Anterior & Lateral Compartment of Leg & Dorsum of Foot PDF

Anterior & lateral compartment of leg Dorsum of foot Dr Sapna Shevade Asst Professor -Anatomy www.gmu.ac.ae COLLEGE OF MEDICINE Objectives Describe origin ,insertion, nerve supply and action of...

Anterior & lateral compartment of leg Dorsum of foot Dr Sapna Shevade Asst Professor -Anatomy www.gmu.ac.ae COLLEGE OF MEDICINE Objectives Describe origin ,insertion, nerve supply and action of muscles of the front of the leg & lateral compartment of leg and dorsum of the foot Describe the origin, course and branches of arteries of anterior and lateral compartment of leg Muscles of anterior compartment of leg- Extensor compartment Tibialis anterior Extensor digitorum longus Extensor hallucis longus Fibularis(peroneus tertius)  Muscles of the anterior compartment & dorsum of foot Tibia (lateral surface) Tibialis anterior Fibula (medial surface) Extensor digitorum longus Extensor hallucis longus Peroneus tertius They dorsiflex the foot (ankle joint) Extensor digitorum brevis Extensor hallucis brevis All muscles are supplied by deep fibular nerve(deep peroneal nerve)  Tibialis anterior Insertion : medial cuneiform and base of first metatarsal bone Action : Dorsiflexion at ankle joint & Inversion at subtalar joint (turning the foot inwards)  Extensor hallucis longus Insertion : distal phalanx of great toe Action : extension of great toe  Extensor digitorum longus Insertion : middle & distal phalanges of the lateral 4 toes Action : Extension of lateral 4 toes at proximal & distal interphalangeal joints  Fibularis tertius : (Peroneus tertius) Insertion : base of 5th metatarsal bone Action : dorsiflex ankle joint Muscles of lateral compartment of leg –Everters of foot Peroneus longus : Origin: upper lateral surface of fibula Insertion: Passes behind lateral malleolus ,forwards & medialy across the sole- inserts on base of 1st metatarsal bone & adjacent medial cuneiform bone Nerve supply : superficial peroneal nerve Action : everter of foot Muscles of lateral compartment of leg –Everters of foot Peroneus brevis : Origin: lower lateral surface of fibula Insertion: Passes behind lateral malleolus in front of peroneus longus tendon-inserts on base of 5th metatarsal bone Nerve supply : superficial peroneal nerve Action :evertor of foot Dorsum of foot Extensor digitorum brevis Origin : superolateral surface of calcaneum Insertion: splits into 4 tendons –base of the great toe, remaining 3 insert into bases of middle phalanx of 2nd ,3rd & 4th toe Extensor hallucis brevis : most medial part –base of proximal phalanx of great toe Nerve supply : pseudo ganglion of deep peroneal nerve Action : dorsiflexion of medial 4 toes Peroneal artery Branch of posterior tibial artery Supplies the lateral compartment of leg Anterior tibial artery Terminal branch of popliteal artery Anteriorly descends down upto ankle joint Continues at the level of ankle joint as dorsalis pedis artery Branches : Muscular Medial & lateral malleolar- anastomosis Dorsalis pedis artery Continuation of anterior tibial artery midway between the malleoli Runs downwards on dorsum of the foot to reach first intermetatarsal space where it turns downwards to enter the sole of foot. Ends by completing plantar arch medially Principal dorsal artery of foot  Branches of dorsalis pedis artery ✓Anterior medial malleolar ✓Anterior lateral malleolar ✓Medial tarsal ✓Lateral tarsal ✓Arcuate artery ✓First dorsal metatarsal artery Arcuate artery ✓Dorsal digital branches Dorsalis pedis artery-pulse Superficial artery Pulse felt easily lateral to extensor hallucis longus tendon Diminished or absent pulse indicates arterial insufficiency of lower limb Thrombosis ,embolism or arteriosclerosis in proximal arteries Gangrene References Netter’s Clinical Anatomy,4th Edition-2019,John T Hanson, Chapter 6,Page 291-366,ISBN 978-0-323-53188-7 https://wwwclinicalkeycom.gmulibrary.com/#!/content/book/3-s2.0- B9780323531887000068  Posterior compartment of leg Dr Sapna Shevade Asst Professor -Anatomy www.gmu.ac.ae COLLEGE OF MEDICINE Objectives Describe the origin ,insertion, nerve supply and action of muscles of the posterior compartment of the leg Muscles of posterior compartment of leg- Flexor compartment Superficial muscles Gastrocnemius Soleus Plantaris Deep muscles Popliteus Tibialis posterior Flexor digitorum longus Flexor hallucis longus  Gastrocnemius Origin Medial head : posterior surface of medial epicondyle of femur & popliteal surface Lateral head: Posterior surface of lateral condyle of femur Insertion : Both the heads join together to form a single muscle belly and forms a tendon called tendo achillis. It inserts on to the posterior surface of calcaneum Nerve supply : tibial nerve Action : plantar flexion  Soleus Origin :Soleal line of tibia and head of fibula Insertion : posterior surface of calcaneum via tendo achillis Nerve supply : tibial nerve Action : plantar flexion at ankle joint Plantaris Origin : Lateral supracondylar ridge Insertion : posterior calcaneus via calcaneal tendon Nerve supply : tibial nerve Action : weakly assists plantar flexion  Popliteus : has tendinous origin & fleshy insertion Origin : popliteal groove on lateral surface of lateral condyle of femur Insertion : posterior surface of tibia on triangular surface above soleal line Nerve supply : tibial nerve Action : rotates femur laterally to unlock the knee joint  Tibialis posterior Origin : upper posterior surface of fibula Insertion : passes posterior to medial malleolus of tibia and reaches the plantar surface and inserts on the navicular bone Nerve supply : tibial nerve Action : ✓plantarflexion ✓Inversion along with tibialis anterior at subtalar joint  Flexor digitorum longus Origin : posterior surface of tibia Insertion : divides into 4 tendons inserts on plantar surface of distal phalanx of lateral 4 digits Nerve supply : tibial nerve Action : plantar flexion at lateral 4 toes  Flexor hallucis longus Origin : posterior surface of fibula Insertion : runs behind the medial malleolus to insert onto distal phalanx of great toe Nerve supply : tibial nerve Action : plantarflexion of great toe Posterior tibial artery Larger terminal branch of popliteal artery Begins at the lower border of popliteus Enters back of the leg Runs downwards and medially to reach the posteromedial side of ankle-divides into medial and lateral plantar arteries Branches Peroneal artery- supplies lateral compartment Muscular arteries Shin splints pain on the medial distal two-thirds of the shaft of tibia. common in athletes. Repetitive pulling of the tibialis posterior tendon caused by pushing off the foot during running. Chronic conditions can lead to stress fractures. Usually begins as soreness after running. Later there is pain which worsens and then occurs while walking or climbing stairs. Osteosarcoma Most common malignant bone tumor of mesenchymal origin Common in males and usually occurs before 30 years of age Commonly seen on the distal femur or proximal tibia. Other sites include the proximal humerus, proximal femur, and pelvis. The tumors often invade cortical bone in this region because of its rich vascular supply and then infiltrate surrounding soft tissue Aggressive and require immediate attention. Tendinitis of the calcaneal (Achilles) painful inflammation that often occurs in runners who run on hills or uneven surfaces. Repetitive stress on the tendon occurs as the heel strikes the ground and when plantarflexion lifts the foot and toes. Tendon rupture is a serious injury and healing is alow Retrocalcaneal bursitis- inflammation of the bursa between the tendon and the calcaneus presents as a tender area just anterior to the tendon attachment. References Netter’s Clinical Anatomy,4th Edition-2019,John T Hanson, Chapter 6,Page 291-366,ISBN 978-0-323-53188-7 https://wwwclinicalkeycom.gmulibrary.com/#!/content/book/3-s2.0- B9780323531887000068