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Lower Limb Leg



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Lower Limb Leg

  1. 1. ANATOMY OF THE LEG<br />By:<br />Dr: Mohammed Faez<br />
  2. 2. The Leg<br />It is the portion between the knee and the ankle.<br />It is comprised of two long bones (tibia –medially and fibula -laterally).<br />
  3. 3. The Leg<br />The leg is divided into four compartments<br />Anterior compartment<br />Lateral compartment<br />(Superficial) Posterior compartment<br />Deep posterior compartment<br />
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  7. 7. Anterior Compartment<br />Anterior compartment contains the muscles that dorsiflex the ankle and extend the toes.<br />Contains Anterior Tibial Nerve<br />Contains Anterior Tibial Artery.<br />
  8. 8. Anterior Compartment<br />Blood supply:<br />Anterior tibial artery.<br />Innervation:<br />Deep peroneal (fibular) nerve.<br />
  9. 9. Anterior Compartment<br />The muscles of the compartment are:<br />Tibialis anterior<br />Extensor hallucislongus<br />Extensor digitorumlongus<br />Fibularistertius (peroneustertius)<br />
  10. 10. Anterior Compartment<br />TA:<br />Tibialis anterior<br />EDL:<br /> Extensor digitorumlongus<br />EHL:<br /> Extensor hallucislongus<br />PT:<br />Peroneustertius<br />
  11. 11. Anterior Compartment<br />Tibialis anterior (TA) <br />Origin -lateral condyle of tibia, upper half/lateral surface of tibia, interosseous membrane<br />Insertion - medial cuneiform, base of 1st metatarsal<br />Nerve - deep fibular (peroneal) (L4-5)<br />Action - ankle dorsiflexion, forefoot inversion <br />
  12. 12. Anterior Compartment<br />Extensor DigitorumLongus (EDL)<br />Origin - lateral condyle of tibia, ant surface of fibula, interosseous membrane<br />Insertion - dorsum of base of middle phalanx, dorsum of base of distal phalanx<br />Nerve - deep fibular (peroneal) (L5-S1)<br />Action - extension of toes, dorsiflexion of ankle<br />
  13. 13. Anterior Compartment<br />Extensor HallucisLongus (EHL) <br />Origin - middle ½ of ant fibula, IM<br />Insertion - distal phalanx of the great toe<br />Nerve - deep fibular (peroneal) (L5-S1)<br />Action - extend the great toe, dorsiflex ankle<br />
  14. 14. Anterior Compartment<br />Fibularis (Peroneus) Tertius<br />Origin - distal 1/3 ant fibula, interosseous membrane<br /> Insertion - dorsum shaft of 5th metatarsal<br />Nerve - deep fibular (peroneal) (L5-S1)<br /> Action - forefoot eversion, weak ankle dorsiflexion<br />
  15. 15. Lateral Compartment<br />Lateral compartment contains the muscles that Everters of the foot (turns foot outward)<br />Contains the superficial peroneal nerve<br />
  16. 16. Lateral Compartment<br />Blood supply:<br /> No major arteries in lateral compartment.<br />Muscular branches arise from the peroneal artery (Branch of posterior tibial).<br />Nerve supply:<br />Superficial peroneal (fibular) nerve<br />
  17. 17. Lateral Compartment<br />Muscles:<br />PeroneusLongus<br />PeroneusBrevis<br />
  18. 18. Lateral Compartment<br />Fibularis (Peroneus) Longus (FL)<br />Origin - head, upper 2/3 lateral surface of fibula<br />Its tendon courses behind lateral malleolus, underneath the fibular trochlea, and lies in the groove in the cuboid bone before going to its place of insertion<br />Insertion - inferolateral surface of medial cuneiform ,<br /> 1st metatarsal on its inferior surface<br />Nerve - superficial fibular (peroneal) (L5-S1)<br />Action - forefoot eversion, ankle plantar flexion<br />
  19. 19. Lateral Compartment<br />Fibularis (Peroneus) Brevis (FB)<br />Origin - lower 2/3 lateral fibula<br />Courses behind lateral malleolus and underneath the fibular trochlea<br />Insertion - tuberosity on base of 5th metatarsal<br />Nerve - superficial fibular (peroneal) (L5-S1)<br />Action - forefoot eversion, ankle plantar flexion<br />
  20. 20. (Superficial) Posterior compartment<br />Posterior compartment contains the plantar flexors muscles. <br />Contains:<br />Short saphenous vein <br />Peroneal communicating branch of the common peroneal nerve <br />Medial cutaneous nerve of the calf <br />Sural nerve<br />
  21. 21. (Superficial) Posterior compartment<br />Innervation:<br />Tibial nerve.<br />
  22. 22. (Superficial) Posterior compartment<br />Muscles:<br />Gastrocnemius<br />Plantaris<br />Soleus<br />
  23. 23. (Superficial) Posterior compartment<br />Gastrocnemius<br />Origin – medial and lateral condyles of femur<br />Insertion –Achilles tendon to calcaneum<br />Nerve -Tibial nerve<br />Action – Plantarflexes foot; flexesleg<br />Blood supply:<br /> The popliteal artery<br />
  24. 24. (Superficial) Posterior compartment<br />Plantaris<br />Origin – lateral supracondylar ridge of femur<br />Insertion – calcaneum<br />Nerve -Tibial nerve<br />Action – Plantarflexes foot; flexesleg<br />
  25. 25. (Superficial) Posterior compartment<br />Soleus<br />Origin – Shafts of tibia and fibula<br />Insertion – Achilles tendon into calcaneum<br />Nerve -Tibial nerve<br />Action – Plantar flexor of foot<br />blood supply <br />Peroneal artery proximally and the posterior tibial artery distally<br />
  26. 26. Deep Posterior Compartment<br />Blood supply:<br /> The posterior tibial artery<br />Innervation:<br />Tibialnerve.<br />
  27. 27. Deep Posterior Compartment<br />Muscles:<br />Popliteus<br />Flexor digitorumlongus<br />Flexor hallucislongus<br />Tibialis posterior<br />
  28. 28. Deep Posterior Compartment<br />Popliteus<br />Origin - lateral condyle of femur<br /> and lateral meniscus<br />Insertion – proximal shaft of tibia<br />Nerve -Tibial nerve<br />Action – flex and medially rotate leg<br />
  29. 29. Deep Posterior Compartment<br />Flexor digitorumlongus<br />Origin - shaft of tibia<br />Insertion - distal phalanges of toe 2-5 <br />Nerve -Tibial nerve<br />Action – plantarflex and invert foot, flex toe<br />
  30. 30. Deep Posterior Compartment<br />Flexor hallucislongus<br />Origin - shaft of fibula<br />Insertion - base of distal phalanx of big toe.<br />Nerve -Tibial nerve<br />Action - plantarflex and invert foot, flex toe<br />
  31. 31. Deep Posterior Compartment<br />Tibialis posterior<br />Origin – shafts of tibia and fibula & interosseous membrane<br />Insertion - Major tendon insertion passes to tuberosity of navicular.<br /> Posterior tendon slips pass to calcaneus, plantar surface of all 3 cuneforms, cuboid and to base of 2nd, 3rd, and 4th metatarsals.<br />-- Nerve -Tibial nerve<br />Action - plantarflex and invert foot<br />
  32. 32. Pop:<br />popliteus<br />TP:<br />tibialis post.<br />PL:<br />peroneuslongus<br />FD:<br /> flex. dig. long.<br />PB:<br />peroneusbrevis<br />FHL:<br /> flex. hall. long.<br />
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  39. 39. THANK YOU<br />