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GROSS ANATOMY GROSS ANATOMY OF FOOTOF FOOTBY BY Dr. Ansari, prof. & chair-person, Dept.of Dr. Ansari, prof. & chair-person, Dept.of anatomy, RAKMHSU.anatomy, RAKMHSU.

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TOPOGRAPHYTOPOGRAPHY

Foot lies distal to the ankle joint.Foot lies distal to the ankle joint. Superior surface of foot is dorsum of foot.Superior surface of foot is dorsum of foot. Inferior surface is the sole/plantar Inferior surface is the sole/plantar

surface.surface. Foot is modified for weight bearing and Foot is modified for weight bearing and

locomotion.locomotion.

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SURFACE ANATOMY OF SURFACE ANATOMY OF FOOTFOOT

Dorsalis pedis artery is palpable at the mid Dorsalis pedis artery is palpable at the mid point of the line joining the two malleoli.point of the line joining the two malleoli.

Medial malleolus is the lower part of tibia, long Medial malleolus is the lower part of tibia, long saphenous vein lies anterior to the malleolus.saphenous vein lies anterior to the malleolus.

Lateral malleolus is the lower end of fibula.Lateral malleolus is the lower end of fibula. Posterior tibial artery is palpable at the mid Posterior tibial artery is palpable at the mid

point between medial malleolus and tuberosity point between medial malleolus and tuberosity of calcaneum.of calcaneum.

Tendo -calcaneum is the Achilles tendon Tendo -calcaneum is the Achilles tendon attached to the tuberosity of calcaneum.attached to the tuberosity of calcaneum.

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BONES OF THE FOOTBONES OF THE FOOT

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DERMATOME – DORSUM DERMATOME – DORSUM OF FOOTOF FOOT

Saphenous nerve supplies the medial side of Saphenous nerve supplies the medial side of foot, up to the root of the great toe.foot, up to the root of the great toe.

Sural nerve supplies the skin of the lateral side Sural nerve supplies the skin of the lateral side of foot.of foot.

Deep peroneal nerve supplies the dorsum of Deep peroneal nerve supplies the dorsum of foot skin of first inter-digital cleft.foot skin of first inter-digital cleft.

Superficial peroneal nerve supplies the rest of Superficial peroneal nerve supplies the rest of the skin of dorsum of foot.the skin of dorsum of foot.

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DERMATOME ON SOLEDERMATOME ON SOLE

Saphenous nerveSaphenous nerve Sural nerveSural nerve Medial plantar nerveMedial plantar nerve Lateral plantar nerveLateral plantar nerve Tibial nerveTibial nerve We walk on S1 segment.We walk on S1 segment.

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We walk on S1 segment

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DEEP FASCIA OF FOOTDEEP FASCIA OF FOOT

Superior extensor retinaculum.Superior extensor retinaculum. Inferior extensor retinaculum.Inferior extensor retinaculum. Flexor retinaculum.Flexor retinaculum. Plantar aponeurosis.Plantar aponeurosis. Fibrous flexor sheaths.Fibrous flexor sheaths.

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EXTENSOR RETINACULUM EXTENSOR RETINACULUM ATTACHMENTSATTACHMENTS

The superior extensor retinaculum binds The superior extensor retinaculum binds the anterior borders of tibia and fibula, the anterior borders of tibia and fibula, proximal to the malleoli.proximal to the malleoli.

It binds down the tendons of anterior It binds down the tendons of anterior compartment of leg, preventing compartment of leg, preventing bowstringing during dorsi flexion of the bowstringing during dorsi flexion of the ankle.ankle.

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The inferior extensor The inferior extensor retinaculumretinaculum

It is a Y- shaped band of deep fascia.It is a Y- shaped band of deep fascia. Attached laterally to the anterosuperior Attached laterally to the anterosuperior

surface of the calcaneus.surface of the calcaneus. It binds round the tendons of peroneus It binds round the tendons of peroneus

tertius and extensor digitorum longus.tertius and extensor digitorum longus.

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The peroneal retinaculaThe peroneal retinacula

These are the bands of deep fascia.These are the bands of deep fascia. Attached from the tip of lateral malleolus Attached from the tip of lateral malleolus

to the calcaneus.to the calcaneus. It binds the tendons of peroneus longus It binds the tendons of peroneus longus

and peroneus brevis.and peroneus brevis.

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TENDONS ON THE TENDONS ON THE DORSUM OF FOOTDORSUM OF FOOT

Long tendons coming from the anterior Long tendons coming from the anterior compartment of leg are:-compartment of leg are:-

Tibialis anteriorTibialis anterior Extensor hallucis longus,Extensor hallucis longus, Extensor digitorum longus,Extensor digitorum longus, Peroneus tertius.Peroneus tertius.

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The intrinsic muscles on The intrinsic muscles on footfoot

Extensor digitorum Extensor digitorum brevis.brevis.

Dorsal interossei.Dorsal interossei.

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OTHER STRUCTURES OTHER STRUCTURES ON DORSUM FOOT ON DORSUM FOOT

Dorsal venous arch.Dorsal venous arch. Long & short saphenous veins.Long & short saphenous veins. Cutaneous branches of saphenous, sural Cutaneous branches of saphenous, sural

deep peroneal and superficial peroneal deep peroneal and superficial peroneal nerves.nerves.

Dorsalis pedis artery and arcuate branch, Dorsalis pedis artery and arcuate branch, and dorsal digital branches.and dorsal digital branches.

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MOVEMENTS OF THE MOVEMENTS OF THE FOOTFOOT

DorsiflexionDorsiflexion Plantar flexionPlantar flexion InversionInversion EvertionEvertion Flexion & extension Flexion & extension

of digits.of digits. Abduction & Abduction &

adduction of digits.adduction of digits.

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RADIOLOGY OF FOOTRADIOLOGY OF FOOT

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ANATOMY OF SOLE ANATOMY OF SOLE GROSS FEATURESGROSS FEATURES

Ball of great toe.Ball of great toe. Ball of little toe.Ball of little toe. Ball of heel.Ball of heel. Thick, non-hairy skinThick, non-hairy skin Plantar Plantar

dermatoglyphics, foot dermatoglyphics, foot & toes prints.& toes prints.

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DEEP FASCIA DEEP FASCIA OF SOLEOF SOLE

Plantar aponeurosis.Plantar aponeurosis. Flexor retinaculum.Flexor retinaculum. Fibrous flexor Fibrous flexor

sheaths.sheaths.

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LAYERS OF SOLELAYERS OF SOLE

There are 4 muscular layers of sole.There are 4 muscular layers of sole. First layer muscles include – abductor First layer muscles include – abductor

hallucis, flexor digitorum brevis & hallucis, flexor digitorum brevis & abductor digiti minimi.abductor digiti minimi.

Plantar nerves and vessels.Plantar nerves and vessels.

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SECOND LAYER OF SOLESECOND LAYER OF SOLE

Flexor accessorius Flexor accessorius (quadratus plantae).(quadratus plantae).

Four lumbricals.Four lumbricals. Tendons of flexor Tendons of flexor

digitorum longus, digitorum longus, flexor hallucis longus flexor hallucis longus and tibialis posterior.and tibialis posterior.

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THIRD LAYER THIRD LAYER OF SOLEOF SOLE

Flexor hallucis Flexor hallucis brevis.brevis.

Flexor digiti minimi Flexor digiti minimi brevis.brevis.

Adductor hallucis.Adductor hallucis.

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THE FOURTH THE FOURTH LAYER OF SOLELAYER OF SOLE

Interossei.Interossei. Tendon of tibialis Tendon of tibialis

posterior.posterior. Tendon of peroneus Tendon of peroneus

longus.longus.

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SKELETAL SKELETAL ARCHES OFARCHES OF FOOT FOOT

Medial longitudinal Medial longitudinal arch,arch,

Lateral longitudinal Lateral longitudinal arch,arch,

Transverse arch.Transverse arch.

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Medial longitudinal bony Medial longitudinal bony archarch

Talus +navicular+medial cuniformTalus +navicular+medial cuniform Intermediate cuniform+lateral cuniform+Intermediate cuniform+lateral cuniform+ Medial 3 meta tarsals+Medial 3 meta tarsals+ Phalanges of digits I,II,III.Phalanges of digits I,II,III.

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Lateral longitudinal archLateral longitudinal arch

Calcaneum+cuboid+Calcaneum+cuboid+ Lateral 2 meta tarsals+Lateral 2 meta tarsals+ Phalanges of digits III &IV.Phalanges of digits III &IV.

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The transverse archThe transverse arch

Talus+Calcaneum+Talus+Calcaneum+ Navicular+ cunneforms+Navicular+ cunneforms+ Cuboid+ all metatarsals.Cuboid+ all metatarsals.

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FACTORS THAT MAINTAIN FACTORS THAT MAINTAIN THE LONGITUDINAL ARCHESTHE LONGITUDINAL ARCHES

Ligaments are – Long plantar ligament+plantar Ligaments are – Long plantar ligament+plantar calcaneocuboid,+plantar calcaneonavicular.calcaneocuboid,+plantar calcaneonavicular.

Long tendons – Tibialis anterior+Tibialis Long tendons – Tibialis anterior+Tibialis posterior+Peroneus longus+Flexor hallucis posterior+Peroneus longus+Flexor hallucis longus+Flexor digitorum longus.longus+Flexor digitorum longus.

Plantar aponeurosis + intrinsic muscles+ bony Plantar aponeurosis + intrinsic muscles+ bony alignments.alignments.

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Applied AnatomyApplied Anatomy

Flat foot.Flat foot. Talipes equino Talipes equino

valgus / Club foot.valgus / Club foot.

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Thank youThank you

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