Self Lecture Clinically Important Aspects of Lower Limb Anatomy Part-6

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FOOT

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In this topic, we'll briefly cover important clinical aspects, nerve injuries, pathological diseases, and medical interventions regarding the Anatomy of Foot in the Lower Limb Anatomy. This series of articles will be helping you as handy notes, in memorizing important clinical conditions while studying the Lower Limb Anatomy.

I - PLANTAR REFLEX

• The lateral aspect of the sole is stroked with a blunt object beginning at the heel & crossing to the base of the great toe. Flexion of toes is a normal response.
• Slight fanning out of lateral four toes and dorsiflexion of the great toe is abnormal response (Babinski sign) indicating brain injury or cerebral disease except in infants.

II - PLANTAR FASCITIS

• It occurs in individuals who do a great deal of standing or walking, causes pain and tenderness of the sole. It is believed to be caused by repeated minor trauma.
• Repeated attacks of this condition induce ossification in the posterior attachment of the aponeurosis, forming a calcaneal spur.

III - TARSAL TUNNEL SYNDROME

• Tarsal tunnel syndrome is a complex symptom resulting from compression of the tibial nerve or its medial and lateral plantar branches in the tarsal tunnel, with pain, numbness, and tingling sensations on the ankle, heel, and sole.
• It may be caused by repetitive stress with activities, Flat feet, or excess weight.

IV - ACHILLES TENDON RUPTURE

• Avulsion or rupture of the Achilles tendon disables the triceps surae (gastrocnemius and soleus) muscles; thus, the patient is unable to plantarflex the foot.

V - PES PLANUS

• Flat foot (pes planus or talipes planus) is a condition of disappearance or collapse of the medial longitudinal arch with eversion and abduction of the forefoot and causes greater wear on the inner border of the soles and heels of shoes than on the outer border.
• It causes pain as a result of stretching of the plantar muscles and straining of the spring ligament and the long and short plantar ligaments.
• Flat foot may be:

1. Flexible (flat, when weight-bearing but normal when not bearing weight) It results from the loose or degenerated intrinsic ligament
2. Rigid (flat even when not bearing weight) results from bone deformity.
3. Acquired flatfoot (fallen arches) are secondary to dysfunction of the tibialis posterior owing to trauma, degeneration, or denervation.

VI - PES CAVUS

• Pes caves (clawfoot) exhibit an exaggerated height of the medial longitudinal arch of the foot (may be seen in poliomyelitis).

VII - ABNORMAL FOOT FRAMEWORKS

1. Talipes varus is an abnormality in which the foot is inverted and adducted and the person walks on the lateral border of the foot.
2. Talipes valgus is an abnormality in which the foot is everted and abducted and the person walks on the medial border of the foot.
3. Talipes calcaneus in abnormality in which foot is dorsiflexed and the person walks on the calcaneus.
4. Talipes equines are an abnormality in which the foot is plantarflexed and the person walks on toes.
5. Clubfoot (talipes equinovarus) is a congenital deformity of the foot in which the foot is plantarflex axed, inverted, and adducted.

(In the next series, we'll cover the clinically important aspects of the Abdomen & Pelvis Anatomy. Stay tuned.)