Sole and Arches of Foot Dr Anita Rani

Sole and Arches of Foot Dr Anita Rani Anatomy Lecture 17 th December 2016

Lesson Plan • • Introduction Skin & Superficial fascia Deep Fascia Layers Muscles Nerves & Arteries Bones: Arches Applied Anatomy

Introduction • Homologous to palm BUT • Is an organ of support and locomotion • Great toe : lost its power of mobility & prehension • Lesser four toes markedly reduced in size • Tarsal bones and Ist Metatarsal forms broad base for better support

Skin • Thick for protection • Firmly adherent to underlying plantar aponeurosis • Creased

Innervation

Plantar Reflex • Babinski’s Sign

Superficial fascia • Fibrous and dense • Fibrous bands bind the skin to plantar aponeuposis • Divide the fat in to tight compartments: water cushion • Reinforce spring effect to arches • Contains superficial nerve and vessels • Forms superficial transverse metatarsal ligament

Superficial and deep transverse metatarsal ligaments

Deep Fascia • Plantar aponeurosis • Deep transverse metatarsal ligament • Fibrous flexor sheath of toes

Muscles of sole of foot • 18 intrinsic + 4 Extrinsic muscles • Arranged in 4 layers • First layer : 3 [2 small abductors & 1 small flexor] • Second layer: 7 (5 +2) [ 2 long tendons of toes – FHL & FDL] + FD Accessorius & 4 lumbricals] • Third Layer: 3 [ 2 small flexors & 1 adductor] • Fourth layer : 9 ( 7+2) [2 long tendons of TP & PL + 3 PI + 4 DI]

First layer Abductor Hallucis FDB Abductor digiti minimi

Second layer

Third Layer 2 small flexors & 1 adductor Adductor Hallucis FHB FDMB

Fourth Layer

Nerves of sole

Arteries of Sole

Arches of foot Foot Support the body weight & Serve as a lever to propel the body Segmented Arches help to sustain stresses of thrusts and weights.

Arches of foot serve as elastic springs for efficient walking

Identify the bony components….

Maintenance of Arches • Bony factor • Intersegmental ties • Tie beams/ bow strings • Slings

Pes Planus & Pes Cavus

Claw foot

Talipes deformities

Club Foot