FASCIAL COMPARTMENTS OF THE LEG presentation

anatomy

1. FASCIAL COMPARTMENTS OF THE LEG

2. DEEP FASCIA: IT SURROUNDS THE LEG IT IS CONTINOUS ABOVE WITH THE DEEP FASCIA OF THE THIGH BELOW THE TIBIAL CONDYLES, IT IS ATTACHED TO THE PERIOSTEUM ON THE ANTERIOR & MEDIAL BORDERS OF THE TIBIA TWO INTERMUSCULAR SEPTA PASS FROM ITS DEEP ASPECT TO BE ATTACHED TO THE FIBULA THESE TOGETHER WITH THE INTEROSSEUS MEMBRANE, DIVIDE THE LEG INTO 3 COMPARTMENTS: ANTERIOR LATERAL POSTERIOR

3. INTEROSSEOUS MEMBRANE BINDS THE TIBIA & FIBULA TOGETHER PROVIDES ATTACHMENT FOR NEIGHBOURING MUSCLES

4. RETINACULA OF ANKLE THE RETINACULA ARE THICKENINGS OF DEEP FASCIA THAT KEEP THE LONG TENDONS AROUND THE ANKLE JOINT IN POSITION & ACT AS PULLEYS SUPERIOR EXTENSOR RETINACULUM INFERIOR EXTENSOR RETINACULUM FLEXOR RETINACULUM SUPERIOR PERONEAL RETINACULUM INFERIOR PERONEAL RETINACULUM

5. FRONT OF THE LEG SKIN: CUTANEOUS NERVES: LATERAL CUTANEOUS NERVE OF CALF : BRANCH OF COMMON PERONEAL NERVE SUPPLIES SKIN ON UPPER PART OF LATERAL SURFACE OF THE LEG SUPERFICIAL PERONEAL NERVE : BRANCH OF COMMON PERONEAL NERVE SUPPLIES SKIN OF LOWER PART OF ANTEROLATERAL SURFACE OF THE LEG SAPHENOUS NERVE : BRANCH OF FEMORAL NERVE SUPPLIES SKIN OF ANTEROMEDIAL SURFACE OF LEG SUPERFICIAL VEINS : DRAIN INTO GREAT SAPHENOUS VEIN LYMPH VESSELS: VERTICAL GROUP OF SUPERFICIAL INGUINAL LYMPH NODES

6. ANTERIOR FASCIAL COMPARTMENT OF LEG: MUSCLES: TIBIALIS ANTERIOR EXTENSOR DIGITORUM LONGUS PERONEUS TERTIUS EXTENSOR HALLUCIS LONGUS BLOOD SUPPLY: ANTERIOR TIBIAL ARTERY NERVE SUPPLY: DEEP PERONEAL NERVE

7. ANTERIOR TIBIAL ARTERY: IT IS THE SMALLER TERMINAL BRANCH OF POPLITEAL ARTERY PATHWAY : IT ARISES AT THE LEVEL OF LOWER BORDER OF POPLITEUS MUSCLE PASSES FORWARD INTO THE ANTERIOR COMPARTMENT OF THE LEG THROUGH AN OPENING IN THE UPPER PART OF INTEROSSEUS MEMBRANE IT DESCENDS ON THE ANTERIOR SURFACE OF THE INTEROSSEOUS MEMBRANE IT IS ACCOMPANIED BY THE DEEP PERONEAL NERVE IN THE UPPER PART OF ITS COURSE, IT LIES DEEP BENEATH THE MUSCLES OF THE COMPARTMENT IN THE LOWER PART OF ITS COURSE, IT LIES SUPERFICIALLY, INFRONT OF THE LOWER END OF TIBIA HAVING PASSED BEHIND THE SUPERIOR EXTENSOR RETINACULUM, IT HAS THE TENDON OF EXTENSOR HALLUCIS LONGUS ON ITS MEDIAL SIDE & DEEP PERONEAL NERVE AND TENDON OF EXTENSOR DIGITORUM LONGUS ON ITS LATERAL SIDE IT IS HERE THAT ITS PULSATIONS CAN BE EASILY FELT IN A LIVING SUBJECT INFRONT OF THE ANKLE JOINT , IT BECOMES THE DORSALIS PEDIS ARTERY BRANCHES : MUSCULAR BRANCHES -> NEIGHBOURING MUSCLES ANASTOMOTIC BRANCHES: KNEE & ANKLE JOINTS

8. DEEP PERONEAL NERVE: ONE OF THE TERMINAL BRANCHES OF COMMON PERONEAL NERVE PATHWAY: IT ARISES IN THE SUBSTANCE OF PERONEUS LONGUS MUSCLE, ON THE LATERAL SIDE OF NECK OF FIBULA IT ENTERS THE ANTERIOR COMPARTMENT BY PIERCING THE ANTERIOR FASCIAL SEPTUM IT THEN DESCENDS DEEP TO THE EXTENSOR DIGITORUM LONGUS MUSCLE, FIRST LYING LATERAL , THEN ANTERIOR , THEN FINALLY LATERAL TO THE ANTERIOR TIBIAL ARTERY THE NERVE PASSES BEHIND THE EXTENSOR RETINACULA BRANCHES: MUSCULAR BRANCHES : TIBIALIS ANTERIOR EXTENSOR DIGITORUM LONGUS PERONEUS TERTIUS EXTENSOR HALLUCIS LONGUS ATRICULAR BRANCH : ANKLE JOINT

9. LATERAL FASCIAL COMPARTMENT OF LEG MUSCLES: PERONEUS LONGUS PERONEUS BREVIS BLOOD SUPPLY: BRANCHES FROM PERONEAL ARTERY NERVE SUPPLY: SUPERFICIAL PERONEAL NERVE

10. SUPERFICIAL PERONEAL NERVE: IT IS ONE OF THE TERMINAL BRANCHES OF COMMON PERONEAL NERVE PATHWAY: IT ARISES IN THE SUBSTANCE OF PERONEUS LONGUS MUSCLE, ON THE LATERAL SIDE OF NECK OF FIBULA IT DESCENDS B/W THE PERONEUS LONGUS & BREVIS MUSCLES IN THE LOWER PART OF THE LEG, IT BECOMES CUTANEOUS BRANCHES : MUSCULAR : TO PERONEUS LONGUS & BREVIS CUTANEOUS: MEDIAL & LATERAL BRANCHES ARE DISTRIBUTED TO THE SKIN ON THE LOWER PART OF FRONT OF LEG & DORSUM OF FOOT BRANCHES SUPPLY THE DORSAL SURFACES OF THE SKIN OF ALL THE TOES, EXCEPT THE ADJACENT SIDES OF 1 ST & 2 ND TOES, AND THE LATERAL SIDE IF THE LITTLE TOE

11. BACK OF THE LEG SKIN: CUTANEOUS NERVES : POSTERIOR CUTANEOUS NERVE LATERAL CUTANEOUS NERVE OF CALF SURAL NERVE SAPHENOUS NERVE SUPERFICIAL VEINS : SMALL SAPHENOUS VEIN LYMPH VESSELS : VERTICAL GROUP OF SUPERFICIAL INGUINAL LYMPH NODES OR POPLITEAL NODES

12. POSTERIOR FASCIAL COMPARTMENT OF LEG MUSCLES: THE DEEP TRANSVERSE FASCIA OF THE LEG IS A SEPTUM THAT DIVIDES THE MUSCLES OF THE POSTERIOR COMPARTMENT INTO: SUPERFICIAL GROUP OF MUSCLES: GASTROCNEMIUS PLANTARIS SOLEUS DEEP GROUP OF MUSCLES: POPLITEUS FLEXOR DIGITORUM LONGUS FLEXOR HALLUCIS LONGUS TIBIALIS POSTERIOR BLOOD SUPPLY: POSTERIOR TIBIAL ARTERY NERVE SUPPLY: TIBIAL NERVE

13. POSTERIOR TIBIAL ARTERY: IT IS ONE OF THE TERMINAL BRANCHES OF POPLITEAL ARTERY PATHWAY: IT BEGINS AT THE LEVEL OF THE LOWER BORDER OF POPLITEUS MUSCLE PASSES DOWNWARD DEEP TO THE GASTROCNEMIUS, SOLEUS & DEEP TRANSVERSE FASCIA OF THE LEG IT LIES ON THE POSTERIOR SURFACE OF TIBIALIS POSTERIOR MUSCLE ABOVE & ON THE POSTERIOR SURFACE OF TIBIA BELOW IN THE LOWER PART OF THE LEG, IT IS ONLY COVERED BY THE SKIN & FASCIA IT PASSES BEHIND THE MEDIAL MALLEOLUS , DEEP TO THE FLEXOR RETINACULUM TERMINATES BY DIVIDING INTO MEDIAL & LATERAL PLANTAR ARTERIES

14. BRANCHES: PERONEAL ARTERY: ARISES CLOSE TO THE ORIGIN OF POSTERIOR TIBIAL ARTERY IT DESCENDS BEHIND THE FIBULA , EITHER WITHIN THE SUBSTANCE OF FLEXOR HALLUCIS LONGUS MUSCLE OR POSTERIOR TO IT IT GIVES OFF NUMEROUS MUSCULAR BRANCHES AND A NUTRIENT ARTERY TO FIBULA ENDS BY TAKING PART IN THE ANASTOMOSIS AROUND THE ANKLE JOINT A PERFORATING BRANCH PIERCES THE INTEROSSEUS MEMBRANE TO REACH THE LOWER PART OF THE FRONT LEG MUSCULAR BRANCHES: NUTRIENT ARTERY TO TIBIA ANASTOMOTIC BRANCHES MEDIAL & LATERAL PLANTAR ARTERIES

15. TIBIAL NERVE: IT IS THE LARGER TERMINAL BRANCH OF SCIATIC NERVE IN THE LOWER THIRD OF THE BACK OF THE THIGH PATHWAY: IT DESCENDS THROUGH THE POPLITEAL FOSSA PASSES DEEP TO THE GASTROCNEMIUS & SOLEUS MUSCLES IT LIES ON THE POSTERIOR SURFACE OF THE TIBIALIS POSTERIOR , AND LOWER DOWN THE LEG, ON THE POSTERIOR SURFACE OF TIBIA IT ACCOMPANIES THE POSTERIOR TIBIAL ARTERY AND LIES AT FIRST ON ITS MEDIAL SIDE, THEN CROSSES POSTERIOR TO IT & FINALLY LIES ON ITS LATERA L SIDE THE NERVE, WITH THE ARTERY, PASSES BEHIND THE MEDIAL MALLEOLUS , B/W THE TENDONS OF FLEXOR DIGITORUM LONGUS & FLEXOR HALLUCIS LONGUS IT IS COVERED HERE BY FLEXOR RETINACULUM AND DIVIDES INTO MEDIAL & LATERAL PLANTAR NERVES BRANCHES IN THE LEG (BELOW POPLITEAL FOSSA): MUSCULAR: SOLEUS FLEXOR DIGITORUM LONGUS FLEXOR HALLUCIS LONGUS TIBIALIS POSTERIOR CUTANEOUS -> MEDIAL CALCANEAL BRANCH -> SKIN OVER THE MEDIAL SURFACE OF THE HEEL ARTICULAR BRANCH -> ANKLE JOINT MEDIAL & LATERAL PLANTAR NERVES