THE LEG

CONTENTS
Bones
Muscles
Nervous supply
Blood supply
Clinical significancy
BY Ms EDITH NAGAWA.
 Bones of the leg
• Patella
• Tibia
• fibula
• The leg is compartmentalized into the
anterior, lateral and posterior
compartments by two intermuscular septa
(FASCIA) and interosseous membrane.
 Anterior compartment
• Muscles: Tibialis anterior, extensor
digitorum longus, extensor hallucis longus,
peronius tertius
• Artery: Anterior tibial artery branch of the
popliteal artery
• Nerves: Deep peroneal nerve a branch of
the common peroneal nerve
 CUTANEOUS SUPPLY

• The lateral cutaneous nerve of the calf, a branch

of the common peroneal nerve, supplies the skin
on the upper part of the lateral surface of the leg
• The superficial peroneal nerve, a branch of the
common peroneal nerve , supplies the skin of
the lower part of the anterolateral surface of the
leg .
• The saphenous nerve, a branch of the femoral
nerve , supplies the skin on the anteromedial
surface of the leg.
 Lateral compartment
• Muscles: peroneus longus and peroneus
brevis
• Nerves: superficial peroneal nerve
• Artery: Peroneal artery branches.
 Posterior compartment.

Cutaneous Nerves
• The posterior cutaneous nerve of the thigh descends on the
back of the thigh . In the popliteal fossa, it supplies the skin
over the popliteal fossa and the upper part of the back of the
leg .
• The lateral cutaneous nerve of the calf, a branch of the
common peroneal nerve, supplies the skin on the upper part of
the postero lateral surface of the leg.
• The sural nerve, a branch of the tibial nerve , supplies the skin
on the lower part of the postero lateral surface of the leg.
• The saphenous nerve, a branch of the femoral nerve, gives off
branches that supply the skin on the posteromedial surface of
the leg.
• Superficial muscles: Gastrocnemius,
Plantaris, soleus
• Deep muscles: flexor hallucis longus,
flexor digitorum longus, tibialis posterior,
popliteus
• Nerves: Tibial nerve
• Artery: posterior tibial artery
• Veins: small saphenous veins
 Clinical notes
• Footdrop is a clinical sign indicating paralysis of the
muscles in the anterior compartment of the leg. It is
most commonly seen when the common fibular nerve
(from which the deep fibular nerve arises) is damaged.

• In footdrop, the muscles in the anterior compartment are

paralysed. The unopposed pull of the plantarflexor
muscles (found in the posterior leg) produces permanent
plantarflexion. This can interfere with walking – as the
affected limb can drag along the ground. To circumvent
this, the patient can flick the foot outwards while walking
– known as an ‘eversion flick‘.
Rapture of the calcaneal tendon
• Rupture of the calcaneal tendon refers to a partial or complete
tear of the tendon. It is more likely to occur in people with a
history of calcaneal tendinitis (chronic inflammation of the
tendon).

• The injury is usually sustained during forceful plantar flexion of

the foot. The patient will be unable to plantar flex the foot
against resistance, and the affected foot will be permanently
dorsi flexed. The soleus and gastrocnemius can contract to
form a lump in the calf region.

• Treatment of a ruptured calcaneal tendon is usually non-

surgical, except in those with active lifestyles.
Tendon rupture
• Management
• Tendon should be sutured ASAP and leg
immobilized with the ankle joint plantar flexed
and knee joint flexed
• Deep venous thrombosis: immobility can lead
to formation of thrombi in veins of the soleus
muscle.
• Anterior compartment syndrome: occurs due
to increase in intracompartmental pressure
probably caused by increased tissue fluid.
Drainage and blood supply are blocked
causing necrosis and compression of the
deep peroneal nerve may result into paralysis
and sensation loss between the first and
second toe.