ANATOMY LECTURE
SOLE OF FOOT10.11.2008
Dermatomes of the footDermatomes of the foot
MUSCLES OF POSTERIOR MUSCLES OF POSTERIOR COMPARTMENT OF LEGCOMPARTMENT OF LEG
Tibialis posteriorTibialis posterior
Flexor digitorum Flexor digitorum longuslongus
Flexor hallucis longusFlexor hallucis longus
Artery & NerveArtery & Nerve
Posterior tibial arteryPosterior tibial artery
Tibial nerve Tibial nerve
BONES OF FOOTBONES OF FOOT
TARSAL :TARSAL :CalcaneusCalcaneus
TalusTalus
NavicularNavicular
CuniformCuniform
(laeral,intermediate(laeral,intermediate
and medialand medial))
MetatarsalMetatarsal
phalanxphalanx
Skin and fasciaSkin and fascia
Skin:Skin: thick & hairless thick & hairless firmly attachedfirmly attached
to the underlying deep fasciato the underlying deep fascia.. Deep fascia:Deep fascia:
Plantar aponeorosisPlantar aponeorosis: : apex apex ΔΔ central thickened deep fascia central thickened deep fasciaattached to the medial & lateral tubercles of attached to the medial & lateral tubercles of calcaneum, base distally.calcaneum, base distally.function: protection of deeper structures & function: protection of deeper structures & maintain the arches of the footmaintain the arches of the foot..
Muscles of the sole:Muscles of the sole:
There are four layers of musclesThere are four layers of muscles::first layer:first layer: abductor hallucis,abductor hallucis, flexor digitorum brevis,flexor digitorum brevis, abductor digiti minimiabductor digiti minimi2nd layer:2nd layer: quadratus plantaequadratus plantaelumbricalis, flexor digitorum longus tendon, lumbricalis, flexor digitorum longus tendon, flexor hallucis longus tendon.flexor hallucis longus tendon.3rd layer3rd layer:: flexor hallucis brevisflexor hallucis brevis adductor hallucis, flexor digiti minimi brevisadductor hallucis, flexor digiti minimi brevis 4th layer4th layerinterossei, peroneus longus tendoninterossei, peroneus longus tendontibialis posterior tendontibialis posterior tendon..
Muscles of the Sole of the Foot (First Layer)Muscles of the Sole of the Foot (First Layer)
MUSCLEMUSCLEflexor flexor hallucis hallucis brevisbrevis
ORIGINORIGINcuboid, lateral cuboid, lateral cuneiform bones; cuneiform bones; tibialis posterior tibialis posterior insertioninsertion
INSERTIONINSERTIONmedial & lateral sides medial & lateral sides of base of proximal of base of proximal phalanx of big toephalanx of big toe
NERVENERVEmedial plantar medial plantar nervenerve
ACTIONACTIONflexes metatarsophalangeal flexes metatarsophalangeal joint of big toe; supports joint of big toe; supports medial longitudinal archmedial longitudinal arch
adductor adductor hallucis hallucis (oblique (oblique head)head)
bases of 2nd, 3rd & bases of 2nd, 3rd & 4th metatarsal bones4th metatarsal bones
lateral side base of lateral side base of proximal phalanx big proximal phalanx big toetoe
deep branch deep branch of lateral of lateral plantarplantar
flexes big toe, supports flexes big toe, supports transverse archtransverse arch
adductor adductor hallucis hallucis (transve(transverse rse head)head)
plantar ligamentsplantar ligamentslateral side of base of lateral side of base of proximal phalanx big proximal phalanx big toetoe
deep branch deep branch of lateral of lateral plantar nerveplantar nerve
flexes big toe; supports flexes big toe; supports transverse archtransverse arch
flexor flexor digiti digiti minimi minimi brevisbrevis
base of 5th base of 5th metatarsal bonemetatarsal bone
lateral side of base of lateral side of base of proximal phalanx of big proximal phalanx of big toetoe
superior superior branch of branch of lateral plantar lateral plantar nervenerve
flexes little toeflexes little toe
muscles of Sole of Foot (Second Layer)muscles of Sole of Foot (Second Layer)
MUSCLEMUSCLEflexor flexor accessoriuaccessorius s (quadratus (quadratus plantae)plantae)
ORIGINORIGINmedial medial and and lateral lateral sides of sides of calcaneucalcaneumm
INSERTIONINSERTIONttendons endons flexor flexor digitorum digitorum longuslongus
NERVENERVElateral plantar nervelateral plantar nerve
ACTIONACTIONaids long flexor tendon aids long flexor tendon to flex lateral four toesto flex lateral four toes
flexor flexor digitorum digitorum longus longus tendontendon
shaft of shaft of tibiatibia
base of base of distal distal phalanx of phalanx of lateral four lateral four toestoes
tibial nervetibial nerve
flexes distal phalanges flexes distal phalanges of lateral four toes; of lateral four toes; plantar flexes foot; plantar flexes foot; supports longitudinal supports longitudinal archarch
lumbricalslumbricals
tendons tendons of flexor of flexor digitorum digitorum longuslongus
dorsal dorsal extensor extensor expansion expansion of lateral of lateral four toesfour toes
1st lumbrical from medial 1st lumbrical from medial plantar; remainder plantar; remainder lumbricals from deep lumbricals from deep branch of lateral plantar branch of lateral plantar nervenerve
extends toes at extends toes at interphalangeal jointsinterphalangeal joints
flexor flexor hallucis hallucis longuslongus
shaft of shaft of fibulafibula
base of base of distal distal phalanx of phalanx of big toebig toe
tibial nervetibial nerve
flexes distal phalanx of flexes distal phalanx of big toe; plantar flexes big toe; plantar flexes foot; supports medial foot; supports medial longitudinal archlongitudinal arch
Muscles of Sole of Foot (Third Muscles of Sole of Foot (Third Layer) Layer)
MUSCLEMUSCLEflexor flexor hallucis hallucis brevisbrevis
ORIGINORIGINcuboid, lateral cuboid, lateral cuneiform bones; cuneiform bones; tibialis posterior tibialis posterior insertioninsertion
INSERTIONINSERTIONmedial & lateral medial & lateral sides of base of sides of base of proximal phalanx proximal phalanx of big toeof big toe
NERVENERVEmedial medial plantar plantar nervenerve
ACTIONACTIONflexes flexes metatarsophalangeal metatarsophalangeal joint of big toe; supports joint of big toe; supports medial longitudinal archmedial longitudinal arch
adductor adductor hallucis hallucis (oblique (oblique head)head)
bases of 2nd, 3rd bases of 2nd, 3rd & 4th metatarsal & 4th metatarsal bonesbones
lateral side base lateral side base of proximal of proximal phalanx big toephalanx big toe
deep deep branch of branch of lateral lateral plantarplantar
flexes big toe, supports flexes big toe, supports transverse archtransverse arch
adductor adductor hallucis hallucis (transvers(transverse head)e head)
plantar ligamentsplantar ligamentslateral side of lateral side of base of proximal base of proximal phalanx big toephalanx big toe
deep deep branch of branch of lateral lateral plantar plantar nervenerve
flexes big toe; supports flexes big toe; supports transverse archtransverse arch
flexor flexor digiti digiti minimi minimi brevisbrevis
base of 5th base of 5th metatarsal bonemetatarsal bone
lateral side of lateral side of base of proximal base of proximal phalanx of big toephalanx of big toe
superior superior branch of branch of lateral lateral plantar plantar nervenerve
flexes little toeflexes little toe
Muscles of Sole of Foot (Fourth Muscles of Sole of Foot (Fourth Layer)Layer)
MUSCLEMUSCLEdorsal dorsal interossei interossei (4)(4)
ORIGINORIGINadjacent adjacent sides of sides of metatarsal metatarsal bonesbones
INSERTIONINSERTIONbases of phalanges and bases of phalanges and dorsal expansion of dorsal expansion of corresponding toescorresponding toes
NERVENERVElateral lateral plantar plantar nervenerve
ACTIONACTIONabduct toes with 2nd toe as the reference; abduct toes with 2nd toe as the reference; flex metatarsophalangeal joints; extend flex metatarsophalangeal joints; extend interphalangeal jointinterphalangeal joint
plantar plantar interossei interossei (3)(3)
3rd, 4th, and 3rd, 4th, and 5th 5th metatarsal metatarsal bonesbones
bases of phalanges & bases of phalanges & dorsal expansion of dorsal expansion of corresponding toescorresponding toes
lateral lateral plantar plantar nervenerve
adduct toes with 2nd toe as reference; adduct toes with 2nd toe as reference; flex metatarsophalangeal joints; extend flex metatarsophalangeal joints; extend interphalangeal jointsinterphalangeal joints
tendon of tendon of peroneus peroneus longuslongus
see abovesee above see abovesee above see see aboveabove see abovesee above
tendon of tendon of tibialis tibialis posteriorposterior
see abovesee above see abovesee above see see aboveabove see abovesee above
Arteries of the Sole of the FootArteries of the Sole of the Foot The arteries of the sole of the foot:The arteries of the sole of the foot:
are derived from the are derived from the posterior tibial arteryposterior tibial artery..
It splits into the medial and lateral plantar arteries. It splits into the medial and lateral plantar arteries.
The The medial plantar arterymedial plantar artery
passes along the medial part of the solepasses along the medial part of the sole of the foot and terminates byof the foot and terminates by branching into digital branches. branching into digital branches.
The The lateral plantar arterylateral plantar artery becomes the becomes the plantar arterial archplantar arterial arch which anastomoses by way ofwhich anastomoses by way of a perforating artery with thea perforating artery with the dorsal pedis arterydorsal pedis artery. . The arch gives rise to several metatarsalThe arch gives rise to several metatarsal branches which split into branches which split into digital branchesdigital branches. .
NERVESNERVES
Nerves of the Sole of the FootNerves of the Sole of the Foot
The The medial and lateral plantar nervesmedial and lateral plantar nerves supply supply muscles and skin of the sole of the foot.muscles and skin of the sole of the foot.
The The medial plantar nervemedial plantar nerve gives rise to digital gives rise to digital branches which then give rise to common digital branches which then give rise to common digital branches and finally, the terminal branches. This branches and finally, the terminal branches. This nerve supplies the skin of the medial three and nerve supplies the skin of the medial three and one half digits.one half digits.
The The lateral plantar nervelateral plantar nerve gives rise to motor gives rise to motor branches, a deep branch and finally branches to branches, a deep branch and finally branches to the skin of the lateral one and one-half digits. the skin of the lateral one and one-half digits.
Arches of the FootArches of the Foot
All of the bones of the foot are All of the bones of the foot are held together by ligaments but held together by ligaments but there are three that are strongly there are three that are strongly implicated in maintaining the implicated in maintaining the
arches of the footarches of the foot:: 1.1. long plantar ligament long plantar ligament
2.2. calcaneocuboid ligament calcaneocuboid ligament
3.3. calcaneonavicular ligament calcaneonavicular ligament
The The longitudinallongitudinal arch arch of the foot is of the foot is higher on the higher on the medialmedial side. It is side. It is made up of the 1st three digits and made up of the 1st three digits and their metatarsals, the cuneiforms, their metatarsals, the cuneiforms, the navicular bone and the talus.the navicular bone and the talus.
The The lateral longitudinallateral longitudinal arch is arch is made up of digits 4 and 5 and their made up of digits 4 and 5 and their metatarsals, the cuboid and the metatarsals, the cuboid and the calcaneum. It is much shallower calcaneum. It is much shallower than the medial arch.than the medial arch.
The The transversetransverse arch arch of the foot is of the foot is primarily formed by the 5 metatarsal primarily formed by the 5 metatarsal bones. bones.
THANK YOUTHANK YOU
Thank you for attentionThank you for attention
AnatomyAnatomy Dr. KumarDr. Kumar Associate Professor Associate Professor Dr. MashairDr. Mashair InstructorInstructor