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Muscles of foot
Dr M Idris Siddiqui
Foot
Plantar aponeurosis
• It is thick central part of deep fascia.
• It is triangular in shape and narrow posteriorly.
• Poste...
Plantar aponeurosis
• Deep slip divides into two parts which embrace
flexor tendons. Then it blends with fibrous flexor
sh...
Functions of plantar aponeurosis
• It fixes skin of sole.
• It maintains longitudinal arch of
foot.
– It helps to preserve...
Clinical Significance
Plantar fasciitis and calcaneal spur:
• The plantar aponeurosis is stretched during standing
positio...
The muscles acting on the foot
• The muscles acting on the foot can be divided into
two distinct groups; extrinsic and int...
DEEP TRANSVERSE METATARSAL LIGAMENTS
• All these are 4 short, flat bands of fibrous
tissue, which attach the plantar ligam...
Plantar Aspect of foot
• There are 10 intrinsic muscles located in
the sole of the foot.
• They act collectively to stabil...
Dorsum of the foot
• Whilst many of the extrinsic muscles attach to
the dorsum of the foot, there are only two
intrinsic m...
MUSCLES OF THE SOLE OF THE FOOT
• The muscles of the sole are described in 4 layers
from superficial to deep.
• The muscle...
Layer Muscles Features
First
layer
1. Flexor digitorum brevis.
2. Abductor hallucis.
3. Abductor digiti minimi
They cover ...
Interossei
• Mnemonic: Plantar interossei ADduct
(PAD) the toes and originate from single
metatarsal as unipennate muscles...
First Layer
Second Layer
Third Layer
Fourth Layer
Neurovascular planes of the sole
There are 2 neurovascular planes between the
muscle layers of the sole.
1. Superficial ne...
First Layer
• The first layer of muscles
is the most superficial to
the sole, and is located
immediately underneath
the pl...
Abductor Hallucis
• The abductor hallucis muscle is located on the
medial side of the sole, where it contributes to a
smal...
Flexor Digitorum Brevis
• The flexor digitorum brevis muscle is
located laterally to the abductor hallucis. It sits in
the...
Abductor Digiti Minimi
• The abductor digiti minimi muscle is located on the
lateral side of the foot. It is homologous wi...
Second Layer
• The second layer contains
two muscles –
• Quadratus plantae, and
• Lumbricals .
• In addition, the tendons ...
The quadratus plantae
• The quadratus plantae muscle is located superior to
the flexor digitorum longus tendons. It is sep...
Lumbricals
• There are four lumbrical muscles in the foot. They
are each located medial to their respective tendon
of the ...
Third Layer
• The third layer contains three
muscles.
• Flexor hallucis brevis and
• Adductor hallucis are
associated with...
Flexor Hallucis Brevis
• The flexor hallucis brevis muscle is located on the
medial side of the foot. It originates from t...
Adductor Hallucis
• The adductor hallucis muscle is located laterally to the
flexor hallucis brevis. It consists of an obl...
Flexor Digiti Minimi Brevis
• The flexor digiti minimi brevis muscle is located on
the lateral side of the foot, underneat...
Fourth Layer
• The plantar and dorsal
interossei comprise
the fourth and final
plantar muscle layer.
• The plantar interos...
Plantar Interossei
• There are three plantar interossei, which are
located between the metatarsals. Each arises from a
sin...
Dorsal Interossei
• There are four dorsal interossei, which are located
between the metatarsals. Each arises from two
meta...
Muscles of foot
Muscles of foot
Muscles of foot
Muscles of foot
Muscles of foot
Muscles of foot
Muscles of foot
Muscles of foot
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Muscles of foot

  1. 1. Muscles of foot Dr M Idris Siddiqui
  2. 2. Foot
  3. 3. Plantar aponeurosis • It is thick central part of deep fascia. • It is triangular in shape and narrow posteriorly. • Posterior part shows attachment on medial tubercle of calcaneus proximal to flexor digitorum brevis. • Anterior end divides into five bands one for each toe. Transverse fibres held together five bands. • Plantar digital vessels and nerves passes between interval between bands protected by transverse fibres. • Near head of metatarsal head digital bands divides into superficial and deep slips. Superficial slip shows attachment on skin and blends with superficial transverse metatarsal ligaments.
  4. 4. Plantar aponeurosis • Deep slip divides into two parts which embrace flexor tendons. Then it blends with fibrous flexor sheaths and deep transverse metatarsal ligaments. • Lateral and medial intermuscular septa passes vertically from medial and lateral aspect of central part. Transverse septa arising from vertical septa divides muscles of sole into four layers. • Morphologically the plantar aponeurosis represents the degenerated tendon of plantaris muscle, which has been divided by the enlarging heel during development.
  5. 5. Functions of plantar aponeurosis • It fixes skin of sole. • It maintains longitudinal arch of foot. – It helps to preserve the longitudinal arches of the foot by acting as tie beam. • It protects vessels and nerves from compression. • It gives origin to muscles of first layer of sole. • It divide sole into different compartments.
  6. 6. Clinical Significance Plantar fasciitis and calcaneal spur: • The plantar aponeurosis is stretched during standing position. Consequently, splitting or inflammation (plantar fasciitis) frequently takes place in people who do a lot of standing or walking, viz. traffic police staff. • It causes pain and tenderness in the sole of the foot particularly underneath the heel during standing. • Continued episode of the plantar fasciitis results in calcification in the posterior connection of the plantar aponeurosis creating a calcaneal spur.
  7. 7. The muscles acting on the foot • The muscles acting on the foot can be divided into two distinct groups; extrinsic and intrinsic muscles. • The extrinsic muscles arise from the anterior, posterior and lateral compartments of the leg. They are mainly responsible for actions such as eversion, inversion, plantarflexion and dorsiflexion of the foot. • The intrinsic muscles are located within the foot and are responsible for the fine motor actions of the foot, for example movement of individual digits.
  8. 8. DEEP TRANSVERSE METATARSAL LIGAMENTS • All these are 4 short, flat bands of fibrous tissue, which attach the plantar ligaments of the adjoining metatarso-phalangeal joints. • They are linked dorsally to interossei, and ventrally to lumbricals and digital nerves and vessels.
  9. 9. Plantar Aspect of foot • There are 10 intrinsic muscles located in the sole of the foot. • They act collectively to stabilise the arches of the foot, and individually to control movement of the digits. • All the muscles are innervated either by the medial plantar nerve or the lateral plantar nerve, which are both branches of the tibial nerve.
  10. 10. Dorsum of the foot • Whilst many of the extrinsic muscles attach to the dorsum of the foot, there are only two intrinsic muscles located in this compartment – the extensor digitorum brevis, and –the extensor hallucis brevis. • They are mainly responsible for assisting some of the extrinsic muscles in their actions. • Both muscles are innervated by the deep fibular nerve.
  11. 11. MUSCLES OF THE SOLE OF THE FOOT • The muscles of the sole are described in 4 layers from superficial to deep. • The muscles of the sole are primarily concerned with supporting the arches of the foot. The short and long muscles of the foot serve as synergists. • There are 2 neurovascular planes between the muscle layers of the sole: – Superficial neurovascular plane between the first and 2nd layers. – Deep neurovascular plane between the 3rd and fourth layers.
  12. 12. Layer Muscles Features First layer 1. Flexor digitorum brevis. 2. Abductor hallucis. 3. Abductor digiti minimi They cover whole of the sole Second layer 1.Flexor digitorum accessories 2.Four lumbricals. 3.Two tendons (tendon of flexor digitorum longus and tendon of flexor hallucis longus) Flexor digitorum accessorius and lumbricals are attached to the tendon of flexor digitorum longus Third layer 1. Flexor hallucis brevis. 2. Flexor digiti minimi brevis. 3. Adductor hallucis 1. They are confined to the metatarsal region of the sole. 2. Two of these muscles act on the big toe and one on the little toe Fourth layer 1. Interossei (3 plantar interossei and 4 dorsal interossei). 2. Tendon of tibialis posterior. 3. Tendon of peroneus longus They fill up the intermetatarsal spaces There are 2 neurovascular planes between the muscle layers of the sole
  13. 13. Interossei • Mnemonic: Plantar interossei ADduct (PAD) the toes and originate from single metatarsal as unipennate muscles; • On the other hand Dorsal interossei ABduct (DAB) the toes and originate from 2 metatarsals as bipennate muscles.
  14. 14. First Layer
  15. 15. Second Layer
  16. 16. Third Layer
  17. 17. Fourth Layer
  18. 18. Neurovascular planes of the sole There are 2 neurovascular planes between the muscle layers of the sole. 1. Superficial neurovascular plane between the first and 2nd layers. In the superficial neurovascular plane is located the trunks of medial and lateral plantar nerves, and the arteries. 2. Deep neurovascular plane between the 3rd and fourth layers. In the deep neurovascular plane is located the deep branches of the lateral plantar nerve and artery.
  19. 19. First Layer • The first layer of muscles is the most superficial to the sole, and is located immediately underneath the plantar fascia. • There are three muscles in this layer.
  20. 20. Abductor Hallucis • The abductor hallucis muscle is located on the medial side of the sole, where it contributes to a small soft tissue bulge. • Attachments: Originates from the medial tubercle of the calcaneus, the flexor retinaculum and the plantar aponeurosis. It attaches to the medial base of the proximal phalanx of the great toe. • Actions: Abducts and flexes the great toe. • Innervation: Medial plantar nerve.
  21. 21. Flexor Digitorum Brevis • The flexor digitorum brevis muscle is located laterally to the abductor hallucis. It sits in the centre of the sole, sandwiched between the plantar aponeurosis and the tendons of flexor digitorum longus. • Attachments: Originates from the medial tubercle of the calcaneus and the plantar aponeurosis. It attaches to the middle phalanges of the lateral four digits. • Actions: Flexes the lateral four digits at the proximal interphalangeal joints. • Innervation: Medial plantar nerve.
  22. 22. Abductor Digiti Minimi • The abductor digiti minimi muscle is located on the lateral side of the foot. It is homologous with the abductor digiti minimi of the hand. • Attachments: Originates from the medial and lateral tubercles of the calcaneus and the plantar aponeurosis. It attaches to the lateral base of the proximal phalanx of the 5th digit. • Actions: Abducts and flexes the 5th digit. • Innervation: Lateral plantar nerve.
  23. 23. Second Layer • The second layer contains two muscles – • Quadratus plantae, and • Lumbricals . • In addition, the tendons of the flexor digitorum longus (an extrinsic muscle of the foot) pass through this layer.
  24. 24. The quadratus plantae • The quadratus plantae muscle is located superior to the flexor digitorum longus tendons. It is separated from the first layer of muscles by the lateral plantar vessels and nerve. • Attachments: Originates from the medial and lateral plantar surface of the calcaneus. It attaches to the tendons of flexor digitorum longus. • Actions: Assists flexor digitorum longus in flexing the lateral four digits. • Innervation: Lateral plantar nerve.
  25. 25. Lumbricals • There are four lumbrical muscles in the foot. They are each located medial to their respective tendon of the flexor digitorum longus. • Attachments: Originates from the tendons of flexor digitorum longus. Attaches to the extensor hoods of the lateral four digits. • Actions: Flexes at the metatarsophalangeal joints, while extending the interphalangeal joints. • Innervation: The most medial lumbrical is innervated by the medial plantar nerve. The remaining three are innervated by the lateral plantar nerve.
  26. 26. Third Layer • The third layer contains three muscles. • Flexor hallucis brevis and • Adductor hallucis are associated with movements of the great toe. • Flexor digiti minimi brevis, moves the little toe.
  27. 27. Flexor Hallucis Brevis • The flexor hallucis brevis muscle is located on the medial side of the foot. It originates from two places on the sole of the foot. • Attachments: Originates from the plantar surfaces of the cuboid and lateral cuneiforms, and from the tendon of the posterior tibialis tendon. Attaches to the base of the proximal phalanx of the great toe. • Actions: Flexes the proximal phalanx of the great toe at the metatarsophalangeal joint. • Innervation: Medial plantar nerve.
  28. 28. Adductor Hallucis • The adductor hallucis muscle is located laterally to the flexor hallucis brevis. It consists of an oblique and transverse head. • Attachments: The oblique head originates from the bases of the 2nd, 3rd and 4th metatarsals. The transverse head originates from the plantar ligaments of the metatarsophalangeal joints. Both heads attach to the lateral base of the proximal phalanx of the great toe. • Actions: Adduct the great toe. Assists in forming the transverse arch of the foot. • Innervation: Deep branch of lateral plantar nerve.
  29. 29. Flexor Digiti Minimi Brevis • The flexor digiti minimi brevis muscle is located on the lateral side of the foot, underneath the metatarsal of the little toe. It resembles the interossei in structure. • Attachments: Originates from the base of the fifth metatarsal. Attaches to the base of the proximal phalanx of the fifth digit. • Actions: Flexes the proximal phalanx of the fifth digit. • Innervation: Superficial branch of lateral plantar nerve.
  30. 30. Fourth Layer • The plantar and dorsal interossei comprise the fourth and final plantar muscle layer. • The plantar interossei have a unipennate morphology, while the dorsal interossei are bipennate.
  31. 31. Plantar Interossei • There are three plantar interossei, which are located between the metatarsals. Each arises from a single metatarsal. • Attachments: Originates from the medial side of metatarsals three to five. Attaches to the medial sides of the phalanges of digits three to five. • Actions: Adduct digits three to five and flex the metatarsophalangeal joints. • Innervation: Lateral plantar nerve.
  32. 32. Dorsal Interossei • There are four dorsal interossei, which are located between the metatarsals. Each arises from two metatarsals. • Attachments: Originates from the sides of metatarsals one to five. The first muscle attaches to the medial side of the proximal phalanx of the second digit. The second to fourth interossei attach to the lateral sides of the proximal phalanxes of digits two to four. • Actions: Abduct digits two to four and flex the metatarsophalangeal joints. • Innervation: Lateral plantar nerve.
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