pacemaker see artificial pacemaker

pachyonychia congenita rare, congenital, autosomal-dominant disease characterized by generalized skin thickening and anhidrosis, and marked onychogryphosis of toenails and fingernails developing during babyhood

pacinian corpuscles specialized nerve endings subserving vibrational awareness, located deep within dermis; formed as lamellated bulbs at termini of A-beta sensory nerve fibres (see Table S2)

packed cell volume (postcentrifuge) volume of blood cells in a sample of blood

packing infilling a wound with dressing material

pad see individually named pads; Table P1 and Figure P1

Table P1 Examples of clinical pads

Pad type Examples Description
Digital pads Plantar bar/long prop SCF pad formed to infill the plantar aspect of the shanks of lesser toes, in order to prevent/reduce overcontraction of one or more lesser toes
  Dorsal bar SCF pad formed to infill the dorsal aspects of one or more hammered or retracted lesser toes, to reduce trauma to the skin overlying the prominent interphalangeal joints
  Dorsoplantar splint SCF pad made as a combination of the plantar and dorsal bars, to correct digital deformity/reduce trauma to the apices and dorsa of lesser toes
  Interdigital wedge SCF or foam (plain, cavitied or holed) pad formed to match the dimensions of the interdigital space to reduce reformation of an interdigital heloma molle
  Dorsal proximal/distal/apical/interdigital crescent A crescent-shaped pad applied proximal/distal to the dorsal/apical/interdigital area of a hyperkeratotic lesion on a digit, to reduce local pressure and friction
  Dorsal horseshoe A horseshoe-shaped pad, where the ‘arms’ of the horseshoe cover the dorsal aspects of toes adjacent to the digit affected by a corn, and the U acts in the same manner as a crescent pad to protect the lesion
Plantar metatarsal pads Plantar cover A pad that covers the plantar skin of the forefoot, from the webbing to a line approximately 1 cm distal to the bases of the metatarsals
  U’d plantar cover A plantar cover into which a U has been cut to deflect pressure away from a plantar lesion. The U may be infilled with cushioning material
  Winged plantar cover A plantar cover into which semicircular cutouts have been made, to deflect pressure from the 1 and/or 5 MTPJs
  Plantar metatarsal pad A pad applied to the 2/3/4 metatarsals, the distal limit of which applies pressure to the 2/3/4 metatarsal heads so that the 2/3/4 MTPJs are extended and the 2/3/4 toes realigned into a more functional position; the pad will also reduce compression between adjacent metatarsal heads
  Plantar bar A pad similar to a plantar cover, the distal limit of which had been shaped to accommodate up to 5 U’d areas
  Shaft pad/long shaft pad A pad applied to an individual metatarsal to allow sagittal-plane realignment
Others D filler
Valgus pad
A pad that is shaped to infill the plantar aspect of the medial longitudinal arch to reduce excessive pronation or ease the pain of foot strain
  Hallux valgus oval An oval pad, with or without a central cavity or hole, that is applied to the medial aspect of the 1 MTPJ to reduce local shear stresses in cases of HAV
  Heel pad A pad shaped to the plantar aspect of the heel, to cushion or reduce pressure to a plantar bursitis or heel spur
  Posterior heel pad A pad designed to deflect pressure from the posterior lateral area of the heel, in cases with Haglund’s deformity
  Doughnut pad
Ring pad
Oval pad
A circular pad with a central cavity or hole applied to the plantar aspect of the heel to protect the point of insertion of the plantar fascia
  Cobra pad A pad that combines a medial heel wedge, a valgus filler and a medial forefoot pad, to reduce excess foot pronation
  Dumbbell pad A pad that combines the action of a shaft pad to dorsiflex an individual metatarsal head, and an interdigital wedge, to reduce friction and pressure at the depth of the interdigital sulcus
  Achilles tendon pad A pad applied to the posterior aspect of the heel, to reduce pressure and friction at the insertion of the tendo Achilles

SCF, semicompressed felt; MTPJ, metatarsophalangeal joint; HAV, hallux abductovalgus.

padding materials clinical materials used specifically to cushion, deflect pressure from or protect an area, substitute for lost tissue; adhesive padding materials include felts, polyurethane and polyethylene sheet foam and fleecy web that are shaped and stuck directly to skin, added to insoles or added to the shoe inner (see individually named pads Tables P1 and P2 and Box P1)

Table P2 Functions of clinical padding materials

Material Function
Compressed felt To apply moderate leverage to a segment of a foot, such as a forefoot or rearfoot wedge
Semicompressed felt To protect vulnerable tissues and reduce the rate of reformation of hyperkeratotic lesions, such as after the enucleation of corns, by cutting a U, a wing, a cavity or a hole in the padding material to correspond to the site of the lesion
To reduce compression on soft tissues imposed e.g. by ground reaction forces and underlying bony prominences
To substitute for lost or atrophic tissues, e.g. overlying a bony prominence
To carry a medicament, e.g. where salicylic acid paste is applied to a lesion by locating the medicament in a cavity within the semicompressed felt pad
Felt and foam To combine the benefits of both semicompressed felt and polyethylene foam in one material
Polyurethane foams To cushion an area lightly
To infill a cavity, wing or U in a semicompressed felt pad
Polyethylene foams To provide a degree of cushioning, e.g. where soft tissues have undergone atrophy
To infill a cavity, wing or U in a semicompressed felt pad
Fleece/fleecy web To aid retention of a small sterile gauze dressing
To reduce friction at the skin surface, after local callosity has been debrided
To reduce shear stress in areas of tissue subject to bursa formation

Paget’s disease see disease, Paget’s

pain unpleasant sensory and emotional experience associated with, or described in terms of, actual or potential tissue damage, due to a complex interaction of sensory, emotional and behavioural factors; pain may be acute or chronic, somatic, visceral or neurogenic; it characterizes inflammation

pain control therapeutic measures used to reduce or resolve all components of pain, including analgesic drugs (e.g. paracetamol, non-steroidal anti-inflammatory drugs [NSAIDs], disease-modifying antirheumatic drugs [DMARDs], opioids and anxiolytics), electrical stimulation of the inhibitory control mechanisms (e.g. transcutaneous electrical nerve stimulation [TENS]), hypnosis and other cognitive and behavioural approaches (Table P3)

pain scale an objective value of subjective pain; value (between 0 and 10) is ascribed by the patient to the pain experience, where 0 = no pain at all, and 10 = worst pain experienced/imaginable; used to note pain in relation to daily activities, or document pain changes over a period of time (e.g. a week or month) in relation to a specific therapeutic interventions

pain sensation evaluation see Table M13

painful heel see heel pain; Table H9

painful neuropathy presentation of sensory neuropathy predominantly affecting patients with diabetes, affecting one or both feet or legs, in a general or patchy distribution, variably as constant burning sensations, paraesthesiae, ‘crawling’ or shooting pains, or exquisite contact discomfort; affected patients may lose weight, and develop motor neuropathy (proximal diabetic myotrophy); persists for ~ 6–18 months, and heralds profound sensory loss; may respond to mild antidepressant agents (e.g. amitriptyline and diazepam) and anticonvulsant drugs (e.g. gabapentin), but is resistant to normal analgesics

painless painful foot presentation of painful sensory neuropathy in diabetes mellitus; patient reports ongoing, and often severe, foot pain, but demonstrates loss of all sensory modalities

palindromic relapsing; recurring

palliation; palliative therapies that reduce symptom severity, but do not cure

palmoplantar keratoderma; PPK rare, inherited group of skin diseases characterized by altered keratin formation; presents variably as diffuse, focal or punctate palmar and plantar hyperkeratosis, e.g. of weight-bearing skin; severe forms are associated with constricting digital bands, leading to autoamputation; treated by regular hyperkeratosis reduction, keratolytic ointments (e.g. 5–10% salicylic acid in white soft paraffin) and oral retinoids (i.e. vitamin A-derivative) drugs

palmoplantar pustular psoriasis; PPP chronic inflammatory disorder of palms and soles, presenting as red, scaly, hyperkeratotic areas of skin studded with sterile pustules (initially yellow, fading over time to form dark brown scales); tends to affect middle-aged, cigarette-smoking women who may or may not show other signs of psoriasis; treated with emollients and keratolytics (e.g. 5% salicylic acid ointment, to reduce scaling), vitamin D cream, topical 1% steroid cream, coal tar preparations, dithranol and retinoids

palpation examination using the hands, e.g. to outline underlying muscular, vascular or neural structures, determine joint mobility and tissue resistance palpate masses

panarthritis inflammation affecting all joints

pancytopenia marked reduction in numbers of circulating blood cells

pandemic widespread epidemic

panhypopituitarism reduced or inadequate secretion of anterior pituitary hormones, due to pituitary destruction (e.g. secondary to local benign tumour)

panniculitis inflammation of the forefoot plantar fibrofat pad

pannus chronic inflammatory hyperplasia of synovial membrane of joints affected by rheumatoid arthritis; characterized by granulation tissue (infiltrated by inflammatory cells and releasing lytic enzymes) that intrudes into the affected joint space, eroding bone margins and articular cartilage

papilla see tactile papilla

papilloma benign epithelial neoplasm

Papillomavirus genus of DNA-containing oncogenic viruses that replicate within nuclei of infected cells; cause warts and verrucae

papule small, solid, circumscribed, elevated skin lesion

paracetamol see acetaminophen; Table P3

paracoccidioidomycosis tropical fungal infection common in Central America; may cause painful, nodular, haemorrhagic ulcerated and verrucous foot lesions

paraesthesia abnormal sensation, e.g. burning, tingling, pricking; i.e. ‘pins and needles’

paraffin gauze; tulle gras low-adherence gauze or mesh dressing, impregnated with paraffin wax; may also incorporate an antiseptic (e.g. chlorhexidine gluconate) (see Table D10)

paraffin wax baths see wax baths

parallel pitch lines parallel lines drawn on a lateral radiograph of rearfoot, to determine the degree of prominence of posterosuperior eminence of calcaneum (see Table R3; Figure P2)

paralysis; palsy loss of voluntary movement due to muscle injury, neuromuscular pathology, loss of blood supply to subserving motor nerve, or motor nerve dysfunction

parametric tests statistical tests, e.g. t-tests or analysis of variance (ANOVA) that analyse for difference between groups of normally distributed data

paraparesis mild paralysis of legs and feet

paraplegia paralysis of lower trunk and both legs

parasympathetic relating to the parasympathetic division of the autonomic nervous system

parasympathetic nervous system; parasympathetic (craniocaudal) division of the autonomic nervous system cell bodies of motor nerves located within the medulla oblongata and intermediate columns of spinal cord (i.e. at cranial nerves III, VII, IX and X and S2–S4 levels); preganglionic parasympathetic synapses use acetylcholine as neurotransmitter; postganglionic fibres use adrenaline as neurotransmitter

parasympathomimetic an agent whose action causes effects resembling parasympathetic activity

parathormone; PTH hormone released by parathyroid glands; low levels of blood calcium stimulate release of PTH; raised levels of circulating PTH levels stimulate osteoclast activity (releasing calcium from bone) and reduce renal excretion of calcium; PTH action is countered by calcitonin (released by thyroid parafollicular cells)

parathyroid gland see gland, parathyroid

parenchyma cells characteristic of an organ, contained within and supported by the stroma

parenteral administration of a medicinal or therapeutic substance, other than through the gastrointestinal or respiratory tracts, e.g. by intravenous, intramuscular or subcuticular injection

paresis partial or complete paralysis

Paris point unit of the continental shoe sizing system; there is 6.66 mm between each Paris point (see Table S4)

parkinsonism; Parkinson’s disease; paralysis agitans; shaking palsy see disease, Parkinson’s

paronychia nail fold/sulcus inflammation and infection, often associated with ingrowing toenail

paroxysm spasm of severe pain, of sudden onset

partial dislocation see subluxation

partial nail avulsion see nail avulsion, partial

partial rupture of Achilles tendon see Achilles tendinitis; Achilles tendon rupture

partial-thickness burns destruction of epidermis and superficial dermis, by dry heat

pascal; Pa SI unit of stress; 1 Pa equates to a 1 newton force distributed uniformly over 1 square metre (1 m2); i.e. 1 Pa = 1 N/m2

passive movement body part or segmental movement, not initiated or sustained by the individual, e.g. clinician-initiated/imposed movement

past pointing patient inability easily, readily or accurately to place his/her fingertip on his/her nose, or on the examiner’s moving finger; characteristic of cerebellar dysfunction

pastes see Table V1

patch test; patch testing see test, patch

patella; kneecap large sesamoid embedded within quadriceps tendon at anterior aspect of knee joint; its cartilaginous internal facet articulates with knee joint; exerts pulley-like action within the patellar groove; acts as a fulcrum for quadriceps action, centralizing action of contributory muscles (i.e. rectus femoris, vastus intermedius, vastus lateralis and vastus medialis) (see Table J1); protects quadriceps tendon, allowing knee extensor apparatus to take high load (by lengthening the lever arm, and giving mechanical advantage to quadriceps)

patellar bursae knee joint bursae; allow free movement of deep tissues across one another, and movement of skin across underlying tissues, e.g. when kneeling

patellar groove anterior groove (between medial and lateral femoral condyles) for patellar travel, under quadriceps correct patellar tracking is maintained by patellotibial and patellofemoral ligaments; misalignment of the patella within patella groove causes anterior knee pain (see syndrome, runner’s knee)

patellar tendon reflex see reflex, patellar

patellofemoral joint; PFJ cartilaginous joint between deep aspect of patella and anterior inferior aspect of femur and anterior superior aspect of tibia

patellofemoral joint syndrome see syndrome, runner’s knee

pathogen microorganism (bacteria, fungus or virus) capable of overcoming host resistance, to cause disease

pathogenesis mode of origin or development of any disease or morbid process

pathognomonic characteristic symptoms of a disease

pathological callus hyperkeratosis formed in response to local stresses or biomechanical dysfunction, and of significance to patient/clinician (see Table C15)

pathology tests analysis of tissue specimens, e.g. to identify tissue (histopathology), chemical constituents of body fluids (chemical pathology) or confirm type/sensitivity of any infecting organisms (microbiology), in order to indicate the most effective patient management regime; see sampling

pathophysiological pain; second pain; slow pain pain that encourages healing by inducing protective behaviours; it originates from stimulation of high-threshold polymodal nociceptors (free nerve endings, present in all tissues and responsive to mechanical, chemical and thermal stimuli) and is transmitted along slow-conduction C fibres (which also induce emotional and behavioural responses to pain via thalamic connections, and activate inhibitory pain pathways and the release of endogenous opioids)

pathway collection of nerve axons that conduct impulses from one group of nerve cells (i.e. ganglion) to another ganglion, or effector organ, e.g. muscle cells or gland tissue

patient contract setting patient involvement in the care plan formulation for a specific clinical problem or episode of care, creating patient empowerment and commitment to the chosen (or advised) care pathway

patient education element of patient empowerment; achieved by teaching patients about their illnesses/conditions, encouraging greater involvement in decisions related to ongoing care and treatment

patient empowerment philosophy that patients are active participants in, not passive recipients of, the caring process, and thus should be well informed about all aspects of their health, ‘wellness status’ and disease state, to gain maximum health benefit within the context of their social demands

pauciarticular affecting only one or two joints

paucibacilliary leprosy tuberculoid leprosy; TT leprosy; see Table H7

pectineus medial thigh muscle

pedal pulses see pulse

pedicle stalk

pediculosis louse infestation

PEDIS ulcer classification system see Table U2

pedobaroscope calibrated plantar pressure visualization device, Table G2

Pegasus rocker see Table O4

‘peg in hole’ arthrodesis surgical joint fixation technique; the head of a proximal bone is fashioned into a peg to fit exactly into a hole drilled/gouged into the base of the distal bone

pellagra niacin (nicotinic acid) deficiency (e.g. in chronic alcoholism)

pelvic girdle; pelvis bowl-shaped bony girdle (formed by fusion of paired ischia, ilia and pubi, together with sacrum and coccyx); forming the articulation between trunk and lower limbs, and containing lower abdominal organs; frontal- and transverse-plane curvatures of the female pelvis are shallower than those of the male

pelvic nutation anterior tilt of upper pole of pelvis (in sagittal plane); associated with lumbar lordosis, internal-limb rotation and excess foot pronation

pelvic tilt pelvic girdle asymmetry; the hips (viewed from anterior) are not parallel to the transverse plane/ground surface, and one leg appears longer than the other

pemphigus vulgaris chronic, initially localized but later generalized autoimmune inflammatory disease; characterized by easily ruptured, flaccid cutaneous bullae and blood-filled blisters at the dermoepidermal junction

‘pencil in cup’ deformity erosive inflammation characteristic of metatarsophalangeal joints in rheumatoid or severe psoriatic arthritis (arthritis mutilans); metatarsal head is eroded and the base of the adjacent proximal phalanx becomes increasingly concave see metatarsal head dystrophy

-penia deficiency

penicillamine immune-disease modifying drug, used to treat rheumatoid arthritis characterized by troublesome extra-articular features, or those taking high doses of corticosteroids; beneficial effects of medication take 6–12 weeks to show

penicillin antibiotic derived from Penicillium moulds; bactericidal against non-resistant Gram-positive microorganisms; may provoke sensitivity reactions, e.g. urticaria and/or anaphylaxis; note: patients with penicillin allergy may also react to penicillamine and cephalosporins

penicillinase enzyme inactivating penicillin; produced by some staphylococci

pencilling of metatarsals see metatarsal head dystrophy

percentage mass calculation to convert drug concentration in solution (%) to mass (in mg); based on the principle that 1% solution contains 10 mg of drug per 1 mL of solution (see Table M5)

percutaneous passage of substances through unbroken skin

perforated film absorbent dressings primary wound dressing; see Table D10

perfusion passage of blood and tissue fluid through the capillary bed

peri- around

periarteritis inflammation of the tunica adventitia of an artery

periarthritis inflammation of tissues surrounding a joint

pericarditis inflammation of pericardial membrane, e.g. in autoimmune disease

pericardium fibroserous, double-layered membrane surrounding the heart

periosteum thick, fibrous, vascular membrane investing bone surface, but not articular cartilage; formed of an inner osteogenic layer (containing osteoblasts that form new bone tissue) and an outer, fibrous layer (carrying neurovascular supply to bone)

periostitis inflammation of periosteum

peripheral tissues/structures furthest from the centre

peripheral arterial disease; PAD see disease, peripheral vascular (Table P4)

Table P4 Clinical tests used in the diagnosis of peripheral arterial disease (PAD)

Test modality Diagnostic indicators
Medical history • Evidence of atherosclerosis, such as ischaemic heart disease, cerebrovascular disease
• Risk of atherosclerosis, such as cigarette smoking, diabetes mellitus
Pulses in the lower limb Popliteal, posterior tibial, dorsalis pedis and peroneal pulses
• Pulse quality (bounding, full, normal, weak, absent)
• Rate (beats/minute)
• Regularity (regular, irregular, regularly irregular, irregularly irregular)
Presenting symptoms • Cold, numb feet
• Intermittent claudication
• Rest pain
• Painful ulceration
Ankle–brachial index (ABI) • 0.9–1.1 = normal
• 0.7–0.9 = PAD, some compromise of tissue viability
• 0.5–0.7 = severe PAD, compromised tissue viability
• <0.5 = threat of ischaemic gangrene/very poor tissue viability
• >1.2 = calcification of tunica media of leg/foot artery, compromised tissue viability
Segmental systolic pressure Serial measurement of systolic blood pressure along length of limb:
• A sudden decrease indicates the location of the vascular obstruction
Venous filling time
Note: this test is not valid if the patient has venous incompetence
The time it takes for veins to refill in a limb that has been drained of venous blood (with the patient supine, the leg is elevated to 45 ° for 1 minute, then the leg placed in a dependent position and the time taken for the dorsal foot veins to refill)
• <15 seconds = normal
• 20–30 seconds = moderate ischaemia
• >40 seconds = severe ischaemia
Buerger’s test The observation of the change in skin colour in response to limb elevation and dependency (with the patient supine, the leg is elevated to 45 ° for 1 minute, then the leg is placed in a dependent position and the time taken for normal skin colour to return is noted)
• <10 seconds = normal response
• Patchy persistent rubor indicates limb ischaemia
• Persistent pallor (>10 seconds) indicates limb ischaemia
• Persistent cyanosis indicates limb ischaemia
Buerger’s angle The colour response of the sole of the foot to limb elevation (with the patient supine, the leg is elevated and the angle of limb elevation is noted when the skin of medial longitudinal arch shows pallor)
• 60–70 ° = normal arterial supply to foot
• < 45 ° = compromised arterial supply to foot
• < 30 ° = severe compromised arterial supply to foot
Capillary refill time
Note: this test is not valid if the patient has signs of current Raynaud’s disease
The time taken for normal skin tone of a horizontal limb to return after the nail bed or digital pulp has been compressed by thumb pressure
• <5 seconds = normal response
• >5 seconds = some ischaemia
• >15 seconds = marked ischaemia
Doppler sounds • Triphasic = normal
• Biphasic = normal/some loss of arterial elasticity
• Monophasic = loss of arterial elasticity/arterial stenosis
• Loud = high rate of blood flow
• Quiet = slow rate of blood flow
• No sound = no blood flow (proximal arterial occlusion)
Skin temperature
Note: this test is not valid if the patient has signs of current Raynaud’s disease
• ~ 31 °C = normal foot skin temperature
• <29 °C = possible poor skin perfusion

peripheral pain receptors see nociceptors

peripheral pulses see pulse, dorsalis pedis

peripheral vascular disease generic term denoting reduced arterial supply to, and compromised venous/lymphatic return from, the lower limbs and feet; see disease, peripheral vascular

peripheral vascular system system of arteries, arterioles, veins and venules, lymphatics and capillaries subserving peripheral tissues

peristalsis waves of alternate contraction and relaxation in circumferential muscle tissue of a tubular structure, driving contents forward, e.g. movement of blood through the vascular system (see law, Starling’s)

peritendinitis inflammation of Achilles peritendon, due to e.g. acute local trauma, chronic overuse, infection or musculoskeletal disease

peritendon tissue surrounding the Achilles tendon; note: the Achilles tendon does not have a synovial sheath

periungual fibroma see Koenen’s tumour

permeability passage of substances through a membrane

permethrin; Lyclear topical scabies treatment

pernicious anaemia chronic macrocytic anaemic due to gastric malabsorption of vitamin B12, characterized by low red blood cell counts and low haemoglobin levels; it is controlled by (usually monthly) depot injections of cyanocobalamin

perniosis see chilblain

peromelia severe congenital malformations of limbs, hands and/or feet, e.g. congenital absence of hand/hands, foot/feet

peroneal artery largest branch of posterior tibial artery; courses along posterior of fibula deep to flexor hallucis longus muscle; enters the foot anterolateral to lateral malleolus (palpated as peroneal pulse); communicates within foot with lateral tarsal and posterior tibial arteries

peroneal cuboid see syndrome, peroneal cuboid

peroneal (fibular) tendinitis trauma-induced injury to peroneus longus (PL) and brevis (PB) tendons, e.g. overuse injury (tendinitis), chronic tendon subluxation (due to peroneal retinaculum tears from a previous ankle inversion injury), acute tendon subluxation/rupture (in association with recent acute ankle eversion injury); presents as local pain, tenderness and swelling along course of PL and/or PB tendons and lateral retromalleolar area; treatment includes rest (strapping into eversion; immobilization), non-steroidal anti-inflammatory drugs, physical therapies, e.g. ice massage + ultrasound, biomechanical evaluation and orthoses to correct excessive supination at heel strike

peroneal muscular atrophy see disease, CMT disease type I

peroneal pulse see pulse, dorsalis pedis; peroneal artery

peroneal spastic flat foot see tarsal coalitions

peroneal tendon rupture full or partial division of fibres of one or both peroneal tendons (longus or brevis, lying within a common synovial sheath deep to extensor retinaculum) due to trauma, e.g. overuse injury; sudden inversion + ankle plantarflexion

peroneus; peronei peroneal muscles (longus [PL] and brevis [PB]) of lateral compartment of lower limb; action eversion of subtalar joint and plantarflexion of foot at ankle joint; PL and PB tendons lie within a common synovial sheath, within the retrofibular groove at the posterior aspect of the lateral malleolus, and enter the foot deep to the superior peroneal retinaculum (creating a point of ischaemic stress, leading to chronic degeneration and degenerative changes in PL and PB tendons; see subluxing peroneal tendons); PL and PB common tendon sheath divides to form individual sheaths at lateral side of foot

peroneus brevis; PB extrinsic foot muscle within the lateral compartment of lower leg

peroneus longus; PL extrinsic foot muscle, within lateral compartment of lower leg

insertion tendon courses along lateral side of fibula, superficial to peroneus brevis (PB), lying in a common sheath with tendon of PB (see peroneus brevis); within the foot, PL tendon turns (in groove on interior aspect of cuboid) to run obliquely across deep area of sole of foot (i.e. sixth layer) and inserts into plantar aspect of medial cuneiform and first metatarsal base

peroneus tertius small extrinsic foot (forms lateral part of extensor digitorum brevis), within anterior compartment of lower leg

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