심층의 발 내재근 - 6개의 근육

[문형철]

deep intrinsic foot muscle

Quadratus Plantae and Lumbricals, Flexor Hallucis Brevis, Adductor Hallucis, Flexor Digiti Minimi Brevis, and Interossei

 트라벨 선생님 왈  독사의 둥지(Vipers' Nest)

발 내재근 운동법 "short foot exercise"

panic bird..

1. 족척 방형근 Quadratus Plantae 

The quadratus plantæ (flexor accessorius) is separated from the muscles of the first layer by the lateral plantar vessels and nerve. It acts to aid in flexing the 2nd to 5th toes (offsetting the oblique pull of the flexor digitorum longus) and is one of the few muscles in the foot with no homolog in the hand.

Origin and insertion[edit]

It arises by two heads, which are separated from each other by the long plantar ligament: the medial or larger head is muscular, and is attached to the medial concave surface of the calcaneus, below the groove which lodges the tendon of the flexor hallucis longus; the lateral head, flat and tendinous, arises from the lateral border of the inferior surface of the calcaneus, in front of the lateral process of its tuberosity, and from the long plantar ligament.

The two portions join at an acute angle, and end in a flattened band which is inserted into the lateral margin and upper and under surfaces of the tendon of the flexor digitorum longus, forming a kind of groove, in which the tendon is lodged. It usually sends slips to those tendons of the Flexor digitorum longus which pass to the second, third, and fourth toes.

Variations
[edit]

Lateral head often wanting; entire muscle absent. Variation in the number of digital tendons to which fibers can be traced. Most frequent offsets are sent to the second, third and fourth toes; in many cases to the fifth as well; occasionally to two toes only.

족척 방형근 Trp

2. 발의 충양근(Lumbricals)

The lumbricals are four small skeletal muscles, accessory to the tendons of the flexor digitorum longus and numbered from the medial side of the foot; they arise from these tendons, as far back as their angles of division, each springing from two tendons, except the first.

The muscles end in tendons, which pass forward on the medial sides of the four lesser toes, and are inserted into the expansions of the tendons of the Extensor digitorum longus on the dorsal surfaces of the proximal phalanges. All four lumbricals insert into extensor hoods of the phalanges, thus creating extension at the inter-phalangeal (PIP and DIP) joints. However as the tendons also pass inferior to the metatarsal phalangeal (MTP) joints it creates flexion at this joint.

Variations[edit]

Absence of one or more; doubling of the third or fourth even the fifth. Insertion partly or wholly into the first phalanges.

Innervation
[edit]

The most medial lumbrical is innervated by the medial plantar nerve while the remaining three lumbricals are supplied by the lateral plantar nerve.

3. 단무지 굴근(Flexor Hallucis Brevis)

The Flexor hallucis brevis arises, by a pointed tendinous process, from the medial part of the under surface of the cuboid bone, from the contiguous portion of the third cuneiform, and from the prolongation of the tendon of the Tibialis posterior which is attached to that bone.

단무지굴근은 cuboid bone바닥면 내측, cuneiform bone 외측, 후경골근의 힘줄 연장선에서 기시

Structure[edit]

It divides in front into two portions, which are inserted into the medial and lateral sides of the base of the first phalanx of the great toe, a sesamoid bone being present in each tendon at its insertion.

The medial portion is blended with the Abductor hallucis previous to its insertion; the lateral portion with the Adductor hallucis; the tendon of the Flexor hallucis longuslies in a groove between them; the lateral portion is sometimes described as the first Interosseous plantaris.

Innervation[edit]

Flexor hallucis brevis is innervated by the medial plantar nerve.

Variation[edit]

Origin subject to considerable variation; it often receives fibers from the calcaneus or long plantar ligament. Attachment to the cuboid sometimes wanting. Slip to first phalanx of the second toe.

4. 무지내전근 Adductor Hallucis

The Adductor hallucis (Adductor obliquus hallucis) arises by two heads—oblique and transverse and is responsible for adducting the big toe. It has two heads, both are innervated by the lateral plantar nerve.

It evolved from the contrahens I muscle as Man's ancestors' thumbs and big toes became opposable.

Structure[edit]

Oblique head[edit]

The oblique head is a large, thick, fleshy mass, crossing the foot obliquely and occupying the hollow space under the first, second, third and fourth metatarsal bones.

It arises from the bases of the second, third, and fourth metatarsal bones, and from the sheath of the tendon of the Peronæus longus, and is inserted, together with the lateral portion of the Flexor hallucis brevis, into the lateral side of the base of the first phalanx of the great toe.

Transverse head[edit]

The transverse head (Transversus pedis) is a narrow, flat fasciculus which arises from the plantar metatarsophalangeal ligaments of the third, fourth, and fifth toes (sometimes only from the third and fourth), and from the transverse ligament of the metatarsus.

It is inserted into the lateral side of the base of the first phalanx of the great toe, its fibers blending with the tendon of insertion of the oblique head.

Variation
[edit]

Slips to the base of the first phalanx of the second toe. Opponens hallucis, occasional slips from the adductor to the metatarsal bone of the great toe.

무지굴근과 무지내전근 Trp

5. 발의 단소지굴근 Flexor Digiti Minimi brevis

The Flexor digiti minimi brevis (Flexor brevis minimi digiti, Flexor digiti quinti brevis) lies under the metatarsal bone on the little toe, and resembles one of theInterossei.

It arises from the base of the fifth metatarsal bone, and from the sheath of the Fibularis longus; its tendon is inserted into the lateral side of the base of the first phalanxof the fifth toe.

Occasionally a few of the deeper fibers are inserted into the lateral part of the distal half of the fifth metatarsal bone; these are described by some as a distinct muscle, the Opponens digiti quinti.

6. 골간근 Interossei

1) dorsal interossei muscle

In human anatomy, the dorsal interossei of the foot are four muscles situated between the metatarsal bones.

Origin[edit]

The four interossei muscles are bipenniform muscles each originating by two heads from the proximal half of the sides of adjacent metatarsal bones. ^[1]

Insertion[edit]

The two heads of each muscle form a central tendon which passes forwards deep to the deep transverse metatarsal ligament.^[1] The tendons are inserted on the bases of the second, third, and fourth proximal phalanges^[2] and into the aponeurosis of the tendons of the extensor digitorum longus^[3] without attaching to the extensor hoods of the toes.^[1]

Thus, the first is inserted into the medial side of the second toe; the other three are inserted into the lateral sides of the second, third, and fourth toes.^[3]

Action[edit]

The dorsal interossei abducts at the metatarsophalangeal joints of the third and fourth toes. Because there is a pair of dorsal interossei muscles attached on both sides of the second toe, contraction of these muscles results in no movement (i.e. the midline of the hand is in the third finger, but the midline of the foot is in the second toe). ^[2]

Abduction is of little importance in the foot, but, together with the plantar interossei, the dorsal interossei also produce flexion at the metatarsophalangeal joints. Also small, the dorsal interossei are powerful muscles that, together with their plantar counterparts, controls the direction of the toes during violent activity, and thus allowing the long and short flexors to perform their actions. ^[1]

Because of the relationship to the metatarsophalangeal joints, the interossei muscles also contributes to maintaining the anterior metatarsal arch of the foot and also, to a limited extent, to the medial and lateral longitudinal arches of the foot. ^[1]

Innervation[edit]

All dorsal interossei are innervated by the lateral plantar nerve (S2–3). Those in the fourth interosseous space are innervated by the superficial branch and the other by the deep branch. ^[1]

Relations
[edit]

In the angular interval left between the heads of each of the three lateral muscles, one of the perforating arteries passes to the dorsum of the foot; through the space between the heads of the first muscle the deep plantar branch of the dorsalis pedis artery enters the sole of the foot. ^[3]

2)  plantar interossei muscle

In human anatomy, the plantar interossei of the foot are three muscles located between the metatarsal bones.

Structure[edit]

The three plantar interosseous muscles are unipennate^{[clarification needed]} and originate on a single metatarsal bone. The three muscles originate on the medial aspect of metatarsals III-V. The muscles cross the metatarsophalangeal joint of toes III-V so the insertions correspond with the origin and there is no crossing between toes.^[1]

The muscles then continue distally along the foot and insert in the proximal phalanges III-V. The muscles cross the metatarsophalangeal joint of toes III-V so the insertions correspond with the origin and there is no crossing between toes.^[1]

Innervation[edit]

All of three interosseous muscles are innervated by the lateral plantar nerve. The lateral plantar nerve is a branch from the tibial nerve, which originally branches off of the sciatic nerve from the sacral plexus.^[1]

Function[edit]

Since the intersseous muscles cross on the metatarsophalangeal joint, then they act on that specific joint and cause adduction of toes III, IV, and V.^[1]

Adduction itself isn't of extreme importance to the toes, but the these muscles work together with the dorsal interosseous muscles in flexion of the foot. They also work together to strengthen the metatarsal arch.^[2]

골간근 Trp 탐구

Training Janda's Short Foot

 

[heoss]

감사합니다.

[혀기]

감사합니다.

[김종현]

지간신경종 환자가 한분 있어서 뭘 해드릴수 있을까 했는데, 운동법을 알려드릴 수 있게 되었습니다. 감사합니다^^
(약침은 한번 썼는데 너무 아파하셔서 두번다시는 놓을 수가 없을 것 같습니다. ㅠㅠ)

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[김영환PT]

좋은자료 감사드립니다ㅎㅎ~~^^

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발의 심층 내재근. 감사합니다!