Ankle and Sole of Foot: Muscles

Muscle Abductor hallucis Flexor digitorum brevis Abductor digiti minimi Lumbricals

Quadratus plantae Adductor hallucis Flexor hallucis brevis Flexor digiti minimi brevis Dorsal interossei Plantar interossei

Innervation medial plantar nerve (S2, S3) medial plantar nerve (S2, S3) lateral plantar nerve (S2, S3) medial one: medial plantar nerve; lateral 3: lateral plantar nerve lateral plantar nerve deep branch of lateral plantar nerve medial plantar nerve superficial branch of lateral plantar nerve lateral plantar nerve (S2, S3) lateral plantar nerve (S2, S3)

Function abducts and flexes 1st digit flexes lateral 4 digits abducts and flexes 5th digit flex proximal phalanges, extend middle and distal phalanges of lateral 4 digits, adduct digits 3-5, abduct digit 2

layer 1

layer 2

assists flexor digitorum longus in flexing lateral 4 digits (corrects medial pull) adducts 1st digits, maintains transverse arch of foot flexes proximal phalanx of 1st digit flexes proximal phalanx of 5th digit

layer 3

abduct digits 3-5. flex metatarsophalangeal joints adduct digits 2-4. flex metatarsophalangeal joints

layer 4

Ankle and Sole of Foot: Ligaments

Ankle and Sole of Foot: Neurovasculature

Ankle and Sole of Foot: Clinical Correlates

Affected structure posterior tibial artery Clinical correlate palpated distal to tarsal tunnel, inferior to medial malleolus loss of function results in flatfeet (pes planus, fallen arches). Passive support of the arches (ligaments) acommodates new position through stretching plantar fasciitis: strain-induced inflammation of plantar aponeurosis. Results in pain of medial plantar foot and heel, esp at origin of aponeurosis on calcaneous. morton's neuroma: point-insult to one of the common plantar digital nerves between MTP joints. Results in inflammation, which pinches the nerve. Chronic pain and pressure feeling like a stone in their shoe. Remove nerve surgically or deaden with ablation bunions (hallus vagus) occur secondary to splayfoot (abnormal lateral expaion of MTP joints). 1st and sometimes 5th metatarsals deviate medially. Bony protrusions cause painful points of increased pressure. Especially painful when wearing pointed shoes

tibialis posterior

plantar aponeurosis

common plantar digital nerves

MTP joints