Lower Limb 10

Intrinsic muscles of the foot

On dorsal aspect of foot: Extensor digitorum brevis. On plantar aspect of foot: Dorsal and plantar interossei. Flexor digiti minimi brevis. Flexor hallucis brevis. Adductor hallucis. Flexor digitorum brevis. Quadratus plantae (flexor accessorius). Abductor digiti minimi. Abductor hallucis. Lumbricals.

On the dorsal aspectExtensor digitorum brevis(and Extensor hallucis brevis)

Extensor digitorum brevis.

Extensor hallucis brevis.

In the soleFirst layer

Abductor hallucis. Flexor digitorum brevis. Abductor digiti minimi.

Abductor hallucis

Flexor digitorum brevis

Abductor digiti minimi

Second layer

Quadratus plantae. Lumbricals.

Quadratus plantae


It has 2 heads of origin: One head from medial surface of calcaneus inferior to sustentaculum tali. The other head from inferior surface of calcaneus.

Lumbricals

Third layer

Flexor hallucis brevis. Adductor hallucis. Flexor digiti minimi brevis.

Flexor hallucis brevis

2 heads: Lateral head. Medial head.

Adductor hallucis

2 heads: Transverse head. Oblique head.

Flexor digiti minimi brevis

Fourth layer

Dorsal interossei. Plantar interossei.

Dorsal interossei

Plantar interossei

Arteries

Posterior tibial artery and plantar arch

Posterior tibial pulse

Lateral plantar artery

Deep plantar arch.

Branches of deep plantar arch: Digital branch to lateral side of little toe. Four plantar metatarsal arteries. Three perforating arteries.

Medial plantar artery

Dorsalis pedis artery

Dorsalis pedis pulse

Branches of dorsalis pedis artery:Tarsal arteries.Arcuate artery → Dorsal metatarsal arteries → Dorsal digital arteries.First dorsal metatarsal artery.

Veins

Great saphenous vein. Small saphenous vein.

Nerves

5 main nerves: tibial, deep peroneal, superficial peroneal, sural, saphenous nerves. All 5 nerves contribute to sensory innervation. Tibial nerve supply all intrinsic muscles of foot except extensor digitorum brevis which is supplied by deep peroneal nerve. Deep peroneal nerve contributes to innervation of first and second dorsal interossei.

Tibial nerve

Medial calcaneal branches. Tibial nerve bifurcates into: Large medial plantar nerve. Smaller lateral plantar nerve.

Medial plantar nerve

Proper plantar digital nerve. 3 Common plantar digital nerves.

Lateral plantar nerve

Deep branch.

Superficial branch: Proper plantar digital nerve. Common plantar digital nerve.

Deep peroneal nerve

2 dorsal digital nerves.

Superficial peroneal nerve

Dorsal digital nerves.

Sural nerve

Saphenous nerve