Sharpey Fibers - Attaches periosteum to bone
Coalitions - Intra-articular fusion of two bones
Bar - extra-articular fusion
Steida process - enlarge Os Trigonum
Only bone in foot without any muscle origin - Talus
What are the plantar muscle layers of the foot from superficial to deep?
1. Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
2. Quadratus plantae, 4 lumbricals
3. Flexor hallucis brevis, adductor hallucis, flexor digiti minimi
4. 3 plantar interossei, 4 dorsal interossei
What layer of the foot does FDL run?
2nd layer – it is the origin of the lumbricals and the insertion of QP
What deformity will result from cutting QP?
Digits 4 and 5 will become adductovarus
How is EDL attached to the proximal phalanxes?
Sling wraps around capsule which attaches to plantar plate, DTML, and flexor tendon sheath
thus attaching to plantar proximal phalanx. No direct insertion to proximal phalanx.
What is the origin and insertion of the capsularis tendon?
Origin – extensor hallucis longus muscle or tendon
Insertion – first metatarsophalangeal joint capsule
What is the Master Knot of Henry?
Fibrous connection between FHL and FDL tendons
What structures attach to the fibular sesamoid?
Plantar metatarsal-phalangeal ligament
Lateral metatarsal-sesamoidal ligament
Are the sesamoids capsular or extra-capsular?
What is the Lisfranc ligament?
Attaches lateral aspect of medial cuneiform to medial base of 2nd metatarsal
What structures in the Lisfranc joint are not connected by ligaments?
1st and 2nd metatarsals
What is the spring ligament?
Plantar calcaneonavicular ligament
What ligaments compose the bifurcate ligament?
Dorsal calcaneonavicular and calcaneocuboid ligaments
Which is stronger – the lateral ankle ligaments or the deltoid ligament?
What are the components of the deltoid ligament?
Superficial – tibionavicular, tibiocalcaneal, posterior tibiotalar
Deep – anterior tibiotalar
What tendons pass over the deltoid ligament?
Tibialis posterior and FDL
What are the lateral ankle ligaments?
Anterior talofibular, calcaneofibular, posterior talofibular
What angle do the ATFL and CFL create?
What is the strongest lateral ankle ligament?
Which ankle ligaments are extra-capsular? Which are capsular?
Calcaneofibular ligament is extra-capsular, all others are capsular
What tendons pass over the lateral ankle ligaments?
Peroneus brevis and longus
What ligaments support the ankle syndesmosis?
Anterior-inferior tibiofibular ligament
Posterior-inferior tibiofibular ligament
Interosseous tibiofibular ligament
What is the Bassett ligament?
Anterior-inferior tibiofibular ligament
What is another name for the flexor retinaculum?
What is another name for the superior extensor retinaculum?
Transverse crural ligament
What is another name for the inferior extensor retinaculum?
Cruciate crural ligament
Where does plantaris insert?
Medial aspect of tendo-Achilles into the calcaneus
What is the incidence of peroneus quartus?
What is the Hoke tonsil?
Fibrous, fatty plug within the sinus tarsi
What is pes anserinus?
Insertion of sartorius, gracilis, and semitendinosus (anteromedial aspect of proximal tibia) where
bursa may cause knee pain (pes anserinus bursitis)
What is a Bakers cyst?
Swelling of the bursa between the tendons of the medial head of the gastrocnemius and the
What is a fabella?
Sesamoid bone occasionally found in tendon of lateral head of gastrocnemius
What nerves form the sural nerve?
Medial sural cutaneous nerve – branch of the tibial nerve
Sural communicating branch – branch of the lateral sural cutaneous nerve, which originates from
the common peroneal nerve
Does a neuroma lie dorsal or plantar to the deep transverse intermetatarsal ligament?
Where do these muscles run in relation to the deep transverse intermetatarsal ligament?
Interossei – dorsal
Lumbricals – plantar
What layers of the foot do the plantar nerves run?
Medial plantar nerve – in the 1st layer (between FDB and abductor hallucis)
Lateral plantar nerve – between the 1st and 2nd
What is the innervation to the plantar muscles of the foot? Blood supply?
(Never LAFF at A FAD)
N – medial plantar Nerve
L – 1st Lumbrical
A – ABH
F – FHB
F – FDB (innervated by both medial and lateral plantar nerves)
A – medial plantar Artery
F – FDB
A – ABH
D – 1st Dorsal interossei
What are the branches of the femoral nerve?
Nerve to femoral artery
Small muscular branch to pectineus
Anterior division (cutaneous)
Posterior division (muscular)
What are the branches of the femoral artery?
Superficial epigastric artery
Superficial circumflex iliac artery
Superficial external pudendal artery
Deep femoral (profunda femoris) artery
Medial femoral circumflex artery
Lateral femoral circumflex artery
Descending genicular artery
Femoral artery continues as the popliteal artery
Trace the path of a drop of blood from left ventricle to the hallux
Ascending aorta → aortic arch → descending aorta → thoracic aorta → abdominal aorta →
common iliac artery → external iliac artery → femoral artery → deep femoral artery →
popliteal artery → anterior tibial artery → dorsalis pedis → 1st dorsal metatarsal artery →
1st dorsal common digital artery → 1st dorsal proper digital artery
What are the sources of blood supply to the talus?
Essentially the 3 major blood supplies to the foot
What are the sources of blood supply to tendons?
Myotendinous junction, paratenon, and at the insertion to bone