BACK OF THE LEG (CALF).pdf

BACK OF THE LEG (CALF)  Posterior Compartment of the leg ❖ Muscles: Ankle flexors (plantar flexors) and invertors ❖ Blood Vessels: Posterior tibial vessels ❖ Nerves: Tibial nerve ❖ They are organized into two groups, superficial and deep: Muscles a) Superficial grou...

BACK OF THE LEG (CALF)  Posterior Compartment of the leg ❖ Muscles: Ankle flexors (plantar flexors) and invertors ❖ Blood Vessels: Posterior tibial vessels ❖ Nerves: Tibial nerve ❖ They are organized into two groups, superficial and deep: Muscles a) Superficial group: three muscles 1. Gastrocnemius 2. Plantaris 3. Soleus b) Deep group: four muscles 1. Popliteus 2. Flexor hallucis longus 3. Flexor digitorum longus 4. Tibialis posterior 1. Gastrocnemius: superficial large muscle, Superficial Group has two heads 2. Plantaris: small muscle with long tendon deep to lat. head of gastrocnemius. 3. Soleus: large flat muscle under the gastrocnemius  INSERTIO NERVE MUSCLE ORIGIN ACTION N SUUPLY Medial head: post. surface of distal Gastro femur lateral head: cnemius posterolateral surface of lateral Plantar femoral condyle flexes foot Inferior part of Via and flexes lateral calcaneal knee supracondylar line Tibial Plantaris tendon, to of femur and nerve oblique popliteal posterior [S1,S2] ligament surface of Soleal line and calcaneus medial border of tibia; posterior Plantarflex-es Soleus aspect of fibular the foot head and adjacent surfaces of neck and proximal shaft 1. Popliteus: the smallest and most superior of the deep Deep Group muscles 2. Flexor hallucis longus: inferolaterally 3. Flexor digitorum longus: medially 4. Tibialis Posterior: deepest one between FHL and FDL  NERVE MUSCLE ORIGIN INSERTION ACTION SUPPLY Unlocks knee Posterior Lateral femoral Tibial nerve joint (laterally Popliteus surface of condyle [L4 to S1] rotates femur on proximal tibia fixed tibia) Posterior surface of Flexor Plantar surface fibula and Tibial nerve hallucis of distal phalanx Flexes great toe adjacent [S2,S3] longus of great toe interosseous membrane Medial side of Plantar surfaces Flexor posterior of bases of distal Tibial nerve Flexes lateral digitorum surface of the phalanges of the [S2,S3] four toes longus tibia lateral four toes Inversion and Mainly to Posterior plantarflexion of tuberosity of Tibialis surfaces of Tibial nerve foot; support of navicular and Posterior interosseous [L4,L5] medial arch of medial membrane foot during cuneiform walking  The larger and more direct terminal branch of the popliteal Posterior artery. It begins at the distal border of Tibial Artery the popliteus accompanied by the tibial nerve and veins. The artery descends on the superficial surfaces of the tibialis posterior and flexor digitorum longus muscles. It passes through the tarsal tunnel behind the medial malleolus and into the sole of the foot where it ends by dividing into medial and lateral plantar arteries.  Posterior Tibial Artery Branches: 1. Muscular 2. Nutrient 3. Circumflex fibular artery 4. Fibular artery 5. Medial and lateral plantar arteries  The largest and most important branch of the Fibular tibial artery, arises inferior Artery to the distal border of the popliteus. Branches: 1. Muscular 2. Nutrient artery of the fibula 3. Perforating branches 4. Terminal lateral malleolar and calcaneal branches.  A major branch of the sciatic nerve that descends into the Tibial posterior compartment from the popliteal fossa. Nerve It leaves the posterior compartment of leg at the ankle by passing through the tarsal tunnel behind the medial malleolus. It enters the foot to supply most intrinsic muscles and skin. Branches: 1. Muscular 2. two cutaneous branches, the sural nerve and medial calcaneal nerve.  It originates high in the leg by union of the Sural medial sural cutaneous nerve (from the tibial nerve) and sural communicating Nerve branch of the common fibular nerve between the two heads of the gastrocnemius muscle descending superficial to it and penetrates into the deep fascia in the middle of the leg. The sural nerve supplies skin on the lower posterolateral surface of the leg and the lateral side of the foot and little toe.  It is formed on the posteromedial TARSAL side of the ankle by: a) a depression formed by the TUNNEL medial malleolus, the medial and posterior surfaces of the talus, and the medial surface of the calcaneus. b) an overlying flexor retinaculum.  It is a strap-like layer of connective tissue attaches Flexor above to the medial Retinaculum malleolus and below and behind to the inferomedial margin of the calcaneus. The retinaculum is continuous above with the deep fascia of the leg and below with deep fascia (plantar aponeurosis) of the foot.  Structures deep to it from medial to lateral are: Flexor 1. Tendon of tibialis posterior Retinaculum 2. Tendon of flexor digitorum longus 3. Posterior tibial artery vein and nerve. 4. Tendon of the flexor hallucis longus THANK YOU