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Download Everything you wanted to know to finish up on the leg and foot
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Everything you wanted to know to finish up on the leg and foot Superficial structures of the leg and foot • Superficial veins • Cutaneous nerves • Retinaculi Veins on dorsum of foot • Great saphenous vein – medially • Dorsal venous arch of the foot • Dorsal metatarsal veins and dorsal digital veins of foot • Small saphenous vein – Begins posterior to lateral malleolus – Lateral leg – In popliteal fossa, enters the popliteal vein Cutaneous nerves: just profund to veins • Saphenous nerve – Longest and largest branch of femoral nerve – Cutaneous innervation • Anteromedial leg and ankle • Distal to head of 1st metatarsal Superficial fibular cutaneous nerve • Dorsal aspect of foot – Dorsal medial cutaneous nerve – Dorsal intermediate cutaneous nerve • See previous picture Sural Nerve • Can form from popliteal fossa to more distal calf (5-8 cm proximal to ankle) • Formed from – Communicating branch of lateral sural cutaneous nerve from: – Medial sural cutaneous nerve from: • Terminal branches of sural nerve in the dorsal lateral cutaneous nerve of the foot • See nerve distribution figure – Lateral and posterior part of inferior 1/3rd of leg – Enters foot posterior to lateral malleolus – Supplies skin on lateral side of foot and lateral side of 5th toe Retinaculum of the foot • Transverse thickenings of the deep fascia that hold tendons in place • Superior extensor retinaculum • Inferior extensor retinaculum • Inferior fibular retinaculum – Inferior part of Y-shaped retinaculum that attaches to lateral calcaneus • Flexor retinaculum – already discussed Structures of anterior compartment that cross ankle anteriorly • Deep to extensor retinaculum – Medial to Lateral • TA tendon • EHL tendon • EDL tendon • Deep to the EDL tendons – EDbr muscle – EHbr muscle – Insert into base of proximal phalanx and lateral side of EDL tendons for the 1st to 4th digits Deep to EDbr • Dorsalis pedis artery • Perforating branch of fibular artery and its branch to lateral malleolar artery • Deep fibular nerves and its branches Other structures on the sole of the foot • Muscles – 4 layers • Plantar vessels and nerves • Heel Fat Pad • Plantar aponeurosis Plantar aponeurosis • Thickening of plantar fascia – Superficial transverse metatarsal ligament – Central portion of plantar aponeurosis – 5 diverging bands of plantar aponeurosis to each phalanx – Lateral band of plantar aponeurosis • First layer of plantar muscles is just deep to the plantar aponeurosis PA Nerves • Tibial Nerve – Medial plantar nerve – Lateral plantar nerve
