arches and sole of the foot - al-mustansiriya university07_35_21_pm.pdfankle joint, arches of the...
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Ankle joint, Arches of the foot & sole of the foot
Lecture objectives• Study type, articulations of the ankle j• Identify the common ligaments &
stabilizing factors• Recognize its blood & nerve supply• Identify its relations & movements• Recognize foot arches & their stabilizing
factors• Identify the layers of the sole of the foot
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Joint capsule and ligaments
Spring ligament
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Stability of ankle joint
• The ankle joint is stable in dorsiflexion and unstable in plantar flexion
• Fitness of articular surfaces
• Ligaments
• Surrounding tendons
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Ankle sprain
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Anterior
Posterior
MedialLateral
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• Lat.: lat. Mal. Rete by lateral mal. Br. Ant. Tibial & post. Mal. Br. Peroneal art
• Med: med mal reter by ant med mal br ant tibial+post med mal brpost tibial
• Ant: perforating peroneal+lat tarsal dorsalis
• Post.: med calc. of post tibial+lat. Calc. of peroneal
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Tarsal joints
• Subtalar joint
• Midtarsal joints
• Talocalcaneonavicular joint
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Arches of the foot
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platform
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lever
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2 Sesamoid bones
below the head of
First metatarsal Heads of lateral
4 metatarsals
Medial process
of calcaneus
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Stone bridge
staples
• Supporting factors
• Pillars, shape of stones & keystone
• Tie beam
• Inferior ties (staples)
• Suspending sling
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Medial longitudinal arch
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Inferior ties & tie beam
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Suspending sling
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Lateral longitudinal arch
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Inferior ties & tie beamshort & long planter ligaments , planter aponeurosis & lateral muscles
Suspending sling
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Transverse arch
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Inferior ties superficial & deep metatarsal ligaments & dorsal interossei
Tie beamPeroneus longus & tibialis posterior
Suspending sling peroneus tertius & brevis laterallyTibialis anterior medially
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Functions of arches
• Weight distribution
• Shock absorption
• MLA propeller during walking, running
• LLA static organ for weight transmission
• Protects the nerves & vessels
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• Flat foot (Pes planus)
• High arched foot (Pes cavus)
Clinical correlation
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• Hallux Valgus (high heels foot !)
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Cutaneous innervation
SOLE OF THE FOOT
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Skin & superficial fasciae
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Deep fascia & planter aponeurosis
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• Planter fasciitis
Clinical correlation
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Calcaneal spur
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Home remedies for planter fasciitis
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• At toes region
• Deep fascia
Fibrous flexor sheath
Fibrous flexor
sheath
Superficial &
deep trans.
Metatarsal
Ligs.
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Muscles of sole of foot
1st layer• FDB
• ABD H
• ABD DM
• 4 layers
• 2 neurovascular planes
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2nd layer
• FDL tendons
• FHL tendon
• 4 lumbricals
• FDA (quadratus plantae)
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3rd layer
• FHB
• AH
• FDMB
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4th layer
• Interossei (3 planter, 4 dorsal)
• TP tendon
• PL tendon
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Arteries of sole of foot
• Superficial neurovascular plane
• Deep neurovascular plane
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Nerves of sole of foot
Medial planter nerve
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Clinical correlation
Jogger’s foot (med. Planter nerve entrapment) repetitive eversion
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Lateral planter nerve