Front of the leg dorsum of foot

Anatomical Description of The Dissection of Front of Leg and Dorsum of the Foot

1. Front of the Leg and Dorsum of the Foot Dr. Mushfiqul Hoque Lecturer Dhaka National Medical College

2. Steps of Dissection A transverse incision from the tibial tuberosity to the lateral aspect of the head of the fibula. Another transverse incision in front of the ankle joint from the medial malleolus to the back of the lateral malleolus. A longitudinal incison along the shin (anterior border of the shaft of the tibia) joining the medial ends of the 1st and 2nd incisions.

3. Layers Skin Superficial fascia: contains cutaneous nerves, superficial veins, lymphatics and unnamed arteries Deep fascia: around the ankles, the deep fascia is thickened to form retinacula. E.g. superior extensor retinacula and inferior extensor retinacula

4. Superficial veins The dorsal venous arch Great or long saphenous vein Small of short saphenous vein

5. Cutaneous nerve Saphenous nerve Infrapatellar branch of saphenous nerve The lateral cutaneous nerve of calf Superficial peroneal nerve Sural nerve The deep peroneal nerve The digital branches of medial and lateral plantar nerves

6. Retinacula Superior Extensor Retinaculum: Attachments: medially it is attached to the lower part of anterior border of tibia, and laterally to the lower part of the anterior border of the fibula. Inferior Extensor Retinaculum: Y shaped band. Attachments: stem is attached to the non-articular part of superior surface of  calcaneum, upper band to the anterior border of the medial malleolus, and lower band to the plantar aponeurosis

7. Structures passing under the Retinacula Tibialis anterior Extensor hallucis longus Anterior tibial vessels Deep peroneal nerve Extensor digitorum longus The peroneus tertius

8. Anterior Tibial Artery Main artery of the front of the leg Smaller terminal branch of popliteal artery Branches:  Muscular branches Anastomotic branches

9. Deep peroneal nerve Main nerve of the anterior compartment of leg One of the two terminal branches of common peroneal nerve   

10. Dorsum of the Foot

11. Dorsalis Pedis Artery Chief palpable artery of the dorsum of the foot Commonly palpated in patients with vaso -occlusive diseases of lower limb. E.g. burger's disease Begins at the front of ankle in between two malleoli Ends at the proximal end of 1st intermetatarsal space