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Anterior posterior compartments of leg7/31/2023 ![]() ![]() ![]() ![]() The sciatic nerve splits into the tibial nerve, which continues inferiorly, and the common peroneal nerve, which travels laterally around the neck of the fibula. The tibial nerve is a component of the sciatic nerve, which comes from the ventral rami of spinal roots L4-S3. The tibial nerve innervates the tibialis posterior muscle. The posterior tibial artery gives off the fibular (peroneal) artery, which courses deep to the flexor hallucis longus and gives off muscular branches to supply some of the posterior compartment before entering its primary destination, the lateral compartment of the lower leg. The posterior tibial artery then continues to the foot behind the medial malleolus along with the tibialis posterior tendon, flexor digitorum longus tendons, tibial nerve, and flexor hallucis longus. It supplies muscular branches to all of the muscles in the posterior compartment, including the posterior tibialis muscle. The posterior tibial artery, which gives off the fibular (peroneal) artery, continues inferiorly through the posterior compartment of the lower leg. The posterior tibial artery courses in the deep posterior compartment of the lower leg, deep to the soleus, and superficial to the deep muscles, including the tibialis posterior. The anterior tibial artery passes through the tibialis posterior muscle and over the interosseous membrane, where it enters the anterior compartment. The popliteal artery courses posterior to the knee and primarily splits into the anterior tibial and posterior tibial arteries. The vascular supply to the tibialis posterior is predominantly via the posterior tibial artery, which arises from the popliteal artery. The medial arch in a normal person is higher than the lateral arch and is maintained by the following bones: calcaneus, talus, navicular, three cuneiforms, and the first three metatarsals. The plantar insertions of the tibialis posterior allow for support of the medial arch of the foot. ![]() This inversion happens at two synovial joints of the foot: the midtarsal joint, between the talus and navicular bone, and the subtalar joint, between the talus and calcaneus.īecause the tibialis posterior (TP) originates from the posterior compartment of the lower leg, the tibialis posterior is also a secondary plantar flexor of the foot along with the gastrocnemius, soleus, and plantaris muscles. The tibialis posterior (TP), along with the tibialis anterior, is a primary inverter of the foot. The TPT passes beneath the flexor retinaculum, covered by a synovial lined tunnel acting as a tendon sheath to reduce friction. The flexor retinaculum forms the canal allowing the passage of the tendons from the posterior compartment of the lower leg. The flexor retinaculum (FR), also known as the laciniate ligament and the tarsal tunnel, is a strong fibrous band that covers the medial ankle from the medial malleolus to the calcaneus. Finally, the recurrent portion has a small insertion site at the sustentaculum tali of the calcaneus. The plantar portion inserts onto the base of the second, third, and fourth metatarsals along with the second and third cuneiform and the cuboid. The main portion inserts primarily onto the navicular bone tubercle as well as the plantar sections of the medial cuneiform. This split allows for the broad attachment site of the tibialis posterior tendon (TPT). Once the TPT travels distal to the medial malleolus, it courses along the plantar aspect of the foot, where it splits into three components: primary, plantar, and recurrent. The tibialis posterior tendon (TPT) travels distally, then posterior to the medial malleolus along with the FDL tendons, posterior tibial artery, tibial nerve, and FHL. These deep attachments lie in the center between the FDL and the FHL. The TPM's muscle belly originates from many proximal attachments these attachments include the posterior surface of the upper half of the posterior tibia, the middle of the posterior fibula, and the posterior interosseous membrane. The deep posterior compartment muscles include the flexor hallucis longus (FHL), flexor digitorum longus (FDL), TPM, and popliteus muscles. The three muscles within the superficial posterior compartment include the gastrocnemius, soleus, and plantaris muscles. Their origins and insertions are difficult to remember, and they are best considered as parts of general functional groups.The posterior compartment of the lower leg consists of superficial and deep divisions. The muscles of the lower limb are numerous and complex. ![]()
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