Download Front of the leg and dorsum of the foot

Front of the leg and dorsum of the
foot
Tibia
• A-Upper end , formed of :
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1- medial condyle
2- lateral condyle
3- inter condylar area
4-tibial tuerosity
• B. shaft formed of :
• 3 border(ant, lat.,and med.)
• 3 surface( med., lat., and
post)
• C- lower end, from its medial side
, it forms subcutaneous
projection called medial
malleolus
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• fibula
fibula
A-Upper end is formed
of :
1- apex (styloid process
2- head 3- neck
B-shaft contins
3 border( ant.,
post.,and lateral)
3 surface(ant., post.,and
Lat.)
C-lower end :project
laterally to form lat. Malleolus
Skeleton of the foot
• A- tarsus (7 in number)
• 1-proximal raw(talus, calcaneus)
• 2-intermediat raw (navicular)
• 3- distal raw(3 cuneiform
bones,medialy and cuboid bone
,laterally
• B- metatarsus( 5 in number)each
bone consists of , proximal
end(base), shaft,and distal end
(head)
• C- phalanges(14 in number)
• Big toe only consist of 2
phalanges
Bones of foot
The deep fascia (crural fascia)
it attached to the patella, •
the patellar ligament and
the tibial tuberosity..the
crural fascia attached to the
tibial condyles and the head
of the fibula Inferiorly ,
at the ankle joint , the deep •
fascia is thickened to form
retinacula which act as a
pulley to prevent
displacement of the
tendons of the muscles.
•
GREAT
SAPHENOUS
VEIN
DEEP FASCIA
IER
SER
Superior peroneal retinaculumlateral
Inferior peroneal retinaculum
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Flexor retinacula
intermuscular septa
• 1-Anterior
intermuscular septa.: It
connects the deep
fascia with anterior
border of the fibula
• 2-- The posterior
intermuscular septa:. It
connects the deep
fascia with posterior
border of the fibula
Movement at ankle j.
Anterior compartment of the leg
• it contains the following
muscles:,Tibialis
anterior m.,.extensor
hallucis longus m.,
extensor digitorum
longus m., peroneus
tertius m.
Anterior compartment of the leg
1- TA. 2-EDL. 3 EHL. 4,PM
1-EHL2- EDL 3- PT 4- EDB
Anterior tibial artery
a
• Origin Arises from the
popliteal artery at the
lower border of the
popliteus m.
• Termination It ends in
the front of the ankle
joint by becoming the
dorsalis pedis artery
midway between the
malleoli
Anterior tibial artery
• Branches:
• 1- muscular branches to the
muscles of the anterior
compartment.
• 2- Anterior tibial recurrent
artery passes upwards to the
knee joint.
• 3- Medial and lateral malleolar
arteries to the lateral and medial
malleoli, the lateral one
anastomosed with the
perforating branch of the
peroneal artery.
Medial
•
malleolar
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•
Anterior tibial
recurrent
lateral
malleolar
Deep peroneal nerve
• It gives :
– articular branch to ankle
joint
Muscular branches •
Superfiscial
peroneal n
EHL
Deep
peroneal
n.
TA
passes to the dorsum of the foot with the dorsalis pedis A. and terminates at lower
border of inferior extensor retinaculum by dividing into lateral terminal branch
(supplies extensor digitorum brevis and joints of the foot) and medial terminal branch
(divides into 2 digital branch to supply adjacent sides between 1st and 2nd toes
DE
medial
terminal
branch of
DPN
dorsum of the foot
•
1Superior Extensor
Retinacula(SER): it is a thickening
of deep fascia in front of lower part
of leg ,attached to lower part of
the anterior borders of tibia and
fibula.
2- Inferior extensor retinacula(IER) it
is a thickening of deep fascia (Y
shaped)in the dorsum of the foot .
its lateral end ( stem )attached to
calcaneus while the medial end
divided into 2 bands, the upper one
attached to the medial malleolus
,the lower one attached to the
deep fascia on medial
Structures pass deep to the ER
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TA
EHL
Anterior tibial vessels
Deep peroneal (Anterior
tibial )n.
• EDL
• PT
The muscles of the dorsum of the
foot
• is :
• Extensor digitorum
brevis muscle: origin: at
the superior surface of
calcaneus
EHB
EDB
Extensor digitorum brevis
Dorsalis pedis artery
• It is the continuation of the
anterior tibial artery begins at the
anterior surface of the ankle joint
• runs in the dorsum of the foot in
line with the first dorsal inter
digital cleft
• At the proximal end of the 1st
intermetatarsal space , the
dorsalis pedis A. divided into
arcuate and 1st dorsalmetatarsal
arteries
• Branches:
• 1- Lateral tarsal branch: runs
laterally deep to EDB to supply it.
• 2- Medial tarsal branch.
3- Arcuate artery •
LATERAL SIDE OF LEG
• Superior peroneal
retinaculum
• extend from the back of lateral
malleolus to lateral surface of
the calcaneus
• inferior peroneal retinaculum
• extend from superior surfaces
to lateral of the calcaneus
• Its subdivided into two
compartments by fibrous
septa, the upper compartment
transmit the tendon of PB
while the lower compartment
transmit the tendon of PL.
Lateral side of the leg
lie between the •
anterior and posterior
intermuscular septa
These are peroneus
longus and brevis ms.
supplied by the
superficial peroneal
.nerve
and peroneal artery. •
PLM
PBM
EDL
Peroneus longus m
Peroneus m
Superficial peroneal nerve
Descend in the peroneus •
longus m. to reach the
peroneus brevis m. supply
both muscles, then it
descend between it and
extensor digitorum
longus m. pierce the deep
fascia in the distal 1/3 of
the leg and divides into
medial and intermediate
dorsal cutaneous nerves.
The back of the leg
• The transverse intermuscular septa divide the
back of the leg into superficial posterior
compartment and the deep posterior
compartment, they supplied by the tibial
nerve
The back of the leg
TP
FHL
FDL
Tibial nerve
• The princible nerve of the
back of the leg is the Tibial
nerve (L4,5,S1,S2,S3) passes
under the tendinous arch of
the solus muscle and
descend under the
transverse intermuscular
septum superficial to the
posterior tibial vessels. in
the upper part of the leg it
lies on the popliteus m.
then posterior to the tibialis
posterior m.
Tibial nerve
terminate by dividing into medial and
lateral planter n.
The posterior tibial artery
Branches in the leg:
1- peroneal artery :
a-muscular bNutrient branch to
the fibula.
c- Perforating artery dThe peroneal artery
ends by giving posterior
lateral malleollar
Art . Of leg
Flexor retinaculum
Sole of the foot
Deep fascia (planter •
fascia)
Planter aponeurosis •
The great toe compartment
•
This compartment
contains the abductor
hallucis and flexor
hallucis brevis muscles,
the medial planter
nerve and vessels, and
the first metatarsal
bone.
The compartment of the little
toe
• It lies under the lateral
planter fascia and is
bounded by the lateral
intermuscular septum
medially and the by the
attachment of the fascia
to the dorsum of the fifth
metatarsal bone laterally.
It includes the abductor
and flexor digiti minimi
muscles and the fifth
metatarsal bone.
The central compartment of the sole
• It lies deep to the planter
aponeurosis, bounded on
either side by the medial and
lateral intermuscular fascia
which passes from the margins
of the aponeurosis to the
planter interosseous fascia. It
contains the flexor digitorum
brevis muscle, the tendons of
the flexor digitorum longus
and its associated muscles (
quadratus plantae and four
lumbrical muscles), the tendon
of the flexor hallucis
Frolich, Human Anatomy,
Lower LImb
Arteries of the sole of the foot
•
• The medial planter
artery
Lateral planter •
arteryThe planter arch
:
The planter arch
•
It is formed from the lateral
planter artery, the arch
completed medially by its union
with the deep planter branch of
the dorsalis pedis artery. The arch
gives:
• four planter metatarsal s.
• The proper digital artery to the
lateral side of the little.
• Each planter metatarsal artery
gives perforating branches which
passes through the interosseous
space anastomosed with the
corresponding branch of the
dorsal metatarsal artery.
.gives off numerous muscular •
The knee joint
• It is a synovial joint of the
hinge type, it is unstable joint
but this overcome by certain
mechanism:
• 1- expansion of the upper end
of the tibia and lower end of
the femur.
• 2- Presence of the strong
collateral ligament and
tendons.
• 3- Strong capsule.
• 4- Presence of the intraarticular ligaments .
•
The capsule is strengthened by
number of ligaments
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•
include:
1- lateral and medial patellar retinacula
2- Iliotibial tract.
3- The ligamentum patellae which is a continuation of
the quadriceps femoris tendon run on the patella to reach
the tibial tuberosity.
• 4- Oblique popliteal ligament it is the posterior
reinforcement of the capsule of the joint and it is extension
from the tendon of the semimembrenosus m.
• 5- Arcuate popliteal ligament arise from the back of the
head of the fibula and runs medially over the popliteus m.
• 6- Collateral ligament they are tibial and fibular collateral
ligaments. They are very strong ligaments.
Ankle joint
•
• This is a hinge type of
joint between the
trochlea of the talus
with the distal end of
the tibia and medial
malleolus medially and
the lateral surface of
the body of the talus
with the lateral
malleolus laterally
Superficial Inguinal Lymph Nodes
Horizontal Group
Vertical Group
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