L11

Sole of Foot

• The sole of the foot is a thick layer of skin that offers protection.
• It firmly adheres to the plantar aponeurosis.
• The skin has creases.
• The plantar aponeurosis is a thickened band of deep fascia.
• Posteriorly, it's attached to the calcaneum.
• Anteriorly, it has five slips that connect to the five toes.
• It protects underlying nerves and vessels.
• It maintains the longitudinal arches of the foot.

First Layer Muscles

• Abductor hallucis: Innervated by the medial plantar nerve; action is abduction of the great toe.
• Flexor digitorum brevis: Innervated by the medial plantar nerve; action is flexion of the lateral four toes.
• Abductor digiti minimi: Innervated by the lateral plantar nerve; action is abduction of the little toe.

Second Layer Muscles and Tendons

• Flexor hallucis longus (FHL): A tendon.
• Flexor digitorum longus (FDL): Atendon.
• Quadratus plantae: A muscle.
• Four lumbricals: Muscles.
• The quadratus plantae assists in plantar flexion, and is innervated by the lateral plantar nerve.

Second Layer Lumbricals

• Origin: Tendons of the FDL muscle.
• Insertion: Middle and distal phalanges of the lateral four toes.
• Nerve Supply: 1st - medial plantar nerve; 2nd, 3rd, and 4th - lateral plantar nerve.
• Action: Flexion at the MCP and extension at the IP joints.

Third Layer Muscles

• Flexor hallucis brevis: Medial plantar nerve.
• Adductor hallucis: Lateral plantar nerve.
• Flexor digiti minimi brevis: Lateral plantar nerve.

Fourth Layer Muscles and Tendons

• Two tendons: Tibialis posterior and Peroneous longus (fibularis longus).
• Three plantar interossei muscles: Innervated by lateral plantar nerve; action: adduction of the 3rd, 4th, and 5th toes to the long axis passing through the second toe.
• Four dorsal interossei muscles: Innervated by the lateral plantar nerve; action: abduction of the second to fourth toes at the metatarsophalangeal joint.

Arteries of the Sole

• Medial plantar artery: A smaller terminal branch of the posterior tibial artery; enters the sole with the medial plantar nerve. Muscular and digital branches.
• Lateral plantar artery: A larger terminal branch of the posterior tibial artery; enters the sole with the lateral plantar nerve. Muscular branches and the 5th plantar metatarsal artery.

Plantar Arch

• The plantar arch runs from the fifth metatarsal to the first metatarsal.
• Formed by the continuation of the lateral plantar artery and anastomoses between the deep branch of the dorsalis pedis artery.
• Gives plantar metatarsal arteries.
• Veins accompany the arteries of the sole. Medial and lateral plantar veins.

Plantar Fasciitis

• Inflammation of the plantar fascia.
• A common cause of heel pain.
• Stabbing pain, common in the morning, eventually reduced throughout the day.
• Long periods of standing intensify the pain.
• Common in runners or professions involving prolonged standing (teachers, ballet dancers).
• Obesity and stress on the fascia can contribute to inflammation.

Ankle Joint

Objectives

• Classify the ankle joint.
• Name the articulating bones in the ankle joint.
• Identify the ligaments of the ankle joint.
• Name the movements of the ankle joint.
• Name the muscles that bring about the movements.

Articulating Bones

• Inferior surface of the tibia.
• Medial malleolus.
• Lateral malleolus.
• Superior surface of the talus.
• Hinge variety of synovial joint.

Ligaments

• Medial (deltoid): Ligament.
• Laterally:
  • Anterior talofibular ligament.
  • Posterior talofibular ligament.
  • Calcaneofibular ligament.

Deltoid Ligament Parts

• Tibio-talar part.
• Tibio-calcaneal part.
• Tibio-navicular part.

Movements

• Dorsiflexion: Tibialis anterior, gastrocnemius, soleus.
• Plantarflexion:
• Inversion:
• Eversion:

Talocalcaneal/Subtalar Joint

• Plane synovial joint.

Joints of the Foot

• The ankle joint (tibia, fibula, and talus).
• The subtalar joint.
• The transverse tarsal joint.

This quiz covers the anatomy of the sole of the foot, including its protective features, layers, and the associated muscles. You'll learn about the different layers of muscles, their functions, and their nerve innervations. Test your knowledge on foot anatomy and the roles of various tendons and muscles.