2. The cutaneous innervation of the sole of the
foot
• The medial planter nerve supplies
the medial 2/3rd
• The lateral plantar nerve supplies the
lateral 1/3rd
, the common border of
their distribution extends along the
fourth metatarsal and digit.
• Laterally by the sural nerve, including
part of the heel.
• Posteriorly (heel) by the calcaneal
branches of the tibial and sural
nerves.
3. DEEP FASCIA OF THE SOLE OF FOOT
• The deep fascia of the sole has a thick
central part (the plantar aponeurosis)
and weaker medial and lateral parts.
• The plantar fascia holds parts of the
foot together, helps protect the sole
from injury, and helps support the
longitudinal arches of the foot.
4. The plantar aponeurosis
• 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 calcaneus. The base of
the aponeurosis divides into
five slips that pass into the
toes.
5. MUSCLES OF THE SOLE OF
THE FOOT
The muscles of the foot divided into 4 layers
12. 4th
Layer Muscles
1. Plantar interossei.
2. Dorsal interossei.
3. Tendon of peroneus longus.
4.Tendon of tibialis posterior
13.
14. ARTERIES OF FOOT
• Medial plantar artery
• Origin: The medial plantar artery is the smaller terminal
branch of the posterior tibial artery
• Course It passes distally along the medial side of the foot,
medial to the medial plantar nerve. At first deep to
abductor hallucis between it and flexor digitorum brevis,
and supplies both muscles.
• Branches
• Muscular branches
• three superficial digital branches join the first, second and
third plantar metatarsal arteries.
• The main trunk of the medial plantar artery anastomoses
with a branch of the first plantar metatarsal artery.
15. Lateral plantar artery
• Origin: It is the larger terminal branch of the posterior tibial
artery.
• Course:
• It passes lateral to the lateral plantar nerve. (The medial and lateral
plantar nerves lie between the corresponding plantar arteries.)
Turning medially to reach the interval between the first and second
metatarsal bases, and unites with the dorsalis pedis artery to
complete the plantar arch. It passes between flexor digitorum brevis
and abductor digiti minimi and is covered by the plantar aponeurosis,
superficial fascia and skin.
• Branches
• Muscular branches supply the adjoining muscles.
• Superficial branches supply the skin and subcutaneous tissue lateral
in the sole.
• Anastomotic branches run to the lateral border of the foot, joining
branches of the lateral tarsal and arcuate arteries.
• A calcaneal branch supply the skin of the heel.
16.
17. Medial plantar nerve
• It is the larger terminal division of the tibial nerve, and lies
lateral to the medial plantar artery.
• It passes deep to abductor hallucis, then appears between
it and flexor digitorum brevis.
• Branches
• 1. Cutaneous branches supply the skin of the sole of the
foot.
• 2. Muscular branches supply abductor hallucis, flexor
digitorum brevis, flexor hallucis brevis and the first
lumbrical.
• 3. Articular branches supply the joints of the tarsus and
metatarsus.
• 4. Three common plantar digital nerves each dividing into
two proper digital branches
• Plantar digital nerves run to the sides of the medial three
and a half toes
18.
19. Lateral plantar nerve
• It is one of the terminal branches of the
tibial nerve.
• It arises beneath the flexor retinaculum
and runs forward deep to the abductor
hallucis and the flexor digitorum brevis,
in company with the lateral plantar
artery.
• On reaching the base of the fifth
metatarsal bone, it divides into
superficial and deep branches
20. Branches of lateral planter nerve
• 1. From the trunk it supplies flexor digitorum
accessorius and abductor digiti minimi and cutaneous
branch to the skin of the lateral part of the sole.
• 2. From the superficial terminal branch to the flexor
digiti minimi and the 3rd
planter and 4th
dorsal interossei
(muscles of the fourth intermetatarsal space).
• Plantar digital branches pass to the sides of the lateral
one and a half toes. The nerves extend onto the
dorsum and supply the nail beds and tips of the toes.
• From the deep terminal branch. This branch curves
medially with the lateral plantar artery and supplies the
adductor hallucis; the second, third, and fourth
lumbricals; and all the interossei, except those in the
fourth intermetatarsal space .
