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篇名
解剖學-小腿與足部肌肉群
重要考點
小腿肌和足部各肌群名稱、位置、起止點、作用與神經支配等重點，您不可不知道喔！
說明
重點整理
一、小腿肌分群、名稱、位置、起止點、作用與神經支配重點整理
| 肌群 | 名稱 | Origin | Insertion | Action | Nerve 支配 |
|
|---|---|---|---|---|---|---|
| 前群 | 脛前肌 Tibialis anterior |
anterior shaft of tibial & fibula; interosseous membrane and superior tibiofibular joint | Medial side of Cuneiform ,base of 1st Metatasal bone | Ankle dorsiflexion ;inversion | Deep peroneal nerve |
|
| 伸拇長肌 Extensor hallucis longus |
Base of distal phalanx of great toe | Extends big toe and foot ; Inverts foot | ||||
| 伸趾長肌 Extensor digitorum longus |
Extensor expansion of lateral four toes | Extends toes and extends foot at ankle | ||||
| 外側群 | 腓骨長肌 peroneus longus |
lateral shaft of fibula, head of fibula | Plantar aspect of base of 1st MT and medial cuneiform ; passing deep to long plantar lig ament | 1.Plantar flexes and everts foot ; Support laterior longitudinal and transverse arches | Superficial peroneal nerve | |
| 腓骨短肌 Peroneus brevis | Tuberosity of base of 5th MT | Dorsiflexes and everts foot ; Supports laterior longitudinal arch | ||||
| 後群 | 淺層 | 腓腸肌 Gastrocnemius |
Lateral head: post surface of lateral condyle of femur and highest of three facets on lateral condyle. Medial head: post surface of femur above medial condyle | Calcaneal tubercle | Plantar flexes foo ;Flexes knee | Tibial N. |
| 比目魚肌 Soleus |
Soleal line and middle third of post border of tibia and upper quarter of post shaft of fibula including neck | Calcaneal tubercle | Plantar flexion | |||
| 深層 | 屈趾長肌 Flexor digitorum longus |
Posterior shaft of tibia below soleal line and broad aponeurosis from fibula | Base of distal phalanges of lat four toes | Flexes distal phalanges of lat four toes and foot at ankle. Supports laterior longitudinal arch | ||
| 後脛肌 Tibialis posterior |
interosseous membrane between tibial and fibula | Navicular bone | plantar flexion, Inversion | |||
| 屈拇長肌 Flexor hallucis longus |
posterior fibula between median crest & posterior border, lower intermuscular septum and aponeurosis of flexor digitorum longus | Base of distal phalanx of big toe and medial two tendons of flexor digitorum longus | Flexes distal phalanx of big toe, ankle dorsiflexion ; Supports medial logitudinal arch | |||
| 肌群 | 名稱 | Origin | Insertion | Action | Nerve 支配 | |
|---|---|---|---|---|---|---|
| 足背肌 | 伸趾短肌 Extensor digitorum brevis |
Superior surface of anterior calcaneus | Four tendons into proximal phalanx of big toe and long extensor tendons to toes 2, 3 and 4 | Extends toes when foot fully dorsiflexed | Deep peroneal nerve |
|
| 伸拇長肌 Extensor hallucis longus |
Base of distal phalanx of great toe | Extends big toe and foot ； Inverts foot and tightens subtalar joints | ||||
| 足底肌 | 內側群 | 外展拇肌 Abductor hallucis |
Medial process of posterior calcaneal tuberosity & flexor retinaculum | Medial aspect of base of proximal phalanx of big toe | Flexes & abducts big toe; Supports med longitudinal arch | Medial plantar N |
| 屈拇短肌 Flexor hallucis brevis |
Cuboid, lateral cuneiform and tibialis posterior insertion over the two remaining cuneiforms | Flexes MTP joint of big toe ; Supports med longitudinal arch | ||||
| 內收拇肌 Adductor hallucis |
Oblique head :base of 2, 3, 4 MTs;Transverse head: plantar MT ligament & deep transverse ligament | Adducts & flexes MTP jnt of big toe ； Supports transverse arch | ||||
| 外側群 | 外展小趾肌Abductor digiti minimi | Medial and lateral processes of posterior calcaneal tuberosity | Lateral side of base of proximal phalanx of 5th toe and 5th MT | Flexes and abducts 5th toe; Supports lateral longitudinal arch | Laterior plantar N | |
| 屈小趾短肌 Flexor digiti minimi brevis |
Base of 5th MT and sheath of peroneus longus | Flexes MTP of little toe | ||||
| 中間群 | 屈趾短肌 Flexor digitorum brevis |
Medial process of posterior calcaneal tuberosity | Four tendons to four lateral toes to borders of middle phalanx; t endon of flexor digitorum longus pass through them | Flexes lat four toes, Supports medial and lateral longitudinal arches | Medial plantar N | |
| 足底方肌 （= 蹠方肌）Quadratus plantae |
Lateral head: tuberosity of calcaneus;medial head:medial side of calcaneus | Lateral border of long flexor tendons |
Lateral plantar N | |||
| 蚓狀肌 Lumbricals |
Lateral : cleft between the four tendons of flexor digitorum longus. Medial : medial aspect of 1st tendon |
Dorsal extensor expansion | Extend toes at IP jnts and flex MTP joints | First: medial plantar N (L4,5). 2~4: deep branch of lateral plantar N (S2,3) |
||
| 骨間蹠側肌 I interossei-plantar of foot |
Inferomedial shafts of 3rd , 4th and 5th MTs | Medial sides of bases of proximal phalanges with slips to dorsal extensor expansions of 3rd, 4th and 5th toes | Adduct 3rd 4th and 5th toes to axis of 2nd toe ； Assist lumbricals in extending IP joints while flexing MTP joints | lateral plantar N | ||
| 骨間背側肌 Interossei-dorsal of foot | Bipennate from inner aspects of shafts of all MTs | Bases of proximal phalanges and dorsal extensor expansions of medial side of 2nd toe and lateral sides of 2nd , 3rd,and 4th toes | Abduct 2nd , 3rd and 4th toes from axis of 2nd toe ； Assist lumbricals in extending IP joints while flexing MTP joints | |||
足底肌 中間群可分淺、中、深三層。
(1) 淺層叫屈趾短肌，位於足底腱膜的深面，遠端分為 4 個肌腱分別至 2~5 趾。
(2) 中層為足底方肌（蹠方肌），起自跟骨結節，止于屈趾長肌腱。
(3) 深層由淺到深排列，分別是 4 塊蚓狀肌， 3 塊骨間蹠側肌和 4 塊骨間背側肌。足趾以第二趾為中心進行 ABDuction 或 ADDuction---- 骨間蹠側肌可讓第 3 ～ 5 趾 ADDuction ；骨間背側肌則讓第 2 ～ 4 趾 ABDuction 。
相關考題
1.下列何者對足底長韌帶（long plantar ligament）及足底短韌帶（short plantar ligament）的敘述錯誤？<95-2-4>
2.一年輕學生因車禍受傷，造成腓骨頸(neck of fibula)骨折導致經過此處的神經受傷，下列那一功能最可能因此受到影響？<96-1-26>
3.下列何者為造成硬腦膜外出血(epidural hematoma)之最可能原因？<96-2-23>
4.下列何者的肌腱會從足底長韌帶(long plantar ligament)前端兩附著點間穿過？<97-2-7>
5.一老年女性跌倒，造成股骨頸骨折（fracture of femoral neck）並傷及鄰近構造時，下列何者最不可能發生？<98-1-3>
- 足底長韌帶在淺層，足底短韌帶在深層
- 足底長韌帶屬於距下關節(subtalar joint)的韌帶
- 兩者後面皆附著於跟骨(calcaneus)
- 兩者前面皆有附著至骰骨(cuboid)
解答：B
2.一年輕學生因車禍受傷，造成腓骨頸(neck of fibula)骨折導致經過此處的神經受傷，下列那一功能最可能因此受到影響？<96-1-26>
- 膝關節伸直(extension of knee)
- 膝關節屈曲(flexion of knee)
- 髁關節屈曲(plantarflexion of ankle)
- 髁關節背屈(dorsiflexion of ankle)
解答：D
3.下列何者為造成硬腦膜外出血(epidural hematoma)之最可能原因？<96-2-23>
- 大腦動脈環(arterial circle of cerebrum)上血管瘤破裂
- 上頜動脈(maxillary artery)出血
- 腦膜中動脈(middle meningeal artery)破裂
- 大腦前動脈(anterior cerebral artery)出血
解答：D
4.下列何者的肌腱會從足底長韌帶(long plantar ligament)前端兩附著點間穿過？<97-2-7>
- 腓短肌(peroneus brevis)
- 腓長肌(peroneus longus)
- 脛後肌(tibialis posterior)
- 脛前肌(tibialis anterior)
解答：B
5.一老年女性跌倒，造成股骨頸骨折（fracture of femoral neck）並傷及鄰近構造時，下列何者最不可能發生？<98-1-3>
- 大腿極度外展(abduction)
- 股神經(femoral nerve)斷裂
- 內旋股動脈(medial circumflex femoral artery)斷裂
- 股骨頭韌帶(ligament of head of femur)斷裂
解答：B
刊名
關鍵詞
解剖學、小腿、足部肌肉、前群、外側群、淺層、足肌分群、足底肌、硬腦膜
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