1. ANATOMY OF THE FOOT
MOHAMED ELADL

2. SENSORY NERVE SUPPLY OF THE SKIN
DORSUM OF THE FOOT
Dr M Eladl
 Derived from superficial peroneal
nerve, assisted by deep peroneal,
saphenous, & sural nerves.
 Superficial peroneal nerve:
 Divides into medial & lateral
cutaneous branches that supply
the skin on the dorsum of the
foot; the medial side of the big
toe; and the adjacent sides of the
2nd, 3rd, 4th, & 5th toes.
 Deep peroneal nerve:
 Supplies the skin of the adjacent
sides of the big and second toes.

3. SENSORY NERVE SUPPLY OF THE SKIN
DORSUM OF THE FOOT
Dr M Eladl
 Saphenous nerve:
 Passes onto the dorsum of the
foot in front of medial malleolus
 Supplies the skin along the medial
side of the foot as far forward as
the head of 1st metatarsal bone.
 Sural nerve:
 Enters the foot behind the lateral
malleolus and supplies the skin
along the lateral margin of the
foot and the lateral side of the
little toe.
 The nail beds & the skin covering
the dorsal surfaces of the terminal
phalanges are supplied by the
medial and lateral plantar nerves.

4. DORSALIS PEDIS ARTERY
Dr M Eladl
 Origin:
 It is the continuation of the anterior tibial
artery.
 Beginning
 On the front of the ankle joint at a point
midway between the medial and lateral
malleoli
 Course:
 Runs forwards on the dorsum of the foot
accompanied by two venae comitants.

5. DORSALIS PEDIS ARTERY
Dr M Eladl
 Origin:
 It is the continuation of the anterior tibial
artery.
 Beginning
 On the front of the ankle joint at a point
midway between the medial and lateral
malleoli
 Course:
 Runs forwards on the dorsum of the foot
accompanied by two venae comitants.
 Termination:
 At the proximal end of the first
interosseous space, the artery turns
towards the sole between the two heads
of the first dorsal interosseous muscle to
anastomose with the end of the planter
arch.

6. DORSALIS PEDIS ARTERY
Dr M Eladl
 Branches.
1. Medial and lateral tarsal arteries:
 They arise just distal to the ankle joint
 Supply the joint of the tarsus
 Share in the anastomosis around the
ankle joint
2. Arcuate artery:
 Origin: arises opposite the bases of
metatarsal bones
 Course: runs laterally with an arched
course
 Branches:
 It gives off the 2nd, 3rd and 4th dorsal
metatarsal arteries. Each dorsal
metatarsal divides into two dorsal digital
arteries to the sides of the adjoining
toes.
 The 4th dorsal metatarsal artery gives off
a branch, which supplies the lateral side
of the little toe.

7. DORSALIS PEDIS ARTERY
Dr M Eladl
 Branches.
3. 1st dorsal metatarsal artery:
 Arises from the termination of the
dorsalis pedis immediately before it
pierces the 1st interosseous space.
 Runs forwards on the 1st dorsal
interosseus muscle & divided into two
branches:
 Medial branch: to the medial border
of the big toe.
 Lateral branch: divides into two
dorsal digital branches, which supply
the adjoining sides of the big &
second toes.

8. DORSALIS PEDIS ARTERY
Dr M Eladl
 Branches.
4. 1st planter metatarsal artery:
 Arises from the ends of the
dorsalis pedis in the sole.
 Branches:
 Planter digital branch to the
medial side of the big toe.
 Common planter digital
branch, which divided into
two planter digital branches
supplies the adjoining sides
of the big & 2nd toe.

9. SURFACE ANATOMY & PULSATIONS OF
DORSALIS PEDIS ARTERY
Dr M Eladl
 It is superficial in position
and is crossed by the inferior
extensor retinaculum and
the first tendon of extensor
digitorum brevis
 Its course can be indicated
by a line extends from
 Point mid way between the 2
malleoli to;
 Point at the proximal end of the
first intermetatarsal space.
 Pulsations can be easily felt
lateral to the tendon of
extensor hallucis longus.

10. EXTENSOR DIGITORUM BREVIS
Dr M Eladl
 Origin:
 Anterior part of the dorsal surface
of the calcaneus.
 Stem of the inferior extensor
retinaculum
 Insertion:
 It forms four tendons. The most
medial is the extensor hallucis
brevis inserted into the base of the
proximal phalanx of the big toe.
 The remaining 3 tendons join the
long extensor tendons of the 2nd,
3rd & 4th toes.
 Nerve Supply:
 Deep peroneal nerve.
 Action:
 Extension of metatarsophalangeal
joints of the medial four toes.
 Extension of interphalangeal joints
of the second, third and fourth toes.

11. SOLE OF THE FOOT
Dr M Eladl
 Skin
 Thick and hairless.
 Firmly bound down to the
underlying deep fascia by numerous
fibrous bands.
 Shows a few flexure creases at the
sites of skin movement.
 Sweat glands are present in large
numbers.
 The sensory nerve supply to
the skin of the sole of the foot
 Medial calcaneal branch of the
tibial nerve, which innervates the
medial side of the heel;
 Medial plantar nerve, which
innervate the medial two thirds of
the sole;
 Lateral plantar nerve, which
innervate the lateral third of the
sole.

12. PLANTAR APONEUROSIS
Dr M Eladl
 Definition:
 Thickened band of deep fascia in
the sole of the foot.
 Attachment:
 Posteriorly: Medial tubercle of
calcaneus.
 Anteriorly: Divides into 5 slips
which pass to the 5 toes.
 On each side: Attached to the
metatarsal bones by medial and
lateral intermuscular septa.
 Functions:
 Protects the underlying nerves and
vessels.
 Maintains the longitudinal arches of
the foot.

13. LAYERS OF THE SOLE
Dr M Eladl
 The muscles of the sole are conveniently described in four
layers from the inferior layer superiorly.
 First layer:
 Abductor hallucis, flexor digitorum brevis, abductor digiti minimi
 Second layer:
 Quadratus plantae, lumbricals, flexor digitorum longus tendon, flexor
hallucis longus tendon
 Third layer:
 Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis
 Fourth layer:
 Interossei, peroneus longus tendon, tibialis posterior tendon
 Unlike the small muscles of the hand, the sole muscles have
few delicate functions and are chiefly concerned with
supporting the arches of the foot.

14. 1ST LAYER
Dr M Eladl
 Three Muscles:
1) Abductor hallucis
2) Flexor digitorum brevis
3) Abductor digiti minimi

15. 2ND LAYER
Dr M Eladl
 Two Tendons:
1) Flexor halusis longus
2) Flexor digitorum longus
 Two Muscles:
1) Quadratus Plantae
(Flexor digitorum accessorius)
2) 4 Lumbricals muscles

16. 1ST & 2ND LAYERS
Dr M Eladl

17. 3RD LAYER
Dr M Eladl
 Three Muscles:
1) Flexor hallucis brevis.
2) Adductor hallucis
3) Flexor digiti minimi brevis

18. 4TH LAYER
Dr M Eladl
 Two Tendons:
1) Tibialis posterior
2) Peroneus Longus
 Two Muscles:
1) 3 Planter Interossei
2) 4 Dorsal Interossei

19. 3RD & 4TH LAYERS
Dr M Eladl

20. EXTENSOR EXPANSION OF LATERAL 4 TOES
Dr M Eladl
 Origin:
 Fibrous expansion on the dorsal surface of the proximal phalanx.
 Formation:
 Tendons of the extensor digitorum longus for 2nd, 3rd, 4th & 5th toes.
 Tendon of the extensor digitorum brevis for 2nd, 3rd & 4th toes.
 Tendons of lumbricals muscle for 2nd, 3rd, 4th & 5th toes.
 Tendons of dorsal interossei 2 for 2nd toe and one for each of 3rd and 4th toe.
 The tendons of planter interossei for 3rd, 4th & 5th toes.

21. EXTENSOR EXPANSION OF LATERAL 4 TOES
Dr M Eladl
 Origin:
 Fibrous expansion on the dorsal surface of the proximal phalanx.
 Formation:
All these tendons unite on the dorsum of the proximal phalanx to form this expansion.
The expansion is divided into three slips.
1) The thick central part of the expansion is inserted into the dorsal surface of the
base of the middle phalanx.
2) The lateral and medial parts joint each other to be inserted into the base of the
terminal phalanx.

22. MEDIAL PLANTAR NERVE
Dr M Eladl
 Origin:
 The larger of the two terminal
branches of the posterior tibial
nerve.
 Course:
 Enter the foot midway between the
medial malleolus and the medial
tubercle of the calcaneus, under
cover the flexor retinaculum.
 Passes forwards deep to the
abductor hallucis muscle.
 Pass between the abductor hallucis
and flexor digitorum brevis muscle.
 The medial planter vessels run
along its medial side
 Termination:
 At the bases of the metatarsal
bones by dividing into 3 planter
digital nerves.

23. MEDIAL PLANTAR NERVE
Dr M Eladl
 Branches:
 Muscular (to four muscles) to:
1) Abductor hallucis.
2) Flexor digitorum brevis.
3) Flexor hallucis brevis
4) First lumbrical muscle
 Cutaneous:
Planter cutaneous branches:
1) To the skin of the medial 2/3 of the
sole of the foot.
2) Planter digital nerves
 Articular branches: To intertarsal
and tarso-metatarsal joints.

24. LATERAL PLANTAR NERVE
Dr M Eladl
 Origin:
 The smaller of the two terminal
branches of the posterior tibial
nerve.
 Course:
 Enters the foot midway between
the medial malleolus and the medial
tubercle of the calcaneus under
cover the flexor retinaculum.
 Passes forwards and laterally deep
to abductor hallusis.
 Passes between flexor digitorum
brevis & flexor digitoum
accessorius.
 The lateral planter vessels rum
along its lateral side.
 Termination:
 At the base of the 5th metatarsal
bone, by dividing into a superficial
and a deep branches.

25. LATERAL PLANTAR NERVE
Dr M Eladl
 Branches:
 Muscular :
1) Flexor digitoum accessorius muscle
2) Abductor digiti minimi
3) Flexor digiti minimi brevis
4) Adductor halucis muscle.
5) Interossei
6) 2nd, 3rd & 4th lumbricals.
 Cutaneous:
1) Skin of the lateral 1/3 of the sole
2) Skin on the lateral side of the
planter surface of the little toe and
the adjoining sides of the 4th & 5th
toes.
3) The planter digital branches, also,
supply the skin on the dorsum of
the terminal phalanges of the lateral
one and half toes.

26. MEDIAL PLANTAR ARTERY
Dr M Eladl
 Origin:
 One of the two terminal branches of
the posterior tibial nerve.
 Course:
 Enter the foot midway between the
medial malleolus and the medial
tubercle of the calcaneus, under
cover the flexor retinaculum.
 Passes forwards deep to the
abductor hallucis muscle.
 Passes between the abductor
hallucis and flexor digitorum brevis.
 It is accompanied by two venae
comitantes.
 The medial planter nerve runs along
its lateral side.
 Termination:
 By anastmosing with the 1st planter
metatarsal artery.

27. MEDIAL PLANTAR ARTERY
Dr M Eladl
 Branches:
 Muscular:
 to the surrounding muscles.
 Digital:
 These are 3 superficial digital
branches these branches end by
anastmosing with the first, second
and third planter metatarsal
arteries.

28. LATERAL PLANTAR ARTERY
Dr M Eladl
 Origin:
 One of the two terminal branches of
the posterior tibial nerve.
 Course:
 At first between the 1st and 2nd
layers, then curves medially
between the 3rd and 4th layers of
the sole.
 The lateral planter nerve lies along
its medial side.
 Termination:
 Turns medially with the deep
branch of the lateral planter nerve
with slight forward convexity to
from the plantar arch between
the 3rd & 4th layers of muscles.

29. LATERAL PLANTAR ARTERY
Dr M Eladl
 Branches:
 Muscular: to the surrounding muscles.
 Anastomotic branches:
 Anastomosis with branches of arcuate & lateral
tarsal arteries of the dorsalis pedis artery.
 Posterior perforating arteries:
 3 branches which ascend through the proximal
ends of the 2nd, 3rd & 4th interosseous spaces to
anastomose with the dorsal metatarsal arteries.
 Planter digital artery: to the lateral side of
the little toe. From the beginning of the arch.
 Three planter metatarsal arteries:
 Each divides into two planter digital arteries
which supply the adjacent sides of two toes.
These planter metatarsal arteries supply the
adjacent sides between the 2nd, 3rd, 4th toes.
Before it division into planter digital arteries,
each planter metatarsal artery sends an anterior
perforating artery to joint the corresponding
dorsal metatarsal artery.

30. THANK YOU