Sole of the foot

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Sole of the foot

• By Essam Eldin Salama

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Cutaneous nerve supply

• 1- Medial calcannean nerves from posterior
  tibial nerve supplying the posterior part.
• 2- Cutaneous branches of lateral planter nerve
  supplying lateral third.
• 3- Cutaneous branches of medial planter nerve
  supplying medial two thirds.
• 4- Digital branches of lateral planter nerve
  supplying the lateral one and half toes.
• 5- Digital branches of medial planter nerve
  supplying the medial three and half toes.

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Planter aponeurosis

• 1- Thickened deep fascia of the sole.
• 2- Attached to calcanean tubercles posteriorly,
  anterioly it is divided to five slips one for
  each toe become continues with the fibrous
  flexor sheath for each toe.
• 3- It protects the underlying structures and
  maintains the longitudinal arch of the foot.

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muscular layers FIRST LAYER

• 1- Abductor hallucis supplied by medial planter
  nerve, it abducts the big toe.
• 2- abductor digiti minimi supplied by the medial
  planter nerve, it abducts the little toe( also
  abductor for the 5th metatarsal bone) .
• 3- Flexor digitorum brevis supplied by medial
  planter nerve, it flexes the lateral four toes.
  

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SECOND LAYER

• 1- tendon of flexor digitorum longus.
• 2- Tendon of flexor hallucis longus.
• 3- Quadratus plantae (Flexor digitorum
  accessorius).supplied by lateral planter nerve,
• 4- Lumbricals the 1st is supplied by the medial
  planter nerve, the lateral three are supplied by
  the lateral planter nerve.

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THIRD LAYER

• 1- Flexor hallucis brevis supplied by medial
  planter nerve,
• 2- Flexor digiti minimi brevis supplied by
  lateral planter nerve,
• 3- Adductor hallucis supplied by lateral

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FOURTH LAYER

• 1- Tendon of peroneus longus.
• 2- Tendon of tibialis posterior.
• 3- Planter interossei three in number, the 1st
  and 2nd supplied by deep branch of lateral
  planter nerve, the 3rd is supplied by superficial
  branch of lateral planter nerve,

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• 4- Dorsal interossei four in number, the medial
  three are supplied by the deep branch of lateral
  planter nerve, the 4th is supplied by superficial
  branch of lateral planter nerve,

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ARCHES OF THE FOOT

• Longitudinal arch
• 1- Medial longitudenal arch its posterior pillar
  is calcaneus, the key stone is talus, its
  anterior pillar is navecular, three cuneiforms
  and the first three metatarsals.
• 2- Lateral longitudenal arch its posterior
  pillar is calcaneus, its anterior pillar is
  cuboid, the 4th and 5th metatarsals.

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• Transverse arch
• It is incomplete.
• Formed by the bases of the metatarsal bones and
  the distal row of the tarsal bones

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Factors maintaining arches of the foot

• 1- Shape of bone
• 2- Legamentous attachments.
• 3- Long tendons.
• 4- Short muscles of the foot.
• 5- Planter aponeuorosis.