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The muscles in the human foot can be divided into two groups: extrinsic and intrinsic muscles. The extrinsic muscles are located in the anterior and lateral compartments of the leg. The extensor digitorum longus is an extrinsic muscle that extends the lateral four toes at the metatarsophalangeal joint. The extensor hallucis longus (EHL) is another extrinsic muscle that extends the big toe at the metatarsophalangeal and interphalangeal joints. The EHL is one of four muscles in the lower limb's anterior compartment, along with the tibialis anterior, extensor digitorum longus, and fibularis tertius.
| Characteristics | Values |
|---|---|
| Muscle Extending Toes | Extensor Digitorum Longus |
| Location | Lateral part of the front of the leg |
| Origin | Inferior part of the lateral tibial condyle, proximal half of the medial surface of fibula, anterior surface of the interosseus membrane |
| Function | Extension of the lateral four toes, dorsiflexion of the foot, eversion of the foot |
| Blood Supply | Anterior tibial artery |
| Innervation | Deep fibular nerve |
| Muscle Extending Big Toe | Extensor Hallucis Longus (EHL) |
| Location | Anterior compartment of the lower leg |
| Origin | Middle half of the anterior fibular surface, adjacent interosseous membrane |
| Insertion | Base of the distal phalanx of the big toe |
| Function | Extension of the big toe, dorsiflexion of the foot, inversion of the foot |
| Innervation | Deep peroneal nerve |
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What You'll Learn
Extensor digitorum longus muscle
The extensor digitorum longus (EDL) muscle is a feather-like muscle of the anterior (extensor) compartment of the leg. It is one of four muscles in this compartment, the others being the tibialis anterior, extensor hallucis longus, and fibularis (peroneus) tertius. The EDL is the most lateral muscle in the anterior compartment.
The extensor digitorum longus originates from the inferior part of the lateral tibial condyle, the proximal half of the medial surface of the fibula, and the anterior surface of the interosseus membrane. The muscle then descends inferiorly and, just above the ankle, gives off a tendon that passes under the superior extensor retinaculum and through the inferior extensor retinaculum. Within the inferior extensor retinaculum, the tendon splits into four smaller tendons that are all wrapped together in a synovial sheath. The muscle passes under the superior and inferior extensor retinaculum of the foot, along with the fibularis tertius, and divides into four slips, which run forward on the dorsum of the foot. These slips are inserted into the second and third phalanges of the four lesser toes. The tendons to the second and fifth toes may be found doubled, or extra slips may be given off from one or more tendons to their corresponding metatarsal bones, or to the short extensor, or to one of the interosseous muscles.
The primary action of the extensor digitorum longus is to extend the lateral four toes at the metatarsophalangeal joint. This means that when acting independently, it is unable to extend the entire length of the toes, extending only at the metatarsophalangeal joint, while at the interphalangeal joints, the toes remain flexed. However, when contracting together with the lumbricals, the extensor digitorum longus contributes to extension at every joint between the bones of the lateral four toes. Acting in synergy with the tibialis anterior, extensor hallucis longus, and fibularis tertius, this muscle also participates in dorsiflexion of the foot when their proximal attachments are fixed. When the distal attachments are fixed and the body is in the anatomical position, all four muscles bring the trunk and lower limb to the front.
The anterior tibial artery and vein pass between the extensor digitorum longus and the tibialis anterior. The leg portion of the muscle is supplied by two arteries of the leg; the proximal part is supplied by the anterior tibial artery, while the distal part receives blood from the fibular artery. The tendons of the muscle are vascularized by the anterior lateral malleolar, lateral tarsal, metatarsal, plantar, and digital arteries. The extensor digitorum longus is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve.
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Extensor hallucis longus (EHL) muscle
The Extensor hallucis longus (EHL) muscle is a thin muscle located in the anterior compartment of the lower leg. It is situated between two muscles: the tibialis anterior and the extensor digitorum longus. The EHL originates from the anteromedial aspect of the fibula and extends to the anterior aspect of the interosseous membrane of the leg, located between the fibula and tibia.
The EHL is responsible for extending the big toe (hallux) at both the metatarsophalangeal and interphalangeal joints. It also assists in the inversion of the foot and dorsiflexion of the ankle. The muscle receives its arterial supply primarily from the anterior tibial artery and its branches, as well as from branches of the fibular artery.
The EHL is innervated by the deep peroneal nerve (L5-S1), a branch of the common peroneal nerve. The venous blood from the EHL muscle drains into the anterior tibial vein, which empties into the popliteal vein. Paralysis or weakness of the EHL muscle can be a sign of L5 nerve root pathology, which may result from a herniated disc. This can lead to constant flexion of the first metatarsal due to the unopposed action of the flexor muscles.
Weakness in the EHL can cause difficulties in normal locomotion and decrease an individual's ability to control the descent of the medial portion of the foot, particularly the great toe. Patients with EHL weakness may report that their toe tends to fold under their foot when putting on socks or shoes, and it can also cause tripping. Additionally, tightness in the EHL can lead to a claw toe deformity, where the toe is pulled into an extended position at the metatarsophalangeal joint, resulting in flexion at the interphalangeal joint.
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Extensor digitorum brevis muscle
The extensor digitorum brevis (EDB) is a thin, small muscle located on the upper surface or dorsum of the foot. It is one of the intrinsic muscles of the foot and is covered by the deep dorsal fascia of the foot. The EDB is richly vascularized and has a well-developed vascular network. Its proximal blood supply comes from the anterior perforating branch of the fibular artery and the anterior lateral malleolar artery, a branch of the anterior tibial artery. More distally, the muscle receives blood supply from the dorsalis pedis artery and its branches, including the lateral tarsal arteries, arcuate artery, dorsal metatarsal arteries, proximal and distal perforating arteries, and dorsal digital arteries to the medial four toes.
The EDB originates from the forepart of the upper and lateral surface of the calcaneus (in front of the groove for the peroneus brevis tendon), from the interosseous talocalcaneal ligament, and the stem of the inferior extensor retinaculum. The fibres pass obliquely forwards and medially across the dorsum of the foot and end in four tendons. The most medial tendon of the EDB crosses the dorsalis pedis artery and inserts into the dorsal surface of the base of the proximal phalanx of the great toe. This medial part of the muscle is also known as the extensor hallucis brevis. The other three tendons insert into the lateral sides of the tendons of the extensor digitorum longus for the second, third, and fourth toes.
The EDB assists the extensor digitorum longus in extending the second, third, and fourth toes at the metatarsophalangeal and interphalangeal joints. It also helps the extensor hallucis longus and brevis in extending the first toe at the metatarsophalangeal joint. The EDB muscle is subject to significant variation, and at times, it may be conjoined with the adjacent dorsal interossei muscles of the foot.
The EDB muscle has clinical significance, as its wasting is a decisive indicator of significant lumbar canal stenosis. Additionally, the EDB muscle flap is used in surgical procedures for small defects and infection prevention of bones and joints following traumatic injuries. It is also used in composite flaps to repair soft tissue and tendon defects, demonstrating its versatility in various medical applications.
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Abductor hallucis muscle
The abductor hallucis muscle is a small but powerful muscle that aids in the flexion and abduction of the big toe. It is located in the medial border of the foot and is considered an intrinsic muscle of the foot. It originates from three points: the medial process of the calcaneal tuberosity, the plantar aponeurosis, and the superficial layer of the flexor retinaculum.
The abductor hallucis muscle is part of the superficial layer of plantar foot muscles, which also includes the flexor digitorum brevis and abductor digiti minimi. It is the most medial muscle of the foot, running medially to the flexor hallucis brevis muscle. The muscle fibres run anteriorly and medially, forming a tendon at the level of the body of the first metatarsal bone. This tendon then inserts on the medial aspect of the base of the proximal phalanx of the big toe.
The function of the abductor hallucis muscle is crucial for maintaining the stability of the foot during walking. By abducting and flexing the big toe, it helps to preserve the central position of the toe and maintain the medial longitudinal arch of the foot. This action contributes to the overall stability of the foot and enables efficient walking.
The abductor hallucis muscle is innervated by the medial plantar nerve (root value S1-S3), which is a terminal branch of the tibial nerve. The blood supply to the muscle comes from two arteries: the medial plantar artery and the first plantar metatarsal artery.
In summary, the abductor hallucis muscle is a crucial intrinsic muscle of the foot that plays an important role in maintaining foot stability during locomotion by abducting and flexing the big toe. It has three origin points and one insertion point, and its nerve and blood supply are essential for its proper function.
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Flexor digitorum brevis muscle
The flexor digitorum brevis muscle is a broad muscle found deep in the sole of the foot. It is situated lateral to the abductor digiti minimi and medial to the abductor hallucis muscles. The flexor digitorum brevis is also classified as one of the central plantar muscles of the foot.
The flexor digitorum brevis has three sites of origin: the medial process of calcaneal tuberosity, the plantar aponeurosis, and the intermuscular septum. Its large muscle belly spans across the medial side of the plantar aspect of the foot. Halfway across the sole of the foot, the muscle fibres divide into four slits, each giving off a tendon for one of the lateral four toes. These tendons course over the plantar surfaces of the lateral four metatarsal bones and proximal phalanges. At the level of the proximal phalanx, each tendon divides into two terminal slits that insert into the base of the middle phalanx of the corresponding digit.
The innervation for the flexor digitorum brevis comes from the medial plantar nerve (S1-S3), which is the larger of the two terminal branches of the tibial nerve. The muscle is vascularized by the branches of the posterior tibial artery, namely the medial plantar and lateral plantar arteries. The majority of blood from the muscle is drained by the medial plantar vein, which drains into the anterior and posterior tibial veins.
The main action of the flexor digitorum brevis is the flexion of the second to fifth digits at the metatarsophalangeal and proximal interphalangeal joints. This is important for the gait cycle, as it works in synergy with the flexor digitorum longus muscle to maintain balance by keeping the toes in firm contact with the ground. The flexor digitorum brevis also supports the longitudinal arch of the foot and stabilizes it during activities such as walking or running.
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Frequently asked questions
The extensor hallucis longus (EHL) muscle extends the big toe at both the metatarsophalangeal and interphalangeal joints.
The extensor digitorum longus muscle extends the lateral four toes at the metatarsophalangeal joint. The extensor digitorum brevis is a small muscle that contributes to the extension of the lateral four toes.
The EHL's primary function is to extend the hallux (big toe) and dorsiflex the foot at the ankle. This movement is critical to gait, as it allows the foot to clear off the ground during the swing phase.
