Front & Lateral Compartment of the leg Dorsum of the foot

Anterior, Lateral Compartments of the Leg & Dorsum of the FootDr Jamila EL MedanyDr Saeed Vohra&OBJECTIVES

At the end of the lecture, student should be able to: Identify the deep fascia of legIdentify the fascial compartments of the leg. Describe the anatomy of the anterior & lateral compartments. List the contents of each compartment (muscles, vessels & nerves).Describe the anatomy and contents of the dorsum of the footFascial Compartments of the LegThe deep fascia surrounds the leg and attached to anterior & medial borders of tibia.Intermuscular Septa Two pass from the deep aspect of this fascia to be attached to :Anterior border of fibula (Anterior fascial septum) Posterior border of fibula (Posterior fascial septum)Interosseous membrane: A thin& strong membrane, that binds the interosseous borders of tibia & fibula. It binds the two bones and provides attachment for muscles.

Compartments of the LegTogether with the interosseus membrane, the septa divide the leg into 3 compartments : 1-Anterior 2-Lateral (Peroneal) 3-PosteriorEach compartment has its own muscles, blood supply and nerve supply.

Anterior Compartment

MusclesArteryNerve1. TibialisAnteriorAnteriorTibialDeepPeroneal2. Ext DigLongus3. Ext HlluciusLongus

4. Peroneus Tertius

Tibialis anteriorLateral surface of shaft of tibia & interosseous membrane.Medial cuneiform & base of 1st metatarsal bone Dorsi flexion &Inversion of foot and maintains Medial Long archExtensor dig longusAnterior surface of shaft of fibulaExtensor expansion of lat (4) toesExtension of toes & Dorsi flexion of footExtensor hallucis longusAnterior surface of shaft of fibula

Base of distal phalanx of great toeDorsi flexion& Inversion of the foot and extension of big toePeroneus tertiusAnterior surface of shaft of fibula

Base of 5th metatarsal boneDorsiflexion and Eversion of the foot.OriginInsertionActionExtensor RetinaculaThickening of deep fascia that keep the long tendons around ankle joint in positionSuperior Extensor Retinaculum : Attached to anterior borders of tibia & fibula above ankleInferior Extensor Retinaculum: Y-shaped band located inferior to ankle

Structures passing Deep to Extensor Retinacula From Medial to Lateral:1.Tibialis anterior2. Extensor Hallucis longus.3. Anterior tibial Vessels4. Deep peroneal Nerve. 5. Extensor Digitorum longus.6.Peroneus tertius.

Lateral compartment of LegMusclesNerveArtery1.PeroneusLongusSuperficialPeronealPeroneal (Fibular)2. PeroneusBrevis

Peroneus longusLateral surface of shaft of fibulaMedial cuneiform & base of 1st metatarsal bone

Plantar flexion & Eversion of the foot and supports lateral longitudinal archPeroneus brevisLateral surface of shaft of fibula

Base of 5th metatarsal bone

Plantar flexion & Eversion of the foot and supports lateral longitudinal arch

OriginInsertionActionPeroneal Retinacula Superior & Inferior peroneal retinacula Connect the lateral malleolus to calcaneum & hold the tendons of peroneus longus & brevis

Tendons of peronei are surrounded by a single common tubular synovial sheath, deep to inferior peroneal retinaculum they have separate sheathsSynovial Sheaths of Peroneal Longus & BrevisDeep Fascia of Dorsum of FootIt is very thin, but just distal to ankle joint, it is thickened to form Inferior extensor retinaculum

Dorsum of Foot

MuscleArteryNerveExt Dig BrevisDorsalis PedisDeepPeronealOriginInsertionActionInferior extensor R &CalcaneumExtensor Hallucius Brevis to base of proximal ph of big toe. Other (3) to EX Expansion

Extension of IP& Metatarsoph Jof 1st, 2nd, 3rd& 4th toes(during Dorsi flex).

Ext Digitorum BrevisInsertion of Long Extensor TendonsThe tendon of Ex dig longus divides into (4) to the lateral four toes.Each tendon to the 2nd , 3rd & 4th toes is joined on its lateral side by a tendon of Ex dig brevis.The extensor tendons form A fascial Expansion (Extensor Expansion) on the dorsum of each toe.The expansion divides into (3) parts:Central: inserted into the base of middle phalanx.Two lateral : inserted into the base of distal ph.The EX receives insertion of Interossei & Lumbrical muscles.

Synovial Sheaths of Extensor Tendonson the Dorsum of FootA separate sheath for each of:Tibialis anteriorExtensor hallucis longusA common sheath for :Extensor digitorum longus & peroneus tertius,It extends to the level of base of 5th metatarsal bone.

THANK YOU