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The three tendons, from front to back, that conjoin to form the pes anserinus come from the sartorius muscle, the gracilis muscle, and the semitendinosus muscle. [1] [2] It inserts onto the proximal anteromedial surface of the tibia. [2] The pes anserinus is around 5 cm below the medial tibial joint line. [2]
The human foot is a strong and complex mechanical structure containing 26 bones, 33 joints (20 of which are actively articulated), and more than a hundred muscles, tendons, and ligaments. [2] The joints of the foot are the ankle and subtalar joint and the interphalangeal joints of the foot.
The two heads of each muscle form a central tendon which passes forwards deep to the deep transverse metatarsal ligament. [1] The tendons are inserted on the bases of the second, third, and fourth proximal phalanges [2] and into the aponeurosis of the tendons of the extensor digitorum longus [3] without attaching to the extensor hoods of the toes.
The intrinsic muscles of the foot, muscles whose bellies are located in the foot proper, are either dorsal (top) or plantar (sole). On the dorsal side, two long extrinsic extensor muscles are superficial to the intrinsic muscles, and their tendons form the dorsal aponeurosis of the toes.
The flexor digitorum brevis or flexor digitorum communis brevis [1] is a muscle which lies in the middle of the sole of the foot, immediately above the central part of the plantar aponeurosis, with which it is firmly united. Its deep surface is separated from the lateral plantar vessels and nerves by a thin layer of fascia.
The muscle ends as a tendon of insertion. The tendon passes through a distinct compartment in the inferior extensor retinaculum of foot. It crosses anterior tibial vessels lateromedially near the bend of the ankle. [citation needed] In the foot, its tendon is situated at along the medial side of the dorsum of the foot. [1]
The muscle 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 arch is further supported by the plantar aponeurosis, by the small muscles in the sole of the foot (short muscles of the big toe), by the tendons of the tibialis anterior and posterior and fibularis longus, flexor digitorum longus, flexor hallucis longus and by the ligaments of all the articulations involved. [1]