Muscles of Foot PDF

Anatomy of LOWER Limb Muscles of Foot By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology  Case Study LOWER LIMB Plantar Fasciitis Muscles of Foot By Dr. Hassan Rezk Oc...

Anatomy of LOWER Limb Muscles of Foot By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology  Case Study LOWER LIMB Plantar Fasciitis Muscles of Foot By Dr. Hassan Rezk October 11, 2024 2  Objectives: by the end of this lecture the student must understand the following knowledge: Identify the shape and attachments of Plantar aponeurosis. LOWER LIMB Identify the Gross structure of the muscle of foot (groups, layers of sole, their arrangement, nerve supply & action). Mention the Full details (origin, insertion, nerve supply & action) of the following ONLY: 1. Three Plantar Interossei. 2. Four Dorsal Interossei. 3. Four Lumbricals. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 3  Objective 1: Plantar Aponeurosis LOWER LIMB ▪ It is a thickening of deep fascia in the sole. ▪ It is attached to calcaneal tuberosity. ▪ Extends forward as 5 thick fibrous digital bands, one for each toe. ▪ Function: 1. Supports the longitudinal arch of the foot. 2. Protects deeper structures in the sole. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 4  Objective 2: Muscles of Foot Foot is the distal segment of lower limb. LOWER LIMB Its skeleton is formed by 26 bones (see the previous lecture). Foot extends distal to ankle joint. Foot contains several joints; we will refer only to the followings: 1. Metatarsophalangeal joints: flexion, extension, adduction & abduction for the whole toe. 2. Interphalangeal joints: flexion & extension of the individual phalanx. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 5  Muscles of Foot LOWER LIMB Extrinsic Muscles of the Foot Intrinsic Muscles of the Foot ▪ Long tendons of the muscles of the leg. Dorsum of the Foot Sole ▪ The tendons that cross the dorsal, From superficial to deep Extensor Digitorum Brevis lateral and ventral surfaces of the 1st 2nd 3rd 4th layer layer layer layer ankle joint. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 6  Muscles of Foot 4 layers of Sole Dorsum of the foot (arranged from superficial to deep) Extensor Digitorum Brevis 1st layer: 3 muscles LOWER LIMB 1. Abductor Hallucis muscle. 2. Abductor Digiti minimi muscle. 3. Flexor Digitorum Brevis muscle. 2nd layer: 2 muscles, 2 tendons 1. Flexor Digitorum Accessorius. attached to tendon of F.D.L. 2. Lumbrical muscles 3. Tendon of Flexor Digitorum Longus. 4. Tendon of Flexor Hallucis Longus. 3rd layer: 3 muscles 1. Adductor Hallucis muscle. 2. Flexor Hallucis Brevis muscle 3. Flexor Digiti minimi muscle. 4th layer: 2 muscles, 2 tendons 1. Planter interossei (3). 2. Dorsal interossei (4) 3. Tendon of peroneus longus. 4. Tendon of tibialis posterior. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 7 LOWER LIMB All muscles of the sole are supplied by lateral plantar nerve EXCEPT the followings which are supplied by medial plantar nerve: 1) Abductor hallucis. 2) Flexor hallucis brevis. 3) Flexor digitorum brevis. 4) First lumbrical. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 8  Extensor Digitorum Brevis It is largest muscle in the dorsum of the foot. It is crossed by the tendons of anterior compartment of leg. LOWER LIMB INSERTION It forms four tendons: - The most medial: the Extensor Hallucis Brevis is inserted into the base of the proximal phalanx of the big toe. - The remaining 3 tendons join the long extensor tendons of the 2nd to 4th toes to form extensor expansion. NERVE SUPPLY Deep peroneal nerve. ACTION 1. Extension of the metatarsophalangeal joints of the medial 4 toes. 2. Extension of the interphalangeal joints of the 2nd, 3rd and 4th toes. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 9 LOWER LIMB ▪ Left foot showing Extension of lateral four toes action of EDL. ▪ Right foot showing Extension of middle 3 toes action of EDB. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 10 LOWER LIMB Layers of Sole Muscles of Foot By Dr. Hassan Rezk October 11, 2024 11 LOWER LIMB Muscles of 1st layer Layers of Sole Muscles of 2nd layer Muscles of Foot By Dr. Hassan Rezk October 11, 2024 12  Muscles of 3rd layer Layers of Sole Muscles of 4th layer Near dorsum of foot LOWER LIMB Muscles of Foot By Dr. Hassan Rezk October 11, 2024 13  Objective 3: Interossei & Lumbrical Muscles of Foot What is the Idea & How we can Study? LOWER LIMB Dorsal Interossei Plantar Interossei Double Head Single Head D D ABduction P ADduction Muscles of Foot By Dr. Hassan Rezk October 11, 2024 14   D ABduction How many abductors for Hallux? 1  How many abductors for Digiti minimi? 1 LOWER LIMB 2 3 4 Dorsal surface of Foot Muscles of Foot By Dr. Hassan Rezk October 11, 2024 15  Dorsal Interossei Number ▪ Arranged 1st,2nd,3rd & 4th from medial to lateral LOWER LIMB Site ▪ Dorsum of the foot – 4th layer of sole ▪ Two heads from shafts of adjacent metatarsal Origin bones. Insertion ▪ Inserted in both the base of the proximal phalanx and into the extensor hood of its related digit. ▪ 1st & 2nd : inserted into the medial & lateral sides of the 2nd toe. ▪ 3rd: inserted into the lateral side of 3rd toe. ▪ 4th: inserted into the lateral side of 4th toe. Nerve Supply ▪ Lateral plantar nerve (S2 & S3). Abductors of the middle 3 toes, at the Action metatarsophalangeal joints. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 16   P ADduction How many adductors for Digiti minimi? How many adductors for Hallux? NO 1 LOWER LIMB 1 2 3 Plantar surface Muscles of Foot By Dr. Hassan Rezk October 11, 2024 17  Plantar Interossei ▪ Three Plantar interossei. Number ▪ Arranged 1st,2nd & 3rd from medial to lateral. Site ▪ deep to dorsal interossei – 4th layer LOWER LIMB ▪ from the metatarsal of the digits with which each is associated ▪ 1st: from the medial side of the plantar surface of 3rd Origin metatarsal. ▪ 2nd: from the medial surface of 4th metatarsal. ▪ 3rd & 4th: from medial surface of 5th metatarsal. ▪ 1st: inserted into the medial side of proximal phalanx of 3rd toe through extensor hood. ▪ 2nd: inserted into the medial side of the extensor hood of 4th Insertion toe. ▪ 3rd : inserted into the medial side of the extensor hood of 5th toe. Nerve ▪ Lateral plantar nerve (S2 & S3). Supply Adduct the lateral 3 toes. The movements occur at the Action metacarpophalangeal joints. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 18  2 3 4 LOWER LIMB 1 F.D.L. Lumbricals Muscles of Foot By Dr. Hassan Rezk October 11, 2024 19  Lumbricals ▪ Four LOWER LIMB Number ▪ Arranged 1st,2nd,3rd & 4th from medial to lateral originate from the tendons of the flexor digitorum longus in Site the 2nd layer of sole of foot. ▪ 1st lumbrical: ✓ originates from the medial side of the tendon of the Origin flexor digitorum longus for second toe. ▪ 2nd,3rd &4th lumbricals: from the sides of adjacent tendons of F.D.L.. ▪ pass dorsally to insert into the free medial margins of the Insertion extensor hoods of the four lateral toes ▪ 1st lumbrical is innervated by the medial plantar nerve. Nerve ▪ 2nd, 3rd & 4th are innervated by the lateral plantar nerve. Supply Resists OverExtension of the metatarsophalangeal joints Action through attachment to extensor expansion. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 20 LOWER LIMB Muscles of Foot By Dr. Hassan Rezk October 11, 2024 21  Clinical Correlation Plantar fasciitis Definition: inflammation of the plantar aponeurosis Etiology: Unknown, Risk factors include: LOWER LIMB Foot deformities: pes cavus, pes planus Training errors: sudden changes in training intensity. long periods of standing and weight-bearing Obesity. Clinical features Pain of the heel and sole of the foot Pain worsens after periods of inactivity (e.g., sleeping) and prolonged weight-bearing. Diagnostics Ultrasound: plantar fascia thickening, edema at the insertion at the calcaneus. X-ray: may show bony outgrowth from calcaneal tuberosity (heel spur) Differential diagnosis Tarsal tunnel syndrome. Achilles' tendinopathy. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 22  Case Scenario (Staff Question) LOWER LIMB A 34-year-old male runner visits the outpatient clinic complaining of pain in his foot for the past week. Physical examination reveals inflammation of the tough band of tissue stretching from the calcaneus to the ball of the foot. Which of the following conditions is characteristic of these symptoms? A. Pott fracture. B. Dupuytren fracture. C. Tarsal tunnel. D. Plantar fasciitis. E. Rupture of spring ligament Muscles of Foot By Dr. Hassan Rezk October 11, 2024 23 LOWER LIMB Reference ISBN: 978-0-7020-5131-9 ISBN: 978-07817-7525-0 ISBN: 978-1-60913-446-4 Copyright© 2015, 2010, 2005 by Copyright© 2010, by Lippincott Copyright© 2012, by Lippincott Churchill Livingstone, an imprint of Williams & Wilkins, a Wolters Williams & Wilkins, a Wolters Elsevier Inc. Kluwer business. Kluwer business. Chapter 6. Chapter 5. Chapter 10. Muscles of Foot By Dr. Hassan Rezk October 11, 2024 24 LOWER LIMB Muscles of Foot By Dr. Hassan Rezk October 11, 2024 25