BY Dr. Ansari, prof. & chair-person, Dept.of anatomy, RAKMHSU. GROSS ANATOMY OF FOOT BY Dr. Ansari, prof. & chair-person, Dept.of anatomy, RAKMHSU. 4/23/2017

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TOPOGRAPHY Foot lies distal to the ankle joint. Superior surface of foot is dorsum of foot. Inferior surface is the sole/plantar surface. Foot is modified for weight bearing and locomotion. 4/23/2017

SURFACE ANATOMY OF FOOT Dorsalis pedis artery is palpable at the mid point of the line joining the two malleoli. Medial malleolus is the lower part of tibia, long saphenous vein lies anterior to the malleolus. Lateral malleolus is the lower end of fibula. Posterior tibial artery is palpable at the mid point between medial malleolus and tuberosity of calcaneum. Tendo -calcaneum is the Achilles tendon attached to the tuberosity of calcaneum. 4/23/2017

BONES OF THE FOOT 4/23/2017

DERMATOME – DORSUM OF FOOT Saphenous nerve supplies the medial side of foot, up to the root of the great toe. Sural nerve supplies the skin of the lateral side of foot. Deep peroneal nerve supplies the dorsum of foot skin of first inter-digital cleft. Superficial peroneal nerve supplies the rest of the skin of dorsum of foot. 4/23/2017

DERMATOME ON SOLE Saphenous nerve Sural nerve Medial plantar nerve Lateral plantar nerve Tibial nerve We walk on S1 segment. 4/23/2017

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We walk on S1 segment 4/23/2017

DEEP FASCIA OF FOOT Superior extensor retinaculum. Inferior extensor retinaculum. Flexor retinaculum. Plantar aponeurosis. Fibrous flexor sheaths. 4/23/2017

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EXTENSOR RETINACULUM ATTACHMENTS The superior extensor retinaculum binds the anterior borders of tibia and fibula, proximal to the malleoli. It binds down the tendons of anterior compartment of leg, preventing bowstringing during dorsi flexion of the ankle. 4/23/2017

The inferior extensor retinaculum It is a Y- shaped band of deep fascia. Attached laterally to the anterosuperior surface of the calcaneus. It binds round the tendons of peroneus tertius and extensor digitorum longus. 4/23/2017

The peroneal retinacula These are the bands of deep fascia. Attached from the tip of lateral malleolus to the calcaneus. It binds the tendons of peroneus longus and peroneus brevis. 4/23/2017

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TENDONS ON THE DORSUM OF FOOT Long tendons coming from the anterior compartment of leg are:- Tibialis anterior Extensor hallucis longus, Extensor digitorum longus, Peroneus tertius. 4/23/2017

The intrinsic muscles on foot Extensor digitorum brevis. Dorsal interossei. 4/23/2017

OTHER STRUCTURES ON DORSUM FOOT Dorsal venous arch. Long & short saphenous veins. Cutaneous branches of saphenous, sural deep peroneal and superficial peroneal nerves. Dorsalis pedis artery and arcuate branch, and dorsal digital branches. 4/23/2017

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MOVEMENTS OF THE FOOT Dorsiflexion Plantar flexion Inversion Evertion Flexion & extension of digits. Abduction & adduction of digits. 4/23/2017

RADIOLOGY OF FOOT 4/23/2017

ANATOMY OF SOLE GROSS FEATURES Ball of great toe. Ball of little toe. Ball of heel. Thick, non-hairy skin Plantar dermatoglyphics, foot & toes prints. 4/23/2017

DEEP FASCIA OF SOLE Plantar aponeurosis. Flexor retinaculum. Fibrous flexor sheaths. 4/23/2017

LAYERS OF SOLE There are 4 muscular layers of sole. First layer muscles include – abductor hallucis, flexor digitorum brevis & abductor digiti minimi. Plantar nerves and vessels. 4/23/2017

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SECOND LAYER OF SOLE Flexor accessorius (quadratus plantae). Four lumbricals. Tendons of flexor digitorum longus, flexor hallucis longus and tibialis posterior. 4/23/2017

THIRD LAYER OF SOLE Flexor hallucis brevis. Flexor digiti minimi brevis. Adductor hallucis. 4/23/2017

THE FOURTH LAYER OF SOLE Interossei. Tendon of tibialis posterior. Tendon of peroneus longus. 4/23/2017

SKELETAL ARCHES OF FOOT Medial longitudinal arch, Lateral longitudinal arch, Transverse arch. 4/23/2017

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Medial longitudinal bony arch Talus +navicular+medial cuniform Intermediate cuniform+lateral cuniform+ Medial 3 meta tarsals+ Phalanges of digits I,II,III. 4/23/2017

Lateral longitudinal arch Calcaneum+cuboid+ Lateral 2 meta tarsals+ Phalanges of digits III &IV. 4/23/2017

The transverse arch Talus+Calcaneum+ Navicular+ cunneforms+ Cuboid+ all metatarsals. 4/23/2017

FACTORS THAT MAINTAIN THE LONGITUDINAL ARCHES Ligaments are – Long plantar ligament+plantar calcaneocuboid,+plantar calcaneonavicular. Long tendons – Tibialis anterior+Tibialis posterior+Peroneus longus+Flexor hallucis longus+Flexor digitorum longus. Plantar aponeurosis + intrinsic muscles+ bony alignments. 4/23/2017

Applied Anatomy Flat foot. Talipes equino valgus / Club foot. 4/23/2017

Thank you 4/23/2017