THE FOOT
ABDULMUJEEB BABATUNDE
Medial View of Foot
Midfoot
Navicular,
cuneiforms
(3) and
cuboid
Rear foot/Hind
foot Forefoot
Talus and Metatarsals (5) and
calcaneus phalanges (14)
Lateral View of the foot
Midfoot
Forefoot Hind foot/Rear
foot
Dorsal view
The 5 metatarsal bones are
made up of three main parts—
the base, the shaft and the
head.
The base is at the proximal
end.
The shaft is in the middle.
The heads are located at the
distal ends of the bones. The
heads are the weight bearing
portion of the foot.
The metatarsals are numbered
1-5 beginning with the great
toe, or hallux.
Sesamoids
Located on the plantar side
of the great toe (hallux).
Identified by the location
on the foot-- tibial (medial)
and fibular (lateral)
sesamoids.
Flexor hallucis longus
tendon runs between
them.
The tendon is responsible
for abducting and
adducting great toe.
Ankle Bones
Posterior view of ankle
1.Tibia
2.Medial malleolus
(tibia)
3.Lateral malleolus
(fibula)
5 4.Talus (slightly
displaced)
5.Calcaneus
SOLE OF THE FOOT
• The skin of the sole of the
foot is thick and hairless
• The skin of the sole shows a
few flexure creases at the
sites of skin movement
• Sweat glands are present in
large numbers
7
DEEP FASCIA
• The plantar aponeurosis
is a triangular thickening
of the deep fascia that
protects the underlying
nerves, blood vessels,
and muscles.
• 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.
8
MUSCLES OF THE SOLE
OF THE FOOT
The muscles of the sole
are conveniently
described in four layers
from superficial to deep.
9
First Layer
1. Abductor hallucis,
2. Flexor digitorum brevis,
3. Abductor digiti minimi
10
Second Layer
1. Quadratus plantae,
2. Lumbricals,
3. Flexor digitorum longus
tendon,
4. Flexor hallucis longus tendon
11
Third Layer
1. Flexor hallucis brevis
2. Adductor hallucis
3. Flexor digiti minimi brevis
12
Fourth Layer
1. Interossei, (3 plantar + 4
dorsal).
2. Peroneus longus tendon,
3. Tibialis posterior tendon
13
3RD & 4TH LAYERS
Dr M Eladl
Function of small muscles of Foot
• Unlike the small
muscles of the hand,
the sole muscles have
few delicate functions
and are chiefly
concerned with
supporting the arches of
the foot.
• Although their names
would suggest control
of individual toes, this
function is rarely used
in most people
15
MUSCLES OF THE DORSAL SURFACE
Proximal
Muscle Attachment Distal Attachment Innervationa Main Action
Extensor Calcaneus Long flexor tendons of Deep fibular Aids the extensor
Digitorum (floor of tarsal four medial toes (digits 5) nerve (L5 or digitorum longus in
brevis sinus); S1, or both) extending the four
interosseous medial toes at the
talocalcaneal metatar-sophalangeal
ligament; stem and interphalangeal
of inferior joints
extensor
retinaculum
Extensor hallucis In common Dorsal aspect of base of Aids the extensor
brevis with extensor proximal phalanx of great hallucis longus in
digitorum toe (digit 1) extending the great toe
brevis (above) at the metatarso-
phalangeal joint
Arches of Foot
Medial longitudinal arch
• Is formed of calcaneum, talus, navicular, 3 cuneiform
bones, and first medial 3 metatarsal bones.
Lateral longitudinal arch Is formed of calcaneum,
cuboid & lateral 4th & 5th metatarsal bones
Transverse arch
• Lies at the level of tarso-metatarsal joints, formed of
bases of metatarsal bones, cuboid & 3 cuneiform
bones.
Arches of the Foot
•The foot arches are formed by the bones,
ligaments, and tendons of the foot.
Medial Longitudinal Arch
•The "medial longitudinal arch"
is the most prominent foot
arch.
• It runs from front to back along
the inner edge of the foot.
•This arch absorbs the majority
of the shock of impact while
walking, jumping or running.
Medial Longitudinal Arch
•This arch is very tall and is extremely flexible due to its large number
of component bones.
•Its apex (the trochlear surface of the talus) and its two extremities
which are the medial tubercle of the calcaneum and the heads of
1st -3rd metatarsals..
• It is formed of calcaneum, talus, navicular, 3 cuneiform bones, and
first medial 3 metatarsal bones.
Lateral Longitudinal Arch
It runs along the outer edge of the foot.
It is most visible in people with very high arches.
It is difficult to define its apex because although body
weight is transmitted into it via the talus, the talus is not part of
the arch.
The extremities are the lateral tubercle of the calcaneum and
the heads of 4th -5th metatarsals.
This arch is flat and contains relatively few bones.
It is formed of calcaneum, cuboid and lateral 4th & 5th
metatarsal bones.
Transverse Arch
• It runs across the midfoot.
• Lies at the level of tarso-metatarsal
joints.
• It provides support and flexibility to the
foot.
• This arch is maintained by the same
muscles and ligaments as the longitudinal
arches.
•Formed of bases of all metatarsal
bones, cuboid and 3 cuneiform bones.
Function of Arches of the Foot
Weight bearing
Support walking & running
Provide potential space neurovascular
bundle of the sole
Act as shock absorber
In young child the foot appears to be flat
because of presence of a large amount of
subcutaneous fat on the sole of foot
VASCULATION OF THE FOOT
Arteries of the Foot
• The arteries of the foot are terminal branches of the anterior
and posterior tibial arteries, respectively: the dorsal and plantar
arteries.
Dorsal Artery of the Foot
• The dorsal artery of the foot (L. arteria dorsalis pedis) often a
major source of blood supply to the forefoot, is the direct
continuation of the anterior tibial artery.
• The dorsal artery begins midway between the malleoli and runs
anteromedially, deep to the inferior extensor retinaculum
between the extensor hallucis longus and the extensor
digitorum longus tendons on the dorsum of the foot.
Arteries of the foot
The Anterior tibial artery passes
Beneath the superior extensor retinaculum,
It is called dorsal artery of the foot or
Dorsalis Pedis artery
Ant. Tibial artery or Dorsalis pedis may give
The lateral tarsal artery, the lateral tarsal and dorsalis pedis
Make the arcuate artery (14) giving rise to
Metatarsal and dorsal digital arteries.
Dorsalis pedis gives a deep branch to join
The plantar arch.
Arteries of the foot (sole)
Posterior tibial artery in the plantar region
gives the medial and lateral Plantar arteries.
MEDIAL PLANTAR ARTERY
Origin: Terminal branch of
posterior tibial artery
Course:
Enter the foot midway between
medial malleolus and medial
tubercle of calcaneus, under
flexor retinaculum
Passes deep to abductor hallucis
Runs b/w abd.hallucis and flexor
digitorum brevis
Accompanied by two venae
comitantes
Med.planter nerve runs along its
lat. side
Dr M Eladl
MEDIAL PLANTAR ARTERY
Branches
Cutaneous
Muscular
Digital: 3 superficial digital
branches these branches
end by anastmosing with the
first, second and third
planter metatarsal arteries.
Dr M Eladl
LATERAL PLANTAR ARTERY
• Origin: One of the two
terminal branches of the
posterior tibial artery
• Course:
At first between the 1st and
2nd layers
Curves medially between
the 3rd and 4th layer
Lateral planter nerve lies
along its medial side
Dr M Eladl
Termination:
Turns medially with the deep
branch of the lateral planter
nerve with slight forward
convexity to from the plantar
arch between the 3rd & 4th
layers of muscles and joins
medially with dorsalis pedis
artery (Plantar Arch).
LATERAL PLANTAR ARTERY
• Branches:
Muscular
Cutaneous
Anastomotic branches:
Anastomosis with branches of arcuate &
lateral tarsal arteries of the dorsalis pedis
artery.
Planter digital artery: to the lateral
side of the little toe
Four planter metatarsal arteries
Proximal & distal perforating arteries:
3 PP & 4 DP ascend through the proximal
and distal ends of interosseous spaces to
anastomose with the dorsal metatarsal
Dr M Eladl
arteries.
Applied Anatomy of Foot
BIRTH DEFECTS (Clubfoot).
High Arches.
Flat Foot.
BIRTH DEFECTS :
Clubfoot is a common congenital deformity involving one foot or both.
The affected foot appears to have been rotated internally at the ankle.
In babies with clubfoot the ligaments and tendons of muscles are
shorter than usual causing their feet to be twisted.
In many cases, the defect can be corrected using casts on the childs's
feet and legs but some cases may require surgery.
Without treatment, people with club feet often appear to walk on their
ankles or on the sides of their feet. However with treatment, the majority
of patients recover completely during early childhood and are able to
walk.
Pes Cavus
(High Foot Arch)
• Cavus foot is a condition in which the foot has a very high
arch.
• It is the opposite of flat foot.
• It is much less common than flat foot.
• There is a fixed plantar flexion deformity of the foot.
Pes Cavus (High Foot Arch)
Causes :
It may be hereditary or acquired, They are
more associated with an orthopedic,
neurological or neuromuscular conditions.
Neuromuscular diseases that cause changes in
muscle tone (shortening of muscles or tendons
of leg or sole), in most cases due to
poliomyelitis.
It usually need foot support. A high arch may
cause significant disability.
Symptoms :
•Shortened length of foot.
•Difficulty fitting shoes.
•Hammertoes (bent toes) or claw toes.
•Foot pain associated with walking, standing,
and running.
The medial longitudinal arch is
Pes planus (Flat Foot) depressed, so the foot is displaced laterally
and everted.
Causes of flat foot :
• Congenital.
• Stretched or torn tendons.
• Damage or inflammation of the tibialis posterior
tendon, which connects from your lower leg, along
your ankle, to the middle of the arch
• Broken or dislocated bones.
• Some health conditions, such as rheumatoid
arthritis.
• Nerve problems.
• So weak muscles & ligaments are stretched and
pain is produced after walking for a short distance.
Other factors that can increase your risk include:
Obesity
Diabetes
Pregnancy
Long standing or Long walking.
QUESTION-2
All of the following belong to 3rd layer of
muscles in sole except:
A) Flexor hallucis brevis
B) Abductor hallucis
C) Adductor hallucis
D) Flexor digiti minimi brevis
