sole consist of 4 layers.this presentation will elobararte the layers of sole.and clinical importance of sole.

1. Sole of Foot
Dr.M.VASANTAKOHILA MBBS
POSTGRADUATE
GOVT.KILPAUK MEDICAL
COLLEGE
DEPARTMENT OF ANATOMY
AN 19.7
DATE :02/12/2023

2. Sole: It is the plantar aspect of the foot and
corresponds to the palm of the hand.
SKIN
Features
1.Thick for protection
2.Firmly adherent to the underlying
plantar aponeurosis
3.Creased
The nerves are:
•Medial calcanean branches of the tibial nerve
•Branches from the medial plantar nerve
•Branches from the lateral plantar nerve

3. Cutaneous nerves supplying the sole

4. • Small areason medial and lateral sides are
innervated by saphenous and sural nerves.
Dermatomes on the sole are shown in figure.
SUPERFICIAL FASCIA
It contains cutaneous nerves
transverse metatarsal ligaments.
and superficial

5. Dermatomes on the sole

6. DEEP FASCIA
1. The plantar aponeurosis in the sole.
2. The deep transverse metatarsal ligaments
3. The fibrous flexor sheaths in the toes.

7. Deep fascia of the sole

8. •Muscles of Sole
The muscles of the sole are arranged in four
layers, which will be considered one by one.
1. FIRST LAYER
2. SECOND LAYER
3. THIRD LAYER
4. FOURT LAYER

9. Muscles of the first layer of the sole

10. Muscles and tendons of the second layer of the sole

11. 3rd LAYER

13. ADDUCTOR HALLUCIS
 AH  ORIGIN :
 Arises by 2 heads
 Large oblique head
from base of the
2nd,3rd,4th
metatarsals.
 Small transverse
head from the
plantar ligaments of
the
metatarsophalangeal
joints of 3rd,4th,5th
toes.

14. ADDUCTOR HALLUCIS
INSERTION: NERVE SUPLY :
 The common tendon
of both heads fuses
with the lateral
tendon of flexor
hallucis brevis.
 Inserted in the base
of proximal phalanx
of the big toe.
 Deep branch of
lateral plantar
nerve(S2,S3).
 ACTION :
 Adduction of the big
toe
 Maintain transverse
arch of the foot.

15. FLEXOR DIGITI MINIMI
BREVIS
 Base of the 5th
metatarsal bone
 Forms narrow
tendon which blends
with the abductor
digiti minimi
INSERTION:
 By a narrrow tendon
into lateral side of
the base of the
proximal phalanx of
the little toe.
 ORIGIN:

16. contd
 NERVE SUPPLY:
Superficial branch of lateral plantar
nerve(S2,S3).
 ACTION:
Flexes the proximal phalanx of the
little toe.

19. Medial Plantar Nerve
It is the larger terminal branch of tibial nerve. Its
distribution is similar to median nerve of the hand. It
lies between abductor hallucis and flexor digitorum
brevis and ends by giving muscular, cutaneous and
articular branches.
Branches:
The branches of medial plantar nerve are shown
in Table A1.6.

20. Scheme to
distribution
show the
of
the
medial plantar nerve
with Morton’s neuroma
on one branch of the
nerve

21. Table A1.6

22. Lateral Plantar Nerve
•It is the smaller terminal branch of tibial nerve,
resembling the ulnar nerve of the hand in its
distribution.
•It runs obliquely between the first and second
layers of sole till the tuberosity of fifth metatarsal
bone, where it divides into its superficial and deep
branches.
Branches: The structures supplied by the trunk, and
its two branches are given in Table A1.7.

23. Table A1.7

24. Scheme to show the distribution of the lateral plantar nerve

25. Arteries of the sole

26. Medial plantar artery and its branches. Lateral plantar artery,
plantar arch and their branches

27. METATARSALGIA
 Metatarsalgia, a forefoot
injury, can occur in anyone,
though athletes who take
part in intense sports that
involve running or jumping
are at the highest risk.
 Metatarsalgia occurs when
there is strong or unusual
pressure on the ball of the
foot, creating pain and
inflammation.


28. METATARSALGIA
 Metatarsalgia pain generally occurs
over time rather than immediately,
and can last several months with
increasing severity.
 SYMPTOMS :
Irritation and inflammation of the
ball of the foot and pain at the end of
one or more of the metatarsal bones.

29. CONTD
 DIAGNOSIS :
MRI
TREATMENT
1. metatarsalgia can be treated in most
cases by rehabilitation and does
not need any surgical
intervention.
2. Icing the foot and applying a pressure
bandage can help start the healing
process.

30. 3. Physical exercise
4. In extreme cases, surgery may be
recommended to treat metatarsalgia. If
there is severe pain and inflammation that
does not subside, surgical realignment of
the metatarsal bones may be required
during metatarsalgia surgery

31. PLANTAR FASCITIS
 Plantar fasciitis (PLAN-tur fas-e-I-tis) is
one of the most common causes of heel
pain.
 It involves inflammation of a thick band of
tissue that runs across the bottom of each
foot and connects the heel bone to the
toes, known as the plantar fascia.
 Plantar fasciitis commonly causes stabbing
pain that often occurs with your first steps
in the morning.
 .

32. CONTD
 As you get up and move, the pain
normally decreases, but it might return
after long periods of standing or when
you stand up after sitting.
 . It is more common in runners and in
people who are overweight.

33. TREATMENT
• Rest
• Icing your foot
• Wearing supportive
shoes
• Massaging and
stretching
• Plantar fasciitis
surgery