Dorsal Interossei of the Foot: Difference between revisions
No edit summary |
No edit summary |
||
| Line 4: | Line 4: | ||
</div> | </div> | ||
== Description == | == Description == | ||
The dorsal interossei muscles are a group of four bicephalic muscles that fill the space between the metatarsal bones of the [[Foot and Ankle Structure and Function|foot]]. Their function lies in spreading the toes apart and in flexing the metatarsophalangeal joints of the second to fifth toe. [[File:Mm. interossei dorsales pedis.png|thumb|499x499px|Mm. interossei dorsales pedis <ref>Gray | The dorsal interossei muscles are a group of four bicephalic muscles that fill the space between the metatarsal bones of the [[Foot and Ankle Structure and Function|foot]]. Their function lies in spreading the toes apart and in flexing the metatarsophalangeal joints of the second to fifth toe. [[File:Mm. interossei dorsales pedis.png|thumb|499x499px|Mm. interossei dorsales pedis <ref name=":1">Gray H. Anatomy of the human body, by Henry Gray, thoroughly rev. and re-edited by Warren H. Lewis. Philadelphia: Lea & Febiger, 1918.</ref>]] | ||
=== Origin === | === Origin === | ||
The interossei dorsales pedis originate on the base of the metatarsal bones I-V<ref name=": | The interossei dorsales pedis originate on the base of the metatarsal bones I-V<ref name=":2">Putz R, Pabst R. Atlas der Anatomie des Menschen Limitierte Jubiläumsausgabe: der komplette Atlas in einem Band. 21. Aufl. München: Urban & Fischer, 2004</ref>. With two heads each, they emenate from the two adjacent bone sides facing each other and integrate into one insertion. Parts of of the Mm. interossei dorsales pedis originate from the Lig. plantare longum which is situated on the bottom side of the foot. | ||
They are part of the deep central forefoot compartment<ref>Faymonville | They are part of the deep central forefoot compartment<ref name=":3">Faymonville C, Andermahr J, Seidel U, Müller LP, Skouras E, Eysel P, Stein G. Compartments of the foot: topographic anatomy. Surgical and radiologic anatomy 2012;34(10):929-933.</ref>, also described as the forth layer <ref name=":4">Teach Me Anatomy Series. Muscles of the foot. Available from: https://teachmeanatomy.info/lower-limb/muscles/foot/ (last accessed: 22.09.2020).</ref>. | ||
=== Insertion === | === Insertion === | ||
The musculus (M.) interosseus dorsalis I inserts on the medial side of the base of the second toe's phalanx proximalis<ref name=": | The musculus (M.) interosseus dorsalis I inserts on the medial side of the base of the second toe's phalanx proximalis<ref name=":2" />. | ||
The musculi (Mm.) interossei dorsales II-IV insert on the lateral side of the base of phalanges proximales II-IV<ref name=": | The musculi (Mm.) interossei dorsales II-IV insert on the lateral side of the base of phalanges proximales II-IV<ref name=":2" />. | ||
=== Nerve === | === Nerve === | ||
Innervation comes from the nervus plantaris lateralis (S2-S3); in rare cases also from the nervus tibialis. <ref name=": | Innervation comes from the nervus plantaris lateralis (S2-S3); in rare cases also from the nervus tibialis. <ref name=":2" /> | ||
== Function == | == Function == | ||
* '''Flexion''' of the metatarso-phalangeal joints (MTPJ) II-IV, medial adduction of the second toe and lateral adduction of the third and fourth toe<ref name=": | * '''Flexion''' of the metatarso-phalangeal joints (MTPJ) II-IV, medial adduction of the second toe and lateral adduction of the third and fourth toe<ref name=":2" /> | ||
* '''Extension''' of the proximal and distal phalangeal joints II-IV<ref name=": | * '''Extension''' of the proximal and distal phalangeal joints II-IV<ref name=":2" /> | ||
=== Synergists === | === Synergists === | ||
MTPJ II-IV<ref name=": | MTPJ II-IV<ref name=":5">Valerius KP, Frank A, Kolster BC, Hamilton C, Alejandre Lafont E, Kreutzer R. Das Muskelbuch Anatomie Untersuchung Bewegung, 6.überarbeitete Auflage. Berlin: KVM Der Medizinverlag, 2002.</ref>: | ||
* Flexion: M. flexor digitorum longus, M. flexor digitorum brevis, Mm. interossei plantares 1-2 (III-IV), Mm. lumbricales pedis 1-3 (II-IV) | * Flexion: M. flexor digitorum longus, M. flexor digitorum brevis, Mm. interossei plantares 1-2 (III-IV), Mm. lumbricales pedis 1-3 (II-IV) | ||
| Line 29: | Line 29: | ||
=== Antagonists === | === Antagonists === | ||
MTPJ II-IV<ref name=": | MTPJ II-IV<ref name=":5" />: | ||
* Flexion: M. extensor digitorum longus, M. extensor digitorum brevis | * Flexion: M. extensor digitorum longus, M. extensor digitorum brevis | ||
| Line 35: | Line 35: | ||
== Clinical relevance == | == Clinical relevance == | ||
The M. interosseus dorsalis pedis IV is an easily accessible muscle and is likely to be used for routine electromyographic diagnosis of neurological diseases: "Abnormal [spontaneous activity] in [fourth dorsal interosseus pedis] correlates well with the overall neurologic condition, and it may be a useful muscle to include in routine electrodiagnostic evaluation."<ref>Siddiqi | The M. interosseus dorsalis pedis IV is an easily accessible muscle and is likely to be used for routine electromyographic diagnosis of neurological diseases: "Abnormal [spontaneous activity] in [fourth dorsal interosseus pedis] correlates well with the overall neurologic condition, and it may be a useful muscle to include in routine electrodiagnostic evaluation."<ref name=":6">Siddiqi ZA, Nasir A, Ahmed SN. The fourth dorsal interosseus pedis muscle: a useful muscle in routine electromyography. Journal of Clinical Neurophysiology, 2007;24(6):444-449.</ref> | ||
== Assessment == | == Assessment == | ||
An [[Muscle Strength|Oxford scale muscle strength assessment]] can be done as follows for the scales of 0/1 and 2/3.<ref name=": | An [[Muscle Strength|Oxford scale muscle strength assessment]] can be done as follows for the scales of 0/1 and 2/3.<ref name=":5" /> Since the interossei dorsales pedis can rarely be activated willingly, the resitance tests are usually avoided. | ||
* 0/1: supine position, knee is in supported flexion. Therapist holds the foot in neutral position and instructs the patient to "spread your toes". | * 0/1: supine position, knee is in supported flexion. Therapist holds the foot in neutral position and instructs the patient to "spread your toes". | ||
| Line 45: | Line 45: | ||
== Treatment == | == Treatment == | ||
=== Trigger points === | === Trigger points === | ||
Trigger points of the interossei dorsales pedis can be located when palpating the muscle belly inbetween the dorsal metatarsi on the instep. Typical patterns are pain on the base of the toes, in some cases expanding all the way to the tip of the toes, or pain on the instep extending to the anterior of the ankle and lower leg.<ref>Davies | Trigger points of the interossei dorsales pedis can be located when palpating the muscle belly inbetween the dorsal metatarsi on the instep. Typical patterns are pain on the base of the toes, in some cases expanding all the way to the tip of the toes, or pain on the instep extending to the anterior of the ankle and lower leg.<ref name=":7">Davies C, Davies A. The trigger point therapy workbook: Your self-treatment guide for pain relief. Oakland: New Harbinger Publications, 2013.</ref> | ||
=== Strechting === | === Strechting === | ||
When [https://learnmuscles.com/glossary/four-dorsal-interossei-pedis-dip-stretching/ stretching each of the Mm. interossei dorsalis pedis] (MIDP) remember that the main function is flextion and abduction in the MTPJ: | When [https://learnmuscles.com/glossary/four-dorsal-interossei-pedis-dip-stretching/ stretching each of the Mm. interossei dorsalis pedis] (MIDP) remember that the main function is flextion and abduction in the MTPJ: | ||
* MIDP I: pulling the second toe into extentsion and lateral abduction | * MIDP I: pulling the second toe into extentsion and lateral abduction | ||
* MIDP II: pulling the second toe into extentsion and medial abduction | * MIDP II: pulling the second toe into extentsion and medial abduction | ||
* MIDP III: pulling the third toe into extension and medial abduction | * MIDP III: pulling the third toe into extension and medial abduction | ||
* MIDP IV: pulling the fourth toe into extension and medial abduction | * MIDP IV: pulling the fourth toe into extension and medial abduction | ||
Revision as of 11:58, 26 September 2020
Original Editor - User:Anna Fuhrmann
Top Contributors - Anna Fuhrmann and Kim Jackson
Description[edit | edit source]
The dorsal interossei muscles are a group of four bicephalic muscles that fill the space between the metatarsal bones of the foot. Their function lies in spreading the toes apart and in flexing the metatarsophalangeal joints of the second to fifth toe.
Mm. interossei dorsales pedis [1]
Origin[edit | edit source]
The interossei dorsales pedis originate on the base of the metatarsal bones I-V[2]. With two heads each, they emenate from the two adjacent bone sides facing each other and integrate into one insertion. Parts of of the Mm. interossei dorsales pedis originate from the Lig. plantare longum which is situated on the bottom side of the foot.
They are part of the deep central forefoot compartment[3], also described as the forth layer [4].
Insertion[edit | edit source]
The musculus (M.) interosseus dorsalis I inserts on the medial side of the base of the second toe's phalanx proximalis[2]. The musculi (Mm.) interossei dorsales II-IV insert on the lateral side of the base of phalanges proximales II-IV[2].
Nerve[edit | edit source]
Innervation comes from the nervus plantaris lateralis (S2-S3); in rare cases also from the nervus tibialis. [2]
Function[edit | edit source]
- Flexion of the metatarso-phalangeal joints (MTPJ) II-IV, medial adduction of the second toe and lateral adduction of the third and fourth toe[2]
- Extension of the proximal and distal phalangeal joints II-IV[2]
Synergists[edit | edit source]
MTPJ II-IV[5]:
- Flexion: M. flexor digitorum longus, M. flexor digitorum brevis, Mm. interossei plantares 1-2 (III-IV), Mm. lumbricales pedis 1-3 (II-IV)
- Abduction: none
Antagonists[edit | edit source]
MTPJ II-IV[5]:
- Flexion: M. extensor digitorum longus, M. extensor digitorum brevis
- Abduction: Mm. interossei plantares 1-2 (III-IV)
Clinical relevance[edit | edit source]
The M. interosseus dorsalis pedis IV is an easily accessible muscle and is likely to be used for routine electromyographic diagnosis of neurological diseases: "Abnormal [spontaneous activity] in [fourth dorsal interosseus pedis] correlates well with the overall neurologic condition, and it may be a useful muscle to include in routine electrodiagnostic evaluation."[6]
Assessment[edit | edit source]
An Oxford scale muscle strength assessment can be done as follows for the scales of 0/1 and 2/3.[5] Since the interossei dorsales pedis can rarely be activated willingly, the resitance tests are usually avoided.
- 0/1: supine position, knee is in supported flexion. Therapist holds the foot in neutral position and instructs the patient to "spread your toes".
- 2/3: supine position, knee is in supported flexion. Therapist holds the foot in neutral position, watching for small movements of the toes and instructs the patient to "try to spread your toes".
Treatment[edit | edit source]
Trigger points[edit | edit source]
Trigger points of the interossei dorsales pedis can be located when palpating the muscle belly inbetween the dorsal metatarsi on the instep. Typical patterns are pain on the base of the toes, in some cases expanding all the way to the tip of the toes, or pain on the instep extending to the anterior of the ankle and lower leg.[7]
Strechting[edit | edit source]
When stretching each of the Mm. interossei dorsalis pedis (MIDP) remember that the main function is flextion and abduction in the MTPJ:
- MIDP I: pulling the second toe into extentsion and lateral abduction
- MIDP II: pulling the second toe into extentsion and medial abduction
- MIDP III: pulling the third toe into extension and medial abduction
- MIDP IV: pulling the fourth toe into extension and medial abduction
Muscle control & strengthening[edit | edit source]
Since the interossei dorsales pedis can rarely be willingly controlled and many patients have weak foot muscles in general, the first step is to establish a feeling of muscle activation. This can be approached by toe-spreading exercises, perhaps with pre-positioning of the toes by the therapist and the command to "keep the toes in this position". Further, the patient can be instructed to strengthen the interossei dorsales pedis by spreading the toes without assistance. In general, foot muscle strengthening exercises can be used to train the whole musclature, e.g. walking in sand, picking up tissues with the toes or holding sticks or pencils between toes.
Resources[edit | edit source]
- ↑ Gray H. Anatomy of the human body, by Henry Gray, thoroughly rev. and re-edited by Warren H. Lewis. Philadelphia: Lea & Febiger, 1918.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Putz R, Pabst R. Atlas der Anatomie des Menschen Limitierte Jubiläumsausgabe: der komplette Atlas in einem Band. 21. Aufl. München: Urban & Fischer, 2004
- ↑ Faymonville C, Andermahr J, Seidel U, Müller LP, Skouras E, Eysel P, Stein G. Compartments of the foot: topographic anatomy. Surgical and radiologic anatomy 2012;34(10):929-933.
- ↑ Teach Me Anatomy Series. Muscles of the foot. Available from: https://teachmeanatomy.info/lower-limb/muscles/foot/ (last accessed: 22.09.2020).
- ↑ 5.0 5.1 5.2 Valerius KP, Frank A, Kolster BC, Hamilton C, Alejandre Lafont E, Kreutzer R. Das Muskelbuch Anatomie Untersuchung Bewegung, 6.überarbeitete Auflage. Berlin: KVM Der Medizinverlag, 2002.
- ↑ Siddiqi ZA, Nasir A, Ahmed SN. The fourth dorsal interosseus pedis muscle: a useful muscle in routine electromyography. Journal of Clinical Neurophysiology, 2007;24(6):444-449.
- ↑ Davies C, Davies A. The trigger point therapy workbook: Your self-treatment guide for pain relief. Oakland: New Harbinger Publications, 2013.
