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BACK OF LEG Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow.

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Presentation on theme: "BACK OF LEG Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow."— Presentation transcript:

1 BACK OF LEG Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow

2 INTRODUCTION Synonyms: Flexor compartment/Posterior compartment/ Posterior Crural region/calf

3 BOUNDARIES Anterior-Posterior surface of: tibia, interosseous membrane, fibula, post. Intermuscular septum Posterior: Deep fascia of leg

4 STRUCTURE (CONTENTS) Skin & Superficial fascia Cutaneous nerves & vessels Lymphatics Fibro fatty tissue Deep fascia Muscles, nerves & vessels

5 CUTANEOUS NERVES Saphenous Nerve Post. division of medial cut. nerve of thigh Post. cut. nerve of thigh Sural Nerve Lateral cut. nerve of thigh Sural communicating nerve Medial calcaneal branches of tibial nerve

6 CUTANEOUS VESSELES Great Saphenous Vein Small Saphenous Vein Small tributeries Lymhatics

7 DEEP FASCIA Also known as fascia cruris Modifications:  Intermuscular septum  Flexor retinaculum

8 FLEXOR RETINACULUM Attachment:  Anterior-Post. Border & tip of medial malleolus  Postero-lateral- medial tubercle of calcaneum

9 MUSCLES OF BACK OF LEG Gastrocnemius Soleus Plantaris Popliteus Flexor digitorum longus Flexor hallucis longus Tibialis posterior

10 GASTROCNEMIUS

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13 SOLEUS & PLANTARIS

14 POPLITEUS

15 FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGUS & TIBIALIS POSTERIOR

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18 S.NoMuscleOriginInsertion 1.GastrocnemiusMedial Head: Posterosuperior depression on medial condyle, popliteal surface of Femur & cpusule of knee joint Lateral head: Lateral condyle & supracondylar line of femur, cpusule of knee joint Middle 1/3 rd of posterior surface of calcaneum as Achilis or tendocacaneus 2.SoleusBack of head & post.surface of fibula Soleal line & middle 1/3 rd of medial border of tibia Tendinous soleous arch 3.PlantarisLateral supracondylar line of femur & obliqe popliteal ligament posterior surface of calcaneum medial to tendocacaneus

19 S.N o MuscleOriginInsertion 4.Popliteus popliteal groove Arcuate popliteal Ligament Lat meniscus Above Soleal line on post surface of tibia 5.Flexor digitorum longus Upper 2/3 rd of medial part of the post. Surface of tibia below soleal line Planter surface of distal phalanx of lat. 4 toes 6.Flexor hallucis longus Lower 3/4 th of post. Surface of fibula & interosseous membrane Planter surface of distal phalanx of great toe 7.Tibialis posterior Upper 2/3 rd of lateral part of the post. Surface of tibia below soleal line, Post. Surface of fibula & interosseous membrane Tuberosity of navicular bone & also on tarsals and 2 nd,3 rd & 4 th metatarsal except talus

20 20 NERVE SUPPLY & ACTIONS Tibial nerve for all muscle Plantar flexion Inversion Maintained longitudinal arch Unlocking of knee by popliteus Flexion at knee joint

21 POSTERIOR TIBIAL ARTERY It Is Large terminal branch of popliteal artery

22 POSTERIOR TIBIAL ARTERY Branches:  Peroneal artery  Muscular  Nutrient  Cicumflex fibular  Communicating  Malleolar  Calcaneal  Terminal-medial & lateral planter artery

23 TIBIAL NERVE Large terminal branch of sciatic nerve in popliteal fossa Branches:  Muscular  Cutaneous  Articular  Terminal-medial & lateral planter nerve

24 Posterior Tibial Vein Formation at the level of lower border of popliteus By joining of venae commitantes running along Ant. & post tibial artery Finally drain in to popliteal vein

25 APPLIED ANATOMY Tennis leg Tendon of plantaris used as a graft Rupture of tendocalcaneus Ankle jerk Deep vein thrombosis Arterial insufficiency Varicose vein Tarsal tunnel syndrome

26 QUESTION -1 Unlocking of knee is done by:  A) Soleus  B) Plantaris  C) Popliteus  D) Gastrocnemius

27 QUESTION -2 All muscles help in plantar flexion except:  A) Tibialis Posterior  B) Gastrocnemius  C) Soleus  D) Popliteus

28 QUESTION -3 Which muscle is known as peripheral heart:  A) Soleus  B) Plantaris  C) Popliteus  D) Gastrocnemius

29 QUESTION -4 False statement about popliteus is:  A) Has intracapsular origin  B)Pulls the medial meniscus backwards and prevent it from being trapped at the beginning of flexion  C) Innervated by tibial nerve  D) Unlock the knee joint

30 QUESTION -5 Tibialis posterior is attached on the following bone except-  A) Talus  B) Navicular  C) 2 nd metatarsal  D) 4 th metatarsal


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