cadaveric study of structures present in second layer of sole

cadaveric study of structures present in second layer of sole

1. Anatomy Seminar Presentation Cadaveric study of arrangement of structures present in Second layer of sole By- Rajkamal Rajbahadur Bind (F-23)

2. AIM INTRODUCTION MATERIALS AND METHOD OBSERVATIONS ANOTHER CASE REPORT CONCLUSIONS CLINICAL SIGNIFICANCES ACKNOWLEDGEMENTS REFERENCES OVERVIEW

3. To identify muscle present in the second layer of sole . To look for any variations present in the pattern of origin, insertion or nerve supply of the muscles present in the second layer of sole . AIM

4. INTRODUCTION What is second layer of sole ? Key features - * also known as the plantar layer. * It is made up of muscle and tissue. * It lies beneath the skin. * It helps to support the foot. * It absorbs shock. * It distributes weight. * It maintains balance. * It is essential for walking and running.

5. What are the two muscles in second layer of sole ? Flexor digitorum accessori u s Quadratus plantae quadrangular-shaped muscle lies in the middle of the second layer of the sole of the foot. The quadratus plantae helps to flex the toes and maintain the arch of the foot. Lumbricals These are four small muscles that lie between the tendons of flexor digitorum longus. The lumbricals help to extend the toes and spread them apart.

6. Origin and insertion of muscle of second layer of sole ? Flexor digitorum accessori u s Quadratus plantae ORIGIN medial side of the calcaneus INSERTION lateral edge of the tendon of flexor digitorum longus . Innervation- by the lateral plantar nerve.

7. Origin and insertion of muscle of second layer of sole ? Lumbricals ORIGIN tendons of flexor digitorum longus INSERTION extensor expansions of the toes . Innervation- by the lateral plantar nerve.

8. lateral plantar nerve

9. What are the two tENDONS in second layer of sole ? Tendons of flexor hallucis longus It helps to flex the big toe. Tendon of flexor digitorum longus It helps to flex the four smaller toes.

10. Origin and insertion of TENDON of second layer of sole ? Tendons of flexor hallucis longus ORIGIN originates from the fibula and passes through the sole of the foot INSERTION distal phalanx of the big toe .

11. Origin and insertion of TENDON of second layer of sole ? Tendon of flexor digitorum longus ORIGIN from the tibia and splits into four tendons that pass through the sole of the foot INSERTION distal phalanges of the four smaller toes .

12. Materials and method The study was carried out on embalmed cadaver of an elderly male person provided by Department of Anatomy, KGMU , Lucknow. The cadavers were preserved by the procedure of embalming by injecting 5% formalin. A dissection of structures second layer of sole was carried out and the structures found were examined .

13. OBSERVATIONS No accessory muscles were found in the second layer of sole during the dissection. No appreciable variations were seen in the pattern of arrangement of the three muscles present in the second layer of sole . No variation were seen in the nerve supply of the two muscles present in the second layer of sole .

14. ANOTHER CASE REPORT In the right lower limb of a female cadaver aged approximately 64-65 years, first plantar interossei took origin from the lateral aspect of the base of the first metatarsal and inserted into the lateral aspect of the base of the proximal phalanx of the great toe The second and third plantar interossei took origin from the medial surface of the base of the second and third metatarsals, respectively, and inserted into the medial side of the base of the proximal phalanges of the corresponding digits third and fourth intermetatarsal spaces were void, indicating the absence of these muscles from those spaces. The attachments of dorsal interossei were normal.

15. CONCLUSION The anatomical knowledge of variations of foot muscle is very important to orthopedic surgeons, radiologists and podiatrists for analysing foot and prosthesis designing. In painful and disabling conditions of foot during differential diagnosis of the presence of accessory muscle of foot should be kept in mind .

16. On the other hand additional muscle slips can be used as replacements flaps in case of tendon rupture or dysfunction. Accessory muscles may result in compression neuropathies especially in relation to the anatomical tunnels.

17. Clinical significance of the second layer of sole muscles Quadratus plantae tear: This injury can occur from a sudden twisting motion of the foot or from a direct blow to the foot. Lumbrical muscle tear: This injury can occur from a sudden twisting motion of the foot or from a direct blow to the foot. Tendonitis : (inflammation of a tendon) Tendinitis can occur in any of the tendons in the second layer of the sole of the foot, but it is most common in the tendons of the flexor digitorum longus and flexor hallucis longus muscles.

18. ACKNOWLEDGEMENTS Dr. Punita Manik ma’am , Professor , Department of Anatomy ,KGMU , Lucknow . Dr. Noor Us Saba ma’am – Moderator Residents of Anatomy department My fellow batchmates

19. REFERENCES Gray’s anatomy for students (second south Asian edition ) Textbook of Anatomy By Vishram Singh (3 rd edition) Article on A Rare Variation of Plantar Interossei Muscles of the Foot – a Case ReportMrudula CHANDRUPATLA, Ariyanachi KALIAPPAN, Hayavadana SUBRAMANYA, Vishwajeet LANDE, Neha GUPTA, and Ragini MUNDA

20. THANK YOU