Intrinsic muscles

• Arise and insert with in foot

•Modify actions of long tendons
•Generate fine movements of toes
•Nerve supply: medial & lateral plantar nerve

Flexors Abductors
• Digitorum brevis • A. hallucis
• Digiti minimi brevis • A. digiti minimi
• Hallucis brevis
• Accessorius

• Lumbricals
• Interossei
 Plantar Aponeurosis
• Attached to medial & lateral calcaneal
tubercles
• Fans out & is inserted by five slips.
• Slips bifurcate for flexor tendons
• Insert in to flexor sheath & transverse
ligaments.
• 1st layer - Short muscles covering the
sole.
• 2nd layer- Long flexor tendons,flexor
accessorius, lumbricals
• 3rd layer-Short muscle of great & little
toes (confined to metatarsal
region).
• 4th layer- Interossei- plantar & dorsal
tendons of tibilias posterior &
peroneus longus.
Plantar nerves & vessels between 1st and 2nd layer
 First Layer
• Abductor
Hallucis
• Flexor
digitorum
brevis
• Abductor
Digiti minimi
 First Layer
Abductor Flexor digitorum Abductor digiti
hallucis brevis minimi
O- Medial tubercle O- Medial tubercle O- Medial & lateral
of calcaneum of calcaneum tubercle of
I- Proximal phalanx I- four tendons calcaneum
of great toe. pass to lateral 4 I- proximal
A- Abduction of toes – middle phalanx of little
great toe phalanx toe.
N- Medical plantar A- Flexion of toes A- Abduction of
nerve N- Medial plantar little toe.
nerve N- lateral plantar
nerve
Second layer
• Tendon of flexor dig.
Longus
• Lumbricals
• Flexor accessorius
 Second layer
Tendon of flexor Flexor Tendon of flexor
hallucis longus Accessorius D.L
• Lies in a groove O- Medial & • Divides in to four
below sustentaculum lateral tubercles slips
tali of calcaneum • Receives the
•Inserted in to distal I- Gets inserted insertion of flexor
phalanx of big toe into tendon of accessorius
•Synovial sheath F.D.L. •Gives off
•Sesamoid bones A- Straightens lumbricals
the pull of •Each slip pierces
F.D.L; flexion F.D.B. & inserts on
N- Lateral distal phalanx of
plantar nerve. lateral 4 toes
 Lumbricals

• Arise from the tendons of flexor D.L.

;each arises by two heads( Except 1st).
• Pass on to medial side of metatarso-
phalangeal joints of lateral four toes.
• Insert to the extensor expansions.
• N- 1st – Medial plantar nerve
– 2-4 – lateral plantar nerve
• To maintain extension of digits at
interphalangeal joints.
 Third layer
• Flexor hallucis brevis
• Adductor hallucis
• Flexor digiti minimi
 Third layer
Adductor Flexor hallucis Flexor digiti
hallucis brevis minimi brevis
O- 2,3,4, O- cuboid & O- 5th metatarsal
metatarsal heads cuneiforms I- Proximal
& ligaments I- Proximal phalanx of little toe
I- Proximal phalanx of big toe N- Lateral plantar
phalanx of big toe (two slips) nerve
(lateral) N- Medial plantar
N- Lateral plantar nerve
nerve A- flexion of
A- Maintain the proximal phalanx
transverse arch of big toe
Fourth layer
• Interossei
Dorsal- 4
Plantar- 3
• Tendons of
Peroneus longus
Tibialis posterior
 Fourth layer
Tendon of peroneus Interosseus Muscles Tendon of tibialis
longus posterior
• Crosses the sole • PAD(3) DAB(4) • inserted into
obliquely •O- Plantar from its own navicular tuberosity,
(lateral to medial) metatarsal ,dorsal from two to three cuniforms
•Inserted at the base metatarsal cuboid.
of 1st metatarsal. •I- Plantar – 3,4,5 digits •2,3,4, metatarsal
dorsal extensor expansions base.
•Dorsal-each arises by two
metatarsal.
- 2 are inserted on 2nd toe.
-3,4 are inserted on 3rd
and 4th toe.
-Proximal phalanges &
dorsal extensor expansion
•N- lateral plantar nerve
 Vessels and nerves
Arteries: post. Tibial artery
Medial and lateral plantar arteries
Nerves: Tibial nerve- Medial and lateral
plantar nerves
Plantar arch- lateral plantar and dorsalis
pedis artery
 Applied Anatomy
• Plantar fascitis
• Calcaneal spur
• Plantar reflex
• Medial plantar nerve entrapment (Jogger’s
foot)
• Infections / puncture wounds