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United States (324,189)
PT 5131 (30)
L Day (25)
Lecture

Foot.docx

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Department
Physical Therapy
Course
PT 5131
Professor
L Day
Semester
Spring

Description
Foot (Overview) Parts of Foot and Retinacula • 3 major portions break up the foot o Hindfoot  Talus  Calcaneus o Midfoot  Navicular  Cuboid  Cuneiforms o Forefoot  Metatarsals  Phalanges • Retinacula: thickening in fascia o Superior Fibular Retinaculum o Inferior Fibular Retinaculum o Superior Extensor Retinaculum o Inferior Extensor Retinaculum o Flexor Retinaculum: convers “Tarsal Tunnel”  Tarsal Tunnel: found behind medial malleolus • Bordered by Flexor Retinaculum, Talus, Navicular, Sustentaculum Tali, and Calcaneus • Contains: o Posterior Tibialis Tendon o Flexor Digitorum Longus Tendon o Posterior Tibial Artery o Tibial Nerve o Flexor Hallucis Longus Tendon • Tarsal Tunnel Syndrome: any of the above tendons becoming inflamed and entrapping the Tibial Nerve o Can also entrap the Lateral Plantar Nerve, which divides off of Tibial Nerve just as it comes out of tarsal tunnel Foot • Dorsal o Loose fascia over it that allows for expansion for edema o Innervated by the Deep Peroneal Nerve (L5-S1) o Supplied by the Dorsalis Pedis Artery, which is a continuation of the Anterior Tibial Artery • Plantar o Broken into subcompartments by intermuscular septums  Medial Compartment  Central Compartment  Lateral Compartment  Interosseus Compartment: only seen in portion under metatarsals  Subcompartments innervated by either the Medial Plantar Nerve (S2-S3) or the Lateral Plantar Nerve (S2-S3), which are branches off of the Tibial Nerve.  Subcompartments are supplied by the Medial Plantar Artery and the Lateral Plantar Artery, which are branches off of the Posterior Tibial Artery. Plantar Surface (Superficial) • Fat Pad: responsible for absorbing shock o If shoes not fitted properly, and we put weight from calcaneus onto ground, calcaneus will push fat pad sideways  Means fat pad is not absorbing shock, and instead the force is transmitted up the calcaneus to the calcaneal tendon • Can cause Achilles’ Bursitis/Tendonitis • Plantar Fascia: located deep to Fat Pads o Plantar Aponeurosis: increased amount of collagen fibers in the middle of the Plantar Fascia  PA: Calcaneus  DA: base of all 5 digits (proximal phalynx)  Reinforced by Superficial Transverse Metatarsal Ligament  3 Functions 1. Protection 2. Windlass Mechanism (useful during gait) 3. Reinforce Arch  Medial Calcaneal Nerve: branch of Tibial Nerve that runs over calcaneus  Medial Calcaneal Artery: branch of Posterior Tibial Artery that runs over calcaneus Arterial Arches and Anastomosis • Anterior Tibial Artery: comes down in middle of dorsum of foot o Changes name to Dorsal Artery of Foot (Dorsalis Pedis) once it crosses the Malleolar Line  Branches into Lateral Tarsal Artery: runs in oblique angle to side of foot o Arcuate Artery: anastomosis of Dorsalis Pedis and Lateral Tarsal Artery  Branches into small branches that anastomosis with blood supply on sole of foot • Deep Plantar Artery: sits between 1 and 2 digit • Digital Arteries: branch off of Arcuate Artery and supply digits of foot • Posterior Tibial Artery: passes behind medial malleolus and travels to sole of foot o Branches into  Lateral Plantar Artery: larger  Medial Plantar Artery o Deep Plantar Arch: anastomosis of Lateral Plantar Artery and Medial Plantar Artery  Has connections to Arcuate Artery Cutaneous Innervation • Dorsum of Foot o
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