Foot in human body


                FOOT


FOOT


• SOLE OF THE FOOT
• THICK AND HAIRLESS.
• IT IS FIRMLY BOUND DOWN TO THE UNDERLYING DEEP FASCIA BY NUMEROUS FIBROUS BANDS.
• THE SKIN SHOWS A FEW FLEXURE CREASES AT THE SITES OF SKIN MOVEMENT.
• SWEAT GLANDS ARE PRESENT IN LARGE NUMBERS.

FOOT
• SENSORY NERVE SUPPLY:
• MEDIAL CALCANEAL BRANCH OF THE TIBIAL NERVE - WHICH INNERVATES THE MEDIAL SIDE OF
THE HEEL;
• BRANCHES FROM THE MEDIAL PLANTAR NERVE- WHICH INNERVATE THE MEDIAL TWO THIRDS
OF THE SOLE
• BRANCHES FROM THE LATERAL PLANTAR NERVE - INNERVATE THE LATERAL THIRD OF THE SOLE


FOOT
• 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.


MUSCLESOF THE FOOT
• CHIEFLY CONCERNED WITH SUPPORTING THE ARCHES OF THE FOOT
• FIRST LAYER: ABDUCTOR HALLUCIS, FLEXOR DIGITORUM BREVIS, ABDUCTOR DIGITI MINIMI
• SECOND LAYER: QUADRATUS PLANTAE, LUMBRICALS, FLEXOR DIGITORUM LONGUS TENDON,
FLEXOR HALLUCIS LONGUS TENDON
• THIRD LAYER: FLEXOR HALLUCIS BREVIS, ADDUCTOR HALLUCIS, FLEXOR DIGITI MINIMI BREVIS
• FOURTH LAYER: INTEROSSEI, PERONEUS LONGUS TENDON, TIBIALIS POSTERIOR TENDON





LONG TENDONS OF THE SOLE OF THE FOOT
• FLEXOR DIGITORUM LONGUS TENDON
• ENTERS THE SOLE BY PASSING BEHIND THE MEDIAL MALLEOLUS BENEATH THE FLEXOR
RETINACULUM
• PASSES FORWARD ACROSS THE MEDIAL SURFACE OF THE SUSTENTACULUM TALI AND THEN
CROSSES THE TENDON OF FLEXOR HALLUCIS LONGUS, FROM WHICH IT RECEIVES A STRONG
SLIP – RECEIVES LATERAL INSERTION OF THE QUADRATUS PLANTAE
• THE TENDON NOW DIVIDES INTO ITS FOUR TENDONS OF INSERTION, WHICH PASS FORWARD,
GIVING ORIGIN TO THE LUMBRICAL MUSCLES.
LONG TENDONS OF THE FOOT
• FLEXOR DIGITORUM LONGUS TENDON
• THE TENDONS THEN ENTER THE FIBROUS SHEATHS OF THE LATERAL FOUR TOES.
• EACH TENDON PERFORATES THE CORRESPONDING TENDON OF FLEXOR DIGITORUM BREVIS
AND PASSES ON TO BE INSERTED INTO THE BASE OF THE DISTAL PHALANX.
LONG TENDONS OF THE FOOT
• FLEXOR HALLUCIS LONGUS TENDON
• ENTERS THE SOLE BY PASSING BEHIND THE MEDIAL MALLEOLUS BENEATH THE FLEXOR
RETINACULUM.
• IT RUNS FORWARD BELOW THE SUSTENTACULUM TALI AND CROSSES DEEP TO THE FLEXOR
DIGITORUM LONGUS TENDON, TO WHICH IT GIVES A STRONG SLIP.
• IT THEN ENTERS THE FIBROUS SHEATH OF THE BIG TOE AND IS INSERTED INTO THE BASE OF THE
DISTAL PHALANX.


LONG TENDONS OF THE FOOT
• FIBROUS FLEXOR SHEATHS
• THE INFERIOR SURFACE OF EACH TOE, FROM THE HEAD OF THE METATARSAL BONE TO THE BASE OF THE
DISTAL PHALANX, IS PROVIDED WITH A STRONG FIBROUS SHEATH, WHICH IS ATTACHED TO THE SIDES OF
THE PHALANGES.
• THE FIBROUS SHEATH, TOGETHER WITH THE INFERIOR SURFACES OF THE PHALANGES AND THE
INTERPHALANGEAL JOINTS, FORMS A BLIND TUNNEL IN WHICH LIE THE FLEXOR TENDONS OF THE TOE.
• SYNOVIAL FLEXOR SHEATHS THE TENDONS OF THE FLEXOR HALLUCIS LONGUS AND THE FLEXOR
DIGITORUM LONGUS ARE SURROUNDED BY SYNOVIAL SHEATHS


LONG TENDONS OF THE FOOT
• PERONEUS LONGUS TENDON
• ENTERS THE FOOT FROM BEHIND THE LATERAL MALLEOLUS AND RUNS OBLIQUELY ACROSS HE
SOLE TO BE INSERTED INTO THE BASE OF THE FIRST METATARSAL BONE AND THE ADJACENT
PART OF THE MEDIAL CUNEIFORM.
• THE TENDON GROOVES THE INFERIOR SURFACE OF THE CUBOID WHERE IT IS HELD IN
POSITION BY THE LONG PLANTAR LIGAMENT AND IS SURROUNDED BY A SYNOVIAL SHEATH.


LONG TENDONS OF THE FOOT
• TIBIALIS POSTERIOR TENDON
• ENTERS THE FOOT FROM BEHIND THE MEDIAL MALLEOLUS.
• IT PASSES BENEATH THE FLEXOR RETINACULUM AND RUNS DOWNWARD AND FORWARD ABOVE
THE SUSTENTACULUM TALI TO BE INSERTED MAINLY INTO THE TUBEROSITY OF THE NAVICULAR.
• SMALL TENDINOUS SLIPS PASS TO THE CUBOID AND THE CUNEIFORMS AND TO THE BASES OF
THE SECOND, THIRD, AND FOURTH METATARSALS.
• THE TENDON IS SURROUNDED BY A SYNOVIAL SHEATH.


BLOOD SUPPLY
• THE MEDIAL PLANTAR ARTERY
• IS THE SMALLER OF THE TERMINAL BRANCHES OF THE POSTERIOR TIBIAL ARTERY. IT ARISES
BENEATH THE FLEXOR RETINACULUM AND PASSES FORWARD DEEP TO THE ABDUCTOR HALLUCIS
MUSCLE.
• IT ENDS BY SUPPLYING THE MEDIAL SIDE OF THE BIG TOE.
• DURING ITS COURSE, IT GIVES OFF NUMEROUS MUSCULAR, CUTANEOUS, AND ARTICULAR
BRANCHES.
BLOODSUPPLY
• THE LATERAL PLANTAR ARTERY
• IS THE LARGER OF THE TERMINAL BRANCHES OF THE POSTERIOR TIBIAL ARTERY.
• IT ARISES BENEATH THE FLEXOR RETINACULUM AND PASSES FORWARD DEEP TO THE ABDUCTOR HALLUCIS
AND THE FLEXOR DIGITORUM BREVIS.
• 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.
• IT GIVES OFF NUMEROUS MUSCULAR, CUTANEOUS, AND ARTICULAR BRANCHES.
• THE PLANTAR ARCH GIVES OFF PLANTAR DIGITAL ARTERIES TO THE TOES


BLOOD SUPPY
• DORSALIS PEDIS ARTERY
• ON ENTERING THE SOLE BETWEEN THE TWO HEADS OF THE FIRST DORSAL INTEROSSEOUS
MUSCLE, THE DORSALIS PEDIS ARTERY IMMEDIATELY JOINS THE LATERAL PLANTAR ARTERY.
• THE FIRST PLANTAR METATARSAL ARTERY, WHICH SUPPLIES THE CLEFT BETWEEN THE BIG AND
SECOND TOES.
• VEINS OF THE SOLE OF THE FOOT: MEDIAL AND LATERAL PLANTAR VEINS


NERVE SUPPLY
• NERVE SUPPLY:
• MEDIAL PLANTAR NERVE THE MEDIAL PLANTAR NERVE IS A TERMINAL BRANCH OF THE TIBIAL
NERVE .
• IT ARISES BENEATH THE FLEXOR RETINACULUM AND RUNS FORWARD DEEP TO THE ABDUCTOR
HALLUCIS, WITH THE MEDIAL PLANTAR ARTERY.
• IT COMES TO LIE IN THE INTERVAL BETWEEN THE ABDUCTOR HALLUCIS AND THE FLEXOR
DIGITORUM BREVIS.
• BRANCHES: MUSCULAR, CUTANEOUS, PLANTAR DIGITAL BRANCHES
NERVESUPPLY
• THE LATERAL PLANTAR NERVE
• IS A TERMINAL BRANCH OF THE TIBIAL NERVE
• IT ARISES BENEATH THE FLEXOR RETINACULUM AND RUNS FORWARD DEEP TO THE ABDUCTOR
HALLUCIS AND THE FLEXOR DIGITORUM BREVIS, IN COMPANY WITH THE LATERAL PLANTAR
ARTERY.
• ON REACHING THE BASE OF THE FIFTH METATARSAL BONE, IT DIVIDES INTO SUPERFICIAL AND
DEEP BRANCHES.
• BRANCHES: FROM MAIN TRUNK, SUPERFICIAL AND DEEP TERMINAL BRANCH.
DORSUMOF THE FOOT
• THE SKIN ON THE DORSUM OF THE FOOT IS THIN, HAIRY, AND FREELY MOBILE ON THE UNDERLYING
TENDONS AND BONES.
• THE SENSORY NERVE SUPPLY TO THE SKIN ON THE DORSUM OF THE FOOT IS DERIVED:
• THE SUPERFICIAL PERONEAL NERVE
• -EMERGES FROM BETWEEN THE PERONEUS BREVIS AND THE EXTENSOR DIGITORUM LONGUS MUSCLE IN
THE LOWER PART OF THE LEG.
• IT NOW DIVIDES INTO MEDIAL AND LATERAL CUTANEOUS BRANCHES THAT SUPPLY THE SKIN ON THE
DORSUM OF THE FOOT; THE MEDIAL SIDE OF THE BIG TOE; AND THE ADJACENT SIDES OF THE SECOND,
THIRD, FOURTH, AND FIFTH TOES.


DORSUM OF THE FOOT
• THE DEEP PERONEAL NERVE - THE SKIN OF THE ADJACENT SIDES OF THE BIG AND SECOND
TOES
• THE SAPHENOUS NERVE - PASSES ONTO THE DORSUM OF THE FOOT IN FRONT OF THE MEDIAL
MALLEOLUS AND SUPPLIES THE SKIN ALONG THE MEDIAL SIDE OF THE FOOT
• THE SURAL NERVE - ENTERS THE FOOT BEHIND THE LATERAL MALLEOLUS AND SUPPLIES THE
SKIN ALONG THE LATERAL MARGIN OF THE FOOT AND THE LATERAL SIDE OF THE LITTLE TOE.


DORSAL VENOUS ARCH
• LIES IN THE SUBCUTANEOUS TISSUE OVER THE HEADS OF THE METATARSAL BONES AND DRAINS ON THE
MEDIAL SIDE INTO THE GREAT SAPHENOUS VEIN AND ON THE LATERAL SIDE INTO THE SMALL SAPHENOUS
VEIN.
• THE GREAT SAPHENOUS VEIN LEAVES THE DORSUM OF THE FOOT BY ASCENDING INTO THE LEG IN FRONT
OF THE MEDIAL MALLEOLUS.
• THE SMALL SAPHENOUS VEIN ASCENDS INTO THE LEG BEHIND THE LATERAL MALLEOLUS.
• THE GREATER PART OF THE BLOOD FROM THE WHOLE FOOT DRAINS INTO THE ARCH VIA DIGITAL VEINS
AND COMMUNICATING VEINS FROM THE SOLE, WHICH PASS THROUGH THE INTEROSSEOUS SPACES.


LONG TENDONS OF THE DORSUM OF THE FOOT
• EXTENSOR DIGITORUM LONGUS TENDONS
• PASSES BENEATH THE SUPERIOR EXTENSOR RETINACULUM AND THROUGH THE INFERIOR
EXTENSOR RETINACULUM WITH THE PERONEUS TERTIUS MUSCLE
• THE TENDON DIVIDES INTO FOUR, WHICH FAN OUT OVER THE DORSUM OF THE FOOT AND
PASS TO THE LATERAL FOUR TOES.
• OPPOSITE THE METATARSOPHALANGEAL JOINTS OF THE SECOND, THIRD, AND FOURTH TOES,
EACH TENDON IS JOINED ON ITS LATERAL SIDE BY A TENDON OF EXTENSOR DIGITORUM BREVIS


LONG TENDONS OF THE DORSUM OF THE FOOT
• EXTENSOR EXPANSION
• ON THE DORSAL SURFACE OF EACH TOE, THE EXTENSOR TENDON JOINS THE FASCIAL
EXPANSION
• NEAR THE PROXIMAL INTERPHALANGEAL JOINT SPLITS INTO THREE PARTS: A CENTRAL PART,
WHICH IS INSERTED INTO THE BASE OF THE MIDDLE PHALANX, AND TWO LATERAL PARTS,
WHICH CONVERGE TO BE INSERTED INTO THE BASE OF THE DISTAL PHALANX.
• THE DORSAL EXPANSION RECEIVES THE TENDONS OF INSERTION OF THE INTEROSSEOUS AND
LUMBRICAL MUSCLES.


LONG TENDONS OF THE DORSUM OF THE FOOT
• SYNOVIAL SHEATH OF THE TENDON OF EXTENSOR DIGITORUM LONGUS.
• THE EXTENSOR DIGITORUM LONGUS AND PERONEUS TERTIUS TENDONS ARE SURROUNDED BY
A COMMON SYNOVIAL SHEATH AS THEY PASS BENEATH THE EXTENSOR RETINACULA.
• THE SHEATH EXTENDS PROXIMALLY FOR A SHORT DISTANCE ABOVE THE MALLEOLI AND
DISTALLY TO THE LEVEL OF THE BASE OF THE FIFTH METATARSAL BONE.


BLOODSUPPLY
• DORSALIS PEDIS ARTERY- BEGINS IN FRONT OF THE ANKLE JOINT AS A CONTINUATION OF THE ANTERIOR
TIBIAL ARTERY
• IT TERMINATES BY PASSING DOWNWARD INTO THE SOLE BETWEEN THE TWO HEADS OF THE FIRST
DORSAL INTEROSSEOUS MUSCLE, WHERE IT JOINS THE LATERAL PLANTAR ARTERY TO FORM THE PLANTAR
ARCH
• BRANCHES:
• LATERAL TARSAL ARTERY
• ARCUATE ARTERY
• FIRST DORSAL METATARSAL ARTERY


NERVE SUPPLY OF THE DORSUM
• DEEP PERONEAL NERVE - ENTERS THE DORSUM OF THE FOOT BY PASSING DEEP TO THE
EXTENSOR RETINACULA ON THE LATERAL SIDE OF THE DORSALIS PEDIS ARTERY
• BRANCHES
• THE MEDIAL BRANCH - SUPPLIES THE SKIN OF THE ADJACENT SIDES OF THE BIG AND SECOND
TOES
• THE LATERAL BRANCH - SUPPLIES THE EXTENSOR DIGITORUM BREVIS MUSCLE.
• BOTH TERMINAL BRANCHES - GIVE ARTICULAR BRANCHES TO THE JOINTS OF THE FOOT.

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