VH Dissector: Lower Limb: Plantar Foot

Osteology of the Foot

Begin with the foot

Be sure to study the individual bones and joints of the foot using the resources in the lab, and in the Toltech resources: cadaveric dissector section of the VH dissector.

STEP 1

Plantar Foot

Rotate to a view of the plantar foot

STEP 2

The skin covering the sole (plantar) of the foot is much thicker than on the dorsum of the foot. The underlying subcutaneous tissue is more fibrous and creates fibrous septa (“skin ligaments) dividing this area, especially over the heel. The space between the fibrous septa are filled with fat to create a shock-absorbing pad. It is most well delevoped over the heel, which is the typical first area of impact during the gait cycle.

Deep to the subcutaneous tissue is the thick band of tissue called the plantar fascia (similar to the palmar aponeurosis in the hand). The function of the plantar fascia is to hold parts of the foot together, protect the sole of the foot from injury, and support the longitudinal arches.

Ligaments of the sole of the foot:

1. plantar calcaneo-navicular (spring ligament)

2. long plantar ligament

3. short plantar (plantar calcaneo-cuboid)

These are not highlighted here.

Fourth layer of the sole of the foot:

Add the Plantar Interossei muscles (adductors of the toes)

STEP 3

Add the Dorsal Interossei muscles (abductors of the toes)

STEP 4

Third layer of the sole of the foot:

Add the Flexor Digiti Minimi muscles.

STEP 5

Add the Adductor Hallicus muscles.

STEP 6

Add the Flexor Hallicus Bevis muscles.

STEP 7

Second layer of the sole of the foot:

Add the 1st Lumbrical muscle.

STEP 8

Add the 2-4 Lumbricals muscles.

STEP 9

Add the Quadratus Plantae muscle.

STEP 10

Add the Tendon of Flexor Digitorum Longus.

STEP 11

Add the Tendon of the Flexor Hallicus Longus.

STEP 12

Superficial layer of the sole of the foot:

Add the Abductor Digiti Minimi muscle.

STEP 13

Add the Flexor Digitorum Brevis muscles.

STEP 14

Add the Abductor Hallicus muscle.

STEP 15

Nerves of the Plantar Foot:

As the tibial nerve enters the plantar foot, it divides into the medial plantar and lateral plantar nerves.

Add the Tibial Nerve.

STEP 16

Add the Medial Plantar nerve.

Passes deep to the abductor hallucis muscle between this muscle and the flexor digitorum brevis.
Terminates as three digital nerves which supply cutaneous to the 3.5 medial digits and motor to the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, and the first (most medial) lumbrical.

STEP 17

Add the Lateral Plantar nerve.

Runs between the first and second layer of muscles sending cutaneous innervation to the lateral 1.5 toes and motor to all of the muscles of the plantar foot that are not innervated by the medial plantar nerve.

STEP 18

Add the Medial Calcaneal nerve. (NOT IDENTIFIED IN THIS CADAVER)

Prior to dividing into the medial and lateral plantar nerves, the tibial nerve gives off medial cutaneous branches that provide sensation to the heel.

STEP 19

Arteries of the Plantar Foot:

The posterior tibial artery takes the same path into the plantar foot as the tibial nerve. The artery divides into the medial plantar and lateral plantar arteries.

Add the Posterior Tibial Artery

STEP 20

Add the Medial Plantar artery.

Passes between the abductor hallucis and flexor digitorum brevis.
It supplies branches to the medial side of the great (big) toe.
It sends a branch deep to become part of the deep plantar arch but it is an insignificant contribution.

STEP 21

Add the Lateral Plantar artery.

Passes laterally between the flexor digitorum brevis and quadratus plantae. It sends a deep branch medial to anastomose with the deep plantar branch of the dorsalis pedis artery (from the dorsum of the foot). The anastomosis between those two arteries comprise the deep plantar arch and give rise to 4 plantar metatarsal arteries which give rise to common digital arteries.

STEP 22

Credits:

VH Dissector steps modified for Drexel Dissector by Dr. Haviva Goldman and Ms. Sophie Geagan (M.D. Student) from original website activity created by Jeffrey Fahl, MD, Kyle Petersen, PhD, Richard Drake, PhD, Alesha Petitt, MA, Claira Ralston, MS and Kim Price, MA and modified by Jeffrey Fahl, MD, Michael Smith, PhD, Albany Medical College.

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