The deep fibular nerve.
Which ligament functions in part to functionally unite the digits so that they (can) act as a single unit? Describe how it does so.
The deep transverse ligament. It travels along the plantar aspect of the foot uniting the joint capsules of the MTP joints and therefore functionally uniting the digits.