Presentation on Dorsum of Foot

Dorsum of Foot

Sensory Nerve Supply

It is primarily derived from superficial fibular nerve, assisted by deep fibular, saphenous and sural nerves.

Superficial Fibular Nerve emerges from between the fibularis brevis and extensor digitorum longus muscle in lower part of leg and divides into medial and lateral cutaneous branches that supply skin on dorsum of foot.

Deep fibular Nerve supplies the skin around big toe and second toe.

Saphenous Nerve supplies skin along the medial side of foot upto head of 1st Meta-tarsal.

Sural Nerve supplies skin along lateral margin of foot.

Dorsal Venous Arch

It lies in the subcutaneous tissue over heads of metatarsal bones and drains on the medial side into the great saphenous vein and on the lateral side into the small saphenous vein. Great saphenous vein ascends into the leg in front of medial malleolus.

Muscles of Dorsum of Foot

1. Extensor digitorum brevis2. Insertion of Extensor digitorum longus

Extensor Digitorum Brevis

Origin: Anterior part of upper surface of calcaneum and from the inferior extensor retinaculum.

Insertion: By four tendons into proximal phalanx of big toe and long extensor tendons to 2nd, 3rd, 4th toes.

Nerve Supply: Deep FibularAction: Extension of Toes

EDL

The tendon of extensor digitorum longus passes beneath the extensor retinaculi, and divides into four slips, which fan out over the dorsum of foot and pass to the lateral four toes. Above the metatarso-phalangeal joints of 2nd, 3rd, 4th toes, each EDL tendon is joined by a tendon of ED brevis. The extensor tendons join a fascial expansion called Extensor Expansion.

continued

The extensor Expansion splits into three parts;Central part: inserted into base of middle

phalanxLateral parts(2) which insert into base of distal

phalanx.

Arterial Supply

Via Dorsalis Pedis Artery and its branches(lateral tarsal artery, arcuate artery, first dorsal metatarsal artery)

Begins in front of ankle joint as continuation of anterior tibial artery. Terminates by passing downwards in the sole between the two heads of the first dorsal interosseus muscle, where it joins the lateral plantar artery and completes the plantar arch.

a. deep plantar artery b. dorsalis pedis artery c. anterior tibial artery

Nerve Supply

Deep Fibular Nerve. It enters the dorsum of foot by passing deep to extensor retinacula on lateral side of dorsalis pedis artery. It divides into terminal, medial and lateral branches. Medial branch supplies the skin around big and second toes. Lateral branch supplies ED brevis. Two terminal branches give articular branches to joints of foot.