Back Of Leg

advertisement

BACK OF LEG

Dr. Rakesh Kumar Verma

Assistant Professor

Department of Anatomy

KGMU UP Lucknow

INTRODUCTION

• Synonyms:

Flexor compartment/ region/calf compartment/Posterior

Posterior Crural

BOUNDARIES

Anterior-Posterior surface of: tibia, interosseous membrane, fibula, post. Intermuscular septum

Posterior: fascia of leg

Deep

STRUCTURE (CONTENTS)

• Skin & Superficial fascia

• Cutaneous nerves & vessels

• Lymphatics

• Fibro fatty tissue

• Deep fascia

• Muscles, nerves & vessels

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

CUTANEOUS VESSELES

• Great Saphenous Vein

• Small Saphenous Vein

• Small tributeries

• Lymhatics

• Also known as fascia cruris

• Modifications:

 Intermuscular septum

 Flexor retinaculum

DEEP FASCIA

FLEXOR RETINACULUM

• Attachment:

 Anterior-Post. Border

& tip of medial malleolus

 Postero-lateralmedial tubercle of calcaneum

MUSCLES OF BACK OF LEG

• Gastrocnemius

• Soleus

• Plantaris

• Popliteus

• Flexor digitorum longus

• Flexor hallucis longus

• Tibialis posterior

GASTROCNEMIUS

SOLEUS & PLANTARIS

POPLITEUS

FLEXOR DIGITORUM LONGUS,

FLEXOR HALLUCIS LONGUS & TIBIALIS

POSTERIOR

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

2.

Soleus Back of head & post.surface of fibula

Soleal line & middle 1/3 rd of medial border of tibia

Tendinous soleous arch

Middle 1/3 rd of posterior surface of calcaneum

Achilis tendocacaneus as or

3.

Plantaris Lateral supracondylar line of femur & obliqe popliteal ligament posterior surface of calcaneum medial to tendocacaneus

S.N

o

Muscle

4.

Popliteus

Origin Insertion popliteal groove

Arcuate popliteal Ligament

Lat meniscus

Above Soleal line on post surface of tibia

5.

Flexor digitorum longus

6.

Flexor hallucis longus

Upper 2/3 rd of medial part of the post. Surface of tibia below soleal line

Lower 3/4 th of post. Surface of fibula & interosseous membrane

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

Planter surface of distal phalanx of lat.

4 toes

Planter surface of distal phalanx of great toe

Tuberosity of navicular bone & also on tarsals and 2 nd ,3 rd

& 4 th metatarsal except talus

NERVE SUPPLY & ACTIONS

• Tibial nerve for all muscle

• Plantar flexion

• Inversion

• Maintained longitudinal arch

• Unlocking of knee by popliteus

• Flexion at knee joint

20

POSTERIOR TIBIAL ARTERY

It Is Large terminal branch of popliteal artery

POSTERIOR TIBIAL ARTERY

• Branches:

 Peroneal artery

 Muscular

 Nutrient

 Cicumflex fibular

 Communicating

 Malleolar

 Calcaneal

 Terminal-medial & lateral planter artery

TIBIAL NERVE

• Large terminal branch of sciatic nerve in popliteal fossa

• Branches:

 Muscular

 Cutaneous

 Articular

 Terminal-medial & lateral planter nerve

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

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

QUESTION -1

• Unlocking of knee is done by:

 A) Soleus

 B) Plantaris

 C) Popliteus

 D) Gastrocnemius

QUESTION -2

• All muscles help in plantar flexion except:

 A) Tibialis Posterior

 B) Gastrocnemius

 C) Soleus

 D) Popliteus

QUESTION -3

• Which muscle is known as peripheral heart:

 A) Soleus

 B) Plantaris

 C) Popliteus

 D) Gastrocnemius

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

QUESTION -5

• Tibialis posterior is attached on the following bone except-

 A) Talus

 B) Navicular

 C) 2 nd metatarsal

 D) 4 th metatarsal

Download