Transcript SO_cyprus_14-15_posterior leg_23

Posterior Aspect of the Leg
Prof. Dr. Selda Önderoğlu
.
Cutaneous Nerves
• Saphenous n. (from femoral n.)
• Posterior femoral cutaneous n.
(from sacral plexus)
• Lateral cutaneous n. of leg
(from common fibular (peroneal)
n.)
• Sural n. (from tibial n & common
fibular (peroneal) n.)
Superficial veins
• Small saphenous vein
– pierces the roof of
the popliteal fossa
and drains into the
popliteal vein
Deep fascia of leg(Fascia cruris)
• interosseous membrane and
the “crural intermuscular
septa” divide the leg into 3
crural compartments:
1-Anterior comp.
2-Lateral comp.
3-Posterior comp.: contains 2
group of muscles:
– superficial
– deep
A
L
P
Flexor Retinaculum
• broad band of deep
fascia which passes
-from medial
malleolus
-to calcaneus
Muscles
Superficial layer
– Gastrocnemius m.
– Soleus m.
– Plantaris m.
insert to calcaneus
with a common
tendon “tendo
calcaneus”
(achille’s tendon)
Deep layer
–
–
–
–
Popliteus m.
Flexor digitorum longus m.
Flexor hallucis longus m.
Tibialis posterior m.
pass deep
to the “flexor
retinaculum”
SUPERFICIAL LAYER
Gastrocnemius m.
• Most superficial of the
muscles in the posterior
crural compartment
• O: 2 heads, lat & med
condyles of femur, they
come together at the
inferior margin of the
popliteal fossa
• I: Calcaneous, via “tendo
calcaneus” (aschilles
tendon)
• N: Tibial n.
• F: Flexion (plantar flexion)
of foot & leg
Soleus m.
•
•
•
•
-Located deep to
gastrocnemius
O: Soleal line, upper part
of fibula
I: calcaneus via “tendo
calcaneus”
N: Tibial nerve
F: Flexion of foot
Gastrocnemius+soleus mm:
Triceps surae m.
Plantaris m.
---Small muscle; variable in
size and extend, it may be
absent.
• O: Lat supracondylar area
of the femur
• I: Medial part of tendo
calcaneus
• N: Tibial n.
• F: assists flexion of leg,
plantar flexion of the foot
DEEP LAYER:
Popliteus m.
---Thin, triangular muscle
• O: Lat condyle of femur &
arcuate popliteal lig.
• I: Post surface of tibia
• N: Tibial nerve
• F: Flexion & medial
rotation of leg
Flexor digitorum
longus m.
• O: Post surface of tibia
below soleal line
• I:Bases of distal
phalanges of 2-5
• N.:Tibial nerve
• F: Flexion of toes 2-5 &
foot, inversion of foot,
helps to maintain the
medial longitudinal
arch of foot
Flexor hallucis longus
m.
•
•
•
•
--The long, powerful and
largest muscle of deep layer
O: Lower part of post
surface of fibula,
interosseos memb.
I: Base of distal phalanx of
hallux (big toe of foot)
N.: Tibial nerve
F: Flexion of hallux & foot,
also important in holding
the leg in the normal
position of foot.
Tibialis
posterior m.
• The deepest m in the
posterior crural
compartment
• O: Lateral part of post
surface of tibia below soleal
line, post surface of fibula,
interosseous membrane
• I: Sustentaculum tali,
tuberosity of navicular b,
talus, cuneiform bb, cuboid
b, 2-4 metatarsal bb
• N.: Tibial n.
• F: Plantar flexes and inverts
foot
cross
Posterior tibial artery
• it begins at the distal
border of the popliteus
muscle
• it is larger terminal branch
of the popliteal artery
• it is accompanied by the
tibial nerve
• Branches:
–
–
–
–
–
–
Fibular ( peroneal) a
Circumflex fibular a
Medial malleolar a
Calcaneal brs
Nutrient a of tibia
Lat & med plantar aa
Fibular (peroneal) artery
•
•
•
•
•
•
Muscular branches
Nutrient a. to fibula
Perforating br.
Communicating br.
Lateral malleolar brr.
Calcaneal brr.
Tuberosity of tibia