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Anterior compartment of leg and Dorsum of foot
The document provides an in-depth overview of the anatomy of the leg and foot, detailing structures such as muscles, blood supply, nerves, and their functions. It highlights the compartmentalization of the leg, the role of various nerves in cutaneous innervation, and the blood flow pathways including the anterior tibial artery and dorsalis pedis artery. Additionally, it discusses clinical conditions related to the compartment, such as foot drop and anterior compartment syndrome.
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Introduction to leg anatomy, featuring tibia and fibula's interconnection and compartmentalization.
Discussion of cutaneous nerves and their regions of supply, including the Tibialis Anterior muscle and blood supply.
Key muscles of the anterior leg including Tibialis Anterior and Extensor Digitorum Longus with their origins, insertions, and actions.
Anatomical details of the anterior tibial artery, its course, superficial position, and related structures.
Anatomical insights on veins accompanying anterior tibial artery and deep peroneal nerve's function.
Clinical relevance regarding conditions like foot drop and the role of retinacula in tendon stability.
Description of the foot's structure including its subdivisions and innervation.
Details regarding the dorsal venous arch, arterial continuation, and muscles on the dorsum of the foot.
Muscle tendon structures, synovial sheaths related to extensor muscles and their organization.
Dorsalis pedis artery's origins, branches, and relation to deep peroneal nerve.
Wrap-up and thank you note for the presentation.
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Anterior compartment of leg and Dorsum of foot
- 3. Contents Introduction Cutaneousinnervation Contents Blood supply Nerve supply Applied anatomy
- 4. Introduction The legis the region between the knee joint and ankle joint, it contains the tibia and fibula. The interossous membrane binds the tibia and fibula together and provides attachment for neighboring muscles.
- 5. Deep fascia ofthe leg The deep fascia surrounds the leg and is continuous above with the deep fascia of the thigh. Below the tibial condyles it is attached to the periosteum on the anterior and medial borders of the tibia. The leg is divided into 3 compartments, by anterior and posterior intermuscular septa, the interosseous membrane and 2 leg bones. Each department having its own muscles,blood supply and nerve supply.
- 6. Cutaneous Nerves Thelateral cutaneous nerve of calf:- it’s a branch of common peroneal nerve supplies the skin on the upper part of the lateral surface of leg. The superficial peroneal nerve :- a branch of CPN supplies the skin of the lower part of the anterolateral surface of the leg. The sapheneous nerve :- a branch of FN, supplies the skin on the anteromedial surface of the leg.
- 8. Contents Muscles :-Tibialis Anterior Extensor digitorum longus Peroneus tertius Extensor hallucis longus. Blood supply :- Anterior tibial artery Nerve supply :- Deep peroneal nerve.
- 10. Tibialis Anterior Origin:-upper half of lateral surface of tibia and interosseous membrane. Insertion:- Medial cuneiform and base of 1st metatarsal bone. Nerve supply:- Deep peroneal nerve or ATN Action:- Dorsiflexion and inversion of foot. Maintenance of the medial longitudinal arch of the foot.
- 12. Extensor Digitorum longus Origin:- Upper 2/4th of anterior surface of fibula and interosseous membrane. Insertion:- Extensor expansion of the lateral 4 toes. Nerve supply :- Deep peroneal nerve. Action :- Extension of the lateral 4 toes and Dorsiflexion of the foot.
- 13. Extensor Hallucis longus Origin :- Middle 1/4th of anterior surface of fibula and interosseous membrane. Insertion :- Base of the distal phalanx of the big toe. Nerve supply :- Deep peroneal nerve. Action :- Extension of the big toe and Dorsiflexion and inversion of the foot.
- 14. Peroneus Tertius Origin:- Lower 1/4th of anterior surface of fibula and interosseus membrane. Insertion :- Medial side of the dorsal aspect of the base of 5th metatarsal bone. Nerve supply :- Deep peroneal nerve. Action :- Dorsiflexion of the foot and eversion of foot.
- 16. Anterior tibial artery Origin :- it is a smaller of the 2 terminal branches of the popliteal artery. Course :- it arises at the level of the lower border of the popliteus muscle and passes forward into the anterior compartment of the leg through an opening in the upper part of the interosseos membrane. It descends on the anterior surface of the interosseus membrane, accompany with deep peroneal nerve.
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- 18. In thelower part of its course, it lies superficial in front of the lower end of the tibia here its pulsations can easily be felt in the living subject. It passed behind the superior extensor retinaculum. Termination :- In front of the ankle joint, the artery becomes the Dorsalis pedis artery.
- 19. Branches Muscular brances:- To Neighboring muscles. Anterior and Posterior tibial recurrent arteries. Anterior medial malleolar and anterior lateral malleolar.
- 21. Veins Venae comitants:- of the anterior tibial artery join those of the posterior tibial artery in the popliteal fossa to form the popliteal vein.
- 22. Deep Peroneal Nerve Origin :- The DPN is one of the terminal branch of the common peroneal nerve. Course :- It arises in the substance of the peroneus longus muscle on the lateral side of the neck of the fibula. The nerve enters the anterior compartment by piercing the anterior fascial septum, it then descends deep to the extensor digitorum longus muscle, first lying lateral then anterior and finally lateral to the anterior tibial artery. The nerve passes behind the extensor retinacula.
- 23. Branches Muscular Branches. Articular branches Cutaneous :- To small area of skin in the web between the 1st and 2nd toes.
- 25. Applied anatomy Footdrop Anterior compartment syndrome Shin splints
- 26. Retinacula of theAnkle The retinacula are thickenings of the deep fascia that keep the long tendons around the ankle joint in position and act as pulleys. They are Extensor retinacula, flexor retinacula, Peroneal retinacula,
- 27. Extensor retinacula • SuperiorExtensor retinacula :- It is attached to the distal ends of the anterior borders of the fibula and tibia. • Inferior Extensor retinacula :- it is a Y- Shaped band located infront of the ankle joint.
- 29. Structures Passes Anteriorto the Extensor retinacula :- Medial to lateral Saphenous nerve and Great saphenous vein Superficial peroneal nerve both branches
- 30. Deep tothe superior and inferior extensor retinacula . Medial to Lateral Tendons of TA EHL Anterior tibial vessels and nerve EDL and Peroneus tertius.
- 32. Foot The footis the region of the lower limb distal to the ankle joint, It is subdivided into the ankle, metatarsus, and the digits. The foot has a superior surface(dorsum) and an inferior (sole). The foot is the body’s point of contact with the ground and provides a stable platform for upright substance, It also levers the body forward during walking.
- 33. Bones of theFoot
- 34. Cutaneous innervation Thedeep peroneal nerve supplies the web of skin between the contiguous sides of the first and second toes The superficial peroneal nerve supplies the remainder of dorsum of foot Medial side by the saphenous nerve, which extends distally to the head of the 1st metatarsal Lateral side by the sural nerve.
- 35. Dorsal Venous arch The dorsal venous arch lies in the subcutaneous tissue over the heads of the metatarsal bones and drains on the medial side into the great saphenous vein and on the lateral side into the small saphenous vein. The GSV leaves the dorsum of foot by ascending into the leg in front of the medial malleolus The SSV ascends into the leg behind the lateral malleolus.
- 36. The partof the blood from the whole foot drains into the arch via digital veins and communicating veins from the sole, which pass through the interosseous spaces.
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- 38. Deep fascia Thinon the dorsum of foot, where it is continuous with the inferior extensor retinaculum MUSCLES Extensor digitorum Brevis Origin :- Upper surface of the calcaneum and from inferior extensor retinaculum Insertion :- By 4 tendons into the proximal phalanx of big toe and long extensor tendons to 2nd , 3rd and 4th toes Nerve :- DPN , Action :- extension of medial of 4 toes.
- 39. Muscle of Dorsumof foot
- 40. Insertion of longExtensor tendons The Tendon of EDL :- Passes deep to the retinacula and tedons divides into 4 , which passes to lateral 4 toes, opp the MP Jt of the 2nd , 3rd and 4th toes , each tendon is joined on its lateral side by a tendon of EDB. The Extensor Expansion :- On the dorsal surface of each toe, the extensor tendon joins the fascial expansion called extensor expansion.
- 41. Near theproximal IPJ, the extensor expansions splits into 3 parts, 1. Central part :- which is inserted into the base of the middle phalanx 2. Two lateral parts :- which converge to be inserted into the base of the distal phalanx. The dorsal expansion, receives the tendons of insertion of the interosseous and lumbrical muscles.
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- 43. Synovial Sheath ofthe tendon of EDL The EDL and PT tendons are surrounded by a common synovial sheath as they pass beneath the extensor retinacula. The sheath extends proximally for a short distance above the malleoli and distally to the level base of the 5th metatarsal bone.
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- 45. Dorsalis Pedis Artery Origin :-It is the direct continuation of the ATA. Course :- it begins midway between the 2 malleoli superficial in position and is crossed by the inferior extensor retinaculum and the first tendon EDB. Relations :- On its lateral side lie the terminal part of the DPN and the EDL tendons, on the medial side lies the tendon of EHL its pulsation can easily felt.
- 46. Termination :-by passing downward into the sole between the 2 heads of the 1st dorsal interosseous muscle, where it joins the lateral plantar artery and completes the plantar arch.
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- 48. Branches The medialand lateral tarsal arteries The 1st dorsal metatarsal artery The Arcuate artery The deep plantar artery
- 49. Deep Peroneal Nerve/ATN The DPN enters the dorsum of foot by passing deep to the extensor retinacula on the lateral side of the DPA. It divides into 1. Medial branch :- supplies the skin of the adjacent sides of the big toe and 2nd toe. 2. Lateral branch :- supplies the EDB muscle 3. Both terminal branch :- give articular branchs to the joints of the foot.
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