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WINDSOR UNIVERSITY SCHOOL OF MEDICINE

WINDSOR UNIVERSITY SCHOOL OF MEDICINE . DEPARTMENT OF ANATOMY. Dr. SREEKANTH THOTA. Lower limb Foot. The Foot. The muscles in the sole of the foot are organized into four layers . Blood supply: Posterior tibial artery Nerve supply: Tibial nerve. Plantar aponeurosis.

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WINDSOR UNIVERSITY SCHOOL OF MEDICINE

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  1. WINDSOR UNIVERSITYSCHOOL OF MEDICINE DEPARTMENT OF ANATOMY Dr. SREEKANTH THOTA Lower limb Foot

  2. The Foot The muscles in the sole of the foot are organized into four layers. Blood supply: Posterior tibial artery Nerve supply: Tibial nerve

  3. Plantar aponeurosis Plantar aponeurosis is a thickening of deep fascia in the sole of the foot. Its apex is attached to the medial and lateral tubercles of the calcaneum. The base of the aponeurosis divides into five slips that pass into the toes.

  4. Muscles of the Sole of the Foot First layer: 1.Abductor hallucis 2. Flexor digitorumbrevis 3.Abductor digitiminimi

  5. Abductor hallucis Origin: calcaneum Insertion: Base of proximal phalanx of big toe Nerve Supply: Medial plantar nerve Action: Abducts big toe

  6. Flexor digitorumbrevis Origin: Calcaneum Insertion: Four tendons to four lateral toes inserted into borders of middle phalanx Nerve Supply: Medial plantar nerve Action: Flexes lateral four toes

  7. Abductor digitiminimi Origin: Calcaneum Insertion: Base of proximal phalanx of fifth toe Nerve Supply: Lateral plantar nerve Action: Abducts fifth toe

  8. Second Layer 1. Quadratusplantae: 2. Lumbricals (4) 3. Flexor digitorumlongus tendon 4. Flexor hallucislongus tendon

  9. Quadratusplantae Origin: Calcaneum Insertion: Tendon of flexor digitorumlongus Nerve Supply: Lateral plantar nerve Action: Assists flexor digitorumlongus in flexing lateral four toes

  10. Lumbricals (4) Origin: Tendons of flexor digitorumlongus Insertion: Dorsal extensor expansion Nerve Supply: First lumbrical: medial plantar nerve. 2nd,3rd and 4th: lateral plantar nerve Action: Extends toes at interphalangeal joints

  11. Third Layer 1. Flexor hallucisbrevis 2. Adductor hallucis 3. Flexor digitiminimibrevis

  12. Flexor hallucisbrevis Origin: Cuboid, lateral cuneiform Insertion: Medial tendon into medial side of base of proximal phalanx of big toe; lateral tendon into lateral side of base of proximal phalanx of big toe Nerve Supply: Medial plantar nerve Action: Flexes metatarsophalangeal joint of big toe

  13. Flexor digitiminimibrevis Origin: Base of fifth metatarsal bone Insertion: Lateral side of base of proximal phalanx of little toe Nerve Supply: Lateral plantar nerve Action: Flexes metatarsophalangeal joint of little toe

  14. Adductor hallucis Origin: transverse head bases of third, fourth and fifth metatarsal bones oblique head from plantar ligaments Insertion: Lateral side of base of proximal phalanx of big toe Nerve Supply: lateral plantar nerve Action: adduct 1st digit

  15. Fourth layer of muscles 1. Dorsal interossei : 4 (DAB) 2. Plantar interossei : 3 ( PAD)

  16. Dorsal interossei : 4 (DAB) Origin: Adjacent sides of metatarsal bones Insertion: Bases of proximal phalanges first: medial side of second toe remainder: lateral sides of second, third, and fourth toes also dorsal extensor expansion Nerve Supply: Lateral plantar nerve Action: Abduction of toes

  17. Plantar interossei : 3 ( PAD) Origin: Inferior surfaces of third, fourth, and fifth metatarsal bones Insertion: Medial side of bases of proximal phalanges of lateral three toes Nerve Supply: Lateral plantar nerve Action: Adduction of toes

  18. Dorsal aspect Extensor digitorumbrevis ORIGIN: Anterior part of upper surface of the calcaneum Insertion: By four tendons into the proximal phalanx of big toe and long extensor tendons to second, third, and fourth toes Nerve Supply: Deep peroneal nerve Action: Extends toes

  19. Arteries Blood supply to the foot is by branches of the posterior tibialand dorsalispedis (dorsal artery of the foot) arteries.

  20. Posterior tibial artery and plantar arch 1. Lateral plantar artery 2. Medial plantar artery

  21. Dorsalispedis artery Branches 1. Tarsal arteries 2. Arcuate artery 3. First dorsal metatarsal artery 4. deep plantar artery: joins with plantar arch

  22. Tibial nerve 1. LATERAL plantar nerve: Innervates all intrinsic muscles in the sole except for the muscles (abductor hallucis, flexor digitorumbrevis, flexor hallucisbrevis, and first lumbrical). 2. MEDIAL plantar nerve

  23. Deep fibular nerve The deep fibular nerve innervates extensor digitorumbrevis, Supplies general sensory branches to the skin on the adjacent dorsal sides of the first and second toes and to the web space between them

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