An Anatomically-Based Model of the Nerves in the Human Foot
Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.
[1] S. Bianchi, and C. Martiloni, "Foot," Ultrasound of Musculoskeletal
System,Springer Verilog, pp.835-850, 2007.
[2] J. Craven, "Nerves of the leg and foot," Anaethesia and Intensive Care
Medicine, Vol. 8:4, pp. 149-150, 2007.
[3] S. Grimnes, and O. J. Martinsen, Excitable tissues and Bioelectric
Signal: Bio impedance and Bioelectricity Basics, San Diego, Calif.,
London: Academic. 2000, pp. 139- 159.
[4] C. Sylantiev, R. Schwartz, J. Chapman, and A. S. Buchman, "Medial
Plantar Nerve Testing Facilities Identification of Polyneuropathy,"
Muscle and Nerve Vol. 38, pp. 1595-1598, 2008.
[5] J. Y. An, M. S. Park, J. S. Kim, Y. M. Shon, S. J. Lee, Y. I. Kim, K. S.
Lee, and B. J. Kim, "Comparison of Diabetic Neuropathy Symptom
Score and Medial Plantar Sensory Nerve Conduction Studies in Diabetic
Patients showing Normal Routine Nerve Conduction Studies,"
International Medicine Vol. 47, 1395-1398, 2008
[6] S. J. Oh, K. W. Lee, J. S. Hah, D. E. Kim, M. Demirci, "Lateral Plantar
Neuropathy," Muscle and Nerve, Vol. 22, pp. 1234-1238, 1999.
[7] S. J. Oh, H. S. Kim, and B. K. Ahmad, "Electrophysiological Diagnosis
of Inter-digital Neuropathy of the foot," Muscle and Nerve, Vol. 7, pp.
218-225, 1984.
[8] S. H. Horowitz and C. Krarup C, "Conduction studies of the normal
sural nerve," Muscle and Nerve, Vol. 15, pp. 374-383, 1992.
[9] S. J. Oh, M. Demirci, B. Dajani, A. C. Melo, and G. C. Claussen, "Distal
Sensory Nerve Conduction of the Superficial Peroneal Nerve: New
Method and its Clinical application," Muscle and Nerve, Vol. 24, pp.
689-694, 2001.
[10] B. Bakotic, "Epidermal Nerve fiber density: an overview," Podiatry
management, pp. 141- 152, 2010.
[11] J. Kim, J. Davidson, O. Rohrle, T. Soboleva, and A. Pullan,
"Anatomically based lower limb model for electrical stimulation,"
Biomedical Engineering online, Vol. 6:48, 2007.
[12] S. Chiu, J. Ritchie, R. Rogart, D. Stagg, and Sweeney,"A quantitative
description of membrane currents in rabbit myelinated nerve,"The
Journal of Physiology,Vol. 292, pp. 149-166, 1979.
[13] H. C. Yeh, "Modeling of Biological Structure," Bulletin of
Mathematical Modeling, vol. 41, pp. 893-898, 1979.
[14] V. Olsbo, and L. Waller, "A point process approach to modeling
epidermal nerves fiber patterns," Technical report 08-03, pp. 1-20, 2008.
[15] M. H. Tawhai, A. J. Pullan, and P. J. Hunter, "Generation of an
anatomically based three dimensional model of the conducting airways,"
Annals of Biomedical Engineering, Vol. 28, pp. 793-802, 2000.
[16] CMISS: http://www.cmiss.org.
[17] V. Spitzer, M. Ackerman, A. Scherzinger, and D. Whitlock, "The
Visible Human Male: a technical report," Journal of American Medical
Informatics Ass Vol. 3, No. 2, pp. 118-130, 1996.
[18] Zinc Digitizer: http://www.cmiss.org/cmgui/zinc.
[19] P. L. William, R. Warwick, M. Dyson, and L. H. Bannister, "Neurology:
The Tibial Nerve," The Gray-s Anatomy, 37 Editions, pp. 1142 - 1149,
1989.
[20] K. L. Moore, A. M. Ragur, and A. F. Dalley,"Lower Limb,"Clinically
oriented anatomy, Edition 6, pp. 614-618,2011.
[21] R. Birch, "The peripheral Nervous system: Gross Anatomy," Surgical
disorders of the peripheral nerves. Springer-verlag London limited, pp.
1-41, 2011.
[22] J. A. Gilroy, B. R. MacPhason, L. M. Roses, "Ankle and foot," Atlas of
Anatomy, Stuttgart; New York: Thieme, pp. 432-445, 2008.
[23] T. Arakawaa, S. Sekiyab, K. Kumakic, and T. Terashimaa,
"Ramification pattern of the deep branch of the lateral plantar nerve in
the human foot," Annals of Anatomy, Vol. 187(3):287-96, 2005.
[24] E. Garner, and D. J. Gray, "The innervation of the joint of the foot," The
Anatomical Record, Vol. 161 (2), pp. 141-148, 1968.
[25] N. K. Narendiran, R. K. G. Mohandas, S. N. Somayaji and V.
Rodriques, "Clinically important anatomical variation of cutaneous
branches of superficial peroneal nerve in the foot," The open anatomy
journal, Vol. 2, pp 1-4, 2010.
[26] C. Madhavi, B. Isaac, B. Antoniswamy, and S. J. Holla, "Anatomical
variations of the cutaneous innervation patterns of the sural nerve on the
dorsum of the foot," Clinical anatomy, Vol. 18, pp. 206-209, 2005.
[27] MATHWORKS: http://www.mathworks.com/products/matlab/.
[28] C. Bradley, A. Pullan, and P. Hunter, (1997). "Geometric Modeling of
the Human Torso," Annals of Biomedical Engineering, Vol. 27(1), pp.
96-111, 1997.
[29] J. W. Fernandez, K. Mithraratne, S. F. Thrupp, M. H. Tawhai, and P.
Hunter, "Anatomically based geometric modelling of the musculoskeletal
system and other organs," Biomechanics and Modeling in
Mechanobiology, Vol. 2(3), pp.139-155, 2004.
[30] J. W. Fernandez, J. Jor, M. Z. Ul Haque, M. D. Jacobs, P. J. Hunter, and
K. Mithraratne, "Nerve excitation in the diabetic foot: An anatomically
based model to explore external therapies for mechano-stimulation of
sensory nerves," Proceedings of the 23rd Congress of the International
Society of Biomechanics, Brussels, 3-7 July 2011.
[31] J. W. Fernandez, M. Z. Ul Haque, P. J. Hunter, and and K. Mithraratne,
"Mechanics of the foot - Part 1: Part 1: A continuum framework for
evaluating soft tissue stiffening in the pathologic foot," in International
Journal for Numerical Methods in Biomedical Engineering; (in press).
[32] C. Y. Wang, J. B. Bassingtwaighte, and L. J. Weissman, "Bifurcating
distributive system using Monte Carlo method," Math. Computational
modeling, Vol.16 (3), pp. 91-98, 1992.
[33] M. C. Ferreira, S. A. T. Vieira, and V. F. D. Carvalho, "Comparative
study of the sensitivity of diabetic lower extremities with and without
ulcers suing the PSSDTM," ActaOrtop Bras, Vol. 18(2), pp. 71-4, 2010.
[34] K. Horsfield, and G. Cumming, "Angles of branching and diameters of
branches in the human bronchial tree," Bulletin Math. Biophysics, Vol.
29, pp. 245-259, 1967.
[35] O. Shefi, A. Harel, D. B. Chklovskii, E. B. Jacobs, and A. Ayali,
"Biophysical constraints on neural branching," Neurocomputing, Vol.
58(60), pp. 487-495, 2004.
[36] O. Shefi, S. Golebowicz, E. B. Jacobs, and A. Ayali, "A two phase
growth strategy in cultured neural networks as reflected by the
distribution of neurite branching angles," Inc. J Neurobiol, Vol. 62, pp.
361-368, 2005.
[1] S. Bianchi, and C. Martiloni, "Foot," Ultrasound of Musculoskeletal
System,Springer Verilog, pp.835-850, 2007.
[2] J. Craven, "Nerves of the leg and foot," Anaethesia and Intensive Care
Medicine, Vol. 8:4, pp. 149-150, 2007.
[3] S. Grimnes, and O. J. Martinsen, Excitable tissues and Bioelectric
Signal: Bio impedance and Bioelectricity Basics, San Diego, Calif.,
London: Academic. 2000, pp. 139- 159.
[4] C. Sylantiev, R. Schwartz, J. Chapman, and A. S. Buchman, "Medial
Plantar Nerve Testing Facilities Identification of Polyneuropathy,"
Muscle and Nerve Vol. 38, pp. 1595-1598, 2008.
[5] J. Y. An, M. S. Park, J. S. Kim, Y. M. Shon, S. J. Lee, Y. I. Kim, K. S.
Lee, and B. J. Kim, "Comparison of Diabetic Neuropathy Symptom
Score and Medial Plantar Sensory Nerve Conduction Studies in Diabetic
Patients showing Normal Routine Nerve Conduction Studies,"
International Medicine Vol. 47, 1395-1398, 2008
[6] S. J. Oh, K. W. Lee, J. S. Hah, D. E. Kim, M. Demirci, "Lateral Plantar
Neuropathy," Muscle and Nerve, Vol. 22, pp. 1234-1238, 1999.
[7] S. J. Oh, H. S. Kim, and B. K. Ahmad, "Electrophysiological Diagnosis
of Inter-digital Neuropathy of the foot," Muscle and Nerve, Vol. 7, pp.
218-225, 1984.
[8] S. H. Horowitz and C. Krarup C, "Conduction studies of the normal
sural nerve," Muscle and Nerve, Vol. 15, pp. 374-383, 1992.
[9] S. J. Oh, M. Demirci, B. Dajani, A. C. Melo, and G. C. Claussen, "Distal
Sensory Nerve Conduction of the Superficial Peroneal Nerve: New
Method and its Clinical application," Muscle and Nerve, Vol. 24, pp.
689-694, 2001.
[10] B. Bakotic, "Epidermal Nerve fiber density: an overview," Podiatry
management, pp. 141- 152, 2010.
[11] J. Kim, J. Davidson, O. Rohrle, T. Soboleva, and A. Pullan,
"Anatomically based lower limb model for electrical stimulation,"
Biomedical Engineering online, Vol. 6:48, 2007.
[12] S. Chiu, J. Ritchie, R. Rogart, D. Stagg, and Sweeney,"A quantitative
description of membrane currents in rabbit myelinated nerve,"The
Journal of Physiology,Vol. 292, pp. 149-166, 1979.
[13] H. C. Yeh, "Modeling of Biological Structure," Bulletin of
Mathematical Modeling, vol. 41, pp. 893-898, 1979.
[14] V. Olsbo, and L. Waller, "A point process approach to modeling
epidermal nerves fiber patterns," Technical report 08-03, pp. 1-20, 2008.
[15] M. H. Tawhai, A. J. Pullan, and P. J. Hunter, "Generation of an
anatomically based three dimensional model of the conducting airways,"
Annals of Biomedical Engineering, Vol. 28, pp. 793-802, 2000.
[16] CMISS: http://www.cmiss.org.
[17] V. Spitzer, M. Ackerman, A. Scherzinger, and D. Whitlock, "The
Visible Human Male: a technical report," Journal of American Medical
Informatics Ass Vol. 3, No. 2, pp. 118-130, 1996.
[18] Zinc Digitizer: http://www.cmiss.org/cmgui/zinc.
[19] P. L. William, R. Warwick, M. Dyson, and L. H. Bannister, "Neurology:
The Tibial Nerve," The Gray-s Anatomy, 37 Editions, pp. 1142 - 1149,
1989.
[20] K. L. Moore, A. M. Ragur, and A. F. Dalley,"Lower Limb,"Clinically
oriented anatomy, Edition 6, pp. 614-618,2011.
[21] R. Birch, "The peripheral Nervous system: Gross Anatomy," Surgical
disorders of the peripheral nerves. Springer-verlag London limited, pp.
1-41, 2011.
[22] J. A. Gilroy, B. R. MacPhason, L. M. Roses, "Ankle and foot," Atlas of
Anatomy, Stuttgart; New York: Thieme, pp. 432-445, 2008.
[23] T. Arakawaa, S. Sekiyab, K. Kumakic, and T. Terashimaa,
"Ramification pattern of the deep branch of the lateral plantar nerve in
the human foot," Annals of Anatomy, Vol. 187(3):287-96, 2005.
[24] E. Garner, and D. J. Gray, "The innervation of the joint of the foot," The
Anatomical Record, Vol. 161 (2), pp. 141-148, 1968.
[25] N. K. Narendiran, R. K. G. Mohandas, S. N. Somayaji and V.
Rodriques, "Clinically important anatomical variation of cutaneous
branches of superficial peroneal nerve in the foot," The open anatomy
journal, Vol. 2, pp 1-4, 2010.
[26] C. Madhavi, B. Isaac, B. Antoniswamy, and S. J. Holla, "Anatomical
variations of the cutaneous innervation patterns of the sural nerve on the
dorsum of the foot," Clinical anatomy, Vol. 18, pp. 206-209, 2005.
[27] MATHWORKS: http://www.mathworks.com/products/matlab/.
[28] C. Bradley, A. Pullan, and P. Hunter, (1997). "Geometric Modeling of
the Human Torso," Annals of Biomedical Engineering, Vol. 27(1), pp.
96-111, 1997.
[29] J. W. Fernandez, K. Mithraratne, S. F. Thrupp, M. H. Tawhai, and P.
Hunter, "Anatomically based geometric modelling of the musculoskeletal
system and other organs," Biomechanics and Modeling in
Mechanobiology, Vol. 2(3), pp.139-155, 2004.
[30] J. W. Fernandez, J. Jor, M. Z. Ul Haque, M. D. Jacobs, P. J. Hunter, and
K. Mithraratne, "Nerve excitation in the diabetic foot: An anatomically
based model to explore external therapies for mechano-stimulation of
sensory nerves," Proceedings of the 23rd Congress of the International
Society of Biomechanics, Brussels, 3-7 July 2011.
[31] J. W. Fernandez, M. Z. Ul Haque, P. J. Hunter, and and K. Mithraratne,
"Mechanics of the foot - Part 1: Part 1: A continuum framework for
evaluating soft tissue stiffening in the pathologic foot," in International
Journal for Numerical Methods in Biomedical Engineering; (in press).
[32] C. Y. Wang, J. B. Bassingtwaighte, and L. J. Weissman, "Bifurcating
distributive system using Monte Carlo method," Math. Computational
modeling, Vol.16 (3), pp. 91-98, 1992.
[33] M. C. Ferreira, S. A. T. Vieira, and V. F. D. Carvalho, "Comparative
study of the sensitivity of diabetic lower extremities with and without
ulcers suing the PSSDTM," ActaOrtop Bras, Vol. 18(2), pp. 71-4, 2010.
[34] K. Horsfield, and G. Cumming, "Angles of branching and diameters of
branches in the human bronchial tree," Bulletin Math. Biophysics, Vol.
29, pp. 245-259, 1967.
[35] O. Shefi, A. Harel, D. B. Chklovskii, E. B. Jacobs, and A. Ayali,
"Biophysical constraints on neural branching," Neurocomputing, Vol.
58(60), pp. 487-495, 2004.
[36] O. Shefi, S. Golebowicz, E. B. Jacobs, and A. Ayali, "A two phase
growth strategy in cultured neural networks as reflected by the
distribution of neurite branching angles," Inc. J Neurobiol, Vol. 62, pp.
361-368, 2005.
@article{"International Journal of Medical, Medicine and Health Sciences:51387", author = "Muhammad Zeeshan UlHaque and Peng Du and Leo K. Cheng and Marc D. Jacobs", title = "An Anatomically-Based Model of the Nerves in the Human Foot", abstract = "Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.
", keywords = "Diabetic neuropathy, Finite element modeling, Monte
Carlo Algorithm, Somatosensory nerve networks", volume = "6", number = "9", pages = "424-6", }
