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.
• 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
• 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.
• 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
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
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
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
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.
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.
• 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.
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.
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
• 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.
• 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,
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
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
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,
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
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
• 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
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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