4. CUTANEOUS NERVE SUPPLY OF
THE LEG.
Front of the leg:
– Medial side:
Saphenous nerve.
– Lateral side:
Common peroneal nerve (Lateral
cutaneous nerve of the calf) for
upper lateral part.
Musclocutaneous nerve for the
lower lateral part.
Back of the leg:
– Posterior cutaneous nerve of the
thigh for the upper part.
– Common sural nerve for the
lower part.
Dr M Eladl
5. COMPARTMENTS OF THE LEG
The leg is subdivided into 3
compartments by the anterior
and posterior intermuscular
septa and the interosseous
membrane between the
interosseous borders of the
tibia and fibula:
1. Anterior compartment:
contains the extensor
group of muscles.
2. Lateral compartment:
contains the peroneal
group of muscles.
3. Posterior compartment:
contains the flexor group of
muscles.
Dr M Eladl
6. ANTERIOR COMPARTMENT OF THE LEG
Four muscles
1. Tibialis Anterior
2. Extensor halucis longus.
3. Extensor digitorum longus
4. Peroneus tertius
Dr M Eladl
7. ANTERIOR COMPARTMENT OF THE LEG
Four muscles
1. Tibialis Anterior
2. Extensor halucis longus.
3. Extensor digitorum longus
4. Peroneus tertius
Dr M Eladl
8. ANTERIOR COMPARTMENT OF THE LEG
Four muscles
1. Tibialis Anterior
2. Extensor halucis longus.
3. Extensor digitorum longus
4. Peroneus tertius
Anterior tibial Artery
Anterior tibial nerve (deep
peroneal nerve).
Dr M Eladl
16. ANTERIOR TIBIAL NERVE
Dr M Eladl
Origin:
Course:
– Enters the anterior
compartment lateral
to the artery (after
piercing the lateral
intermuscular septum)
17. ANTERIOR TIBIAL NERVE
Dr M Eladl
Origin:
Course:
– Enters the anterior
compartment lateral
to the artery (after
piercing the lateral
intermuscular
septum).
– Relations to the artery
!!
24. MUSCLES OF THE LATERAL COMPARTMENT
Dr M Eladl
Peroneus longus muscle Peroneus brevis muscle
Origin Lateral surface of the head of the
fibula.
Upper 2/3 of the lateral surface of the
shaft of the fibula.
Anterior & posterior intermuscular
septa.
Deep fascia.
Lower 2/3 of the lateral surface of the
shaft of the fibula.
Anterior and posterior intermuscular
septa
Deep fascia
Insertion Medial cuneiform & base of 1st metatarsal
bone.
Base of the 5th metatarsal bone.
Nerve
supply
Superficial peroneal nerve
Action 1) Eversion of the foot at the subtalar
joint.
2) Planter flexion of the ankle joint.
3) Maintain the transverse arch of the foot.
1) Eversion of the foot at the subtalar
joint.
2) Planter flexion of the foot at the ankle
joint.
27. MUSCULOCUTANEOUS NERVE
Dr M Eladl
Termination
In the distal third of the leg, by
piercing the deep fascia and
divides into two branches;
medial and lateral branches.
28. MUSCULOCUTANEOUS NERVE
Dr M Eladl
Branches
1. Muscular branches: to
peroneus longus & brevis
muscles.
2. Cutaneous branch: to the
lower half of the anterior
surface of the leg.
3. Terminal branches:
Medial branch: supply:
The medial side of
the dorsum of the
foot.
Digital branches to
the medial side of
the big toe and the
adjacent sides of
the 2nd & 3rd toes.
(the 2nd interdigital
left)
29. MUSCULOCUTANEOUS NERVE
Dr M Eladl
Branches
1. Muscular branches: to
peroneus longus & brevis
muscles.
2. Cutaneous branch: to the
lower half of the anterior
surface of the leg.
3. Terminal branches:
Lateral branch: supply:
The intermediate
part of the dorsum
of the foot.
Digital branches to
the adjacent sides
of the 3rd & 4th (the
3rd interdigital
cleft) and 4th & 5th
toes (the 4th
interdigital cleft)
30. SUPERIOR EXTENSOR RETINACULUM
Thickened band of deep fascia
in the lower part of the front of
the leg (above the ankle joint).
Attachment:
Medially: to lower part of the
anterior border of tibia.
Laterally: to lower part of the
anterior border of fibula.
Function:
keeps the extensor tendons in
contact with the lower end of
the tibia during their
contraction (prevent the
spring out of the extensor
tendon during their
contraction). Dr M Eladl
31. INFERIOR EXTENSOR RETINACULUM
Thick Y-shaped band of deep
fascia in front of the ankle joint
Attachment:
The lateral end (the stem of Y):
attached to the anterior part of
upper surface of calcaneus
Medially:
The upper band: is attached to
the medial malleolus.
The lower band: passes to the
medial side of the foot & fuses
with the deep fascia of sole.
Dr M Eladl
32. EXTENSOR RETINACULA
Structures undercover of the
retinaculua: from the medial
to the lateral side:
1. Tibialis anterior
2. Extensor Hallucis longus
3. Anterior tibial Vessels
4. Anterior tibial Nerve
5. Extensor Digitorum longus
6. Peroneus tertius
Dr M Eladl
33. PERONEAL RETINACULA
Dr M Eladl
Superior peroneal
retinaculum
Inferior peroneal
retinaculum
Definition Thickened bands of deep fascia on the lateral aspect of the ankle joint.
Attachment: From the lateral malleolus to the
lateral surface of the calcaneus
Upper end: is attached to the
anterior part of the superior
surface of the calcaneus where it
is continuous with the stem of the
inferior extensor retinaculum.
Lower end: is attached to the
peroneal trochlea on lateral
surface of the calcaneus
Function: Keep the tendons of the peroneal muscles in position during their
contraction
34. PERONEAL RETINACULA
Dr M Eladl
1. Superior peroneal retinaculum
From the lateral malleolus to
the lateral surface of the
calcaneus
2. Inferior Peroneal retinaculum
Attached to the anterior part
of the superior surface of the
calcaneus where it is
continuous with the stem of
the inferior extensor
retinaculum.