Posterior Compartment of Leg & Sole of Foot PDF

C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ Prof. Mujahid Khan ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ C o ll e g e o f At the end of this lecture the students should be able M to know: e d ic i The contents of posterior fascial compartment n e of Leg – ‫ك‬ The structures hol...

C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ Prof. Mujahid Khan ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ C o ll e g e o f At the end of this lecture the students should be able M to know: e d ic i The contents of posterior fascial compartment n e of Leg – ‫ك‬ The structures hold by retinacula at ankle ‫ ل‬ Layers forming in the sole of foot & bone ‫ية‬ ‫ا‬ forming the arches of the foot ‫ل‬ ‫ط‬ ‫ب‬  The transverse intermuscular septum of the leg is a septum divides the muscles of the posterior compartment into superficial and deep groups dicine – ‫كلية الطب‬ Loading… Contents: 1. Superficial group of muscles 2. Deep group of muscles 3. Posterior tibial artery 4. Tibial nerve 0 C o ll e 1. Gastrocnemius 2. Plantaris 3. Soleus g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  Muscle Origin Insertion Nerve Action Gastrocn Lateral head Posterior Tibial Plantar flexes foot at ankle emius from lateral surface of joint; flexes knee joint condyle of femur calcaneum via & medial head tendo calcaneus from above medial condyle dicine – ‫كلية الطب‬ Plantaris Lateral Loading…Plantar flexes foot at ankle Posterior Tibial supracondylar surface of joint; flexes knee joint ridge of femur calcaneum Soleus Shafts of tibia and Posterior Tibial Together with gastrocnemius and fibula surface of plantaris is powerful plantar flexor calcaneum via of ankle joint; provides main tendo calcaneus propulsive force in walking and running 0 C o ll e Popliteus 2. Flexor digitorum longus 3. Tibialis posterior g 4. Flexor hallucis longus e o 4. Tibialis posterior f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬  Poplite Groove on Lateral surface Post surface of shaft of tibia Tibial Flexes knee joint : Unlocks knee joint us of lateral condyle of femur above soleal line by lateral rotation of femur on tibia(or (Intracapsular) slight medial rotation of leg which accompanies the flexion) Flexor Posterior surface of shaft of Bases of distal phalanges of Tibial Flexes distal phalanges of lateral four digitor tibia lateral 4 toes toes; plantar Flexes foot at ankle joint; um Supports medial and lateral longus longitudinal arches dicine – ‫كلية الطب‬ Flexor Posterior surface of shaft of Base of distal phalanx of Tibial Flexes distal phalanx of big toe; halluci fibula big toe plantar flexes foot at ankle joint; s supports medial longitudinal arch longus Tibiali Posterior surface of shafts Tuberosity of navicular Tibial Plantar flexes foot at ankle joint; s of tibia and fibula and bone and other neighboring inverts foot at subtalar and transverse posteri interosseous membrane tarsal bones. tarsal joints; supports medial or longitudinal arch C o ll e g e o f M e It is one of the terminal d ic branches of the popliteal n i artery e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  It is the larger terminal branch of the sciatic nerve in the lower 1/3 of the back of the thigh dicine – ‫كلية الطب‬ The nerve enters the posterior compartment of the leg by passing beneath the soleus muscle 0 C o ll e g e o Extends from back of f medial malleolus of tibia to M e medial side of d ic calcaneum i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬  Medial to lateral Tibialis posterior tendon Flexor digitorum longus 3 tendon 4 5 Posterior tibial artery with Loading… dicine – venae comitantes ‫كلية الطب‬ 1 2 Tibial nerve Flexor hallucis longus tendon All the tendons are surrounded by a synovial sheath  The skin of the sole of the foot is thick and hairless It shows a few flexure creases at the sites of skin movement Sweat glands are present in large numbers ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0 C o ll e The plantar aponeurosis is a g triangular thickening of the e deep fascia that protects the o f underlying nerves, blood M vessels, and muscles e d ic Its apex is attached to the i medial and lateral tubercles of n the calcaneum e – ‫ك‬ The base of the aponeurosis ‫ل‬ divides into five slips that pass ‫ية‬ into the toes ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  The muscles of the sole are conveniently described in four layers from superficial to deep. dicine – ‫كلية الطب‬ 0 C o ll e g e o f M e 1. Abductor hallucis d ic 2. Flexor digitorum brevis i n 3. Abductor digiti minimi e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  1. Quadratus plantae 2. Lumbricals dicine – ‫كلية الطب‬ 3. Flexor digitorum longus tendon 4. Flexor hallucis longus tendon 0 C o ll e g e o f M e 1. Flexor hallucis brevis d ic 2. Adductor hallucis i 3. Flexor digiti minimi brevis n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  1. Interossei, (3 plantar+4 dorsal) dicine – ‫كلية الطب‬ 2. Peroneus longus tendon, 3. Tibialis posterior tendon plantar 0 C o Function of small muscles of sole of Foot ll e g e Unlike the small muscles o of the hand, the sole f M muscles have few delicate e functions and are chiefly d ic concerned with supporting i the arches of the foot n e – Although their names ‫ك‬ ‫ل‬ would suggest control ‫ية‬ movements of individual ‫ا‬ toes ‫ل‬ ‫ط‬ ‫ب‬ 0 C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0 ‫كلية الطب – ‪dicine‬‬ ‫‪0‬‬ C o ll e g e Medial longitudinal arch o f Is formed of calcaneum, talus, navicular, M 3 cuneiform bones, and 3 medial e metatarsal bones d ic i Lateral longitudinal arch Is formed n of calcaneum, cuboid & lateral 4th & 5th e metatarsal bones – ‫ك‬ ‫ل‬ Transverse arch ‫ية‬ Lies at the level of tarso-metatarsal ‫ا‬ joints, formed of bases of metatarsal ‫ل‬ bones, cuboid & 3 cuneiform bones ‫ط‬ ‫ب‬  Weight bearing Support walking & running Provide potential space for neurovascular bundle of dicine –the ‫ الطب‬sole ‫كلية‬ Act as shock absorber In young child, the foot appears to be flat because of presence of a large amount of subcutaneous fat on the sole of foot C o ll e g e o The inferior surface of each toe, from f the head of the metatarsal bone to the M base of the distal phalanx, is provided e with a strong fibrous sheath, which is d attached to the sides of the phalanges ic i The fibrous sheath, together with the n inferior surfaces of the phalanges and e the interphalangeal joints, forms a – blind tunnel in which lie the flexor ‫ك‬ tendons of the toes ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0  The tendons of the flexor hallucis longus and the flexor digitorum longus are surrounded by synovial dicine – ‫كلية الطب‬ sheaths 0 C o ll e g e o Gray's Anatomy for Students, Fourth edition f M e d Snell Clinical Anatomy, Ninth edition ic i n Clinically Oriented Anatomy , Keith L. Moore- Seventh edition e – ‫ك‬ Netter’s Clinical Anatomy, Second edition ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ 0 dicine – ‫كلية الطب‬ ‫قرر‬$‫ – اسم ورقم ا‬Course Name and No. 0