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4/12/2012




                                                                 The leg
                                                                           Dr. Rania Sherif
                                                                 Lecturer of Anatomy, Mansoura university




                                                              Dorsiflexion                  Planter flexion
     Inversion                             Eversion            Extension                        Flexion




           Sciatic Nerve
                     Sciatic nerve


  Medial popliteal n         Lateral popliteal n
         Or                          Or
      Tibial n               Common peroneal n


                     Deep peroneal n Superficial peroneal n
Posterior tibial n          Or                  Or
                                                                Flexion                        Extension
                     Anterior tibial n   Musculcutaneous n




                                                                                                                     1
4/12/2012




                                                                                   Deep peroneal n
                                                                             Dorsiflexion of foot (extension)
                                                                           Inversion except 1 (subtalar joint)

                                                                                        Ant 4
                                                           Superficial peroneal n      Extensor

   Anterior Group                                          Planter-flexion
                                                             Eversion
                                                                                          Post 7         Med
                                                                            Lat
                                                                                          Flexor


                                                                                     Tibial n (4)
                                                                                Posterior tibial n (4)
                                                                           Planter-flexion of foot (flexion)
                                                                                      Inversion




 3 fibula (ant                              1 tibia (lat
   surface)                                  surface)                                               Tibialis
                                                                                                    anterior
  Extensor digitorum
     longus (3/4)                      Tibialis
                                       anterior
         Extensor                                                                                     Extensor
       hallucis longus                                                                                digitorum
            (2/4)                                                                                       longus

Peroneus tertius (1/4)
                                                                                                         Extensor
                                                                                                       hallucis longus
                                                                     Peroneus
                                                                      tertius




Extensor digitorum longus                                  Tibialis anterior
Origin:                                                     Origin:
Ant surface of fibula (upper ¾)                             Lat surface of tibia (upper ½ )
Insertion:                                                  Insertion:
Divide into 4 tendons                                       Medial cuneiform bone
Bases of Middle & distal phalanx                            Base of 1st metatarsal bone
of lateral 4 toes (extensor
expansion)                                                  NS: deep peroneal n
NS: deep peroneal n
Action:                                                     Action:
Dorsiflexion of foot                                        Dorsiflexion
Inversion of foot                                           Inversion
Extension to all joints of lateral 4
toes




                                                                                                                           2
4/12/2012




Peroneus tertius                     Extensor hallucis longus
 Origin:                             Origin:
 Ant surface of fibula (lower ¼ )    Ant surface of fibula (middle
 Insertion:                          2/4)
 Dorsal surface of base of 5th       Insertion:
 metatarsal                          Base of Distal phalanx of big
 NS: deep peroneal n                 toe
 Action:                             NS: deep peroneal n
 Dorsiflexion of foot                Action:
 Eversion of foot                    Dorsiflexion of foot
                                     Inversion of foot
                                     Extension to all joints of big toe




     Peroneus
      longus




      Peroneus
                                          Lateral Group
       brevis




Peroneus brevis                      Peroneus longus
                                     Origin:
 Origin:                             Lat surface of fibula (upper
 Lat surface of fibula (lower 2/3)   2/3)
 Insertion:                          Lat surface of head of fibula
 Base of 5th metatarsal bone
 NS: superficial peroneal n          Pass in groove on undersurface
 Action:                             of cuboid bone
 Planter-flexion of foot             Insertion:
 Eversion of foot                    Medial cuneiform bone
                                     Base of 1st metatarsal bone
                                     NS: superficial peroneal n
                                     Action:
                                     Planter-flexion of foot
                                     Eversion of foot
                                     Mentain arches of the foot




                                                                                 3
4/12/2012




                                          Gastrocnemius


       Plantaris



                                                            Posterior Group
                                         Tendocalcaneus
                                         Achilles Tendon




Gastrocnemius                                                 Popliteus
Origin:
Medial head:popliteal surface above
medial condyle
Lateral head: above lateral epicondyle
Insertion:                                                        Flexor
Tendocalcaneus
                                                                digitorum                         Tibialis
Middle of post surface of calcaneus
                                                                  longus                         posterior
NS: medial popliteal n (tibial n)

Action:
Planterflexion
Flexion of knee joint




Plantaris                                                  Soleus
                                                           Origin:
Origin:                                                    Back of Head of fibula
Popliteal surface above lateral                            Posterior surface of fibula
condyle                                                    Tendenous arch
Insertion:                                                 Soleal line
Tendocalcaneus                                             Medial border of tibia
Or Middle of post surface of                               Insertion:
calcaneus                                                  Tendocalcaneus
                                                           Middle of post surface of calcaneus
NS: medial popliteal n (tibial n)                          NS: (tibial) + post tibial n
                                                           Action:
Action:                                                    Planterflexion
Planterflexion                                             Propelling force in walking
Fexion of knee                                             Steady leg on ground
                                                           Help venous return from LL




                                                                                                                    4
4/12/2012




                                                         Popliteus
                                                         Origin:
                                                         Groove below lat epicondyle
                                                         Insertion:
                                                         Back of tibia above soleal line
   Flexor digitorum                   Flexor hallucis    NS: med politeal n (tibial n)
        longus                            longus
                                                         Action:
                                                         Unlocking of knee
                                    Tibialis posterior




Flexor hallucis longus                                   Flexor digitorum longus
Origin:                                                  Origin:
Post surface of fibula lateral to                        Post surface of tibia medial to
medial crest                                             vertical line
Insertion:                                               Insertion:
Terminal phalanx of big toe                              Terminal phalanx of lateral 4 toes
NS: posterior tibial n                                   NS: posterior tibial n

Action:                                                  Action:
Planterflexion                                           Planterflexion
Inversion                                                Inversion
Flexion of all joints of big toe                         Flexion of all joints of lat 4 toes
Maintain arches of foot                                  Maintain arches of foot




                                                         Tibialis posterior
                                                         Origin:
                                                         Post surface of fibula medial to
                                                         medial crest
                                                         Interosseus membrane
                                                         Post surface of tibial lateral to

      Tibial vessels                                     vertical line
                                                         Insertion:
                                                         Tuberosity of navicular bone
                                                         All tarsal except talus
                                                         2nd, 3rd, 4th, metatarsals
                                                         NS: posterior tibial n

                                                         Action:
                                                         Planterflexion
                                                         Inversion
                                                         Maintain arches of foot




                                                                                                      5
4/12/2012




                                                                  Femoral artery


                                                                  Popliteal artery




           Retinacula
                                 Anterior tibial                            Posterior tibial
                                    artery                                      artery




                                                                                     Post compart. of leg
                                         Ant compart. of leg
                                Dorsalis pedis artery                           Planter arteries




                                Superior extensor retinaculum
Superior peroneal retinaculum   Inferior extensor retinaculum


Inferior peroneal retinaculum


                                Tom    Tibialis anterior
                                Has    Extensor Hallucis Longus
Peroneus longus & brevis ms     Very   Anterior tibial vessles
                                Nice   Anterior Tibial nerve
                                Dog    Extensor digitorum longus
                                  &
                                       Peroneus Terieus
                                 Pig




                                Flexor Retinaculum
                                  Tom                          Tibialis posterior
                                  Does                         Flexor Digitorum Longus
                                  Very                         Posterior tibial vessles
                                  Nice                         Posterior Tibial nerve
                                                               Flexor Hallucis longus
                                Homework




                                                                                                                   6

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Anatomy of the Leg Muscles and Nerves

  • 1. 4/12/2012 The leg Dr. Rania Sherif Lecturer of Anatomy, Mansoura university Dorsiflexion Planter flexion Inversion Eversion Extension Flexion Sciatic Nerve Sciatic nerve Medial popliteal n Lateral popliteal n Or Or Tibial n Common peroneal n Deep peroneal n Superficial peroneal n Posterior tibial n Or Or Flexion Extension Anterior tibial n Musculcutaneous n 1
  • 2. 4/12/2012 Deep peroneal n Dorsiflexion of foot (extension) Inversion except 1 (subtalar joint) Ant 4 Superficial peroneal n Extensor Anterior Group Planter-flexion Eversion Post 7 Med Lat Flexor Tibial n (4) Posterior tibial n (4) Planter-flexion of foot (flexion) Inversion 3 fibula (ant 1 tibia (lat surface) surface) Tibialis anterior Extensor digitorum longus (3/4) Tibialis anterior Extensor Extensor hallucis longus digitorum (2/4) longus Peroneus tertius (1/4) Extensor hallucis longus Peroneus tertius Extensor digitorum longus Tibialis anterior Origin: Origin: Ant surface of fibula (upper ¾) Lat surface of tibia (upper ½ ) Insertion: Insertion: Divide into 4 tendons Medial cuneiform bone Bases of Middle & distal phalanx Base of 1st metatarsal bone of lateral 4 toes (extensor expansion) NS: deep peroneal n NS: deep peroneal n Action: Action: Dorsiflexion of foot Dorsiflexion Inversion of foot Inversion Extension to all joints of lateral 4 toes 2
  • 3. 4/12/2012 Peroneus tertius Extensor hallucis longus Origin: Origin: Ant surface of fibula (lower ¼ ) Ant surface of fibula (middle Insertion: 2/4) Dorsal surface of base of 5th Insertion: metatarsal Base of Distal phalanx of big NS: deep peroneal n toe Action: NS: deep peroneal n Dorsiflexion of foot Action: Eversion of foot Dorsiflexion of foot Inversion of foot Extension to all joints of big toe Peroneus longus Peroneus Lateral Group brevis Peroneus brevis Peroneus longus Origin: Origin: Lat surface of fibula (upper Lat surface of fibula (lower 2/3) 2/3) Insertion: Lat surface of head of fibula Base of 5th metatarsal bone NS: superficial peroneal n Pass in groove on undersurface Action: of cuboid bone Planter-flexion of foot Insertion: Eversion of foot Medial cuneiform bone Base of 1st metatarsal bone NS: superficial peroneal n Action: Planter-flexion of foot Eversion of foot Mentain arches of the foot 3
  • 4. 4/12/2012 Gastrocnemius Plantaris Posterior Group Tendocalcaneus Achilles Tendon Gastrocnemius Popliteus Origin: Medial head:popliteal surface above medial condyle Lateral head: above lateral epicondyle Insertion: Flexor Tendocalcaneus digitorum Tibialis Middle of post surface of calcaneus longus posterior NS: medial popliteal n (tibial n) Action: Planterflexion Flexion of knee joint Plantaris Soleus Origin: Origin: Back of Head of fibula Popliteal surface above lateral Posterior surface of fibula condyle Tendenous arch Insertion: Soleal line Tendocalcaneus Medial border of tibia Or Middle of post surface of Insertion: calcaneus Tendocalcaneus Middle of post surface of calcaneus NS: medial popliteal n (tibial n) NS: (tibial) + post tibial n Action: Action: Planterflexion Planterflexion Propelling force in walking Fexion of knee Steady leg on ground Help venous return from LL 4
  • 5. 4/12/2012 Popliteus Origin: Groove below lat epicondyle Insertion: Back of tibia above soleal line Flexor digitorum Flexor hallucis NS: med politeal n (tibial n) longus longus Action: Unlocking of knee Tibialis posterior Flexor hallucis longus Flexor digitorum longus Origin: Origin: Post surface of fibula lateral to Post surface of tibia medial to medial crest vertical line Insertion: Insertion: Terminal phalanx of big toe Terminal phalanx of lateral 4 toes NS: posterior tibial n NS: posterior tibial n Action: Action: Planterflexion Planterflexion Inversion Inversion Flexion of all joints of big toe Flexion of all joints of lat 4 toes Maintain arches of foot Maintain arches of foot Tibialis posterior Origin: Post surface of fibula medial to medial crest Interosseus membrane Post surface of tibial lateral to Tibial vessels vertical line Insertion: Tuberosity of navicular bone All tarsal except talus 2nd, 3rd, 4th, metatarsals NS: posterior tibial n Action: Planterflexion Inversion Maintain arches of foot 5
  • 6. 4/12/2012 Femoral artery Popliteal artery Retinacula Anterior tibial Posterior tibial artery artery Post compart. of leg Ant compart. of leg Dorsalis pedis artery Planter arteries Superior extensor retinaculum Superior peroneal retinaculum Inferior extensor retinaculum Inferior peroneal retinaculum Tom Tibialis anterior Has Extensor Hallucis Longus Peroneus longus & brevis ms Very Anterior tibial vessles Nice Anterior Tibial nerve Dog Extensor digitorum longus & Peroneus Terieus Pig Flexor Retinaculum Tom Tibialis posterior Does Flexor Digitorum Longus Very Posterior tibial vessles Nice Posterior Tibial nerve Flexor Hallucis longus Homework 6