Gross anatomy and four Layers of sole,Applied aspect

sole consist of 4 layers.this presentation will elobararte the layers of sole.and clinical importance of sole.

1. Sole of Foot
Dr.M.VASANTAKOHILA MBBS
POSTGRADUATE
GOVT.KILPAUK MEDICAL
COLLEGE
DEPARTMENT OF ANATOMY
AN 19.7
DATE:02/12/2023

2. Sole:It is the plantar aspect ofthefootand
corresponds to the palm of the hand.
SKIN
Features
1.Thick for protection
2.Firmly adherent to theunderlying
plantar aponeurosis
3.Creased
The nerves are:
•Medial calcanean branches of the tibial nerve
•Branches from the medial plantar nerve
•Branches from the lateral plantar nerve

3. Cutaneousnervessupplyingthe sole

4. •Small areasonmedialandlateralsidesare
innervated by saphenous and sural nerves.
Dermatomes on the sole are shown in figure.
SUPERFICIALFASCIA
It contains cutaneous nerves
transverse metatarsal ligaments.
andsuperficial

5. Dermatomeson thesole

6. DEEPFASCIA
1.The plantaraponeurosisinthesole.
2.Thedeeptransversemetatarsal ligaments
3.Thefibrousflexorsheathsinthetoes.

7. Deep fasciaofthesole

8. •Muscles of Sole
The muscles of the sole are arranged in four
layers, which will be considered one by one.
1. FIRST LAYER
2. SECOND LAYER
3. THIRD LAYER
4. FOURT LAYER

9. Musclesofthefirstlayerofthesole

10. Musclesandtendonsof thesecondlayerofthesole

11. 3
rd
LAYER

13. ADDUCTOR HALLUCIS
AH ORIGIN :
Arises by 2 heads
Large oblique head
from base of the
2nd,3
rd
,4
th
metatarsals.
Small transverse
headfrom the
plantar ligaments of
the
metatarsophalangeal
joints of 3
rd
,4
th
,5
th
toes.

14. ADDUCTOR HALLUCIS
INSERTION: NERVE SUPLY :
The common tendon
of both heads fuses
with the lateral
tendon of flexor
hallucis brevis.
Inserted in the base
of proximal phalanx
of the big toe.
Deep branch of
lateral plantar
nerve(S2,S3).
ACTION:
Adduction of the big
toe
Maintain transverse
arch of the foot.

15. FLEXOR DIGITI MINIMI
BREVIS
Base of the 5
th
metatarsal bone
Forms narrow
tendon which blends
with the abductor
digitiminimi
INSERTION:
By a narrrowtendon
into lateral side of
the base of the
proximal phalanx of
the little toe.
ORIGIN:

16. contd
NERVE SUPPLY:
Superficial branch of lateral plantar
nerve(S2,S3).
ACTION:
Flexes the proximal phalanx of the
little toe.

19. MedialPlantarNerve
Itisthelargerterminalbranchoftibialnerve.Its
distributionissimilartomediannerveofthehand.It
liesbetweenabductorhallucisandflexordigitorum
brevisandendsbygivingmuscular,cutaneousand
articularbranches.
Branches:
Thebranchesofmedialplantarnerveareshown
inTableA1.6.

20. Schemeto
distribution
showthe
of
themedialplantarnerve
withMorton’sneuroma
ononebranchofthe
nerve

21. TableA1.6

22. LateralPlantarNerve
•Itisthesmallerterminalbranchoftibialnerve,
resemblingtheulnarnerveofthehandinits
distribution.
•Itrunsobliquelybetweenthefirstandsecond
layersofsoletillthetuberosityoffifthmetatarsal
bone,whereitdividesintoitssuperficialanddeep
branches.
Branches:Thestructuressuppliedbythetrunk,and
itstwobranchesaregiveninTableA1.7.

23. TableA1.7

24. Schemetoshowthedistributionofthelateralplantarnerve

25. Arteriesofthesole

26. Medialplantararteryanditsbranches.Lateralplantarartery,
plantar arch and their branches

27. METATARSALGIA
Metatarsalgia, a forefoot
injury, can occur in anyone,
though athletes who take
part in intense sports that
involve running or jumping
are at the highest risk.
Metatarsalgia occurs when
there is strong or unusual
pressure on the ball of the
foot, creating pain and
inflammation.


28. METATARSALGIA
Metatarsalgia pain generally occurs
over time rather thanimmediately,
andcan last several months with
increasing severity.
SYMPTOMS:
Irritation and inflammation of the
ball of the foot and pain at the end of
one or more of the metatarsal bones.

29. CONTD
DIAGNOSIS :
MRI
TREATMENT
1. metatarsalgiacan be treated in most
cases by rehabilitation and does
not need any surgical
intervention.
2. Icing the foot and applying a pressure
bandage can help start the healing
process.

30. 3. Physical exercise
4. In extreme cases, surgery may be
recommended to treat metatarsalgia. If
there is severe pain and inflammation that
does not subside, surgical realignment of
the metatarsal bones may be required
during metatarsalgia surgery

31. PLANTAR FASCITIS
Plantar fasciitis (PLAN-turfas-e-I-tis) is
one of the most common causes of heel
pain.
It involves inflammation of a thick band of
tissue that runs across the bottom of each
foot and connects the heel bone to the
toes, known as the plantar fascia.
Plantar fasciitis commonly causes stabbing
pain that often occurs with your first steps
in the morning.
.

32. CONTD
As you get up and move, the pain
normally decreases, but it might return
after long periods of standing or when
you stand up after sitting.
. It is more common in runners and in
people who are overweight.

33. TREATMENT
•Rest
•Icing your foot
•Wearing supportive
shoes
•Massaging and
stretching
•Plantar fasciitis
surgery