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Posterior Aspect of the Leg Prof. Dr. Selda Önderoğlu . Cutaneous Nerves • Saphenous n. (from femoral n.) • Posterior femoral cutaneous n. (from sacral plexus) • Lateral cutaneous n. of leg (from common fibular (peroneal) n.) • Sural n. (from tibial n & common fibular (peroneal) n.) Superficial veins • Small saphenous vein – pierces the roof of the popliteal fossa and drains into the popliteal vein Deep fascia of leg(Fascia cruris) • interosseous membrane and the “crural intermuscular septa” divide the leg into 3 crural compartments: 1-Anterior comp. 2-Lateral comp. 3-Posterior comp.: contains 2 group of muscles: – superficial – deep A L P Flexor Retinaculum • broad band of deep fascia which passes -from medial malleolus -to calcaneus Muscles Superficial layer – Gastrocnemius m. – Soleus m. – Plantaris m. insert to calcaneus with a common tendon “tendo calcaneus” (achille’s tendon) Deep layer – – – – Popliteus m. Flexor digitorum longus m. Flexor hallucis longus m. Tibialis posterior m. pass deep to the “flexor retinaculum” SUPERFICIAL LAYER Gastrocnemius m. • Most superficial of the muscles in the posterior crural compartment • O: 2 heads, lat & med condyles of femur, they come together at the inferior margin of the popliteal fossa • I: Calcaneous, via “tendo calcaneus” (aschilles tendon) • N: Tibial n. • F: Flexion (plantar flexion) of foot & leg Soleus m. • • • • -Located deep to gastrocnemius O: Soleal line, upper part of fibula I: calcaneus via “tendo calcaneus” N: Tibial nerve F: Flexion of foot Gastrocnemius+soleus mm: Triceps surae m. Plantaris m. ---Small muscle; variable in size and extend, it may be absent. • O: Lat supracondylar area of the femur • I: Medial part of tendo calcaneus • N: Tibial n. • F: assists flexion of leg, plantar flexion of the foot DEEP LAYER: Popliteus m. ---Thin, triangular muscle • O: Lat condyle of femur & arcuate popliteal lig. • I: Post surface of tibia • N: Tibial nerve • F: Flexion & medial rotation of leg Flexor digitorum longus m. • O: Post surface of tibia below soleal line • I:Bases of distal phalanges of 2-5 • N.:Tibial nerve • F: Flexion of toes 2-5 & foot, inversion of foot, helps to maintain the medial longitudinal arch of foot Flexor hallucis longus m. • • • • --The long, powerful and largest muscle of deep layer O: Lower part of post surface of fibula, interosseos memb. I: Base of distal phalanx of hallux (big toe of foot) N.: Tibial nerve F: Flexion of hallux & foot, also important in holding the leg in the normal position of foot. Tibialis posterior m. • The deepest m in the posterior crural compartment • O: Lateral part of post surface of tibia below soleal line, post surface of fibula, interosseous membrane • I: Sustentaculum tali, tuberosity of navicular b, talus, cuneiform bb, cuboid b, 2-4 metatarsal bb • N.: Tibial n. • F: Plantar flexes and inverts foot cross Posterior tibial artery • it begins at the distal border of the popliteus muscle • it is larger terminal branch of the popliteal artery • it is accompanied by the tibial nerve • Branches: – – – – – – Fibular ( peroneal) a Circumflex fibular a Medial malleolar a Calcaneal brs Nutrient a of tibia Lat & med plantar aa Fibular (peroneal) artery • • • • • • Muscular branches Nutrient a. to fibula Perforating br. Communicating br. Lateral malleolar brr. Calcaneal brr. Tuberosity of tibia