Slideshow: The Foot

The Foot

The foot has two surfaces

Plantar Surface

sole of the foot

Dorsal Surface upper part of the

foot

The Dorsal Surface

The tendons of the muscles of the anterior compartment of the leg are situated on the

dorsal aspect of the foot

Tendon of Tendon of Tibialis AnteriorTibialis Anterior

Tibialis Anterior

• Dorsiflexes Ankle Joint• Inverts the foot

Tendons of Extensor Tendons of Extensor Digitorum LongusDigitorum Longus

Extensor Digitorum Longus• Extends the Toes 2-5• Dorsiflexes Ankle Joint

Tendon of Peroneus Tertius

Peroneus Tertius

• Dorsiflexes Ankle Joint• Everts Foot

Tendon of Extensor Hallucis Longus

Extensor Hallucis Longus

• Extends Big Toe• Dorsiflexes Ankle Joint

Extensor Digitorum Brevis

This is an intrinsic muscle of foot (ie: it originates and inserts within the foot)


Originates from the superior surface of the anterior

calcaneum

Inserts via 4 tendons to toes 1-4


Extends the toes when the foot is fully

dorsiflexed

Originates from the superior surface of the anterior

calcaneum

Inserts via 4 tendons to toes 1-4

The Dorsalis Pedis Artery supplies the foot and is a direct continuation of the

Anterior Tibial Artery

Dorsalis Pedis Artery


The Dorsalis Pedis Artery supplies the foot and is a direct continuation of the



The pulse may be felt between the medial and

lateral Malleoli

Dorsalis Pedis Artery

The Plantar Surface

The Plantar Surface of the foot is also known as the

sole of the foot

sole of right foot

It is covered in a layer of thick cornified skin that is

nevertheless sensitive

sole of right foot

Under the skin is a layer of loculated subcutaneous fat

sole of right foot

Under the subcutaneous fat is a thick fascial layer

that covers all the muscles in the foot –

the Plantar Aponeurosis or Plantar Fascia

sole of right foot

There are four layers of Intrinsic Muscles

that are present in the foot

sole of right foot

1st Layer

Consists of 3 muscles

sole of right foot

1st Layer


Abductor Digiti Minimi

sole of right foot

1st Layer



Flexor Digitorum Brevis

sole of right foot

1st Layer




Abductor Hallucis

sole of right foot

1st Layer

Abductor Hallucis

sole of right foot

1st Layer

Abductor Hallucis

Originates from •Medial process of the Calcaneum•Flexor retinaculum•Plantar aponeurosis

sole of right foot

1st Layer

Abductor Hallucis


Inserts onto medial side of base of Proximal Phalanx of Great Toe

sole of right foot

1st Layer

Abductor Hallucis


Inserts onto medial side of base of Proximal Phalanx of Great Toe

Abducts the Great Toe

sole of right foot

1st Layer


This muscle is similar to Flexor Digitorum Superficialis

in the hand

sole of right foot

1st Layer


Originates from •Medial process of the Calcaneum•Plantar aponeurosis

sole of right foot

1st Layer


Splits into 4 tendons that enter the tendon sheaths of toes 2-5

Each tendon splits into two slips at the base of the proximal phalanx to allow the tendon of Flexor

Digitorum Longus to pass through

The slips then reunite and insert onto the sides of the shaft of the

middle phalanx of toes 2-5

sole of right foot

1st Layer


Originates from•Lateral and medial Calcaneal tubercles•Plantar aponeurosis

sole of right foot

1st Layer


Inserts onto the lateral aspect of the base of the proximal phalanx of the little toe

sole of right foot

Originates from•Lateral and medial Calcaneal tubercles•Plantar aponeurosis

1st Layer


Originates from•Calcaneal tuberosity•Plantar aponeurosis

Inserts onto the lateral aspect of the base of the proximal phalanx of the little toe

Abducts the little toe

sole of right foot

2nd Layer

Consists of the Long Flexor Tendons and

intrinsic muscles (lumbricals and flexor accessorious)

sole of right foot

2nd Layer

Flexor Digitorum Longus tendons

sole of right foot

2nd Layer


Flexor Hallucis Longus tendon

sole of right foot

2nd Layer



Lumbricals

sole of right foot

2nd Layer



Lumbricals

Flexor Accessorius

sole of right foot

2nd Layer

Flexor Tendon Sheaths

sole of right foot

2nd Layer


Contains tendons of Flexor Digitorum Longus

sole of right foot

2nd Layer


Contains tendon of •Flexor Digitorum Longus•Flexor Hallucis Longus

sole of right foot

2nd Layer

Lumbricals

4 small muscles similar to the Lumbricals in the Hand

sole of right foot

2nd Layer

Lumbricals

Originate from the Tendons of Flexor Digitorum Longus

sole of right foot

2nd Layer

Lumbricals


Lumbrical Tendons insert onto the medial aspect of the dorsal digital expansions of

toes 2-5

sole of right foot

2nd Layer

Lumbricals

Assist in maintaining extension of IP joints of the toes

sole of right foot


Lumbrical Tendons insert onto the medial aspect of the dorsal digital expansions of

toes 2-5

2nd Layer

Flexor Accessorius

Deeply placed muscle also known as

Quadratus Plantae

sole of right foot

2nd Layer

Flexor Digitorum Accessorius

Originates from the Calcaneum with 2 heads

sole of right foot

2nd Layer


Originates from the Calcaneum by 2 heads

Inserts onto the tendon of Flexor Digitorum Longus

sole of right foot

2nd Layer


Originates from the Calcaneum by 2 heads

Inserts onto the tendon of Flexor Digitorum Longus

Assists Flexor Digitorum Longus in flexing the toes 2-5

sole of right foot

3rd Layer


sole of right foot

3rd Layer

Flexor Hallucis Brevis

sole of right foot

3rd Layer


Adductor Hallucis

sole of right foot

3rd Layer


Adductor Hallucis

Flexor Digiti Minimi Brevis

sole of right foot

3rd Layer


sole of right foot

3rd Layer


Originates in 2 parts:•Medial limb from the medial and intermediate cuneiforms and from the tendon of Tibialis Posterior•Lateral limb from the Cuboid and Lateral Cuneiform

sole of right foot

3rd Layer


Inserts onto either side of the base of the Proximal Phalanx of Big Toe

sole of right foot


3rd Layer


sole of right foot


Inserts onto either side of the base of the Proximal Phalanx of Big Toe

which it flexes

3rd Layer

Adductor HallucisVery deeply placed and awkward to demonstrate

Similar to Adductor Pollicis in the hand

sole of right foot

3rd Layer

Adductor HallucisOriginates by 2 heads:•Oblique Head - bases of 2,3,4 metatarsals•Transverse head – from plantar metatarsophalangeal ligaments of 3,4,5 toes

sole of right foot

3rd Layer

Adductor Hallucis

Inserts onto: •Lateral Sesamoid•Base of the Proximal Phalanx

Originates by 2 heads:•Oblique Head - bases of 2,3,4 metatarsals•Transverse head – from plantar metatarsophalangeal ligaments of 3,4,5 toes

sole of right foot

3rd Layer

Adductor Hallucis

Adducts the Proximal Phalanx of the Big Toe

Stabilizes the Metatarsal Heads

sole of right foot

3rd Layer


Originates from medial part of plantar surface of base of the 5th Metatarsal

sole of right foot

3rd Layer



Inserts onto lateral side of base ofProximal Phalanx of Little Toe

sole of right foot

3rd Layer



Inserts onto lateral side of base ofProximal Phalanx of Little Toe

Flexes Metatarso-phalangeal Joint(MTPJ) of Little Toe

sole of right foot

4th Layer

The Interossei

sole of right foot

4th Layer

Similar to the Hand there are

Dorsal Interossei

sole of right foot

4th Layer

Similar to the Hand there are

Dorsal Interossei

Plantar Interossei

sole of right foot

4th Layer

Dorsal Interossei

There are 4 bipennate dorsal interossei that arise by two heads from adjacent metatarsals

sole of right foot

4th Layer

Dorsal Interossei

Insertion1st dorsal interossei inserts onto the medial aspect of proximal phalanx of the second toeThe other three insert onto the lateral aspect of proximal phalanges of toes 2,3,4 respectively

sole of right foot

4th Layer

Dorsal Interossei

Abduct the toes relative to the 2nd toe

sole of right foot

4th Layer

Plantar Interossei

There are 3 Plantar Interossei

3rd plantar interosseous sole of right foot

4th Layer

Plantar Interossei


They are unipennate muscles.


4th Layer

Plantar Interossei




Originate from medial sides of 3, 4, 5 metatarsals

4th Layer

Plantar Interossei

sole of right foot



Originate from medial sides of 3, 4, 5 metatarsals

Adduct toes 3, 4, 5 (towards the 2nd toe)Flex MTP joints Extend IP joints

In Summary

1st Layer• Abductor Hallucis• Flexor Digitorum Brevis• Abductor Digiti Minimi

2nd Layer• Flexor Hallucis Longus• Flexor Digitorum Longus• Flexor Accessorius• Lumbricals

3rd Layer• Flexor Hallucis Brevis• Adductor Hallucis• Flexor Digiti Minimi Brevis

4th Layer• Plantar Interossei• Dorsal Interossei(also included in the fourth

layer are the tendons of Tibialis Posterior and Peroneus Longus)

To try and remember the layers think of

1st layer – 1 Flexor between 2 Abductors

2nd Layer – All the long flexors and their accessories

3rd layer – 1 adductor between 2 Flexors

4th Layer – the Interossei

To try and remember the layers think of

1st layer – 1 Flexor between 2 AbductorsAbductor Hallucis - Flexor Digitorum Brevis - Abductor Digiti Minimi

2nd Layer – All the long flexors and their accessoriesFlexor Hallucis Longus - Flexor Digitorum Longus – Flexor Accessorius -Lumbricals

3rd layer – 1 Adductor between 2 FlexorsFlexor Hallucis Brevis - Adductor Hallucis - Flexor Digiti Minimi Brevis

4th Layer – the Interossei Plantar Interossei - Dorsal Interossei

Neurovascular Supply

Tibial Tibial NerveNerve

Medial Medial Plantar Plantar NerveNerve

Lateral Lateral Plantar Plantar NerveNerve

It passes behind the Medial Malleolus, crosses the Tarsal Tunnel and divides into •Medial Plantar Nerve •Lateral Plantar Nerve

The Tibial Nerve innervates all the muscles in the foot

sole of right foot

Lateral Plantar Nerve Branches Medial Plantar Nerve Branches sole of right foot

Posterior Posterior Tibial ArteryTibial Artery

Medial Medial PlantarPlantarArteryArtery

Lateral Lateral Plantar Plantar ArteryArtery

The Posterior Tibial Artery accompanies the Tibial Nerve and passes behind the Medial Malleolus through the Tarsal Tunnel

It divides into two branches•Medial Plantar Artery•Lateral Plantar Artery

sole of right foot

The Posterior Tibial Artery accompanies the Tibial Nerve and passes behind the Medial Malleolus through the Tarsal Tunnel

It divides into •Medial Plantar Artery•Lateral Plantar Artery

Lateral Plantar Artery

sole of right foot

Muscle Summaries

Extensor Digitorum LongusOrigin Lateral condyle of Tibia, upper

2/3 anterior fibular shaft, interosseous membrane

Insertion Splits into 4 tendons, inserts via extensor expansions onto dorsum of middle and distal phalanges. Part of extensor expansion complex

Action Extend toes 2 - 5 and dorsiflexes ankle

Nerve Supply Deep peroneal nerve (L5, S1)

Blood Supply Anterior tibial artery

Anterior Leg

Extensor Hallucis LongusOrigin Anterior surface of the fibula,

interosseous membraneInsertion Base of distal phalanx great toe

Action Extends great toe and dorsiflexes ankle

Nerve Supply Deep peroneal nerve (L5, S1)


Anterior Leg

Tibialis AnteriorOrigin Lateral condyle of tibia, proximal

2/3rds lateral surface tibia, interosseous membrane

Insertion Medial and plantar surfaces of medial cuneiform and base of first metatarsal

Action Dorsiflexor of ankle, invertor of foot

Nerve Supply Deep peroneal nerve (L4, L5)Blood Supply Anterior tibial artery

Anterior Leg

Fibularis TertiusOrigin Distal 1/3rd anterior surface of

fibulaInsertion Base of dorsal aspect 5th

metatarsalAction Dorsiflexes foot;

everts foot weaklyNerve Supply Deep peroneal nerve (L5, S1)


Anterior Leg

Abductor Digiti MinimiOrigin Medial and lateral processes of

calcaneal tuberosity and intervening plantar surface of calcaneum. Plantar aponeurosis

Insertion Lateral side of base of proximal phalanx of 5th toe and head of 5th metatarsal

Action Flexes and abducts 5th toeSupports lateral longitudinal arch

Nerve Supply Lateral plantar nerve

Blood Supply Medial and lateral plantar arteries

1st Layer Foot

Flexor Digitorum BrevisOrigin Medial process of calcaneal

tuberosity

Insertion Splits into four tendons that insert onto the sides of the shaft of the middle phalanx of toes 2-5(Each tendon splits into two at the base of the proximal phalanx and then reunites to form a tunnel allowing the tendon of Flexor Digitorum Longus to pass)

Action Flexes toes 2-5, supports medial arch

Nerve Supply Medial plantar nerve


1st Layer Foot

Abductor HallucisOrigin Medial process of calcaneal

tuberosity, and flexor retinaculum

Insertion Medial sesamoid and medial aspect base of proximal phalanx of big toe

Action Flexes and abducts big toe, supports medial longitudinal arch

Nerve Supply Medial plantar nerveBlood Supply Medial and lateral plantar

arteries

1st Layer Foot

LumbricalsOrigin Lateral 3 are bipennate between the

tendons of flexor digitorum longus.Medial lumbrical is from the medial aspect of the medial tendon of FDL

Insertion Dorsal extensor expansion

Action Extends toes at IP joints and flexes MTP joints

Nerve Supply 1st lumbrical – medial plantar nerve2-4 lumbricals - lateral plantar nerve


2nd Layer Foot

Flexor Accessorius (Quadratus Plantae)

Origin Medial and lateral sides of calcaneus

Insertion Tendons of flexor digitorum longus

Action Assists flexor digitorum longus to flex toes 2-5 when ankle joint is plantarflexed



2nd Layer Foot

Flexor Digiti Minimi BrevisOrigin Base of the 5th metatarsal and the

sheath of peroneus longusInsertion Lateral side of the base of the

proximal phalanx of 5th toeAction Flexes MTP joint of 5th toe


Blood Supply Lateral plantar artery

3rd Layer Foot

Adductor HallucisOrigin Oblique head: base of 2,3, 4

metatarsalsTransverse head: plantar metatarsal ligaments, deep transverse ligament

Insertion Lateral sesamoid and lateral side of base of proximal phalanx of big toe

Action Adducts and flexes MTP joint of big toe



3rd Layer Foot

Flexor Hallucis BrevisOrigin Arises by medial and lateral

tendons from cuboid, cuneiforms and tendon of tibialis posterior

Insertion Medial slip to medial side, and lateral slip to lateral side of base of proximal phalanx of big toe

Action Flexes MTP joint of big toe and supports medial longitudinal arch

Nerve Supply Medial plantar nerve


3rd Layer Foot

Plantar InterosseiOrigin Lower medial aspects of the shafts

of metatarsals 3, 4, 5Insertion Medial side of bases of proximal

phalanges of toes 3, 4, 5 and corresponding dorsal extensor expansions

Action Adducts 3, 4, 5 toes to axis of 2nd toe. Assists lumbricals in extending IP joints whilst flexing MTP joints



4th Layer Foot

Dorsal InterosseiOrigin 4 bipennate muscles from the

inner aspects of all 5 metatarsalsInsertion Base of proximal phalanges and

dorsal extensor expansions of medial side of 2nd toe and lateral side of toes 2, 3, 4

Action Abducts toes 2,3,4 away from axis of 2nd toe. Assists lumbricals in extending IP joints whilst flexing MTP joints



4th Layer Foot

Date post:	14-Jan-2017
Category:	Health & Medicine
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Slideshow: The Foot

Health & Medicine