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Sole Of The Foot
The Foot
• 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.
CUTANEOUS NERVES
Medial calcaneal
branch of the
tibial nerve
Medial plantar
nerve
Lateral plantar
nerve
Sural & saphenous
nerve
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.
Plantar aponeurosis
• Definition:
Thickened band of deep
fascia in the sole of the
foot.
• Attachment:
Posteriorly: Medial
tubercle of calcaneus.
Anteriorly: Divides into
5 slips which pass to the
5 toes.
On each side: Attached
to the metatarsal bones
by medial and lateral
intermuscular septa.
Medial Plantar Nerve
It is larger of the two terminal branch
of the posterior tibial nerve.
Enter the foot midway between the
medial malleolus and the medial
tubercle of the calcaneus, under
cover the flexor retinaculum.
Passes forwards deep to the
abductor hallucis muscle.
Terminate at the bases of the
metatarsal bones by dividing into 3
planter digital nerves.
Medial Plantar Nerve
• Branches:
 Muscular (to four muscles) to:
Abductor hallucis.
1) Flexor digitorum brevis.
2) Flexor hallucis brevis
3) First lumbrical muscle
 Cutaneous:
Planter cutaneous branches:
1) To the skin of the medial 2/3
of the sole of the foot.
2) Planter digital nerves
 Articular branches: To intertarsal
and tarso-metatarsal joints.
Lateral Plantar Nerve
It is smaller of the two terminal
branches of the posterior tibial
nerve.
Enters the foot midway between the
medial malleolus and the medial
tubercle of the calcaneus under
cover the flexor retinaculum.
Passes forwards and laterally deep
to abductor hallusis.
Terminate at the base of the 5th
metatarsal bone, by dividing into a
superficial and a deep branches.
Lateral Plantar Nerve
Branches: Muscular :
1) Flexor digitoum accessorius
muscle
2) Abductor digiti minimi
3) Flexor digiti minimi brevis
4) Adductor halucis muscle.
5) Interossei
6) 2nd, 3rd & 4th lumbricals.
Cutaneous:
1) Skin of the lat. 1/3 of the
sole
2) Skin on the lat.side of the
planter surface of the little
toe and the adjoining sides
of the 4th & 5th toes.
3) The planter digital branches,
also, supply the skin on the
dorsum of the terminal
Medial Plantar Artery
One of the two terminal branches of the
posterior tibial artery.
Enter the foot midway between the medial
malleolus and the medial tubercle of
the calcaneus, under cover the flexor
retinaculum. Passes forwards deep to
the abductor hallucis muscle. Passes
b/w the abd.hallucis and flexor
digitorum brevis.
Medial Plantar Artery
Termination: By anastmosing with the
1st planter metatarsal artery.
Branches:
Muscular
Digital: 3 superficial digital branches
these branches end by
anastmosing with the first, second
and third planter metatarsal
arteries.
Lateral Plantar Artery
• One of the two
terminal branches of
the posterior tibial
artery.
• At first between the 1st
and 2nd layers, then
curves medially
between the 3rd and
4th layers of the sole.
• Turns medially with the
deep branch of the
lateral planter nerve
with slight forward
convexity to from the
plantar arch between
Lateral Plantar Artery
On reaching the base of the 5th metatarsal bone, the artery curves
medially to form the plantar arch and at the proximal end of the first
intermetatarsal space joins the dorsalis pedis
artery
Lateral Plantar Artery
• Branches:
 Muscular
 Anastomotic branches: b/w
arcuate & lateral tarsal arteries
of the dorsalis pedis artery.
 Posterior perforating arteries:
 3 branches which anastomose
with the dorsal metatarsal
arteries.
 Planter digital artery: to the
lateral side of the little toe.
 Three planter metatarsal arteries
MUSCLES FOUR LAYERS
FIRST(SUPERFICIAL)
SECOND
THIRD
FOURTH
1st Layer
• Three Muscles:
1)Abductor hallucis
2)Flexor digitorum
brevis
3)Abductor digiti
minimi
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi
SECOND LAYER
• 1.QUADRATUS
PLANTAE/FLEXOR
DIGITORUM
ACCESSORIOUS
• 2.LUMBRICALS
• 3.TENDON OF
FLEXOR DIGITORUM
LONGUS
• 4.TENDON OF
FLEXOR HALLUCIS
LONGUS
2nd Layer
• Two Tendons:
1) Flexor halusis longus
2) Flexor digitorum
longus
• Two Muscles:
1) Quadratus Plantae
(Flexor digitorum
accessorius)
2) 4 Lumbricals muscles
Quadratus Plantae (Flexor digitorum accessorius)
4 Lumbricals muscles
3rd Layer
• Three Muscles:
1)Flexor hallucis
brevis.
2)Adductor hallucis
3)Flexor digiti minimi
brevis
Flexor hallucis brevis.
Adductor hallucis
Flexor digiti minimi brevis
4th Layer
• Two Tendons:
1) Tibialis posterior
2) Peroneus Longus
• Two Muscles:
1) 3 Planter Interossei
2) 4 Dorsal Interossei
3 Planter Interossei
4 Dorsal Interossei
Plantar Fasciitis
• Straining and inflammation of the plantar aponeurosis, a condition called
plantar fasciitis, may result from running and standing , especially when
inappropriate footwear is worn. It causes pain on the plantar surface of
the heel and on the medial aspect of the foot.

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sole of foot.pptx

  • 1. Sole Of The Foot
  • 2. The Foot • 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.
  • 3. 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.
  • 4. CUTANEOUS NERVES Medial calcaneal branch of the tibial nerve Medial plantar nerve Lateral plantar nerve Sural & saphenous nerve
  • 5. 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.
  • 6. Plantar aponeurosis • Definition: Thickened band of deep fascia in the sole of the foot. • Attachment: Posteriorly: Medial tubercle of calcaneus. Anteriorly: Divides into 5 slips which pass to the 5 toes. On each side: Attached to the metatarsal bones by medial and lateral intermuscular septa.
  • 7. Medial Plantar Nerve It is larger of the two terminal branch of the posterior tibial nerve. Enter the foot midway between the medial malleolus and the medial tubercle of the calcaneus, under cover the flexor retinaculum. Passes forwards deep to the abductor hallucis muscle. Terminate at the bases of the metatarsal bones by dividing into 3 planter digital nerves.
  • 8. Medial Plantar Nerve • Branches:  Muscular (to four muscles) to: Abductor hallucis. 1) Flexor digitorum brevis. 2) Flexor hallucis brevis 3) First lumbrical muscle  Cutaneous: Planter cutaneous branches: 1) To the skin of the medial 2/3 of the sole of the foot. 2) Planter digital nerves  Articular branches: To intertarsal and tarso-metatarsal joints.
  • 9. Lateral Plantar Nerve It is smaller of the two terminal branches of the posterior tibial nerve. Enters the foot midway between the medial malleolus and the medial tubercle of the calcaneus under cover the flexor retinaculum. Passes forwards and laterally deep to abductor hallusis. Terminate at the base of the 5th metatarsal bone, by dividing into a superficial and a deep branches.
  • 10. Lateral Plantar Nerve Branches: Muscular : 1) Flexor digitoum accessorius muscle 2) Abductor digiti minimi 3) Flexor digiti minimi brevis 4) Adductor halucis muscle. 5) Interossei 6) 2nd, 3rd & 4th lumbricals. Cutaneous: 1) Skin of the lat. 1/3 of the sole 2) Skin on the lat.side of the planter surface of the little toe and the adjoining sides of the 4th & 5th toes. 3) The planter digital branches, also, supply the skin on the dorsum of the terminal
  • 11. Medial Plantar Artery One of the two terminal branches of the posterior tibial artery. Enter the foot midway between the medial malleolus and the medial tubercle of the calcaneus, under cover the flexor retinaculum. Passes forwards deep to the abductor hallucis muscle. Passes b/w the abd.hallucis and flexor digitorum brevis.
  • 12. Medial Plantar Artery Termination: By anastmosing with the 1st planter metatarsal artery. Branches: Muscular Digital: 3 superficial digital branches these branches end by anastmosing with the first, second and third planter metatarsal arteries.
  • 13. Lateral Plantar Artery • One of the two terminal branches of the posterior tibial artery. • At first between the 1st and 2nd layers, then curves medially between the 3rd and 4th layers of the sole. • Turns medially with the deep branch of the lateral planter nerve with slight forward convexity to from the plantar arch between
  • 14. Lateral Plantar Artery On reaching the base of the 5th metatarsal bone, the artery curves medially to form the plantar arch and at the proximal end of the first intermetatarsal space joins the dorsalis pedis artery
  • 15. Lateral Plantar Artery • Branches:  Muscular  Anastomotic branches: b/w arcuate & lateral tarsal arteries of the dorsalis pedis artery.  Posterior perforating arteries:  3 branches which anastomose with the dorsal metatarsal arteries.  Planter digital artery: to the lateral side of the little toe.  Three planter metatarsal arteries
  • 17. 1st Layer • Three Muscles: 1)Abductor hallucis 2)Flexor digitorum brevis 3)Abductor digiti minimi
  • 21. SECOND LAYER • 1.QUADRATUS PLANTAE/FLEXOR DIGITORUM ACCESSORIOUS • 2.LUMBRICALS • 3.TENDON OF FLEXOR DIGITORUM LONGUS • 4.TENDON OF FLEXOR HALLUCIS LONGUS
  • 22. 2nd Layer • Two Tendons: 1) Flexor halusis longus 2) Flexor digitorum longus • Two Muscles: 1) Quadratus Plantae (Flexor digitorum accessorius) 2) 4 Lumbricals muscles
  • 23. Quadratus Plantae (Flexor digitorum accessorius)
  • 25. 3rd Layer • Three Muscles: 1)Flexor hallucis brevis. 2)Adductor hallucis 3)Flexor digiti minimi brevis
  • 29. 4th Layer • Two Tendons: 1) Tibialis posterior 2) Peroneus Longus • Two Muscles: 1) 3 Planter Interossei 2) 4 Dorsal Interossei
  • 32. Plantar Fasciitis • Straining and inflammation of the plantar aponeurosis, a condition called plantar fasciitis, may result from running and standing , especially when inappropriate footwear is worn. It causes pain on the plantar surface of the heel and on the medial aspect of the foot.