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 Posterior: Deep fascia of leg
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

13. SOLEUS & PLANTARIS

14. POPLITEUS

15. FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGUS & TIBIALIS POSTERIOR

18. S.No
Muscle
Origin
Insertion 1.
Gastrocnemius
Medial 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 1/3rd of posterior surface of calcaneum as Achilis or tendocacaneus 2.
Soleus
Back of head & post.surface of fibula
Soleal line & middle 1/3rd of medial border of tibia
Tendinous soleous arch 3.
Plantaris
Lateral supracondylar line of femur & obliqe popliteal ligament
posterior surface of calcaneum medial to tendocacaneus

19. S.No
Muscle
Origin
Insertion 4.
Popliteus
popliteal groove
Arcuate popliteal Ligament
Lat meniscus
Above Soleal line on post surface of tibia 5.
Flexor digitorum longus
Upper 2/3rd 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 3/4th of post. Surface of fibula & interosseous membrane
Planter surface of distal phalanx of great toe 7.
Tibialis posterior
Upper 2/3rd 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 2nd ,3rd & 4th metatarsal except talus

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) 2nd metatarsal
D) 4th metatarsal