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Intrinsic Muscles of the Foot [Figure 11.21 and Table 11.9]

The small intrinsic muscles that move the toes originate on the bones of the tarsus and foot (Figure 11.21and Table 11.9). Some of the flexor muscles originate at the anterior border of the calcaneus; their muscle tone con-tributes to maintenance of the longitudinal arch of the foot.

As in the hand, the small interossei muscles (singular, interosseus) originate on the lateral and medial surfaces of the metatarsal bones. The four dorsal interossei muscles abduct the metatarsophalangeal joints of toes 3 and 4, while the three plantar interossei muscles adduct the metatarsophalangeal joints of toes 3–5.

Three intrinsic muscles of the foot move the great toe. The flexor hallucis brevis muscle flexes the great toe, while the adductor hallucis muscle adducts and the abductor hallucis muscle abducts the great toe.

Popliteus Semitendinosus

Semimembranosus

Popliteal fossa

Lateral head of gastrocnemius Gluteus maximus

Vastus lateralis covered by iliotibial tract

Biceps femoris, long head

Tendon of biceps femoris, short head

Medial head of gastrocnemius Adductor magnus

(d) Posterior view

(f) Origins and insertions, posterior view (e) Posterior view

Sartorius

Gracilis

Hamstrings

Hamstrings

Biceps femoris, short head

Biceps femoris, short head

Semimembranosus

Semimembranosus Adductor magnus

Semimembranosus Adductor

magnus

Semitendinosus

Semitendinosus

Biceps femoris, long head

Biceps femoris, long head

Adductor longus

Sartorius

Popliteus

Sartorius Rectus femoris

Psoas major Pectineus Iliacus

Vastus medialis

Vastus intermedius Vastus lateralis

Tensor fasciae latae

Origin Insertion

Figure 11.17 (continued)

Soleus Popliteus

Calcaneal tendon

Calcaneus Soleus Gastrocnemius, medial head

Gastrocnemius, lateral head

(a) Superficial muscles, posterior view

Tendon of biceps femoris Common fibular nerve

Gastrocnemius, lateral head Tendon of gracilis Tendon of semitendinosus

Gastrocnemius, medial head

Soleus Tendon of

semimembranosus

Tibial nerve

Fibularis longus

Flexor hallucis longus

Fibularis brevis

Calcaneus Calcaneal

tendon Flexor digitorum longus Tendon of tibialis posterior Gastrocnemius

(cut and removed)

(b) Posterior view Plantaris

Plantaris (cut)

Figure 11.18 Extrinsic Muscles That Move the Foot and Toes, Part I

(a) Superficial muscles of the posterior surface of the legs; these large muscles are primarily responsible for plantar flexion.

(b) Posterior view of a dissection of the superficial muscles of the right leg. (c) Posterior view of deeper muscles of the leg.

(d) A posterior view of the bones of the right leg and foot, showing the origins and insertions of selected muscles. For sectional views of the leg, see Figure 11.24c,d.

Tendon of fibularis longus

Tendon of fibularis brevis

Fibularis brevis

Head of fibula

Gastrocnemius,

medial head Gastrocnemius,

lateral head Plantaris

Soleus

Tibialis posterior Popliteus

Flexor digitorum longus

Flexor hallucis longus

Fibularis brevis

Calcaneal tendon (for gastrocnemius and soleus) Tibialis

posterior

Fibularis longus

Flexor hallucis longus

Flexor digitorum longus

(c) Deep muscles, posterior view (d) Origins and insertions, posterior view

Origin Insertion

Figure 11.18 (continued)

Inferior extensor retinaculum Superior extensor retinaculum Lateral malleolus

Tendon of extensor hallucis longus Extensor

digitorum longus Soleus

Tibialis anterior Lateral head of gastrocnemius Head of fibula

(b) Lateral view Tendon of

tibialis anterior

Abductor hallucis

Medial malleolus Calcaneal tendon

Inferior extensor retinaculum Superior extensor

retinaculum

Flexor retinaculum Soleus

Tibialis posterior Tibialis anterior Medial head of gastrocnemius Medial surface of tibial shaft Patellar ligament

Patella Iliotibial tract

(a) Medial view

Iliotibial tract

Patella

Head of fibula

Tibialis anterior

Superficial fibular nerve

Extensor digitorum longus

Lateral malleolus

Calcaneus

(c) Right lateral view, superficial muscles Inferior extensor retinaculum Calcaneal tendon Soleus Lateral head of gastrocnemius Patellar ligament Vastus lateralis

Biceps femoris, short head

Fibularis brevis Fibularis longus

Fibularis brevis Fibularis longus

Figure 11.19 Extrinsic Muscles That Move the Foot and Toes, Part II

(a) Medial view of the superficial muscles of the left leg. (b) Lateral view of the superficial muscles of the right leg. (c) Lateral view of a dissection of the superficial muscles of the right leg.

More intrinsic muscles participate in flexion of joints at the toes than participate in extension. The flexor digitorum brevis muscle, the quadratus plantae muscles, and the four lumbrical muscles are responsi-ble for flexion at joints of toes 2–5. The flexor digiti minimi brevis muscle is responsible for flexion of toe 5. Extension of the toes is accomplished by the extensor digitorum brevis muscle. This muscle assists the extensor hallucis longus muscle in extension of the great toe, and also assists the ex-tensor digitorum longus muscle (see Table 11.8) in extension of toes 2–4. It is the only intrinsic muscle found on the dorsum of the foot.

1. What leg movement would be impaired by injury to the obturator muscles?

2. Often one hears of athletes suffering a “pulled hamstring.” Describe the muscles in such an injury.

3. To which group of muscles do the pectineus and gracilis belong?

4. What is the collective name for the knee extensors?

See blue “Answers” tab at back of book.

Patella

Patellar ligament Tibial tuberosity

Tibia

Extensor digitorum longus

Extensor hallucis longus Tibialis anterior Fibularis

longus Patellar ligament

Medial condyle of femur Iliotibial tract Quadriceps tendon

Gastrocnemius

Soleus Vastus medialis

Vastus lateralis Sartorius Rectus femoris

(c) Anterior view (b) Origins and insertions,

anterior view Inferior extensor

retinaculum Lateral malleolus Superior extensor retinaculum

Extensor hallucis

longus Extensor digitorum longus

Tibia Tibialis anterior Fibularis longus Patella Iliotibial tract Patellar ligament

Tibial tuberosity

(a) Anterior view Fibula

Lateral malleolus Fibularis brevis Origin

Insertion SUPERFICIAL DEEP

Figure 11.20 Extrinsic Muscles That Move the Foot and Toes, Part III

(a) Anterior views showing superficial and deep muscles of the right leg. (b) Anterior view of the bones of the right leg, showing the origins and insertions of selected muscles. (c) Anterior view of a dissection of the superficial muscles of the right leg.

Fibularis brevis

Superior extensor retinaculum

Lateral malleolus of fibula

Inferior extensor retinaculum

Tendons of extensor digitorum longus

Dorsal interossei Tendons of extensor digitorum brevis

Medial malleolus of tibia

Tendon of tibialis anterior

Calcaneal tendon (for attachment of gastrocnemius and soleus)

Extensor digitorum brevis

Fibularis brevis

Dorsal interossei

Extensor digitorum brevis

Extensor digitorum longus

Extensor hallucis longus

Extensor hallucis brevis

Tendon of extensor hallucis longus Abductor hallucis

Extensor expansion Tendon of extensor hallucis brevis

Dorsal view Superior extensor

retinaculum Tendon of fibularis brevis

Lateral malleolus of fibula Inferior extensor retinaculum

Medial malleolus of tibia

Tendon of tibialis anterior

Extensor hallucis brevis

Tendon of extensor hallucis longus

Tendons of extensor digitorum brevis Tendons of extensor digitorum longus

Dorsal interossei

Abductor hallucis

Extensor expansion

Abductor hallucis Flexor digitorum brevis

Abductor digiti minimi Quadratus plantae Flexor hallucis brevis Flexor digiti minimi brevis Adductor hallucis Plantar interossei Abductor digiti minimi Flexor digitorum brevis Flexor digitorum longus

Flexor hallucis longus

Abductor hallucis and flexor hallucis brevis

Tibialis posterior Tibialis anterior Fibularis longus (a) Dorsal view

Plantar view (b) Origins and insertions

Tendon of extensor hallucis brevis

Origin Insertion

Figure 11.21 Intrinsic Muscles That Move the Foot and Toes

(a) Dorsal views of the right foot. (b) Dorsal (superior) and plantar (inferior) views of the bones of the right foot, showing the origins and insertions of selected muscles. (c) Right foot, sectional view through the metatarsal bones. (d) Plantar (inferior) view, superficial layer of the right foot. (e) Plantar (inferior) view, deep layer of the right foot. (f) Plantar (inferior) view, deepest layer of the right foot.

Tendon of

hallucis (cut and retracted) Tendon of tibialis

posterior

(e) Plantar view, deep layer (f) Plantar view, deepest layer

Tendon of flexor hallucis longus

Flexor digiti

minimi brevis Flexor digiti

minimi brevis

(d) Plantar view, superficial layer (c) Right foot, sectional view through the metatarsal bones

Tendon of

Tendon of flexor hallucis longus First metatarsal bone Tendons of flexor digitorum longus Abductor hallucis

Flexor hallucis brevis

Tendons of flexor digitorum brevis Tendons of extensor

digitorum longus

Tendons of extensor digitorum brevis tendons of flexor digitorum longus I

II III

IV V

Figure 11.21 (continued)

TABLE 11.9 Intrinsic Muscles of the Foot

Muscle Origin Insertion Action Innervation

Extensor digitorum brevis Calcaneus (superior and lateral surfaces)

Dorsal surface of toes 1–4 Extension at metatarsophalangeal joints of toes 1–4

Deep fibular nerve (S1, S2)

Abductor hallucis Calcaneus (tuberosity on inferior surface)

Medial side of proximal phalanx of great toe

Abduction at metatarsophalangeal joint of great toe

Medial plantar nerve (S2, S3)

Flexor digitorum brevis As above Sides of middle phalanges, toes 2–5

Flexion of proximal interphalangeal joints of toes 2–5

As above

Abductor digiti minimi As above Lateral side of proximal phalanx, toe 5

Abduction and flexion at metatarsophalangeal joint of toe 5

Lateral plantar nerve (S2, S3)

Quadratus plantae Calcaneus (medial, inferior surfaces)

Tendon of flexor digitorum longus

Flexion at joints of toes 2–5 As above

Lumbricals (4) Tendons of flexor digitorum longus

Insertions of extensor digitorum longus

Flexion at metatarsophalangeal joints; extension at interphalangeal joints of toes 2–5

Medial plantar nerve (1), lateral plantar nerve (2–4)

Flexor hallucis brevis Cuboid and lateral cuneiform

Proximal phalanx of great toe Flexion at metatarsophalangeal joint of great toe

Medial plantar nerve (L4–S5)

Adductor hallucis Bases of metatarsal bones II–IV and plantar ligaments

As above Adduction and flexion at

metatarsophalangeal joint of great toe

Lateral plantar nerve (S1–S2)

Flexor digiti minimi brevis Base of metatarsal bone V Lateral side of proximal phalanx of toe 5

Flexion at metatarsophalangeal joint of toe 5

As above

Dorsal interossei (4) Sides of metatarsal bones Medial and lateral sides of toe 2; lateral sides of toes 3 and 4

Abduction at metatarsophalangeal joints of toes 3 and 4; flexion of metatarsophalangeal joints and extension at the interphalangeal joints of toes 2 through 4

As above

Plantar interossei (3) Bases and medial sides of metatarsal bones

Medial sides of toes 3–5 Adduction of metatarsophalangeal joints of toes 3–5; flexion of metatarsophalangeal joints and extension at interphalangeal joints

As above

Fascia, Muscle Layers,

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