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Published byDominick Lawson Modified over 9 years ago
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BACK OF LEG Dr. Rakesh Kumar Verma Assistant Professor
Department of Anatomy KGMU UP Lucknow
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INTRODUCTION Synonyms:
Flexor compartment/Posterior compartment/ Posterior Crural region/calf
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BOUNDARIES Posterior: Deep fascia of leg
Anterior-Posterior surface of: tibia, interosseous membrane, fibula, post. Intermuscular septum Posterior: Deep fascia of leg
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STRUCTURE (CONTENTS) Skin & Superficial fascia
Cutaneous nerves & vessels Lymphatics Fibro fatty tissue Deep fascia Muscles, nerves & vessels
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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
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CUTANEOUS VESSELES Great Saphenous Vein Small Saphenous Vein
Small tributeries Lymhatics
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DEEP FASCIA Also known as fascia cruris Modifications:
Intermuscular septum Flexor retinaculum
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FLEXOR RETINACULUM Attachment:
Anterior-Post. Border & tip of medial malleolus Postero-lateral- medial tubercle of calcaneum
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MUSCLES OF BACK OF LEG Gastrocnemius Soleus Plantaris Popliteus
Flexor digitorum longus Flexor hallucis longus Tibialis posterior
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GASTROCNEMIUS
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SOLEUS & PLANTARIS
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POPLITEUS
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FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGUS & TIBIALIS POSTERIOR
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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 Middle 1/3rd of posterior surface of calcaneum as Achilis or tendocacaneus 2. Soleus Back of head & post.surface of fibula Soleal line & middle 1/3rd of medial border of tibia Tendinous soleous arch 3. Plantaris Lateral supracondylar line of femur & obliqe popliteal ligament posterior surface of calcaneum medial to tendocacaneus
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S.No Muscle Origin Insertion 4. Popliteus popliteal groove Arcuate popliteal Ligament Lat meniscus Above Soleal line on post surface of tibia 5. Flexor digitorum longus Upper 2/3rd of medial part of the post. Surface of tibia below soleal line Planter surface of distal phalanx of lat. 4 toes 6. Flexor hallucis longus Lower 3/4th of post. Surface of fibula & interosseous membrane Planter surface of distal phalanx of great toe 7. Tibialis posterior Upper 2/3rd of lateral part of the post. Surface of tibia below soleal line, Post. Surface of fibula & interosseous membrane Tuberosity of navicular bone & also on tarsals and 2nd ,3rd & 4th metatarsal except talus
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NERVE SUPPLY & ACTIONS Tibial nerve for all muscle Plantar flexion
Inversion Maintained longitudinal arch Unlocking of knee by popliteus Flexion at knee joint
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POSTERIOR TIBIAL ARTERY
It Is Large terminal branch of popliteal artery
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POSTERIOR TIBIAL ARTERY
Branches: Peroneal artery Muscular Nutrient Cicumflex fibular Communicating Malleolar Calcaneal Terminal-medial & lateral planter artery
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TIBIAL NERVE Large terminal branch of sciatic nerve in popliteal fossa
Branches: Muscular Cutaneous Articular Terminal-medial & lateral planter nerve
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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
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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
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QUESTION -1 Unlocking of knee is done by: A) Soleus B) Plantaris
C) Popliteus D) Gastrocnemius
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QUESTION -2 All muscles help in plantar flexion except:
A) Tibialis Posterior B) Gastrocnemius C) Soleus D) Popliteus
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QUESTION -3 Which muscle is known as peripheral heart: A) Soleus
B) Plantaris C) Popliteus D) Gastrocnemius
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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
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QUESTION -5 Tibialis posterior is attached on the following bone except- A) Talus B) Navicular C) 2nd metatarsal D) 4th metatarsal
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