Ankle Retinacula PDF

Anatomy of LOWER Limb Ankle Retinacula By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology  Case Scenario LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 2 ...

Anatomy of LOWER Limb Ankle Retinacula By Dr. Hassan Mohammed Rizk (Ph.D.) Associate Professor of Human Anatomy and Embryology  Case Scenario LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 2  Objectives: by the end of this lecture the student must understand the following knowledge: LOWER LIMB ▪ Identify and demonstrate the: 1)Flexor retinaculum. 2)Extensor retinaculum (Superior & Inferior) 3)Peroneal retinaculum. ▪ Identify and demonstrate the contents, compartments and relations of: 1)Tarsal tunnel. Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 3  Objective 1: Flexor Retinaculum LOWER LIMB ▪ Definition: Is a thickening of deep fascia that holds the long flexor tendons in position at the ankle. ▪ Site: Stretches across the medial aspect of the ankle behind the medial malleolus. ▪ Function: Converts the space behind the medial malleolus into an osteo- fascial tunnel, tarsal tunnel, for the passage of nerve and the flexor tendons of the toes. Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 4 LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 5  Tarsal Tunnel ▪ Contents of tarsal tunnel (structures deep to flexor LOWER LIMB retinaculum): from medial to lateral 1) Tibialis posterior tendon. 2) Flexor Digitorum Longus Tendon. 3) Posterior tibial artery (the pulse can be recorded). 4) Posterior tibial nerve. 5) Flexor Hallucis Longus Tendon. Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 6  Objective 2: Extensor Retinaculum LOWER LIMB ▪ Definition: is a thickening of deep fascia holds the long extensor tendons in position. ▪ Site: stretches across the front of the ankle. ▪ Types: 1. Superior Extensor Retinaculum. 2. Inferior Extensor Retinaculum (Y-shaped). Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 7  Objective 2: Extensor Retinaculum ▪ Structures lie deep to extensor retinaculum: LOWER LIMB from medial to lateral 1) Tibialis anterior tendon. 2) Extensor Hallucis longus tendon 3) Dorsalis pedis artery (terminal branch of the anterior tibial artery). 4) Anterior tibial (deep peroneal) nerve. 5) Extensor digitorum longus tendons 6) Fibularis tertius tendon ▪ Structures lie superficial to extensor retinaculum: 1) Great saphenous vein. 2) Saphenous nerve Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 8 LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 9  Objective 3: Peroneal Retinaculum ▪ Definition: is a thickening of deep fascia holds the tendons of lateral LOWER LIMB compartment of the leg ▪ Site: stretches across the lateral side of the ankle behind the lateral malleolus. ▪ Structures lie deep to peroneal retinaculum: 1) Peroneus longus tendon. 2) Peroneus Brevis tendon. ▪ Structures lie superficial to peroneal retinaculum: 1) Small saphenous vein. 2) Sural nerve. Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 10 LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 11  Clinical Correlation Tarsal tunnel syndrome ▪ Definition: is an entrapment syndrome caused by pressure on contents within tarsal tunnel. LOWER LIMB ▪ Cause: a) Fracture talus, calcaneous & medial malleolus. b) Rheumatoid arthritis. ▪ Clinical Picture: Symptoms develop in areas innervated by the tibial nerve: ✓ Neuropathic pain and paresthesia in the heel, sole of the foot, and first three toes. ✓ Weakness and atrophy of intrinsic foot muscles (severe cases) Symptoms worsen with walking, prolonged standing, and at night Positive Tinel sign: radiating paresthesia triggered by tapping the flexor retinaculum posterior to the medial malleolus Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 12  Case Scenario LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 13 LOWER LIMB Reference ISBN: 978-0-7020-5131-9 ISBN: 978-07817-7525-0 ISBN: 978-1-60913-446-4 Copyright© 2015, 2010, 2005 by Copyright© 2010, by Lippincott Copyright© 2012, by Lippincott Churchill Livingstone, an imprint of Williams & Wilkins, a Wolters Williams & Wilkins, a Wolters Elsevier Inc. Kluwer business. Kluwer business. Chapter 6. Chapter 5. Chapter 10. Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 14 LOWER LIMB Ankle Retinacula By Dr. Hassan Rezk October 11, 2024 15