Arches of the Foot.ppt

anatomy of foot arches

1. Arches of the Foot
for 30
th
batch
by
Dr MB Samarawickrama
Nov. 2008
(MBBS MS)

2. Introduction
•The foot has perhaps undergone the
greatest evolutionary change within
the lower limb
•Primate’s grasping tactile organ to a
locomotion in human
•The joints within the human foot are
much less mobile
•An adaptation to ground walking

3. An arch foot is a distinctive feature of man
This distinguishes man from other primates
The foot has two important functions
1.Support the body weight
2.Lever to propel the body forward in
walking & running
Introduction

4. The foot function cont…
•To fulfill these functions
•the pedal platform must be able to
spread the stresses of standing
and moving and be pliable enough
for uneven and sloping surfaces.
•it must be transformable into a
strong adjustable lever to resist
inertia and powerful thrust.

5. The foot function cont…
•To serve these functions foot is made up of
series of small bones and designed in a form of
elastic arches or springs.
‘A segmented lever can best meet
such stresses if arched in form’

6. If the foot possessed a single strong bone still
–could sustain the body weight
–could propel the body forward
But
•It could not adapt to an uneven surfaces
Presence of arches and multiple joints makes
•The foot flexible
•and adapt itself to uneven surfaces
Introduction cont..

7. Foot Arches
•In infants and young children, plantar
fatty, connective tissue may give the
foot a flat appearance;
•soft tissues variably modify its
appearance at all ages.
•But the human foot is normally arched
in its skeletal basis
•Presence from birth

8. Foot Arches cont…
•The pedal arch is dynamic
•Two curvatures
–longitudinal and transverse arches
•They vary individually
–in height, especially the longitudinal
in its medial part,
–in different phases of activity

9. The arches are formed and maintained
by
•bones
•ligaments
•Muscles
•Tendons
•Aponeuroses
Introduction cont..

10. 1. Longitudinal arches
–Medial
–Lateral
2. Transverse arches
–Anterior –complete
–Posterior –incomplete
Classification of arches

11. Partsof an arch
Ends
Summit
Pillars
Joints

12. Shape of stones (bones)
Staples
Tie beam
Slings
All these methods are being used in maintaining
foot arches
Methods of maintaining an arch

13. Methods of maintaining an arch cont..
•Shape of bones
Keystone

14. Methods of maintaining an arch cont..
Staples
Strong Plantar ligaments
Calcaneonavicular
ligament
Short plantar ligament
long plantar ligament

15. Methods of maintaining an arch cont..
•Tie beam
Peroneous longus
tendon

16. Methods of maintaining an arch cont..
Slings
Suspension bridge

17. Bones of the foot
Tarsal
•cuboid navicular
•Calcaneum talus
•cuniforms x 3metatarsals x 5
Phalanges –Do not
form arches

18. Medial longitudinal arch
It is
•higher
•more mobile
•more resilient
Than the lateral arch
Absorbs forces of thrust & weight

19. Medial longitudinal arch cont..
Ends
Anterior –1
st
three metatarsal heads
Posterior –medial tubercle of calcaneum
Summit
Superior articular surface of the body of talus
Constitutions
Metatarsals
Calcaneus
Talus
Navicular
Cuniforms

20. Medial longitudinal arch cont..
Pillars
–Anterior –long & weak
By –talus, navicular 3 cumiforms
1
st
three metatarsals
Posterior –short & strong
By medial ½ of
calcaneum
Main joint –
Talocalcaneonavicular joint

21. Maintenance
Bony factor is least important
Medial longitudinal arch cont..

22. Medial longitudinal arch cont..
Intersegmental ties
(staples)bind the
adjacent bones
1. Spring ligament
The most important
member
Support the head of the
talus

23. Medial longitudinal arch cont..
2.Dosal ligaments
Connecting adjacent bones
3. Plantar aponeurosis
4. Flexo digitorum Brevis
5. Tendon of tibialis
Posterior

24. 1.Medial part of the plantar aponeurosis
2.Medial part of the flexor digitorum brevis
3.Abductor hallucis, assisted by flexor
hallucis brevis
Medial longitudinal arch cont..
Tie beams or bow-strings

25. Medial longitudinal arch cont..
Slings
Support & suspend
the arch from above
•Tibialis posterior
•Flexor hallucis
longus
The strongest
muscle to support
the arch
3.Assist –flexor
digitorum longus &
tibialis anterior

26. Lateral longitudinal arch
Is very low
Has limited mobility
Built to transmit weight & thrust to the ground

27. Lateral longitudinal arch cont..
Constitutions
Ends
Anterior –heads of 4
th
& 5
th
metatarsals
Posterior –lateral tubercle of calcaneum
Summit –The articular facets on the superior surfaces of calcaneum (subtalar
joint)

28. Lateral longitudinal arch cont..
Pillars
Anterior –long & weak
By cuboid, 4
th
& 5
th
metatarsals
Posterior –short & strong
By lateral ½ of calcaneum
Main joint -calcaneocuboid

29. Maintenance
Bony factor
Has no role to play
Cuboid is the ‘key stone’
Lateral longitudinal arch cont..

30. Lateral longitudinal arch cont..
Intersegmental ties (staples)
Short plantar ligaments
Long plantar ligaments
Dosal ligaments between calcaneum,
cuboid and the related metatarsals

31. Tie beams or bow-strings
Plantar aponeurosis –lateral part
Flexor digitorum brevis –lateral part
Abductor digitiminimi, flexor digitiminimi
(assist)
Lateral longitudinal arch cont..

32. Lateral longitudinal arch cont..
Slings
Peroneus longusPeroneus brevis

33. Transverse arches
•serial transverse arches are
described
•most developed inferior to the
metatarsus and adjoining tarsus
•metatarsal heads form a complete
anterior arch
•The posterior transverse arch is
incomplete
•Hence the foot has been likened to
a half-dome

34. Anterior transverse arch
•is formed by heads of the five metatarsal bones
•is complete
Posterior transverse arch
•is formed by grater parts of tarsus & metatarsus
•is incomplete –only the lateral end comes in contact
with the ground
Transverse arches

35. Maintenance
Bony factor is important
•marked wedge shaping of the cumiform bones help in
forming & maintenance of transverse arches
•smaller planta surface
Intersegmental ties
Deep transverse ligaments
Strong plantaligaments
Dosalinterossi & transverse head of the adductor
hallucis
Transverse arches cont..

36. Tie beam or bow strings
Peroneus longus tendon
Slings
Peroneus longus & brevis/tibialis posterior
Transverse arches cont..

37. 1.Shape of the bones
2.Strong ligaments
3.Muscle tone
Which one is most important?
Muscles give no support in static posture
They are active during walking & running
Main factor for maintaining the arches

38. Main factor for maintaining the arches cont…
•It is perhaps unwise to give any
factor major emphasis;
•experiments show
•that instanding-ligamentsplay a
major role
•duringmovement-muscles
predominate
•Peroneus longus is a strong agent
in maintaining the transverse
curvature.

39. Functions of the arches
1.Arches of the foot
distribute the body weight
to the weight bearing
points of the sole
•heel
•six points of contact
–ball of toes
–two sesamoid bones under
the head of the first
metatarsus
–heads of the remaining four
metatarsals Mainly 1
st
& 5
th

40. Functions of the arches cont..
2.The springs of the arches help in walking &
running
3.Act as shock absorbers stepping & jumping
4.Walk on uneven surface

41. Applied Anatomy
Pes planus(Flat foot)
-Absence or collapse of the arches leads to flat foot
-Congenital/acquired

43. Applied Anatomy
Effects of Pesplanus (Flat foot)
-Clumsy suffling gait –loss of spring
-Liable to trauma & osteo arthrosis –loss of
shock absorbs
-Compression of the vessels & nerves of the
sole –loss of concavity
Results in neuralgic pain in the forefoot &
ischeamic effect on forefoot

44. Pes cavus
•Exagiration of the longitudinal arches
Results from contracture of the transverse tarsal
joints (plantaflexion)
Common causes
spinabifida
poliomyelitis
Applied Anatomy cont..

45. Other deformities of the foot
•talepes equines –pt walks with heel raised
•talepes calcaneus –pt walks with forefoot
raised
Applied Anatomy cont..

46. Applied Anatomy cont..
•talepes equinovarus –(clubfoot) is the commonest
•foot is inverted, adducted & plantar flexed