Sitting or lying supine
Ask the patient to wear shorts or roll up long pants and remove shoes and socks.
Anterior to the patient.
Please sit down. May I touch the top of your foot? (or point to the area). Please bring your toes up (or demonstrate). (If needed sayÖ. ìhold this position while I try to push your toes downîÖ.)
In most cases, a hand or foot muscle attaching to multiple digits attaches to the four lesser digits of the hand or foot. The extensor digitorum brevis muscle is an exception, in that it attaches to the hallux and the next three lateral digits.
Guide or ask the patient to sit down. With the patient relaxed and with permission, place your fingers on the lateral aspect of the dorsum of the foot and ask the patient to extend the toes. This muscle action produces a muscle bulge, usually visually observed, on the dorsolateral foot and just anterior and plantar to the lateral malleolus. Palpation of the tendons to toes 1-4 may or may not be palpable as the toes alternately extend and then relax. The tendons of the extensor digitorum longus to toes 2, 3 and 4 and extensor hallucis longus to the hallux are more superficial and prominent and the actions of these muscles are the same as those of the extensor digitorum brevis.
With unclear muscle activity, increase the contraction of all of these toe extensor muscles by asking the patient to extend the toes while you provide a push on toes 1-4 in the direction of toe flexion.
Guide or ask the patient to sit down. With the patient relaxed and with permission, place your fingers on the lateral aspect of the dorsum of the foot and ask the patient to extend the toes. This muscle action produces a muscle bulge, usually visually observed, on the dorsolateral foot and just anterior and plantar to the lateral malleolus. Palpation of the tendons to toes 1-4 may or may not be palpable as the toes alternately extend and then relax. The tendons of the extensor digitorum longus to toes 2, 3 and 4 and extensor hallucis longus to the hallux are more superficial and prominent and the actions of these muscles are the same as those of the extensor digitorum brevis.
With unclear muscle activity, increase the contraction of all of these toe extensor muscles by asking the patient to extend the toes while you provide a push on toes 1-4 in the direction of toe flexion.
VH - Leg and foot skeleton with extensor digitorum brevis muscle and tendons ñ add extensor digitorum longus, anterior tibialis, extensor hallucis longus and peroneus tertius muscles and tendons, superior and inferior extensor retinacula and superior and inferior peroneal retinacula on one side