1. Foot Anatomy
Dr Rania Gabr

2. Objectives Know the retinaculae around the ankle and their relations.
Discuss the characteristic features of joints of foot.
Explain the layers of foot with their contents.
Identify the muscles present in the layers of foot with their actions.
Understand the arches of foot.

4. Extensor Retinacula
A thickening of deep fascia that keeps the long tendons around ankle joint in position
Superior Extensor retinaculum :
Attached to anterior borders of tibia & fibula above ankle
Inferior Extensor retinaculum:
Y-shaped band located inferior to ankle

5. the stem of the Y being attached laterally to the upper surface of the calcaneus,

6. Structures Passing Deep to Extensor Retinacula
From medial to lateral:
1.Tom
2.Has
3.Very (vessels)
4.Nice ( nerve)
5.Dog &
6.Pigeon

7. Peroneal Retinacula Superior peroneal retinaculum
Connects the lateral malleolus to calcaneum & holds the tendons of peroneus longus & brevis
Inferior peroneal retinaculum
Synovial Sheaths of Peroneal Longus & Brevis:
Tendons of peronei are surrounded by a single common tubular synovial sheath,
deep to inferior peroneal retinaculum, they have separate sheaths

8. Deep Fascia of Dorsum of Foot
It is very thin, but just distal to ankle joint, it is
thickened to form Inferior extensor retinaculum

9. Dorsum of Foot Extensor Digitorum Brevis Dorsalis Pedis MUSCLE
BLOOD VESSEL
NERVE
Extensor Digitorum Brevis
Dorsalis Pedis
DEEP & Superficial
Peroneal

10. Extensor Digitorum Brevis
Origin
Insertion
Action
Anterior part of upper surface of the Calcaneum and from the Inferior extensor retinaculum
By four tendons into the proximal phalanx of big toe and long extensor tendons to second, third, and fourth toes
Extend toes

11. Insertion of Long Extensor Tendons
The tendons of Extensor digitorum longus pass to the lateral four toes.
Each tendon to the 2nd , 3rd & 4th toes is joined on its lateral side by a tendon of Extensor digitorum brevis.
The extensor tendons form a Fascial Expansion (Extensor Expansion) on the dorsum of each toe.
The expansion divides into (3) parts.
Central part: inserted into the Base of Middle ph.
Two Lateral parts: inserted into the Base of Distal ph.
The (Extensor Expansion) receives insertion of :
Interossei & Lumbrical muscles.

13. Synovial Sheaths of Extensor Tendons on the Dorsum of Foot
Tibialis anterior Extensor hallucis longus (Both have its own synovial sheath) Extensor digitorum longus & peroneus tertius : have a common sheath, it extends to the level of Base of 5th Metatarsal bone.

14. Flexor Retinaculum
Extends from the back of the medial malleolus to the medial side of calcaneum

15. Structures passing posterior to medial malleolus, deep to flexor retinaculum
Medial to lateral
Tibialis posterior tendon
Flexor digitorum longus tendon
Posterior tibial artery with venae comitantes
Tibial nerve
Flexor hallucis longus tendon

16. From anterior to posterior:
1.Tom
2.Does a
3.Very (vessels)
4.Nice ( nerve)
5.Hat

17. 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.
The base of the aponeurosis divides into five slips that pass into the toes.

18. MUSCLES OF THE SOLE OF THE FOOT
The muscles of the sole are conveniently described in four layers from superficial to deep.

19. First Layer Abductor hallucis, Flexor digitorum brevis,
Abductor digiti minimi

20. Second Layer Quadratus plantae, Lumbricals,
Flexor digitorum longus tendon,
Flexor hallucis longus tendon

21. Third Layer Flexor hallucis brevis Adductor hallucis
Flexor digiti minimi brevis

22. Fourth Layer Interossei, (3 plantar + 4 dorsal).
Peroneus longus tendon,
Tibialis posterior tendon

23. Function of small muscles of Foot
Unlike the small muscles of the hand, the sole muscles have few delicate functions and are chiefly concerned with supporting the arches of the foot.
Although their names would suggest control of individual toes, this function is rarely used in most people

24. Arches of Foot Medial longitudinal arch
Is formed of calcaneum, talus, navicular, 3 cuneiform bones, and first medial 3 metatarsal bones.
Lateral longitudinal arch Is formed of calcaneum, cuboid & lateral 4th & 5th metatarsal bones
Transverse arch
Lies at the level of tarso-metatarsal joints, formed of bases of metatarsal bones, cuboid & 3 cuneiform bones.

26. Function of Arches of the Foot
Weight bearing
Support walking & running
Provide potential space neurovascular bundle of the sole
Act as shock absorber
In young child the foot appears to be flat because of presence of a large amount of subcutaneous fat on the sole of foot

27. 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 toes.

28. Synovial Flexor Sheaths
The tendons of the flexor hallucis longus and the flexor digitorum longus are surrounded by synovial sheaths