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ANTERIOR AND LATERAL COMPARTMENT OF LEG
LEARNING OBJECTIVES
FASCIAL COMPARTMENTS OF LEG
Two intermuscular septa arise from deep fascia of leg Attached to fibula Together with interosseus membrane divide leg into 3 compartments
- Anterior
- Lateral
- Posterior
CONTENTS OF ANTERIOR FASCIAL
COMPARTMENT OF LEG
Cutaneous nerves Superficial veins Muscles:
- Tibialis anterior
- Extensor digitorum longus
- Peroneus tertius
- Extensor hallucis longus Anterior tibial artery Deep peroneal nerve RETINACULA ASSOCIATED WITH ANTERIOR COMPARTMENT
Thickening of deep fascia Retain long tendons in position Superior extensor retinaculum attached to distal ends of tibia and fibula Deep extensor retinaculum Y shaped stem attached to calcaneum Upper limb to medial malleolus Lower limb continuous with plantar fascia medially CUTANEOUS NERVES OF ANTERIOR COMPARTMENT Lateral cutaneous nerve of calf Branch of common peroneal Upper part of anterolateral surface Superficial peroneal nerve lower part of anterolateral surface Saphenous nerve Branch of femoral nerve Anteromedial surface of leg MUSCLES OF ANTERIOR COMPARTMENT Tibialis anterior Extensor digitorum longus Peroneus tertius Extensor hallucis longus Nerve supply Deep peroneal nerve
Dorsiflex foot at ankle joint Extends toes EXTENSOR DIGITORUM LONGUS Extensor expansion 4 tendons of extensor digitorum longus incorporate into extensor expansion Center part of expansion inserted into base of middle phalanx Two lateral parts converge insert into base of distal phalanx PERONEUS TERTIUS Part of extensor digitorum longus Origin Lower 1/3rd^ of anterior surface of fibula Interosseus membrane Share the synovial sheath of extensor digitorum longus tendon Passes beneath both extensor retinacula Insertion Medial side of base of fifth metatarsal Action Extends foot at ankle Everts foot at subtalar and transverse tarsal joint EXTENSOR HALLUCIS LONGUS Origin Middle half of anterior surface of fibula Interosseus membrane
Passes beneath both retinacula Insertion Base of distal phalanx of great toe Actions Extends foot at ankle Extends big toe Invert foot at subtalar and transverse talar joints SUMMARY OF ACTION OF ANTERIOR COMPARTMENT MUSCLE At ankle
Dorsiflexion
- All muscles of anterior compartment Subtalar and transverse tarsal joint Inversion
- Tibialis anterior
- Extensor hallucis longus Eversion
- Peroneus tertius Extension of big toe and lateral toes
- Extensor hallucis and extensor digitorum longus ANTERIOR TIBIAL ARTERY Artery of anterior compartment Smaller terminal branch of popliteal artery
- Anterior and posterior tibial recurrent For ankle
- Anterior medial and anterior lateral malleolar DEEP PERONEAL NERVE Nerve of anterior compartment Terminal branch of common peroneal Arise within peroneus longus muscle on lateral side of neck of fibula Enters anterior compartment by piercing anterior intermuscular septum
DEEP PERONEAL NERVE In anterior compartment Descends on interosseus membrane Lies deep to extensor digitorum longus Lies first on the lateral side of anterior tibial artery then anterior then finally lateral to it At the ankle lies behind the extensor retinacula between extensor hallucis and digitorumlongus
Enters foot by passing beneath both extensor retinacula
DEEP PERONEAL NERVE Branches in anterior compartment Muscular
- Tibialis anterior
- Extensor digitorum longus
- Peroneus tertius
- Extensor hallucis longus
Articular branch to ankle joint CONTENTS OF LATERAL COMPARTMENT OF LEG Muscles
- Peroneus longus
- Peroneus brevis
Peroneal artery
Superficial peroneal nerve RETINACULA ASSOCIATED WITH LATERAL COMPARTMENT Superior peroneal retinaculum Start from lateral malleolus Extends backwards and downwards Attached at lateral surface of calcaneum Inferior peroneal retinaculum Extends from peroneal tubercle to calcaneum MUSCLES OF LATERAL COMPARTMENT Peroneus longus Peroneus brevis
At ankle
- Plantar flexion At subatalar and transverse tarsal joint
- Eversion SUPERFICIAL PERONEAL NERVE Terminal branch of common peroneal arises on the lateral side of neck of fibula in the substance of peroneus longus Descends between peroneus longus and brevis In the lower part of leg becomes cutaneous , divides into medial and lateral branch SUPERFICIAL PERONEAL NERVE Branches Muscular Peroneus longus peroneus brevis
Cutaneous Skin of lower part of front of leg Dorsum of foot Adjacent sides of 1st^ and 2nd^ toe Lateral side of little toe ARTERY OF LATERAL COMPARTMENT Branches from peroneal artery A branch of posterior tibial artery Arises in posterior compartment
Descends behind fibula Related with flexor hallucis longus muscle Pierces posterior fascial septum and supplies muscle of lateral compartment Branches
- Muscular
- Nutrient artery to fibula
- Anastomotic branch
- Perforating branch
