解剖學-小腿與足部肌肉群

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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
外側群		腓骨短肌 Peroneus brevis	lateral shaft of fibula, head of fibula	Tuberosity of base of 5th MT	Dorsiflexes and everts foot ; Supports laterior longitudinal arch	Superficial peroneal nerve
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.
	淺層	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

二、足肌分群、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
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
足背肌		伸拇長肌 Extensor hallucis longus	Superior surface of anterior calcaneus	Base of distal phalanx of great toe	Extends big toe and foot ； Inverts foot and tightens subtalar joints	Deep peroneal nerve
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
	外側群	屈小趾短肌 Flexor digiti minimi brevis	Base of 5th MT and sheath of peroneus longus		Flexes MTP of little toe	Laterior plantar N
	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	lateral plantar N

【註1】
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>

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

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