Transcript BACK OF LEG - :: King George's Medical University, Chowk

BACK OF LEG
Dr. Rakesh Kumar Verma
Assistant Professor
Department of Anatomy
KGMU UP Lucknow
INTRODUCTION
• Synonyms:
Flexor
compartment/Posterior
compartment/
Posterior
Crural
region/calf
BOUNDARIES
Anterior-Posterior
surface of: tibia,
interosseous
membrane, fibula,
post. Intermuscular
septum
Posterior:
fascia of leg
Deep
STRUCTURE (CONTENTS)
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Skin & Superficial fascia
Cutaneous nerves & vessels
Lymphatics
Fibro fatty tissue
Deep fascia
Muscles, nerves & vessels
CUTANEOUS NERVES
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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
DEEP FASCIA
• Also known as
fascia cruris
• Modifications:
Intermuscular
septum
Flexor retinaculum
FLEXOR RETINACULUM
• Attachment:
 Anterior-Post. Border
& tip of medial
malleolus
 Postero-lateralmedial tubercle of
calcaneum
MUSCLES OF BACK OF LEG
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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
1.
Origin
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
Insertion
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 & posterior surface of
obliqe popliteal ligament
calcaneum medial
to tendocacaneus
S.N
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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 Planter surface of
post. Surface of tibia below soleal distal phalanx of lat.
line
4 toes
6.
Flexor hallucis Lower 3/4th of post. Surface of Planter surface
longus
fibula & interosseous membrane
distal phalanx
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
of
of
Tuberosity
of
navicular bone & also
on tarsals and 2nd ,3rd
& 4th
metatarsal
except talus
NERVE SUPPLY & ACTIONS
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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
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
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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) 2nd metatarsal
D) 4th metatarsal