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Anterior, Lateral Compartments of the Leg & Dorsum of the Foot Dr Jamila EL Medany Dr Saeed Vohra &

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Presentation on theme: "Anterior, Lateral Compartments of the Leg & Dorsum of the Foot Dr Jamila EL Medany Dr Saeed Vohra &"— Presentation transcript:

1 Anterior, Lateral Compartments of the Leg & Dorsum of the Foot Dr Jamila EL Medany Dr Saeed Vohra &

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3 The deep fascia surrounds the leg and attached to anterior & medial borders of tibia. Intermuscular Septa Two pass from the deep aspect of this fascia to be attached to : Anterior border of fibula (Anterior fascial septum) Posterior border of fibula (Posterior fascial septum) The deep fascia surrounds the leg and attached to anterior & medial borders of tibia. Intermuscular Septa Two pass from the deep aspect of this fascia to be attached to : Anterior border of fibula (Anterior fascial septum) Posterior border of fibula (Posterior fascial septum) Interosseous membrane: A thin& strong membrane, that binds the interosseous borders of tibia & fibula. It binds the two bones and provides attachment for muscles. Interosseous membrane: A thin& strong membrane, that binds the interosseous borders of tibia & fibula. It binds the two bones and provides attachment for muscles.

4 Together with the interosseus membrane, the septa divide the leg into 3 compartments : 1-Anterior 2-Lateral (Peroneal) 3-Posterior Each compartment has its own muscles, blood supply and nerve supply. Together with the interosseus membrane, the septa divide the leg into 3 compartments : 1-Anterior 2-Lateral (Peroneal) 3-Posterior Each compartment has its own muscles, blood supply and nerve supply.

5 Anterior Compartment MusclesArteryNerve 1. Tibialis Anterior Tibial Deep Peroneal 2. Ext Dig Longus 3. Ext Hllucius Longus 4. Peroneus Tertius

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7 Tibialis anterior Lateral surface of shaft of tibia & interosseous membrane. Medial cuneiform & base of 1 st metatarsal bone Dorsi flexion &Inversion of foot and maintains Medial Long arch Extensor dig longus Anterior surface of shaft of fibula Extensor expansion of lat (4) toes Extension of toes & Dorsi flexion of foot Extensor hallucis longus Anterior surface of shaft of fibula Base of distal phalanx of great toe Dorsi flexion& Inversion of the foot and extension of big toe Peroneus tertius Anterior surface of shaft of fibula Base of 5 th metatarsal bone Dorsiflexion and Eversion of the foot. Origin Insertion Action

8 Thickening of deep fascia that keep the long tendons around ankle joint in position Superior Extensor Retinaculum : Attached to anterior borders of tibia & fibula above ankle Inferior Extensor Retinaculum: Y-shaped band located inferior to ankle Thickening of deep fascia that keep the long tendons around ankle joint in position Superior Extensor Retinaculum : Attached to anterior borders of tibia & fibula above ankle Inferior Extensor Retinaculum: Y-shaped band located inferior to ankle

9 From Medial to Lateral: 1.Tibialis anterior 2. Extensor Hallucis longus. 3. Anterior tibial Vessels 4. Deep peroneal Nerve. 5. Extensor Digitorum longus. 6.Peroneus tertius. From Medial to Lateral: 1.Tibialis anterior 2. Extensor Hallucis longus. 3. Anterior tibial Vessels 4. Deep peroneal Nerve. 5. Extensor Digitorum longus. 6.Peroneus tertius.

10 MusclesNerveArtery 1.Peroneus Longus Superficial Peroneal Peroneal (Fibular) 2. Peroneus Brevis

11 Peroneus longus Lateral surface of shaft of fibula Medial cuneifor m & base of 1 st metatars al bone Plantar flexion & Eversion of the foot and supports lateral longitudina l arch Peroneus brevis Lateral surface of shaft of fibula Base of 5 th metatars al bone Plantar flexion & Eversion of the foot and supports lateral longitudinal arch Origin Insertion Action

12 Superior & Inferior peroneal retinacula Connect the lateral malleolus to calcaneum & hold the tendons of peroneus longus & brevis Superior & Inferior peroneal retinacula Connect the lateral malleolus to calcaneum & hold the tendons of peroneus longus & brevis Tendons of peronei are surrounded by a single common tubular synovial sheath, deep to inferior peroneal retinaculum they have separate sheaths

13 It is very thin, but just distal to ankle joint, it is thickened to form Inferior extensor retinaculum It is very thin, but just distal to ankle joint, it is thickened to form Inferior extensor retinaculum

14 Muscle Artery Nerve Ext Dig Brevis Dorsalis Pedis Deep Peroneal

15 OriginInsertionAction Inferior extensor R & Calcaneum Extensor Hallucius Brevis to base of proximal ph of big toe. Other (3) to EX Expansion Extension of IP& Metatarsoph J of 1 st, 2 nd, 3 rd& 4th toes (during Dorsi flex). Ext Digitorum Brevis

16 Insertion of Long Extensor Tendons The tendon of Ex dig longus divides into (4) to the lateral four toes. Each tendon to the 2 nd, 3 rd & 4 th toes is joined on its lateral side by a tendon of Ex dig brevis. The extensor tendons form A fascial Expansion (Extensor Expansion) on the dorsum of each toe. The expansion divides into (3) parts: Central: inserted into the base of middle phalanx. Two lateral : inserted into the base of distal ph. The EX receives insertion of Interossei & Lumbrical muscles. The tendon of Ex dig longus divides into (4) to the lateral four toes. Each tendon to the 2 nd, 3 rd & 4 th toes is joined on its lateral side by a tendon of Ex dig brevis. The extensor tendons form A fascial Expansion (Extensor Expansion) on the dorsum of each toe. The expansion divides into (3) parts: Central: inserted into the base of middle phalanx. Two lateral : inserted into the base of distal ph. The EX receives insertion of Interossei & Lumbrical muscles.

17 A separate sheath for each of: Tibialis anterior Extensor hallucis longus A common sheath for : Extensor digitorum longus & peroneus tertius, It extends to the level of base of 5 th metatarsal bone. A separate sheath for each of: Tibialis anterior Extensor hallucis longus A common sheath for : Extensor digitorum longus & peroneus tertius, It extends to the level of base of 5 th metatarsal bone.

18 THANK YOU


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