Download MBBS Anatomy PPT 83 Anterior Compartment And Dorsum Gk Notes

CUTANEOUS NERVES

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Lateral cutaneous n. of the

Saphenous n. (br. of

calf (br. of common peroneal

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post. div. of femoral

nerve) supplies the skin on

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nerve)

the upper part of the

supplies the skin on the

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anterolateral surface of the

anteromedial surface of

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leg.

the leg

Superficial peroneal n. (br. of

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Deep peroneal n. (br. of

common peroneal nerve)

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common peroneal nerve)

supplies the skin of the lower

supplies the skin of the

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part of the anterolateral

adjacent sides of the big

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surface of the leg and dorsum

and second toes

of the foot

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Digital branches. (br. of

Sural n. (br. of tibial n)

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tibial n) Curve up and

supplies the skin of the

supply the distal part of

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lateral border of the foot upto

dorsum of toes.

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the tip of the little toe.

Med. Plantar n.-3 ? toes
Lat. Plantar n.-1 ? toes

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Veins present in superficial fascia of leg

Dorsal venous arch lies over proximal

part of metatarsals, and receives 4

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dorsal metatarsal veins formed by union
of 2 digital dorsal veins.

Great saphenous vein formed by union

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of medial end of dorsal venous arch with
medial marginal vein

Small/ Short saphenous vein formed

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by union of lateral end of dorsal venous
arch with lateral marginal vein

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SKELETON OF FOOT

Deep fascia of leg

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Anterior

Anterior

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intermuscular

compartment

septum

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Lateral

Interosseous

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compartment

membrane

Posterior

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Posterior

compartment

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intermuscular
septum

Replaced by periosteum at subcutaneous areas.
Forms intermuscular septae to form three

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compartments


Retinacula

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Deep fascia is thickened to
form bands.
Retain tendons in place.

?Superior Extensor

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Retinaculum

? Inferior Extensor
Retinaculum

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?Superior Peroneal
Retinaculum

? Inferior Peroneal
Retinaculum

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Contents of the anterior compartment

o Muscles:

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1. Tibialis anterior

2. Extensor

digitorum longus

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3. Extensor hallucis

longus

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4. Peroneus tertius


Contents of the anterior compartment

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o Anterior

tibial artery

o Deep

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peroneal

nerve.

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TIBIALIS ANTERIOR

Origin:

?Upper two- thirds of the

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lateral surface of the
shaft of tibia.

?Adjacent interosseous
membrane.

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TIBIALIS ANTERIOR

Insertion:

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?Infero-medial side of
the base of the first
metatarsal bone.

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?Adjacent medial
cuneiform bone.

TIBIALIS ANTERIOR

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Nerve Supply:
Deep Peroneal nerve.

Actions:

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?Dorsiflexion of foot at the
ankle joint.

?Maintains medial
longitudinal arch.

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?Inversion of foot at mid-
tarsal and sub-talar joints.

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EXTENSOR HALLUCIS LONGUS

Origin:

?Middle 2/4 of the medial

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surface of the shaft of fibula
medial to the origin of
extensor digitorum longus.

?Adjacent interosseous

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membrane.

EXTENSOR HALLUCIS LONGUS

Insertion:

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?The tendon crosses in front
of anterior tibial vessels and
deep peroneal nerve from
lateral to medial side.

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?Base of the terminal phalanx
of great toe.

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EXTENSOR HALLUCIS LONGUS

Nerve supply:
Deep Peroneal nerve

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Actions:

?Dorsiflexion of the great toe.

?Stretches the plantar

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aponeurosis.

?Increases the concavity of
the medial longitudinal arch.

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EXTENSOR DIGITORUM LONGUS

Origin:

?Upper three-fourths of the

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medial surface of the shaft
of fibula.

?A small area of lateral tibial
condyle.

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?Interosseous membrane.

?Anterior intermuscular
septum.

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EXTENSOR DIGITORUM LONGUS

Insertion:

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?Tendon divides into four
digital slips for insertion
into lateral four toes.

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?The slips join laterally with
the three digital slips of
extensor digitorum brevis
to form the dorsal digital
expansion.

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EXTENSOR DIGITORUM LONGUS

Nerve Supply:
Deep peroneal nerve

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Actions:

?Dorsiflexion of foot at the
ankle joint.

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?Dorsiflexion of lateral four
toes.

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PERONEUS TERTIUS

Origin:

?Lower one-fourth of the

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medial surface of the shaft of
fibula in continuity with the
origin of extensor digitorum
longus.

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?Adjacent inerosseous
membrane.

PERONEUS TERTIUS

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Insertion:

?Dorsal surface of the base of
the fifth metatarsal bone.

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Nerve Supply:
Deep Peroneal nerve

Actions:

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?Dorsiflexion of foot at the
ankle joint.

?Weak evertor of the foot.

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Superior Extensor
Retinaculum

Lateral: lower part of

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subcutaneous anterior
border of fibula.

Medial: anterior border of
tibia above the medial

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malleolus.

Encloses tendon of

Tibialis anterior.

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Inferior Extensor
Retinaculum

Stem: upper surface of

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calcaneus anterior to
sulcus calcanei.

encloses tendons of

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Peroneus tertius &
Extensor digitorum longus.


Upper limb: Tibial

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malleolus.

encloses tendons of

Extensor hallucis longus &

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Tibialis anterior.

Lower limb: blends with
Plantar aponeurosis.

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arches over tendons

of Extensor hallucis
longus & Tibialis anterior.

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ANTERIOR

TIBIAL ARTERY

It arises at the lower

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border of popliteus.

The artery passes
forwards between
two heads of tibialis

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posterior and
appears on the
interosseus
membrane through
an oval gap in it.

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ANTERIOR

TIBIAL ARTERY

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In the lower part it
lies over tibia midway
between the two
malleoli.

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It terminates as
dorsalis pedis artery
distal to the ankle.

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Branches :

1. Posterior tibial

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recurrent artery.

2. Anterior tibial

recurrent artery.

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3. Muscular branches.

4. Medial malleolar

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artery.

5. Lateral malleolar

artery.

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Deep peroneal
nerve

It arises from the

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bifurcation of
common peroneal
nerve lateral to neck
of fibula.

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Spirals around the
fibular neck, pierces
anterior
intermuscular
septum.

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Lies deep to Extensor
digitorum longus
over interosseus

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membrane lateral to
tibial vessels.

Branches :

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1. Muscular

branches.

2. Articular

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branches to
ankle joint.

Common peroneal nerve

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Peroneus longus

Deep peroneal nerve

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Tibialis Anterior

Extensor Digitorium Longus

Extensor Hallucis Longus

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Superficial
Peroneal nerve

Lateral branch of Deep

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peroneal nerve to Extensor

Medial branch to skin of 1st

Digitorium Brevis

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interdigital cleft


EXTENSOR DIGITORUM BREVIS

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Origin:

? Anterior part of the upper
surface of calcaneus.

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? Stem of inferior extensor
retnaculum.

EXTENSOR DIGITORUM BREVIS

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Insertion:
? Muscle divides into four tendons
for insertion into medial four toes.

? Most medial tendon is known as

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Extensor hallucis brevis. It is
inserted separately into base of
proximal phalanx of great toe.

? The other three tendons join with

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the dorsal digital expansion of the
second to fourth toes and get
inserted into the bases of middle
and distal phalanges.

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EXTENSOR DIGITORUM BREVIS

Nerve supply:
By a pseudoganglion from lateral

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terminal branch of deep peroneal
nerve.

Actions:
Dorsifexion of medial four toes in

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dorsiflexed foot.

DORSALIS PEDIS ARTERY

Begins infront of ankle between

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two malleoli.

Passes forward to the medial
side of the dorsum into the gap
between two heads of first

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dorsal interosseous muscle.

Enters the sole and forms
plantar arch by joining with the
deep branch lateral plantar

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artery.


DORSALIS PEDIS ARTERY

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Branches:

?Lateral tarsal artery.

?Medial tarsal artery.

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?Arcuate artery

?First dorsal metatarsal
artery.

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DEEP PERONEAL NERVE

Present lateral to dorsalis pedis in

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the foot between the tendon of

extensor hallucis longus and first

tendon of extensor digitorum

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longus.


DEEP PERONEAL NERVE

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LATERAL BRANCH
?Extensor digitorium brevis
?Tarsal joints
?2nd Dorsal Interosseus muscle

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MEDIAL BRACH-
?1st Dorsal Interosseus muscle
?Proximal joint of great toe
?Skin of 1st interdigital cleft

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APPLIED ANATOMY

1. Foot Drop- Paralysis of anterior compartment muscles

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2. Dorsalis pedis artery- Pulse felt between tendons of

Extensor hallucis longus andfirst tendon of extensor
digitorum longus.

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3. Anterior Tibial compartment syndrome

4. Nerve entrapments in deep fascia

Saphenous nerve

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Superficial Peroneal nerve