Presentation on theme: "Anterior, Lateral Compartments of the Leg & Dorsum of the Foot"— Presentation transcript:
1Anterior, Lateral Compartments of the Leg & Dorsum of the Foot Dr Jamila EL MedanyDr Saeed Vohra&
2OBJECTIVES At the end of the lecture, student should be able to: Identify the deep fascia of legIdentify the fascial compartments of the leg.Describe the anatomy of the anterior & lateral compartments.List the contents of each compartment (muscles, vessels & nerves).Describe the anatomy and contents of the dorsum of the foot
3Fascial Compartments of the Leg The deep fascia surrounds the leg and attached to anterior & medial borders of tibia.Intermuscular SeptaTwo 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.
4Compartments of the Leg Together with the interosseus membrane, the septa divide the leg into 3 compartments : Anterior2-Lateral (Peroneal)3-PosteriorEach compartment has its own muscles, blood supply and nerve supply.
5Anterior Compartment Muscles Artery Nerve Tibial Deep Peroneal 1. TibialisAnteriorTibialDeepPeroneal2. Ext DigLongus3. Ext Hllucius4. Peroneus Tertius
7ActionOriginInsertionTibialis anteriorLateral surface of shaft of tibia & interosseous membrane.Medial cuneiform & base of 1st metatarsal boneDorsi flexion &Inversion of foot and maintains Medial Long archExtensor dig longusAnterior surface of shaft of fibulaExtensor expansion of lat (4) toesExtension of toes & Dorsi flexion of footExtensor hallucis longusBase of distal phalanx of great toeDorsi flexion& Inversion of the foot and extension of big toePeroneus tertiusBase of 5th metatarsal boneDorsiflexion and Eversion of the foot.
8Extensor RetinaculaThickening of deep fascia that keep the long tendons around ankle joint in positionSuperior Extensor Retinaculum :Attached to anterior borders of tibia & fibula above ankleInferior Extensor Retinaculum:Y-shaped band located inferior to ankle
9Structures passing Deep to Extensor Retinacula From Medial to Lateral:1.Tibialis anterior2. Extensor Hallucis longus.3. Anterior tibial Vessels4. Deep peroneal Nerve.5. Extensor Digitorum longus.6.Peroneus tertius.
10Lateral compartment of Leg MusclesNerveArtery1.PeroneusLongusSuperficialPeronealPeroneal (Fibular)2. PeroneusBrevis
11Lateral surface of shaft of fibula InsertionActionOriginPeroneus longusLateral surface of shaft of fibulaMedial cuneiform & base of 1st metatarsal bonePlantar flexion & Eversion of the foot and supports lateral longitudinal archPeroneus brevisBase of 5th metatarsal bone
12Peroneal Retinacula Superior & Inferior peroneal retinacula Connect the lateral malleolus to calcaneum & hold the tendons of peroneus longus & brevisSynovial Sheaths of Peroneal Longus & BrevisTendons of peronei are surrounded by a single common tubular synovial sheath, deep to inferior peroneal retinaculum they have separate sheaths
13Deep Fascia of Dorsum of Foot It is very thin, but just distal to ankle joint, it isthickened to form Inferior extensor retinaculum
14Dorsum of Foot Artery Muscle Nerve Ext Dig Brevis Dorsalis Pedis Deep Peroneal
15Ext Digitorum Brevis Origin Insertion Action Inferior extensor R & CalcaneumExtensor Hallucius Brevis to base of proximal ph of big toe. Other (3) to EX ExpansionExtension ofIP& Metatarsoph Jof 1st, 2nd, 3rd& 4th toes(during Dorsi flex).
16Insertion of Long Extensor Tendons The tendon of Ex dig longus divides into (4) to the lateral four toes.Each tendon to the 2nd , 3rd & 4th toes is joined on its lateral side by a tendon of Ex dig brevis.The extensor tendons formA 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.
17Synovial Sheaths of Extensor Tendons on the Dorsum of Foot 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 5th metatarsal bone.