Foot and Ankle Muscular Anatomy

Dorsiflexors

Tibialis Anterior Origin Insertion Action Nerve Supply Palpation Upper two thirds of the lateral surface of the tibia and the adjoining part of the interosseous membrane Insertion Medial side of the medial cuneiform and base of the first metatarsal Action Ankle DorsiFlexion, Foot Inversion Nerve Supply Deep peroneal nerve Palpation Resist dorsiFlexion. Tendon can be palpated medial to ankle joint

Peroneus Tertius Origin Insertion Action Nerve Supply Palpation Front of the lower quarter of the fibula Insertion Medial and dorsal aspect of the base of the fifth metatarsal Action Ankle DorsiFlexion, Foot Eversion Nerve Supply Deep peroneal nerve Palpation Resist dorsiFlexion and Eversion. Palpation from medial aspect of base of 5th metatarsal. Tendon is lateral to the extensor digitorum longus tendon

Extensor Digitorum Longus Origin Upper 2/3 of the anterior surface of the fibula; upper part of the interosseous membrane and the lateral condyle of the tibia Insertion Splits into 4 tendons. Attaches onto the base of the middle and distal phalanx via the extensor hood of the 2nd,3rd,4th and 5th digits Action Extension of lateral 4 toes, Ankle DorsiFlexion Nerve Supply Deep peroneal nerve Palpation Palpate approximately 2 cm inferior and medial from fibula head. Resist toe Extension

Extensor Hallucis Longus Origin Middle half of the anterior surface of the fibula and the adjacent interosseous membrane Insertion Base of distal phalanx on its dorsal surface Action Extension of all the joints of the great toe, Ankle DorsiFlexion Nerve Supply Deep peroneal nerve Palpation Palpate tendon with great toe extended. Follow superiorly and slightly laterally for approx. 12 cm past the ankle joint. Rhythmical Extension and Flexion of the great toe aids palpation

Plantarflexors

Gastrocnemius Origin Insertion Action Nerve Supply Palpation Medial supracondylar ridge and adductor tubercle of the medial femur. Lateral condyle femur. Posterior capsule of the knee from oblique popliteal ligament Insertion Middle Part of the posterior surface of the calcaneus Action Ankle Plantarflexion, Knee Flexion. Nerve Supply Tibial Nerve Palpation  

Middle part of the posterior surface of the calcaneus Soleus Origin Soleal line on the posterior surface of the tibia, the posterior surface of the upper third of the fibula Insertion Middle part of the posterior surface of the calcaneus Action Ankle Plantarflexion Nerve Supply Tibial Nerve Palpation Lateral border can be palpated lateral and inferior to lateral head of gastroc when ankle plantarflexed

Ankle Plantarflexion, Ankle Plantarflexion Plantaris Origin Lowest part of the lateral supracondylar ridge, the popliteal surface of the femoral and the knee joint capsule Insertion Medial aspect of the tendocalcaneus or posterior medial surface of the calcaneus Action Ankle Plantarflexion, Ankle Plantarflexion Nerve Supply Tibial Nerve Palpation Prone with knee Flexion 90. Hand over heel and forearm over the plantar aspect of the foot. Resist Plantarflexion and knee Flexion. Palpate medial and superior to the lateral head of gastrocnemius in the popliteal fossa

Peroneus Longus Origin Insertion Action Nerve Supply Palpation Lateral condyle of the tibia, upper 2.3 of the lateral surface of the fibula and the lateral side of the fibula head Insertion Plantar and lateral surfaces of the medial cuneiform and base of the first metatarsal Action Foot Eversion, Ankle Plantarflexion Nerve Supply Superficial peroneal nerve Palpation Palpate distal to the fibula head while resisting ankle Eversion

Peroneus Brevis Origin Insertion Action Nerve Supply Palpation Lower two thirds of the lateral surface of the fibula Insertion Tubercle on the lateral side of the base of the 5th metatarsal Action Foot Eversion, Ankle Plantarflexion Nerve Supply Peroneal Nerve Palpation Superior to the tendon of peroneus longus anterior the lateral malleolus

Foot Inversion, Ankle Plantarflexion, Tibialis Posterior Origin Upper half of the lateral aspect of the posterior surface of the tibia, the interosseous membrane and the posterior surface of the tibula Insertion Tubercle on the medial side of the navicular and the plantar surface of the medial cuneiform Action Foot Inversion, Ankle Plantarflexion, Nerve Supply Tibial nerve Palpation Resist Inversion of the plantarflexed foot. The tendon can palpated and seen behind the medial malleolus and attachment onto the navicular

Flexor Digitorum Longus Origin Medial part of the posterior surface of the tibia Insertion Plantar surface of the base of the distal phalanx of the 2nd, 3rd, 4th, 5th digits Action Flexion of the lateral 4 toes, Ankle Plantarflexion Nerve Supply Tibial nerve Palpation Inferior to the tibialis posterior tendon underneath the sustentaculum tali. Resist toe Flexion for confirmation

Flexor Hallucis Longus Origin Lower 2/3 of the posterior surface of the fibula Insertion Plantar surface of the base of the distal phalanx Action Great Toe Flexion, Ankle Plantarflexion Nerve Supply Tibial nerve Palpation N/A

Toe Extension

Extensor Digitorum Brevis Origin Anterior roughened part of the upper surface of the calcaneus Insertion Dorsal aspect of the base of the proximal phalanx of the great toe. Lateral side of the extensor hood of the 2nd, 3rd and 4th toes Action Great Toe and Toe Extension Nerve Supply Deep peroneal nerve Palpation With the toes extended palpation lateral and deep to the tendons of extensor digitorum longus

Lumbricals Origin Insertion Action Nerve Supply Palpation Medial and adjacent tendon of flexor digitorum longus Insertion Medial side of the extensor hood and base of the proximal phalanx of 2nd, 3rd, 4th, 5th digits Action Metatarsophalangeal Flexion, Interphalangeal Extension Nerve Supply Medial and Lateral plantar nerve Palpation N/A

Toe Flexion

Flexor Hallucis Brevis Origin Medial side of the plantar surface of the cuboid and the adjacent surface of the lateral cuneiform Insertion Base of the proximal phalanx of the great toe Action Flexion of the metatarsophalangeal joint Nerve Supply Medial plantar nerve Palpation N/A

Flexor Digitorum Brevis Origin Medial tubercle of the calcaneus Insertion Side of the base of the middle phalanx of the 2nd, 3rd, 4th and 5th digits Action Proximal interphalangeal Flexion, Metatarsophalangeal Flexion Nerve Supply Medial Planatar Nerve Palpation N/A

Flexor Digiti Minimi Brevis Origin Plantar aspect of the base of the 5th metatarsal Insertion Lateral side of the plantar surface of the proximal phalanx of the 5th digit Action 5th Metatarsophalageal joint Flexion Nerve Supply Lateral Plantar Nerve Palpation Deep palpation of the lateral plantar aspect during little toe Flexion

Dorsal Interossei Origin Insertion Action Nerve Supply Palpation Proximal half of the side of adjacent metatarsals Insertion Side of the proximal phalanx Action Metatarsophalanheal Flexion, Toe abduction Nerve Supply Lateral Plantar Nerve Palpation Place the fingers inbetween the proximal aspect of the metatarsal dorsally. Abduct the toes

Plantar Interossei Origin Insertion Action Nerve Supply Palpation Plantar and medial aspect of the base and proximal end of the shaft of the metatarsals Insertion Medial side of the base of the proximal phalanx of the same toe Action Metatarsophalangeal Flexion, Toe adduction Nerve Supply Lateral plantar nerve Palpation NA

Flexor Accessorius (Quadratus Plantae) Origin Medial and lateral tubercles of the calcaneus Insertion Tendon of flexor digitorum Action Pulls on the tendon of flexor digitorum to flex the toes towards the heel rather than towards the medial malleolus Nerve Supply Lateral Plantar Nerve Palpation NA

Toe Abduction

Abductor Digit Minimi Origin Insertion Action Nerve Supply Palpation Medial and lateral tubercles of the calcaneus Insertion Lateral side of the base of the proximal phalanx of the 5th toe Action Abduction of 5th toe, Metatarsophalangeal joint Flexion Nerve Supply Lateral Plantar Nerve Palpation NA

Toe Adduction

Adductor Hallucis Origin Insertion Action Nerve Supply Palpation Oblique: Plantar surface of the bases of the 2nd, 3rd, 4th metatarsals Transverse: Plantar surface of the lateral 3 metatarsophalanheal joints Insertion Lateral side of the base of the proximal phalanx of the great toe Action Great Toe adduction, 1st Metatarsophalangeal Joint Flexion Nerve Supply Lateral Plantar Nerve Palpation NA

Ankle Dorsiflexors Tibialis Anterior Peroneus Tertius Extensor Digitorum Longus Extensor Hallucis Longus

Ankle Plantflexors Gastrocnemius Soleus Peroneus Longus Peroneus Brevis Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus

Ankle Inversion Tibialis Anterior Tibialis Posterior Flexor Digitorum Longus Flexor Hallucis Longus Extensor Hallucis Longus

Ankle Eversion Peroneus Longus Peroneus Brevis Peroneus Tertius

Flexion of Toes Flexor Digitorum Longus Flexor Hallucis Longus Flexor Digitorum Brevis Flexor Hallucis Brevis Flexor Accessorius Interossei Flexor Digiti Minimi Brevis Lumbricals

Extension of Toes Extensor Digitorum Longus Extensor Hallucis Longus Extensor Digitorum Brevis Lumbricals

Abductor Digiti Minimi Abduction of Toes Abductor Hallucis Abductor Digiti Minimi Dorsal Interossei

Adduction of Toes Adductor Hallucis Plantar Interossei