This document describes the anatomy of the sole of the foot. It discusses:
1. The skin and vascular supply to the plantar skin, including arteries, veins and lymphatic drainage.
2. The plantar fascia which connects the heel to the toes and divides into bands for each toe. Retinacula connect the fascia to the skin.
3. The muscles of the foot are divided into four layers, with the first layer including abductor hallucis, flexor digitorum brevis and abductor digiti minimi.
The document provides a detailed overview of leg anatomy, including:
1- The skin and subcutaneous tissue of the leg consist of an epidermis and dermis layer.
2- The leg contains 3 fascial compartments dividing muscles into anterior, posterior, and lateral groups.
3- Key bones are the tibia and fibula, which are connected by interosseous membrane.
4- Major nerves include the tibial, deep peroneal, and superficial peroneal nerves which provide motor and sensory innervation.
5- The document describes muscles and blood vessels of each compartment.
The document provides details on the anatomy of the foot, including:
- The sensory nerve supply to the skin of the dorsum comes from the superficial peroneal, deep peroneal, saphenous, and sural nerves.
- The dorsalis pedis artery originates from the anterior tibial artery and runs along the dorsum of the foot, giving off branches.
- The sole of the foot contains 4 layers of muscles and its skin has sensory innervation from the medial and lateral plantar nerves.
- The medial and lateral plantar arteries originate from the posterior tibial artery and supply structures in the sole.
Applied and clinical anatomy of lower limbdrjabirwase
The document describes the anatomy of the lower limb, including the pelvis, femur, patella, tibia, fibula, and hip joint. It discusses the bones that make up each part and their blood supply, fractures commonly seen in each bone, and movements at the hip joint. The lower limb consists of the gluteal region, thigh, leg, and foot and its main functions are to support body weight and enable locomotion.
This document describes the anatomy of the sole of the foot, including four layers of muscles, arteries, nerves, and the plantar aponeurosis. The four layers of muscles in the sole are the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi in the first layer. The second layer contains the flexor hallucis longus, flexor digitorum longus, and other muscles. The third layer has two muscles and the fourth layer contains nine muscles including the interossei muscles. The document also outlines the arterial blood supply and nerves to the sole, with branches from the posterior tibial, medial and lateral plantar arteries and nerves.
The document summarizes the anatomy of the pectoral region. It describes the origin, insertion, innervation and actions of the pectoralis major, pectoralis minor, serratus anterior, and clavipectoral fascia muscles. It also details the structure, extent, relations, and lymphatic drainage of the mammary gland. The arterial supply, venous drainage and nerve supply of the breast are outlined. Applied aspects such as mammography and treatment for breast cancer and abscess are briefly discussed.
The posterior compartment of the thigh contains the hamstring muscles (biceps femoris, semitendinosus, semimembranosus, and part of the adductor magnus), which are supplied by branches from the sciatic nerve. It also contains cutaneous nerves that innervate the skin (medial, posterior, and lateral cutaneous nerves) and veins that drain into the great and small saphenous veins. The blood supply comes from branches of the profunda femoris artery and drains into the profunda femoris vein.
The document describes the muscles of the thigh and gluteal region. It discusses:
1. The thigh region is divided into four compartments - anterior, medial, posterior, and lateral. The anterior compartment contains muscles that flex the hip and extend the knee. The medial compartment contains adductor muscles. The posterior compartment contains hamstring muscles that extend the hip and flex the knee.
2. The gluteal region contains the gluteal muscles - gluteus maximus, medius, and minimus. It also contains smaller lateral rotator muscles.
3. Several important structures pass through openings in the pelvis. The sciatic nerve passes through the greater and lesser sciatic foramina.
The document provides a detailed overview of leg anatomy, including:
1- The skin and subcutaneous tissue of the leg consist of an epidermis and dermis layer.
2- The leg contains 3 fascial compartments dividing muscles into anterior, posterior, and lateral groups.
3- Key bones are the tibia and fibula, which are connected by interosseous membrane.
4- Major nerves include the tibial, deep peroneal, and superficial peroneal nerves which provide motor and sensory innervation.
5- The document describes muscles and blood vessels of each compartment.
The document provides details on the anatomy of the foot, including:
- The sensory nerve supply to the skin of the dorsum comes from the superficial peroneal, deep peroneal, saphenous, and sural nerves.
- The dorsalis pedis artery originates from the anterior tibial artery and runs along the dorsum of the foot, giving off branches.
- The sole of the foot contains 4 layers of muscles and its skin has sensory innervation from the medial and lateral plantar nerves.
- The medial and lateral plantar arteries originate from the posterior tibial artery and supply structures in the sole.
Applied and clinical anatomy of lower limbdrjabirwase
The document describes the anatomy of the lower limb, including the pelvis, femur, patella, tibia, fibula, and hip joint. It discusses the bones that make up each part and their blood supply, fractures commonly seen in each bone, and movements at the hip joint. The lower limb consists of the gluteal region, thigh, leg, and foot and its main functions are to support body weight and enable locomotion.
This document describes the anatomy of the sole of the foot, including four layers of muscles, arteries, nerves, and the plantar aponeurosis. The four layers of muscles in the sole are the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi in the first layer. The second layer contains the flexor hallucis longus, flexor digitorum longus, and other muscles. The third layer has two muscles and the fourth layer contains nine muscles including the interossei muscles. The document also outlines the arterial blood supply and nerves to the sole, with branches from the posterior tibial, medial and lateral plantar arteries and nerves.
The document summarizes the anatomy of the pectoral region. It describes the origin, insertion, innervation and actions of the pectoralis major, pectoralis minor, serratus anterior, and clavipectoral fascia muscles. It also details the structure, extent, relations, and lymphatic drainage of the mammary gland. The arterial supply, venous drainage and nerve supply of the breast are outlined. Applied aspects such as mammography and treatment for breast cancer and abscess are briefly discussed.
The posterior compartment of the thigh contains the hamstring muscles (biceps femoris, semitendinosus, semimembranosus, and part of the adductor magnus), which are supplied by branches from the sciatic nerve. It also contains cutaneous nerves that innervate the skin (medial, posterior, and lateral cutaneous nerves) and veins that drain into the great and small saphenous veins. The blood supply comes from branches of the profunda femoris artery and drains into the profunda femoris vein.
The document describes the muscles of the thigh and gluteal region. It discusses:
1. The thigh region is divided into four compartments - anterior, medial, posterior, and lateral. The anterior compartment contains muscles that flex the hip and extend the knee. The medial compartment contains adductor muscles. The posterior compartment contains hamstring muscles that extend the hip and flex the knee.
2. The gluteal region contains the gluteal muscles - gluteus maximus, medius, and minimus. It also contains smaller lateral rotator muscles.
3. Several important structures pass through openings in the pelvis. The sciatic nerve passes through the greater and lesser sciatic foramina.
The plantar aponeurosis is a thick central part of the deep fascia of the foot that divides into bands to attach to the toes. It helps maintain the longitudinal arch and protects the plantar vessels and nerves. The muscles of the foot can be divided into intrinsic muscles within the foot and extrinsic muscles originating from the leg. The intrinsic muscles are described in four layers - the superficial layer acts to flex the toes, the second layer includes flexor muscle accessories, the third layer acts on the big and little toes, and the deepest fourth layer contains the interossei muscles.
The fascial compartments of thigh are the three fascial compartments that divide and contain the thigh muscles. The fascia lata is the strong and deep fascia of the thigh that surrounds the thigh muscles and forms the outer limits of the compartments. Internally the muscle compartments are divided by the lateral and medial intermuscular septa.
The document provides details on the anatomy of the wrist and carpal bones. It can be summarized as:
1. The wrist joint is made up of the distal ends of the radius and ulna articulating with the proximal and distal rows of carpal bones, which then articulate with the metacarpal bones.
2. The carpal bones are arranged in two rows - the proximal row includes the scaphoid, lunate, triquetrum, and pisiform bones. The distal row includes the trapezium, trapezoid, capitate, and hamate bones.
3. The carpal bones are stabilized by intrinsic and extrinsic ligaments including the scapholunate and
The document describes the anatomy of the foot, including:
1) The first layer of muscles in the sole contains the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi muscles.
2) The second layer contains the quadratus plantae muscle and lumbricals, and transmits the tendons of the flexor digitorum longus muscle.
3) Other structures described include the plantar aponeurosis, neurovascular planes, interossei muscles, and the four layers of muscles in the sole.
The femoral triangle contains important structures in the upper thigh. It has boundaries of the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially. The floor contains muscles that aid in hip adduction. The femoral nerve provides sensation and motor function, and the femoral artery and vein are also located here, with the artery giving off deep branches. The structures of the femoral triangle are clinically relevant to conditions like varicose veins, hernias, and addressing muscle spasticity in cerebral palsy.
The ankle joint is a uniaxial synovial hinge joint formed between the distal end of the tibia, lateral malleolus of the fibula, and talus bone. It is stabilized by strong ligaments including the deltoid ligament medially and three lateral ligaments. The joint allows for dorsiflexion and plantar flexion movement about its axis and is supplied by the posterior and anterior tibial arteries and nerves. Common injuries include ankle sprains from excessive inversion or eversion stretching the lateral or deltoid ligaments, respectively.
The document describes the anatomy of the anterior thigh compartment. It is divided into 3 sections - anterior, medial, and posterior - by intermuscular septa. The major muscles of the anterior compartment are the sartorius and quadriceps femoris group (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis). Together they perform knee extension. Each muscle originates on the pelvis or femur and inserts via the patella and quadriceps tendon. They are innervated by branches of the femoral nerve.
This document summarizes the major muscles of the upper and lower extremities. It describes the muscles of the arm, forearm, thigh, and leg, organized by anatomical compartment. For each region, it lists the superficial and deep muscle groups from lateral to medial and their main actions. The upper extremity sections cover the muscles of the arm's anterior, posterior, and lateral compartments and the forearm's anterior and posterior groups. The lower extremity sections discuss the thigh muscles that act on the femur and the anterior, posterior, and lateral muscle compartments of the leg and their actions on the ankle.
The adductor canal is located on the medial thigh and contains the femoral artery, femoral vein, and saphenous nerve. John Hunter first used the region to compress blood vessels during lower limb operations. The canal has boundaries formed by the adductor longus, vastus medialis, and sartorius muscles. Structures passing through the roof of the canal include the nerve to vastus medialis, saphenous nerve and artery, and genicular branches. Injuries penetrating the adductor canal can damage the femoral artery and nerves, resulting in loss of blood flow and sensation in the leg and foot.
The anterior tibial artery is a terminal branch of the popliteal artery that supplies the anterior compartment of the leg. It originates below the popliteus muscle and courses vertically down the leg between muscle compartments before becoming the dorsalis pedis artery. It gives off branches that anastomose around the knee and ankle joints. The posterior tibial artery is the larger terminal branch of the popliteal artery, supplying the posterior and lateral leg compartments and sole of the foot. It travels behind the tibia and fibula, giving muscular and nutrient branches before terminating as the medial and lateral plantar arteries. Throughout its course it is accompanied by the tibial nerve.
The document summarizes the embryological development of the skeletal system. It describes how the axial skeleton, including the vertebral column and ribs, and appendicular skeleton develop from somites in the embryo. It explains the three stages of development - blastemal/membranous, cartilaginous, and bony. It provides details on the formation of individual bones and joints, such as the development of vertebrae, ribs, sternum, skull, and others from sclerotomes, notochord, and cartilage models.
The document summarizes the muscles of the foot in 4 layers. The intrinsic muscles are within the foot and responsible for fine motor control, while extrinsic muscles originate from the leg and control larger motions like plantarflexion and dorsiflexion. The first layer includes the abductor hallucis, abductor digiti minimi, flexor digitorum brevis. The second layer includes lumbricals and the tendons of flexor digitorum longus and flexor hallucis longus. The third layer includes the flexor hallucis brevis, adductor hallucis, and flexor digiti minimi brevis. The fourth layer includes the tendons of peroneus longus
The duodenum has 4 parts: superior, descending, horizontal, and ascending. The superior part is the most mobile and begins at the pylorus. The descending part is retroperitoneal and passes behind the head of the pancreas. The horizontal part crosses behind blood vessels. The ascending part meets the jejunum. The duodenum has relationships with nearby organs and vessels. It receives blood supply from the celiac trunk and superior mesenteric artery. The duodenum is susceptible to ulcers and trauma due to its fixed retroperitoneal position.
The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
This lecture give us an understanding about the pathway of the peripheral nerves that emerges from the brachial and cervical plexus. I also discuss about the motor and cutaneous innervation from these nerves and also some condition relate to peripheral nerve injury.
The peritoneum is a serous membrane that lines the abdominal cavity and covers organs within. It has parietal and visceral layers. Folds of peritoneum like the mesentery, omenta, and ligaments suspend organs and allow passage of structures. The greater and lesser sacs are potential spaces within the peritoneal cavity. The lesser sac is posterior to the stomach and separated from the greater sac by the epiploic foramen. Folds like the mesentery provide blood supply to the intestines and omenta can seal infections and absorb fluid.
The ulnar nerve originates from the C8-T1 nerve roots of the brachial plexus. It descends along the back of the humerus and enters the forearm, running deep to the flexor carpi ulnaris muscle alongside the ulna. In the forearm, it supplies branches to the flexor carpi ulnaris and flexor digitorum profundus muscles. It continues into the hand, passing through the carpal tunnel to supply branches to small muscles of the hand and provide cutaneous innervation to the skin of the palm and back of the hand.
The jejunum and ileum are the coiled parts of the small intestine located between the duodenum and colon. Together they are around 6 meters long. The jejunum is located in the middle of the small intestine, between the duodenum and ileum. The ileum is the final section of the small intestine leading to the large intestine. Both sections are supplied by the superior mesenteric artery and drained by the superior mesenteric vein. They absorb nutrients and pass contents to the large intestine.
The popliteal fossa is a diamond shaped space behind the knee with several important structures passing through it. It is bounded above and medially by the semimembranosus and semitendinosus muscles, above and laterally by the biceps femoris muscle, below and medially by the medial head of the gastrocnemius, and below and laterally by the lateral head of the gastrocnemius with the plantaris. The popliteal vessels and tibial nerve pass through the fossa, along with lymph nodes, fat, and branches of surrounding nerves. The roof of the fossa contains skin, fascia, and vessels like the short saphenous vein, while the floor is
The foot supports the body weight and provides leverage for walking and running.
It is unique in that it is constructed in the form of arches, which enable it to adapt its shape to uneven surfaces.
It also serves as a resilient spring to absorb shocks, such as in jumping.
skin Thick and hairless. Firmly bound down to the underlying deep fascia by numerous fibrous bands.
Shows a few flexure creases at the sites of skin movement.
Sweat glands are present in large numbers.
medial calcaneal branch of the tibial nerve
Medial plantar nerve
Lateral plantar nerve
Sural & saphenous nerve
This document discusses anatomy and reconstruction techniques for the heel. It describes the layers of the sole, including muscles, tendons, and nerves. The medial and lateral plantar nerves and arteries are examined in detail. Reconstruction options for the anterior and posterior heel are provided, such as local flaps, skin grafting, and free flaps. The medial plantar and sural flaps are highlighted as examples. In summary, this document reviews the anatomy of the foot sole and discusses approaches for reconstructing soft tissue injuries of the heel region.
The plantar aponeurosis is a thick central part of the deep fascia of the foot that divides into bands to attach to the toes. It helps maintain the longitudinal arch and protects the plantar vessels and nerves. The muscles of the foot can be divided into intrinsic muscles within the foot and extrinsic muscles originating from the leg. The intrinsic muscles are described in four layers - the superficial layer acts to flex the toes, the second layer includes flexor muscle accessories, the third layer acts on the big and little toes, and the deepest fourth layer contains the interossei muscles.
The fascial compartments of thigh are the three fascial compartments that divide and contain the thigh muscles. The fascia lata is the strong and deep fascia of the thigh that surrounds the thigh muscles and forms the outer limits of the compartments. Internally the muscle compartments are divided by the lateral and medial intermuscular septa.
The document provides details on the anatomy of the wrist and carpal bones. It can be summarized as:
1. The wrist joint is made up of the distal ends of the radius and ulna articulating with the proximal and distal rows of carpal bones, which then articulate with the metacarpal bones.
2. The carpal bones are arranged in two rows - the proximal row includes the scaphoid, lunate, triquetrum, and pisiform bones. The distal row includes the trapezium, trapezoid, capitate, and hamate bones.
3. The carpal bones are stabilized by intrinsic and extrinsic ligaments including the scapholunate and
The document describes the anatomy of the foot, including:
1) The first layer of muscles in the sole contains the abductor hallucis, flexor digitorum brevis, and abductor digiti minimi muscles.
2) The second layer contains the quadratus plantae muscle and lumbricals, and transmits the tendons of the flexor digitorum longus muscle.
3) Other structures described include the plantar aponeurosis, neurovascular planes, interossei muscles, and the four layers of muscles in the sole.
The femoral triangle contains important structures in the upper thigh. It has boundaries of the inguinal ligament superiorly, the sartorius muscle laterally, and the adductor longus muscle medially. The floor contains muscles that aid in hip adduction. The femoral nerve provides sensation and motor function, and the femoral artery and vein are also located here, with the artery giving off deep branches. The structures of the femoral triangle are clinically relevant to conditions like varicose veins, hernias, and addressing muscle spasticity in cerebral palsy.
The ankle joint is a uniaxial synovial hinge joint formed between the distal end of the tibia, lateral malleolus of the fibula, and talus bone. It is stabilized by strong ligaments including the deltoid ligament medially and three lateral ligaments. The joint allows for dorsiflexion and plantar flexion movement about its axis and is supplied by the posterior and anterior tibial arteries and nerves. Common injuries include ankle sprains from excessive inversion or eversion stretching the lateral or deltoid ligaments, respectively.
The document describes the anatomy of the anterior thigh compartment. It is divided into 3 sections - anterior, medial, and posterior - by intermuscular septa. The major muscles of the anterior compartment are the sartorius and quadriceps femoris group (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis). Together they perform knee extension. Each muscle originates on the pelvis or femur and inserts via the patella and quadriceps tendon. They are innervated by branches of the femoral nerve.
This document summarizes the major muscles of the upper and lower extremities. It describes the muscles of the arm, forearm, thigh, and leg, organized by anatomical compartment. For each region, it lists the superficial and deep muscle groups from lateral to medial and their main actions. The upper extremity sections cover the muscles of the arm's anterior, posterior, and lateral compartments and the forearm's anterior and posterior groups. The lower extremity sections discuss the thigh muscles that act on the femur and the anterior, posterior, and lateral muscle compartments of the leg and their actions on the ankle.
The adductor canal is located on the medial thigh and contains the femoral artery, femoral vein, and saphenous nerve. John Hunter first used the region to compress blood vessels during lower limb operations. The canal has boundaries formed by the adductor longus, vastus medialis, and sartorius muscles. Structures passing through the roof of the canal include the nerve to vastus medialis, saphenous nerve and artery, and genicular branches. Injuries penetrating the adductor canal can damage the femoral artery and nerves, resulting in loss of blood flow and sensation in the leg and foot.
The anterior tibial artery is a terminal branch of the popliteal artery that supplies the anterior compartment of the leg. It originates below the popliteus muscle and courses vertically down the leg between muscle compartments before becoming the dorsalis pedis artery. It gives off branches that anastomose around the knee and ankle joints. The posterior tibial artery is the larger terminal branch of the popliteal artery, supplying the posterior and lateral leg compartments and sole of the foot. It travels behind the tibia and fibula, giving muscular and nutrient branches before terminating as the medial and lateral plantar arteries. Throughout its course it is accompanied by the tibial nerve.
The document summarizes the embryological development of the skeletal system. It describes how the axial skeleton, including the vertebral column and ribs, and appendicular skeleton develop from somites in the embryo. It explains the three stages of development - blastemal/membranous, cartilaginous, and bony. It provides details on the formation of individual bones and joints, such as the development of vertebrae, ribs, sternum, skull, and others from sclerotomes, notochord, and cartilage models.
The document summarizes the muscles of the foot in 4 layers. The intrinsic muscles are within the foot and responsible for fine motor control, while extrinsic muscles originate from the leg and control larger motions like plantarflexion and dorsiflexion. The first layer includes the abductor hallucis, abductor digiti minimi, flexor digitorum brevis. The second layer includes lumbricals and the tendons of flexor digitorum longus and flexor hallucis longus. The third layer includes the flexor hallucis brevis, adductor hallucis, and flexor digiti minimi brevis. The fourth layer includes the tendons of peroneus longus
The duodenum has 4 parts: superior, descending, horizontal, and ascending. The superior part is the most mobile and begins at the pylorus. The descending part is retroperitoneal and passes behind the head of the pancreas. The horizontal part crosses behind blood vessels. The ascending part meets the jejunum. The duodenum has relationships with nearby organs and vessels. It receives blood supply from the celiac trunk and superior mesenteric artery. The duodenum is susceptible to ulcers and trauma due to its fixed retroperitoneal position.
The tibiofibular joints are a set of articulations that unite the tibia and fibula. These two bones of the leg are connected via three junctions; The superior (proximal) tibiofibular joint - between the superior ends of tibia and fibula. The inferior (distal) tibiofibular joint - between their inferior ends.
This lecture give us an understanding about the pathway of the peripheral nerves that emerges from the brachial and cervical plexus. I also discuss about the motor and cutaneous innervation from these nerves and also some condition relate to peripheral nerve injury.
The peritoneum is a serous membrane that lines the abdominal cavity and covers organs within. It has parietal and visceral layers. Folds of peritoneum like the mesentery, omenta, and ligaments suspend organs and allow passage of structures. The greater and lesser sacs are potential spaces within the peritoneal cavity. The lesser sac is posterior to the stomach and separated from the greater sac by the epiploic foramen. Folds like the mesentery provide blood supply to the intestines and omenta can seal infections and absorb fluid.
The ulnar nerve originates from the C8-T1 nerve roots of the brachial plexus. It descends along the back of the humerus and enters the forearm, running deep to the flexor carpi ulnaris muscle alongside the ulna. In the forearm, it supplies branches to the flexor carpi ulnaris and flexor digitorum profundus muscles. It continues into the hand, passing through the carpal tunnel to supply branches to small muscles of the hand and provide cutaneous innervation to the skin of the palm and back of the hand.
The jejunum and ileum are the coiled parts of the small intestine located between the duodenum and colon. Together they are around 6 meters long. The jejunum is located in the middle of the small intestine, between the duodenum and ileum. The ileum is the final section of the small intestine leading to the large intestine. Both sections are supplied by the superior mesenteric artery and drained by the superior mesenteric vein. They absorb nutrients and pass contents to the large intestine.
The popliteal fossa is a diamond shaped space behind the knee with several important structures passing through it. It is bounded above and medially by the semimembranosus and semitendinosus muscles, above and laterally by the biceps femoris muscle, below and medially by the medial head of the gastrocnemius, and below and laterally by the lateral head of the gastrocnemius with the plantaris. The popliteal vessels and tibial nerve pass through the fossa, along with lymph nodes, fat, and branches of surrounding nerves. The roof of the fossa contains skin, fascia, and vessels like the short saphenous vein, while the floor is
The foot supports the body weight and provides leverage for walking and running.
It is unique in that it is constructed in the form of arches, which enable it to adapt its shape to uneven surfaces.
It also serves as a resilient spring to absorb shocks, such as in jumping.
skin Thick and hairless. Firmly bound down to the underlying deep fascia by numerous fibrous bands.
Shows a few flexure creases at the sites of skin movement.
Sweat glands are present in large numbers.
medial calcaneal branch of the tibial nerve
Medial plantar nerve
Lateral plantar nerve
Sural & saphenous nerve
This document discusses anatomy and reconstruction techniques for the heel. It describes the layers of the sole, including muscles, tendons, and nerves. The medial and lateral plantar nerves and arteries are examined in detail. Reconstruction options for the anterior and posterior heel are provided, such as local flaps, skin grafting, and free flaps. The medial plantar and sural flaps are highlighted as examples. In summary, this document reviews the anatomy of the foot sole and discusses approaches for reconstructing soft tissue injuries of the heel region.
This document provides an overview of the surgical anatomy of the hand. It describes the surface landmarks and structures of the palmar aspect of the hand such as the tubercles and bones that can be felt. It details the layers of the palm including the skin, superficial and deep fascia, muscles such as the palmaris brevis, nerves, blood vessels, and other structures. It also describes the dorsal aspect including fascia and extensor retinaculum. Key areas covered include the carpal tunnel, flexor retinaculum, fibrous flexor sheaths, intrinsic hand muscles, and fascial spaces of the palm.
The document describes the anatomy of the leg, including:
- The leg is divided into anterior, posterior, and lateral compartments by connective tissue like the interosseous membrane.
- The posterior compartment contains superficial muscles like gastrocnemius and soleus that plantarflex the foot, and deep muscles that also plantarflex and invert the foot.
- Gastrocnemius originates on the femur and inserts on the calcaneus via the Achilles tendon. Soleus originates on the tibia and fibula and also inserts on the calcaneus.
The sole of the foot has four layers of muscles covered by a thick deep fascia called the plantar aponeurosis. The medial and lateral plantar nerves innervate the medial and lateral portions of the sole, respectively. The main arteries are the medial and lateral plantar arteries, which arise from the posterior tibial artery and supply blood to the muscles and skin. The medial and lateral plantar nerves branch throughout the sole, providing sensation and innervating the muscles.
The document provides an overview of the anatomy of the forearm, including its osteology, fascial compartments, muscles, nerves, blood vessels, and other structures. It describes the objectives as outlining the osteology, cutaneous nerve supply, fascial compartments, muscles within each compartment, blood supply, and compartment syndrome of the forearm. Key points include the forearm being divided into anterior, lateral, and posterior compartments by fascia, each with their own muscles, nerves and blood vessels. The median and ulnar nerves and arteries are discussed along with the muscles in the various compartments.
The document summarizes the anatomy of the sole of the foot. It describes the skin, superficial and deep fascia including the plantar aponeurosis. It then describes the muscles of the sole which are arranged in four layers - the first layer includes the flexor digitorum brevis, abductor hallucis, and abductor digiti minimi muscles. The second layer includes the quadratus plantae and lumbricals muscles as well as the tendons of the muscles of the leg that insert on the foot.
The document summarizes the anatomy of the posterior compartment of the leg. It describes the cutaneous nerves, muscles, arteries and nerves located in the superficial and deep groups of the posterior compartment. The key muscles are the gastrocnemius, soleus, plantaris, popliteus, flexor digitorum longus, flexor hallucis longus and tibialis posterior. The main artery is the posterior tibial artery and main nerve is the tibial nerve. Common injuries involving the Achilles tendon and gastrocnemius/soleus muscles are also discussed.
The document describes the bones, joints, arches, muscles, blood vessels and nerves of the human foot. It includes 26 bones in the foot, the ankle joint formed by the talus, tibia, fibula and ligaments, and three arches - longitudinal and transverse. It details the structures that pass behind and in front of the medial and lateral malleolus, as well as the extensor expansion of the lateral four toes. It provides an overview of the dorsal and plantar blood vessels and nerves that supply the foot.
anatomy foot 2for dpt and m bs students.pptxTaroTari
The document provides an overview of the anatomy of the foot, including its bones, joints, ligaments, muscles and fascia. It discusses the tarsal bones, metatarsals, phalanges and sesamoid bones. It describes the extensor, fibular and flexor retinacula, as well as the tarsal tunnel. It outlines the layers of muscles in the sole of the foot and the plantar aponeurosis. In conclusion, it provides questions to test understanding of the key structures and concepts covered.
L16) Popliteal fossa & back of leg & sole foot.pdfNandhini V
1. The document discusses the structures of the popliteal fossa, posterior leg fascia, ankle retinacula, layers of the sole of the foot, and foot arches.
2. It describes the contents and boundaries of the popliteal fossa, as well as muscles of the posterior leg compartment and their actions.
3. Details are provided on the muscles of the sole of the foot arranged in four layers, the plantar aponeurosis, and longitudinal and transverse foot arches.
The document summarizes the muscles and structures on the back of the forearm. There are seven superficial muscles including the brachioradialis, extensor carpi radialis longus and brevis. Deep to these are five deep muscles. Key structures discussed include the extensor retinaculum which holds the extensor tendons in place at the wrist. The extensor digitorum and extensor indicis pass through the retinaculum and fan out over the back of the hand. Near the fingers, the extensor tendon divides and attaches via slips to the dorsal surfaces of the finger bones.
Review of Gait, Locomotion & Lower LimbsDrSaeed Shafi
This document provides information on the arteries, nerves and veins of the lower limb. It discusses:
- The major arteries of the lower limb including the femoral, profunda femoris, gluteal arteries, anterior and posterior tibial arteries.
- Arterial anastomoses in the lower limb including the trochanteric, cruciate and genicular anastomoses.
- The superficial veins of the lower limb including the great and small saphenous veins.
- The nerves of the lower limb including the femoral, obturator, sciatic, tibial and common peroneal nerves.
- Dermatomes and venous insufficiency in the lower limb.
1. The gastrocnemius muscle consists of medial and lateral heads that are supplied by the medial and lateral sural arteries respectively.
2. The medial gastrocnemius flap is most commonly used due to its large size and reliable vascular pedicle. It can be raised as a muscle or musculocutaneous flap to cover defects of the upper leg and knee.
3. The lateral gastrocnemius flap is smaller but can be used for smaller defects of the upper lateral leg and knee. Both flaps have consistent anatomy and can be reliably elevated based on the dominant sural artery pedicles.
The document describes various anatomical structures of the foot and ankle. It discusses bones like the talus, calcaneus, and tarsal bones. It describes joints like the ankle joint and tarsal joints. It discusses ligaments supporting these joints. It provides details on arches of the foot. It describes muscles, tendons, vessels, and nerves of the foot and ankle. It discusses common fractures and conditions like plantar fasciitis. It also summarizes various flaps used in foot and ankle reconstruction.
The document summarizes the anatomy of the wrist joint and joints of the hand. It describes the articulations, types of joints, ligaments, movements, and relations of the wrist joint. It then discusses the intercarpal joints, carpometacarpal joints, metacarpophalangeal joints, and interphalangeal joints of the hand. Each joint is described in terms of its articulation, type of joint, capsule, synovial membrane, ligaments, and movements.
The document describes the anatomy of the posterior compartment of the leg and the plantar region of the foot. It outlines five layers of muscles in the posterior leg, including the triceps surae calf muscles and deep flexor muscles. It also details the four layers of muscles in the plantar foot region, along with associated neurovascular structures like the posterior tibial artery and medial and lateral plantar nerves.
This document provides an overview of the anatomy of the palm. It describes the palmar skin as thick, glabrous, and rich in sweat glands. It is firmly attached to the underlying palmar aponeurosis by fibrous bands. The document outlines the creases and lines of the palmar skin, as well as the layers of fascia in the palm including the palmar aponeurosis and flexor retinaculum. It also describes the muscles of the palm including the thenar, hypothenar, interossei and lumbrical muscles. Additionally, it discusses the arteries, nerves and fascial spaces of the palm.
This document describes the anatomy of the front of the thigh. It details the cutaneous nerves, muscles in the anterior compartment including the pectineus, sartorius and quadriceps femoris. It describes the femoral triangle containing the femoral vessels and nerve. The adductor canal containing the continuation of the femoral artery and vein is also summarized. Finally, the courses and branches of the femoral artery and vein are outlined.
The document summarizes the flexor and extensor retinacula of the hand. The flexor retinaculum forms the roof of the carpal tunnel, containing 9 tendons and the median nerve. The extensor retinaculum divides into 6 compartments over the back of the hand, enclosing the tendons of the extensor muscles in synovial sheaths as they pass to the fingers.
Similar to Sole of foot soft tissue and muscles (20)
The perineum is the region between the thighs and behind the genitals. It is divided into an anterior urogenital triangle and a posterior anal triangle by an imaginary line between the ischial tuberosities. The pelvic outlet forms the inferior boundary and consists of the pubic arch anteriorly and sciatic notches posteriorly. The perineum contains the anus, ischiorectal fossae in the anal region, and male or female genitals in the urogenital region. It has three spaces - subcutaneous, superficial, and deep perineal pouches. The urethral sphincter mechanism surrounds the membranous urethra in males and middle/lower u
The document provides details about the ankle joint and joints of the foot. It discusses the tibiofibular articulation including the superior, interosseous, and inferior tibiofibular joints. It then describes the ankle (talocrural) joint, including its range of motion, articulating surfaces, joint capsule, ligaments, synovial membrane, vascular supply, innervation, and factors maintaining stability. Finally, it summarizes the small joints of the foot including the talocalcaneal, talocalcaneonavicular, calcaneocuboid, naviculocuneiform, and intercuneiform joints.
This document provides an overview of the surface and radiological anatomy of the abdomen and pelvis. It describes the abdominal planes and regions, including vertical, horizontal, and soft tissue landmarks. It also outlines various abdominal incisions and portals used in laparoscopic surgery. Finally, it reviews the radiological anatomy of intra-abdominal organs and various imaging modalities used to visualize the abdomen such as x-rays, CT, MRI, ultrasound, and endoscopy.
This document discusses the radiological anatomy of the lower limb through different stages of life. It compares X-Ray and MR imaging of the knee joint and tibiofibular joint. It also examines age determination through X-Ray analysis of hip bone ossification and femur development from infancy through adulthood. Different stages of development are outlined for the hip bone, femur, and foot from newborn through 50 years old.
The midbrain (mesencephalon) connects the pons and cerebellum to the forebrain. It is the shortest segment of the brainstem at around 2 cm long, located in the posterior cranial fossa. The midbrain contains the crus cerebri, mesencephalic nucleus of the trigeminal nerve, and decussation of the superior cerebellar peduncles. Its lateral relations include the parahippocampal gyri and interpeduncular fossa. The midbrain is divided into the dorsal tectum and cerebral peduncles.
This document provides details on the sulci, gyri, and lobes of the cerebral hemispheres. Some key points:
- The cerebral hemispheres are separated by the longitudinal fissure and contain ventricles and white matter. Each hemisphere has frontal, parietal, temporal, occipital, and limbic lobes defined by sulci.
- Major sulci include the central sulcus separating frontal and parietal lobes, lateral sulcus outlining the temporal lobe, and parieto-occipital sulcus marking the border of the parietal and occipital lobes.
- Gyri are raised ridges of cortex separated by sulci, including precentral and postcentral gy
The pelvis consists of bones that form a bony ring and cavity. There are differences in pelvic measurements between males and females to facilitate childbirth. The female pelvis has a wider inlet and cavity to allow passage of the infant's head. Key measurements include the anteroposterior diameter, oblique diameter, and transverse diameter of the inlet, mid-pelvis, and outlet. The plane of greatest dimensions is in the mid-pelvis. Sex differences exist in structures like the sciatic notch, ischiopubic index, and acetabulum to accommodate childbirth in females.
Fetal circulation differs significantly from adult circulation. In the fetus, oxygenated blood from the placenta travels through the umbilical vein to the ductus venosus and inferior vena cava into the right atrium. Most blood then passes through the foramen ovale into the left atrium and ventricle before being pumped through the aorta to the body. After birth, closure of the ductus venosus, ductus arteriosus, and foramen ovale, along with establishment of pulmonary circulation through breathing, complete the transition to adult circulation. Persistence of fetal circulatory structures like the patent foramen ovale or ductus arteriosus can cause clinical issues.
The three main arteries that develop in early human embryos are:
1) The dorsal aortae, which are the first major blood vessels to form and connect the heart to the developing vascular system.
2) The aortic arch arteries, which develop from the aortic sac to supply the pharyngeal arches as the embryo grows.
3) The umbilical arteries, which develop from the dorsal aortae and connect to the placenta to allow nutrient exchange with the mother.
As the embryo develops, these major arteries and the accompanying vascular networks are refined through vasculogenesis and angiogenesis guided by growth factors to establish the adult circulatory system.
1. Muscle is composed of excitable cells called muscle fibers that contain contractile filaments of actin and myosin which allow the cell to change shape.
2. Muscle fibers are classified as skeletal, smooth, or cardiac muscle depending on their structure and location in the body.
3. Skeletal muscle fibers are long, cylindrical, and multinucleated, containing repetitive contractile units called sarcomeres made up of bands of actin and myosin proteins.
This 25 slide presentation by Dr. Komal Parmar covers the key components and structures of the cell membrane, including lipids, carbohydrates, and proteins. It discusses modifications to the cell membrane through microvilli, mesosomes, and various junctional complexes. Specifically, it examines tight junctions, gap junctions, desmosomes, and belt desmosomes. The presentation concludes with an exploration of membrane transport.
The document discusses anatomical structures in the perineum region including the urogenital triangle and pudendal canal which supplies neurovascular structures. It focuses on key areas and passages in the lower pelvic region between the anus and genitalia.
This 37 slide presentation provides an overview of the pelvis and pelvic floor anatomy. It discusses the bones that make up the pelvis, the true and false pelvis cavities, and the pelvic viscera in males and females. The muscles of the pelvic floor are described in detail, including the levator ani muscle and its components. Other structures covered include the pelvic fasciae, vasculature, nerves, pudendal canal, and related clinical terms. The presentation provides a comprehensive review of key anatomical structures and relationships in the pelvis region.
This document discusses the process of microtomy, which involves preparing tissue samples for microscopic examination through sectioning. Key steps include:
1) Fixing tissue samples in formalin to preserve structure, then dehydrating them through a series of alcohol baths and clearing them in xylene.
2) Embedding tissue samples in paraffin wax, allowing it to solidify into blocks.
3) Sectioning the paraffin blocks with a microtome into thin slices, mounting them onto slides, and staining for examination.
4) Important considerations for microtomy include knife selection and maintenance, proper trimming and section thickness, and techniques for difficult tissues.
Tissue Processing for Histopathological AnalysisKomal Parmar
This document provides an overview of histological and histopathological tissue processing techniques. It discusses the key steps in processing tissue, including fixation, dehydration, clearing, embedding, sectioning, and staining. Proper tissue processing is important for microscopic analysis and involves techniques to harden tissues without distortion, remove water, and infiltrate paraffin wax to allow thin sectioning. Automated tissue processors can standardize and expedite the multi-step procedure.
The document summarizes the blood supply of the gastrointestinal tract in three parts:
1) The arterial supply comes from branches off the abdominal aorta including the celiac trunk, superior mesenteric artery, and inferior mesenteric artery.
2) Venous drainage occurs through the portal vein, which is formed by the superior mesenteric vein and splenic vein. It drains into the liver.
3) The hepatic portion describes the hepatic arteries, portal vein branches in the liver, hepatic lobules, and hepatic veins draining into the inferior vena cava.
The skin is the largest organ of the body. It covers the entire external surface and has important protective, sensory, and metabolic functions. The skin is composed of two main layers, the epidermis and dermis. The epidermis contains keratinocytes, melanocytes, Merkel cells, and Langerhans cells. The dermis lies underneath and contains collagen, elastic fibers, nerves, blood vessels, and skin appendages. The skin regulates body temperature, provides immune protection and sensation, and plays a role in vitamin D synthesis and hormone reception.
The document discusses various lymphatic tissues in the body, including the thymus, tonsils, mucosa-associated lymphoid tissue (MALT), and tertiary lymphoid organs. It describes the microanatomy and functions of the thymus, tonsils, Peyer's patches in the small intestine, and nasal-associated lymphoid tissue. It also explains that tertiary lymphoid organs can develop in non-lymphoid tissues affected by chronic conditions to provide immune responses.
Lymphatic system- Lymph nodes and SpleenKomal Parmar
This document discusses the microanatomy of lymphoid organs and immune cells. It describes the structure and function of lymphocytes, macrophages, endothelial cells, lymph nodes, spleen, and lymphatic and circulatory systems. Key cells and tissues discussed include B cells, T cells, macrophages, lymph nodes, spleen, lymphatic vessels, sinusoids, and white and red pulp. The roles of these components in immune function, antigen presentation, and filtration are summarized.
Blastulation refers to the process in early embryonic development where the zygote undergoes rapid cell divisions through cleavage to form a solid ball of cells called a morula. The morula then develops a fluid-filled cavity, forming a structure called a blastocyst composed of an inner cell mass and outer layer of trophoblast cells. The blastocyst undergoes further differentiation, with the inner cell mass forming the embryo and extraembryonic tissues such as the amnion, yolk sac, and allantois developing to support the growth and development of the embryo.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
2. SKIN
• The plantar skin is supplied by perforating
branches of the medial and lateral plantar
arteries (the terminal branches of the
posterior tibial artery).
• The skin of the forefoot is supplied by
cutaneous branches of the common digital
arteries.
• On the plantar aspect, a superficial venous
network forms an intradermal and subdermal
mesh that drains to the medial and lateral
marginal veins.
• Superficial lymphatic drainage is via vessels
that accompany the long saphenous vein
medially and the short saphenous vein
laterally and drain via the inguinal lymph
nodes.
• Deep lymphatic vessels accompany the
dorsalis pedis, posterior tibial and fibular
arteries and pass via the popliteal lymph
3.
4. Venous Drainage of Foot
• Some foot perforating veins are characterized by flow that is oriented
from deep to superficial veins, due to the presence of one-way valves,
a unique feature in the venous system of the lower limbs.
• From a hemodynamic point of view, the foot veins should not be
classified into deep and superficial systems, but into medial and
lateral functional units.
• The medial unit is comprised of the medial plantar veins, the medial
marginal vein, and the medial foot perforator veins.
• The lateral unit is comprised of the lateral plantar veins, the lateral
perforator veins, and perforator veins of the calcaneus.
• Ankle perforator veins are mainly the dorsal perforator veins that are
connected to the initial segment of anterior tibial and fibular veins
and the lateral perforator veins along the distal fibula.
5.
6.
7. The most frequent location is between the third and
fourth metatarsals (third webspace). Other, less
common locations are between the second and third
metatarsals (second webspace) and, rarely, between
the first and second (first webspace) or fourth and
fifth (fourth webspace) metatarsals.
8.
9. Flexor Retinaculum of Foot
• Attached anteriorly to the tip
of the medial malleolus,
distal to which it is
continuous with the deep
fascia on the dorsum of the
foot.
• From its malleolar
attachment it extends
posteroinferiorly to the
medial process of the
calcaneus and the plantar
aponeurosis.
• Distally, its border is
continuous with the plantar
aponeurosis, and many
fibres of abductor hallucis
are attached to it.
10. Plantar Fascia
• The central part is the strongest
and thickest. The fascia is narrow
posteriorly, where it is attached to
the medial process of the
calcaneal tuberosity proximal to
flexor digitorum brevis, and
traced distally it becomes broader
and somewhat thinner.
• Just proximal to the level of the
metatarsal heads it divides into
five bands, one for each toe. As
these five digital bands diverge
below the metatarsal shafts, they
are united by transverse fibres
11. Retinacula Cutis: From
superficial stratum of
Planter Fascia
• Proximal, plantar and a little distal to
the metatarsal heads and the
metatarsophalangeal joints, the
superficial stratum of each of the five
bands is connected to the dermis by
skin ligaments (retinacula cutis).
• These ligaments reach the skin of
the ball of the foot proximal to, and in
the floors of, the furrows that
separate the toes from the sole:
Dupuytren’s disease may involve
these ligaments resulting in
12. • The deep stratum of each digital band of the
aponeurosis yields two septa that flank the
digital flexor tendons and separate them from
the lumbricals and the digital vessels and
nerves.
• These septa pass deeply to fuse with
• the interosseous fascia
• the deep transverse metatarsal
ligaments (which run between
the heads of adjacent
metatarsals)
• the plantar ligaments of the
metatarsophalangeal joints
• the periosteum and fibrous
flexor sheaths at the base of
13. • The medial and lateral parts: at
the junctions, two intermuscular
septa, medial and lateral, extend
in oblique vertical planes
between the medial,
intermediate and lateral groups
of plantar muscles to reach bone.
• Thinner horizontal intermuscular
septa, derived from the vertical
intermuscular septa, pass
between the muscle layers.
14. • The lateral part of the plantar aponeurosis,
which covers abductor digiti minimi, is thin
distally and thick proximally, where it forms
a strong band, sometimes containing
muscle fibres, between the lateral process
of the calcaneal tuberosity and the base of
the fifth metatarsal bone.
• The medial part of the plantar aponeurosis,
which covers abductor hallucis, is thin. It is
continuous proximally with the flexor
retinaculum, medially with the fascia
dorsalis pedis, and laterally with the central
part of the plantar aponeurosis.
16. • The medial compartment
contains abductor hallucis and flexor
hallucis brevis, and is bounded
inferiorly and medially by the medial
part of the plantar aponeurosis and
its medial extension, laterally by an
intermuscular septum, and dorsally
by the first metatarsal.
• The central compartment
contains flexor digitorum brevis, the
lumbricals, flexor accessorius and
adductor hallucis, and is bounded by
the plantar aponeurosis inferiorly, the
osseofascial tarsometatarsal
structures dorsally and intermuscular
septa medially and laterally.
17. • The lateral compartment
contains abductor digiti
minimi and flexor digiti
minimi brevis, and its
boundaries are the fifth
metatarsal dorsally, the
plantar aponeurosis inferiorly
and laterally, and an
intermuscular septum
medially.
• The interosseous
compartment contains the
seven interossei and its
boundaries are the
interosseous fascia and the
metatarsals.
18. Specialized adipose tissue (heel and
metatarsal pad)
• The adult heel pad has an average
thickness of 18 mm and a mean
epidermal thickness of 0.64
• The heel pad contains elastic
adipose tissue organized as spiral
fibrous septa anchored to each
other, to the calcaneus and to the
skin.
• The septa are U-shaped fat-filled
columns designed to resist
compressive loads and are
reinforced internally with elastic
diagonal and transverse fibres,
which separate the fat into
compartments.
22. MUSCLES
• Functional Division: The plantar muscles in the foot can be divided
into medial, lateral and intermediate groups.
• The medial and lateral groups consist of the intrinsic muscles of the
hallux and minimus, respectively, and the central or intermediate
group includes the lumbricals, interossei and short digital flexors.
• Gross Anatomical Division: It is customary to group the muscles
in four layers, because this is the order in which they are encountered
during dissection.
• However, in clinical practice and in terms of function, the former
grouping is often more useful.
24. 1.1 Abductor hallucis
• Attachments
• Flexor retinaculum
• medial process of the
calcaneal tuberosity
• the plantar aponeurosis
• intermuscular septum between
this muscle and flexor
digitorum brevis.
• The muscle fibres end in a tendon that
is attached, together with the medial
tendon of flexor hallucis brevis, to the
medial side of the base of the
proximal phalanx of the hallux.
• Some fibres are attached more
proximally to the medial sesamoid bone
of this toe. The muscle may also derive
some fibres from the dermis along the
medial border of the foot.
25.
26. 1.2 Flexor Digitorum Brevis
• Attachments
• medial process of the calcaneal tuberosity
• Central part of the plantar aponeurosis
• intermuscular septa between it and adjacent muscles.
• The tendons enter digital tendon
sheaths accompanied by the tendons of
flexor digitorum longus, which lie deep to
them.
• At the bases of the proximal phalanges, each
tendon divides around the corresponding
tendon of flexor digitorum longus; the two
slips then reunite and partially decussate,
forming a tunnel through which the tendon of
flexor digitorum longus passes to the distal
phalanx.
• The short flexor tendon divides again and
attaches to both sides of the shaft of the
middle phalanx
27.
28. 1.3 Abductor digiti minimi
• Attachments
• both processes of the calcaneal tuberosity
• plantar surface of the Calcaneum
• plantar aponeurosis
• intermuscular septum between the muscle and flexor digitorum
brevis.
• Insertion: lateral side of the base of the proximal phalanx of
the fifth toe
• Some of the fibres arising from the lateral calcaneal process
usually reach the tip of the tuberosity of the fifth metatarsal and
may form a separate muscle, abductor ossis metatarsi
digiti quinti.
• Relations Abductor digiti minimi lies along the lateral border of
the foot, and its medial margin is related to the lateral plantar
vessels and nerve
• Vascular supply medial and lateral plantar arteries, the
plantar digital artery to the lateral side of minimus, branches
from the plantar arch, the fourth plantar metatarsal artery and
end twigs of the arcuate and lateral tarsal arteries.
• Innervation lateral plantar nerve, S1, S2 and S3.
• Action Despite its name, abductor digiti minimi is more a flexor
than an abductor of the metatarsophalangeal joint of the little
30. 2.3 & 2.4 Flexor tendon sheaths
• Osseo-aponeurotic canals
• Bounded by
• Superiorly- phalanges
• Inferiorly- Digital fibrous sheaths, which
arch across the tendons and attach on
either side to the margins of the phalanges
• Along the proximal and intermediate
phalanges, the fibrous bands are strong,
and the fibres are transverse (anular part);
opposite the joints they are much thinner
and the fibres decussate (cruciform part).
• Each osseo-aponeurotic canal has a
synovial lining, which is reflected
around its tendon; within this sheath,
vincula tendinum are arranged as
they are in the fingers.
31.
32.
33.
34. 2.1- Flexor digitorum accessorius
• The medial head is larger and more fleshy
and is attached to the medial concave
surface of the calcaneus, below the groove
for the tendon of flexor hallucis longus.
• The lateral head is flat and tendinous and is
attached to the calcaneus distal to the lateral
process of the tuberosity, and to the long
plantar ligament.
• The muscle belly inserts into the tendon of
flexor digitorum longus at the point where it
is bound by a fibrous slip to the tendon of
flexor hallucis longus and where it divides
into its four tendons.
35.
36.
37. 2.2- Lumbricals
• Accessory to the tendons of flexor
digitorum longus
• arise from these tendons at their angles
of separation, each springing from the
sides of two adjacent tendons, except for
the first lumbrical.
• Attached to the dorsal digital
expansions on their proximal
phalanges.
• The lumbricals remain outside the fibrous
flexor sheaths and cross the plantar
aspects of the deep transverse
metatarsal ligaments before reaching the
dorsal digital expansions.
38.
39.
40.
41.
42.
43. Plantar
Plates
• In the human foot,
the plantar or volar plates (also
called plantar or volar ligaments
are fibrocartilaginous structures found
in the metatarsophalangeal (MTP)
and interphalangeal (IP) joints. Due to
the weight-bearing nature of the
human foot, the plantar plates are
exposed to extension forces not
present in the human hand.
• Flexible fibrocartilage with a
composition similar to that found in
the menisci of the knee
44.
45. 3.1 Flexor Hallucis Brevis
• The lateral limb arises from the medial part of the plantar surface of the cuboid,
posterior to the groove for the tendon of fibularis longus, and from the adjacent part of
the lateral cuneiform.
• The medial limb has a deep attachment directly continuous with the medial division of
the tendon of tibialis posterior, and a more superficial attachment to the middle band of
the medial intermuscular septum.
• Insertion: attached to the sides of the base of the proximal phalanx of the hallux.
• The medial part blends with the tendon of abductor hallucis, and the lateral with that of
adductor hallucis, as they reach their terminations.
46.
47.
48.
49. 3.2 Adductor Hallucis
• The oblique head springs from the bases of the
second, third and fourth metatarsal bones, and from
the fibrous sheath of the tendon of fibularis longus.
• The transverse head, arises from the plantar
metatarsophalangeal ligaments of the third, fourth and
fifth toes, and from the deep transverse metatarsal
ligaments between them.
• The oblique head has medial and lateral parts.
• The medial part blends with the lateral part of flexor
hallucis brevis and is attached to the lateral sesamoid
bone of the hallux.
• The lateral part joins the transverse head and is also
attached to the lateral sesamoid bone and directly to
the base of the first phalanx of the hallux.
• There is no phalangeal attachment for the transverse
part of the muscle; fibres that fail to reach the lateral
sesamoid bone are attached with the oblique part.
57. Dorsal Interossei
• Attachments The dorsal
interossei are situated
between the metatarsal
bones.
• They consist of four bipennate
muscles, each arising by two
heads from the sides of the
adjacent metatarsal bones.
• Their tendons are attached to
the bases of the proximal
phalanges and to the dorsal
digital expansions.
• The first inserts into the
medial side of the second toe;
the other three pass to the
lateral sides of the second,
third and fourth toes.
62. Dorsalis pedis artery
• Continuation of the anterior tibial artery
distal to the ankle.
• It passes to the proximal end of the first
intermetatarsal space, where it turns into
the sole between the heads of the first
dorsal interosseous to complete the
plantar arch, and provides the first
plantar metatarsal artery.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73. Branches
• The plantar arch gives off three perforating
and four plantar metatarsal
branches, and numerous branches that supply
the skin, fasciae and muscles in the sole.
• Three perforating branches ascend through the
proximal ends of the second to fourth
intermetatarsal spaces, between the heads of
dorsal interossei, and anastomose with the dorsal
metatarsal arteries.
• Each planter Metatarsal Artery divides into two
plantar digital arteries, supplying the adjacent digital
aspects.
• Near its division, each plantar metatarsal artery
sends a distal perforating branch dorsally to join a
dorsal metatarsal artery.
• Haemorrhage from the plantar arch is difficult to
stem, because of the depth of the vessel and its
74.
75. Medial plantar nerve
• lies lateral to the medial plantar artery.
• Point of Origin- Under Flexor
Retinaculum of Foot
• It passes deep to abductor hallucis
• Then appears between it and flexor digitorum brevis,
gives off a medial proper digital nerve to the hallux,
and divides near the metatarsal bases into three
common plantar digital nerves.
• Cutaneous branches pierce the plantar aponeurosis
between abductor hallucis and flexor digitorum brevis
to supply the skin of the sole of the foot.
• Muscular branches supply abductor hallucis, flexor
digitorum brevis, flexor hallucis brevis and the first
lumbrical.
76. • The branch to
flexor hallucis
brevis is from
the hallucal
medial
digital nerve,
and that to
the first
lumbrical
from the first
common
plantar
digital nerve.
77.
78. Lateral Plantar Nerves
• It passes laterally forwards medial to the
lateral plantar artery, towards the tubercle
of the fifth metatarsal.
• Next, it passes between flexores digitorum
brevis and accessorius, and ends between
flexor digiti minimi brevis and abductor
digiti minimi by dividing into superfi cial and
deep branches.
• Before division, it supplies
• flexor digitorum accessorius
• abductor digiti minimi and gives rise
to small branches that pierce the plantar fascia
to supply the skin of the lateral part of the sole.
79. • The superficial branch splits into two common
plantar digital nerves:
• the lateral supplies
• lateral side of the fifth toe
• flexor digiti minimi brevis
• the two interossei in the fourth intermetatarsal space
The medial connects with the third common plantar
digital branch of the medial plantar nerve and
divides into two to supply the adjoining sides of the
fourth and fifth toes.
• The deep branch accompanies the lateral plantar
artery deep to the flexor tendons and adductor
hallucis and supplies
• the second to fourth lumbricals (L2- L4)
• adductor hallucis
• all the interossei (except those of the fourth intermetatarsal
space).
• Branches to the second and third lumbricals pass
distally deep to the transverse head of adductor
hallucis, and curl round its distal border to reach
them.