ANATOMY OF anterolateral compartment of leg and ankle joint.pdf

The anterolateral compartment of the leg and the ankle joint play essential roles in locomotion, posture, and balance. The anterolateral compartment, located between the tibia and fibula, contains muscles primarily responsible for dorsiflexion of the foot and extension of the toes, as well as eversion of the foot. These muscles, together with their nerve (deep and superficial peroneal nerves) and blood supply (anterior tibial artery), are vital in maintaining dynamic stability during walking and running. The ankle joint, or talocrural joint, is a hinge-type synovial joint formed by the articulation between the distal ends of the tibia and fibula with the talus bone. It allows dorsiflexion and plantar flexion movements, which are crucial for gait and weight transmission. Understanding the anatomy and functional relationships of these structures provides a foundation for interpreting common clinical conditions such as foot drop, sprains, and fractures around the ankle region.

1. ANTEROLATERAL
COMPARTMENT
OFLEG
&
ANKLE JOINT
BY
ASWANI CLEVIN

2. introduction
Leg is made up of tibia
and fibula bones
Terms
Plantar flexion
Dorsiflexion
Inversion
Eversion

3. Superficial fascia contents
Superficial veins
Dorsal venous arch: lies in the subcutaneous tissue
over the heads of the metatarsal bones and drains on
the medial side into the great saphenous v. and on the
lateral side into the small saphenous v.
Great saphenous v.:
Drains the medial end of dorsal venous arch of foot
and passes upward directly in front of the medial
malleolus.
Then ascends in company with the saphenous n. in the
superficial fascia over the medial side of the leg.

4. Cutaneous nerves
Lateral cutaneous n. of the calf: supplies
the skin on the upper part of the
anterolateral surface of the leg
Superficial peroneal n. supplies the skin of
the lower part of the anterolateral surface
of the leg and dorsum of the foot
Saphenous n. supplies the skin on the
anteromedial surface of the leg
Deep peroneal n. supplies the skin of the
adjacent sides of the big and second toes

5. Deep fascia
Surrounds the leg and forms two intermuscular
septa to be attached to the fibula.
Divided the leg into three compartments
anterior, lateral and posterior
Inferiorly, two band-like thickenings of the deep
fascia form retinacula that bind the tendons of
the anterior compartment muscles before and
after they cross the ankle joint, preventing
them from bowstringing anteriorly during
dorsiflexion of the joint. i.e. superior extensor
retinaculum & inferior extensor retinaculum:

6. Leg
compartments
separated into:
Anterior
lateral
posterior

7. Contents of the anterior compartment of the leg
Muscles:
Tibialis anterior
Extensor digitorumlongus
Extensor hallucislongus
Peroneus tertius
Blood supply: Anterior tibiala.
Nerve supply: Deep peroneal n.

8. ASWANI CLEVIN

9. Name Action Skeletal Attachments Innervation
Fibularis (Peroneus) TertiusDorsiflexesand evertsfoot
during walking;
helps toes clear the ground
during forward swing of leg
O:Medial surface of lower
one-third of fibula;
interosseous membrane
I:Metatarsal V
Deep fibular (peroneal) nerve
Extensor DigitorumLongusExtends toes;
dorsiflexesfoot;
tautens plantar aponeurosis
O:Lateral condyle of tibia;
shaft of fibula; interosseous
membrane
I:Middle and distal phalanges
II–V
Deep fibular (peroneal) nerve
Extensor HallucisLongus Extends great toe;
dorsiflexesfoot
O:Anterior surface of middle
of fibula; interosseous
membrane
I:Distal phalanx I
Deep fibular (peroneal) nerve
Tibialis Anterior Dorsiflexesand inverts foot;
resists backward tipping of
body (as when standing on a
moving boat deck);
helps support medial
longitudinal arch of foot
O:Lateral condyle and lateral
margin of proximal half of
tibia; interosseous membrane
I:Medial cuneiform;
metatarsal I
Deep fibular (peroneal) nerve
ASWANI CLEVIN

10. Anterior tibialartery
Arises from the popliteal artery at the lower
border of popliteus.
It passes forwards above the interosseous
membrane, and turns downwards on the anterior
surface of that membrane with the deep peroneal
nerve.
Ending: In front of ankle joint becomes the
dorsalis pedisa.
anterior tibialveins are closely applied to the artery.

11. Common peroneal n.
Passes over posterior aspect of head of fibula and
then winds around neck of fibula
Deep to peroneus longus, where it divides into
deep and superficial peroneal nerves
Deep peroneal nerve
Arises from the common peroneal nerve between the
neck of the fibula and the peroneus longus muscle
Descends in the anterior compartment of the leg with
the anterior tibialvessels.
Supplies all the muscles of the anterior compartment of
the leg and extensor digitorumbrevis.

12. Contents of the lateral compartment of the leg
Muscles
Peroneus longus
Peroneus brevis
Blood supply: branches from the peroneal
artery
Nerve supply: superficial peroneal n.

13. Name Action Skeletal
Attachments
Innervation
Fibularis
(Peroneus)
Brevis
Maintains concavity
of sole during toe-off
and tiptoeing;
may evertfoot and
limit inversion and
help steady leg on
foot
O:Lateral surface of
distal two-thirds of
fibula
I:Base of
metatarsal V
Superficial fibular
(peroneal) nerve
Fibularis
(Peroneus)
Longus
Maintains concavity
of sole during toe-off
and tiptoeing;
evertsand plantar
flexes foot
O:Head and lateral
surface of proximal
two-thirds of fibula
I:Medial
cuneiform;
metatarsal I
Superficial fibular
(peroneal) nerve
ASWANI CLEVIN

14. Contents of the lateral fascial
compartment of the leg
Superficial peroneal n.
supplies peroneus longus and brevis and
skin on anterior surface of leg and dorsum
of foot

15. Anterior tibial a.
Dorsal a. of foot
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Deep peroneal n.
Superficial peroneal n.

16. Injury to the common peroneal nerve
common fibular nerve may be severed during fracture
of the fibula neck or severely stretched when the
knee joint is injured of dislocated.
Severance of the common fibular n. results in
paralysis of all muscles in the anterior and lateral
compartments of the leg. The loss of eversion of the
foot and dorsiflexion of the ankle causes foot-drop.
foot drops and the toes drag of the floor when
walking. Because it is impossible to make the heel
strike the ground first, the patient has a high stepping
(‘steppage”) gait, raising the foot as high as
necessary to keep the toes from hitting the ground.

17. ANKLE/TALOCRURAL JOINT
includes two articulations:
medial joint between tibia and talus
lateral joint between fibula and talus
both enclosed in one joint capsule.
malleoli of tibia and fibula overhang the
talon each side and prevent side-to-side
motion.
ankle therefore has a more restricted range
of motion than wrist.
ASWANI CLEVIN

18. ligaments of ankle include:
anterior and posterior tibiofibular
ligaments, which bind tibia to
fibula
multipart medial (deltoid)
ligament, which binds tibia to foot
on medial side
multipart lateral collateral
ligament, which binds the fibula to
the foot on the lateral side.
ASWANI CLEVIN

19. ASWANI CLEVIN

20. calcaneal (Achilles) tendon
extends from the calf muscles
to the calcaneus.
It plantar flexes the foot and
limits dorsiflexion.
Plantar flexion is limited by:
extensor tendons on the
anterior side of the ankle
anterior part of the joint
capsule.
ASWANI CLEVIN

21. blood supply
from the malleolar branches of the anterior tibial,
posterior tibial, and peroneal (fibular) arteries.

22. nerve supply
branches of:
tibial,
superficial fibular
deep fibular nerves

23. Clinical relevance
Sprains (torn ligaments and tendons) are common
at ankle, especially when the foot is suddenly
inverted or everted excessively.
They are painful and usually accompanied by
immediate swelling.
They are best treated by immobilizing the joint
and reducing swelling with an ice pack, but in
extreme cases may require a cast or surgery

24. ANY QUESTIONS
THANK YOU