1. Dr. Ahmed Fathalla Ibrahim

2. FUNCTIONS OF FOOT Support body weightSupport body weight Serves as a lever to propel the body forward in walking & runningServes as a lever to propel the body forward in walking & running

3. FUNCTIONS OF FOOT IF THE FOOT POSSESSED A SINGLE BONE It cannot adapt itself to uneven surfacesIt cannot adapt itself to uneven surfaces Its propulsive action depends entirely on gastrocnemius & plantarisIts propulsive action depends entirely on gastrocnemius & plantarisBUT Gastrocnemius & plantaris

4. FUNCTIONS OF FOOT IF THE FOOT IS FORMED OF SMALL BONES & MANY JOINTS It can adapt itself to uneven surfacesIt can adapt itself to uneven surfaces Long flexors & small muscles of foot assist in propulsive actionLong flexors & small muscles of foot assist in propulsive action

5. WHY THERE ARE ARCHES? A segmented structure can hold up weight only if it is built in the form of archesA segmented structure can hold up weight only if it is built in the form of arches Weight will be distributed on: 1) the heel (behind) & 2) heads of metatarsal bones (in front): pressure will be minimized on nerves & vessels in soleWeight will be distributed on: 1) the heel (behind) & 2) heads of metatarsal bones (in front): pressure will be minimized on nerves & vessels in sole Forward propulsive action will be easierForward propulsive action will be easier

6. ARCHES OF FOOT MEDIAL LONGITUDINAL ARCH: Higher than lateral archHigher than lateral arch Formed of: calcaneum, talus (key stone), navicular, three cuneiform & first three metatarsal bonesFormed of: calcaneum, talus (key stone), navicular, three cuneiform & first three metatarsal bones

7. ARCHES OF FOOT LATERAL LONGITUDINAL ARCH: Lower than medial archLower than medial arch Formed of: calcaneum, cuboid (key stone), fourth & fifth metatarsal bonesFormed of: calcaneum, cuboid (key stone), fourth & fifth metatarsal bones

8. ARCHES OF FOOT TRANSVERSE ARCH: It is only half an archIt is only half an arch It is formed of: bases of metatarsal bones, cuboid & three cuneiform bonesIt is formed of: bases of metatarsal bones, cuboid & three cuneiform bones

9. FACTORS MAINTAINING ARCHES OF FOOT Shape of bonesShape of bones Strength of ligamentsStrength of ligaments Tone of musclesTone of muscles

10. MECHANISM OF ARCH SUPPORT SHAPE OF BONES Bones are wedge- shaped with the thin edge lying inferiorlyBones are wedge- shaped with the thin edge lying inferiorly This applies particularly to the bone occupying the center of the arch “keystone”This applies particularly to the bone occupying the center of the arch “keystone”

11. MECHANISM OF ARCH SUPPORT INFERIOR EDGES OF BONES ARE TIED TOGETHER

12. MECHANISM OF ARCH SUPPORT INFERIOR EDGES OF BONES ARE TIED TOGETHER Medial longtitudinal arch: plantar calcaneonavicular ligament, tibialis posteriorMedial longtitudinal arch: plantar calcaneonavicular ligament, tibialis posterior Lateral longtitudinal arch: long & short plantar ligamentsLateral longtitudinal arch: long & short plantar ligaments Transverse arch: deep transverse ligaments, transverse head of adductor hallucis, dorsal interosseiTransverse arch: deep transverse ligaments, transverse head of adductor hallucis, dorsal interossei

13. MECHANISM OF ARCH SUPPORT TYINGTHE ENDS OF THE ARCH TOGETHER TYING THE ENDS OF THE ARCH TOGETHER

14. MECHANISM OF ARCH SUPPORT TYINGTHE ENDS OF THE ARCH TOGETHER TYING THE ENDS OF THE ARCH TOGETHER Medial longtitudinal arch: plantar aponeurosis, medial part of flexor digitorum longus & brevis, flexor hallucis longus, flexor hallucis brevis, abductor hallucisMedial longtitudinal arch: plantar aponeurosis, medial part of flexor digitorum longus & brevis, flexor hallucis longus, flexor hallucis brevis, abductor hallucis Lateral longtitudinal arch: plantar aponeurosis, lateral part of flexor digitorum longus & brevis, abductor digiti minimi, flexor digiti minimiLateral longtitudinal arch: plantar aponeurosis, lateral part of flexor digitorum longus & brevis, abductor digiti minimi, flexor digiti minimi Transverse arch: peroneus longusTransverse arch: peroneus longus

15. MECHANISM OF ARCH SUPPORT SUSPENDING THE ARCH FROM ABOVE

16. MECHANISM OF ARCH SUPPORT SUSPENDING THE ARCH FROM ABOVE Medial longtitudinal arch: tibialis anterior, tibialis posterior, medial ligament of ankle jointMedial longtitudinal arch: tibialis anterior, tibialis posterior, medial ligament of ankle joint Lateral longtitudinal arch: peroneus longus, peroneus brevisLateral longtitudinal arch: peroneus longus, peroneus brevis Transverse arch: peroneus longusTransverse arch: peroneus longus

17. PES PLANUS (FLAT FOOT) A condition in which the medial longitudinal arch is depressedA condition in which the medial longitudinal arch is depressed The forefoot is evertedThe forefoot is everted The head of talus is forced downward & mediallyThe head of talus is forced downward & medially The causes are both congenital and acquiredThe causes are both congenital and acquired