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BACK OF LEG. Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow. INTRODUCTION. Synonyms: Flexor compartment/Posterior compartment/ Posterior Crural region/calf. BOUNDARIES.
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BACK OF LEG Dr. Rakesh Kumar Verma Assistant Professor Department of Anatomy KGMU UP Lucknow
INTRODUCTION Synonyms: Flexor compartment/Posterior compartment/ Posterior Crural region/calf
BOUNDARIES Anterior-Posterior surface of: tibia, interosseous membrane, fibula, post. Intermuscular septum Posterior: Deep fascia of leg
STRUCTURE (CONTENTS) Skin & Superficial fascia Cutaneous nerves & vessels Lymphatics Fibro fatty tissue Deep fascia Muscles, nerves & vessels
CUTANEOUS NERVES Saphenous Nerve Post. division of medial cut. nerve of thigh Post. cut. nerve of thigh Sural Nerve Lateral cut. nerve of thigh Sural communicating nerve Medial calcaneal branches of tibial nerve
CUTANEOUS VESSELES Great Saphenous Vein Small Saphenous Vein Small tributeries Lymhatics
DEEP FASCIA • Also known as fascia cruris • Modifications: • Intermuscular septum • Flexor retinaculum
FLEXOR RETINACULUM • Attachment: • Anterior-Post. Border & tip of medial malleolus • Postero-lateral- medial tubercle of calcaneum
MUSCLES OF BACK OF LEG Gastrocnemius Soleus Plantaris Popliteus Flexor digitorum longus Flexor hallucis longus Tibialis posterior
FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGUS & TIBIALIS POSTERIOR
NERVE SUPPLY & ACTIONS Tibial nerve for all muscle Plantar flexion Inversion Maintained longitudinal arch Unlocking of knee by popliteus Flexion at knee joint
POSTERIOR TIBIAL ARTERY It Is Large terminal branch of popliteal artery
POSTERIOR TIBIAL ARTERY • Branches: • Peroneal artery • Muscular • Nutrient • Cicumflex fibular • Communicating • Malleolar • Calcaneal • Terminal-medial & lateral planter artery
TIBIAL NERVE • Large terminal branch of sciatic nerve in popliteal fossa • Branches: • Muscular • Cutaneous • Articular • Terminal-medial & lateral planter nerve
Posterior Tibial Vein Formation at the level of lower border of popliteus By joining of venae commitantes running along Ant. & post tibial artery Finally drain in to popliteal vein
APPLIED ANATOMY Tennis leg Tendon of plantaris used as a graft Rupture of tendocalcaneus Ankle jerk Deep vein thrombosis Arterial insufficiency Varicose vein Tarsal tunnel syndrome
QUESTION -1 • Unlocking of knee is done by: • A) Soleus • B) Plantaris • C) Popliteus • D) Gastrocnemius
QUESTION -2 • All muscles help in plantar flexion except: • A) Tibialis Posterior • B) Gastrocnemius • C) Soleus • D) Popliteus
QUESTION -3 • Which muscle is known as peripheral heart: • A) Soleus • B) Plantaris • C) Popliteus • D) Gastrocnemius
QUESTION -4 • False statement about popliteus is: • A) Has intracapsular origin • B)Pulls the medial meniscus backwards and prevent it from being trapped at the beginning of flexion • C) Innervated by tibial nerve • D) Unlock the knee joint
QUESTION -5 • Tibialis posterior is attached on the following bone except- • A) Talus • B) Navicular • C) 2nd metatarsal • D) 4th metatarsal