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

P L A

Flexor Retinaculum broad band of deep fascia which passes -from medial malleolus -to calcaneus

Muscles Superficial layer – Gastrocnemius m. – Soleus m. – Plantaris m. Deep layer – Popliteus m. – Flexor digitorum longus m. – Flexor hallucis longus m. – Tibialis posterior m. insert to calcaneus with a common tendon “tendo calcaneus” (achille’s tendon) 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