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Lower Leg (Nerve Supply (Sciatic nerve (Location (continues into the back…
Lower Leg
Nerve Supply
Femoral nerve
origin
L2,3,4
motor to
iliacus
pectineus
quadriceps femoris
Supplies
skin of thigh
Anterior
Medial
InterMedial
anterior Compartment
Obturator nerve
Origin
L2,3,4
Location
divides around adductor longus & brevis
passes though obturator foramen into thigh
motor to
obturator externus
adductors (+ magnus)
pectineus
supplies
skin of medial thigh
Sciatic nerve
Origin
L4,5 S1,2,3
Location
continues into the back of thigh
emerges from pelvis below piriformis
motor to
hamstrings
adductor magnus
posterior cutaneous nerve of thigh
divides at the popliteal fossa into
tibial
common fibular nerves
Bones
Shin Region
Long Bones
Tibia
Composed of...
tibial tuberosity
facet
Articulates with Head of fibula
anterior border
interosseous border
soleal line
medial malleolus
fibular notch
concave articular surface
Articulates with talus
medial and lateral condyles
intercondylar area
Anterior
Fibula
Composed of...
interosseous border
lateral malleolus
facet
Articulates with talus
malleolar fossa
for insertion of
anterior talofibular ligament of ankle joint
head & apex [styloid process] & facet
articulates with tibial condyle
Foot Region
Three Groups
tarsals
calcaneus
largest
forms prominence of heel
tuberosity
sustentaculum tali
[medial aspect of calcaneus]
talus
neck
head
body
navicular
prominent tuberosity
cuboid
groove on its plantar surface
cuneiform bones
medial
intermediate
lateral
metatarsals
bases
articulate with...
cuneiform bones
heads articulate with phalanges
phalanges
3 in four lateral toes
2 in 1st toes
Fascia
Superficial
General
deep fascia thickened
forms
retinaculae [synovial] to hold tendons in place
retinaculae
attached to
fibula
calcaneus
plantar aponeurosis
tibia
flexor retinaculum
binds tendons of posterior compartment
extensor [superior & inferior bands]
cover tendons of anterior compartment
fibular (peroneal) retinaculae
cover tendons of lateral compartment
Deep
Divides into
posterior
anterior
lateral
compartment syndrome most common in this region
Posterior vs Anterior
posterior the most expansile
subdivided into
superficial
deep
anterior compartment is least expansile
Muscles
posterior compartment of Leg
superficial muscles
plantaris
(absent in 10%)
action
plantarflexion of foot
flexion of knee
insertion
medial side of
tendo calcaneus
origin
lateral supracondylar ridge
gastrocnemius
action
plantarflexion of foot
flexion of knee
provides force for
propulsion in walking
running
leaping
insertion
tendo calcaneus
origin
fabella
Mostly in lateral head
sometimes in medial head
lateral heads from lateral femoral condyles
medial from medial condyles
soleus
insertion
tendo calcaneus
Attaches Muscles to Heel of the foot
Action
plantarflexion of foot
more of a postural role in standing/balancing
weight of body passes anterior to ankle joint (loose in erect position)
soleus acts as strong brace behind joint
origin
tibia
below soleal line
posterior aspect head & shaft of fibula
& fibrous
arches across I-O membrane [covering popliteal vessels & tibial nerve]
Deep Muscles
popliteus
action
forms floor of
popliteal fossa
flexion of knee
rotates
femur laterally
tibia medially
important stabilizer
popliteofibular ligament
resists external rotation of tibia on femur
Unlocks the Knee
insertion
lateral femoral condyle
origin
posterior tibia
above soleal line
within capsule of knee joint
sends slips to lateral meniscus
flexor hallucis longus
origin
posterior
distal 1/3 fibula
I-O membrane
insertion
distal phalanx 1st digit [between sesamoid bones]
action
flexion of 1st digit
major role
in toe-off phase of gait
flexor digitorum longus
origin
posterior tibia
I-O membrane
insertion
distal phalanges lateral 4 toes [via split in FDB]
action
flexion toes
plantarflexion of foot
fibres of FHL extend quite far distally
can impinge on calcaneal tendon in athletes
tibialis posterior
origin
tibia
I-O membrane [between FDL & FHL]
fibula
insertion
plantar surfaces of tuberosity of
navicular
cuneiforms
action
plantarflexion
inversion of foot
Lateral Compartment
fibularis longus
origin
upper lateral aspect of fibula
head lateral aspect of fibula
insertions
medial cuneiform
1st metatarsal
action
eversion of foot
plantarflexion of ankle
fibularis brevis
origin
lateral aspect of fibula
insertions
tubercle on base of 5th metatarsal
action
dorsiflexion of ankle
eversion
Anterior
tibialis anterior
origin
lateral aspect tibial shaft
I-O membrane
insertions
medial cuneiform
1st metatarsal
action
dorsiflexion of ankle
inversion of foot
extensor hallucis longus
origin
medial aspect of fibula
I-O membrane
insertions
base of distal phalanx of 1st toe
action
extension of hallux
dorsiflexion of ankle
extensor digitorum longus
origin
lateral tibial condyle
fibula
I-O membrane
insertions
phalanges of lateral 4 toes
action
extension of toes
dorsiflexion of ankle
MTPJ (over proximal phalanges)
gives rise to expansion interconnected across toes
form slips to middle & distal phalanges
fibularis (peroneus) tertius
(Absent in 10%)
origin
distal 1/3 fibula
I-O membrane
insertions
base of 5th metatarsal
action
dorsiflexion
eversion of foot
working in conjunction with EDL & TA
levels foot & helps toes clear ground