רגל, קרסול וכף רגל- אנטומיה Flashcards
Anterior region of the Leg
מתחת העור ה-
TISSUE CUTANEUS SUB מכילה את :
- Lateral sural cutaneous nerve
- Superficial fibular nerve
- Branches of Great & Small saphenous veins
- Superficial lymphatic vessels
Anterior region of the Leg
Deep plan
- Deep fascia – crural fascia
- superior extensor retinaculum
- Tibial crest
- Tibialis anterior muscle
- Extensor digitorum longus
- Extensor hallucis longus
מתווסף בערך החל מהשליש האמצעי
fibula & interosseus M. -ה של - Deep fibular nerve
- Anterior tibial artery & veins
Interosseous membrane
מה המוצא הספינאלי של ה
Deep peroneal nerve
ומה כיוון התנועה שלו
L5–S2
oblique anterior inferior medial
גיד ה-
FT
כלול במעטפת עם איזה שריר ?
EDL
Deep peroneal nerve branches
Muscular Branches
את מה מספקים הענפים הללו?
- Tibialis anterior
- Extensor digitorum longus
- Extensor halucis longus
Peroneus tertius
Deep plan – anterior compartment
Deep peroneal nerve branches
Articular Branches
מה מספקים הענפים הללו ?
- Distal tibio-fibular joint
- Ankle joint
Deep peroneal nerve branches
Medial terminal branch
מה מספקים הענפים הללו?
- cutaneous innervation to the
first inter-digital space - first metatarsophalangeal joint
(articular branch)
Deep peroneal nerve branches
Lateral terminal branch
מה מספקים הענפים הללו ?
- extensor digitorum brevis and extensor
hallucis brevis mm. - tarsal joint as well as the middle three
metatarsophalangeal joints (articular
branches).
Deep peroneal nerve branches
Dorsal digital nerve
מה מספקים הענפים הללו ?
- Sensory innervation to the skin of
adjacent space of the 1st & 2nd toes
(dorsal aspect) - Dorsal aspect of the joints of the 1 st toe.
מה הוא המסלול של ה-
Anterior tibial artery & veins ?
- commences at the bifurcation of
the popliteal, at the lower border
of the Popliteus. - passes forward the 2 heads of TP, & through the sup. Aperture of interosseus M.
- descends on the anterior surface of the interosseous membrane.
עם מי עושה אנסטומוזה ה-
Posterior tibial recurrent artery?
inferior genicular branches
Anterior tibial artery & veins branches :
Posterior tibial recurrent artery
מספק את ?
- superior tibiofibular joint
- Popliteus m.
Anterior tibial artery & veins branches :
Anterior tibial recurrent artery
מספק את ?
Knee joint
Anterior tibial recurrent artery
עושה אנסטומוזה עם?
genicular branches of the popliteal and circumflex fibular arteries
Anterior tibial artery & veins branches :
Muscular branches
מספקים את ?
- Muscles of anterior compartment
- Some of these branches pierce the deep fascia and
supply the skin of the anterior leg - Some branches pass through the interosseous M. and
anastomose with branches of the posterior tibial and
medial plantar arteries
Anterior tibial artery & veins branches :
Perforating branches
עוברים מאוחרי ה-
EDL
מחוררים את הפאשיה ומספקים את העור של האנטריור לג.
עוזרים בוסקולריזציה של הפרוקסימל לטרל קומפרטמנט של הלג.
Anterior tibial artery & veins branches :
Anterior medial malleolar artery
מספק את ?
- ankle joint
- anastomose with branches of the posterior tibial and medial plantar arteries.
Anterior tibial artery & veins branches :
Anterior lateral malleolar artery
מספק את?
- ankle joint
- anastomose with the perforating branch of the
fibular (peroneal) artery, and the ascending
branches of the lateral tarsal artery.
Deep plan – lateral compartment
גבולות
- Anterior intermuscular septum
- Posterior intermuscular septum
- Crural fascia
- Lateral border of fibula
Deep plan – anterior intermuscular septum of leg
Anatomical relations
Anteriorly : extensor digitorum longus m.
Posteriorly : peroneus longus & brevis mm.
Medially : anterior border of the fibula
Deep plan – posterior intermuscular septum of leg
Anatomical relations
anteriorly : peroneus longus & brevis mm.
posteriorly : flexor hallucis longus & soleus mm.
Medially : posterior border of the fibula
Deep plan – muscles – lateral compartment
שרירים ועצבים
- Peroneus longus m.
- Peroneus brevis m.
- common fibular nerve
- Superficial fibular nerve
מה מרחב ה
T (טי)
של האחז הפרוקסימלי של
FL
מאפשר?
האחז הפרוקסימלי של ה-
FL
מותיר מרחב טי על עצם
ה-fibula
חופשי מכל אחז.
הזרוע ההוריזונטלית של הטי
נותנת מעבר ל-
common peroneal nerve
הזרוע הוורטיקלית של הטי
נותנת מעבר ל-
superficial peroneal nerve
מה המוצא הספינאלי של ה-
superficial peroneal nerve
L4–S1
מה מסלול ה-
superficial peroneal nerve
- Passes between the fibula and the proximal part of fibularis longus
muscle. - then descends deep to the fibularis longus muscle.
- Between FL & EDL separate by anterior intermuscular septum.
- It pierces the deep fascia in the
distal third of the leg and subsequently divides into the
medial dorsal cutaneous nerve
and the intermediate dorsal cutaneous nerve.
superficial peroneal nerve branches
Muscular branches
מספקים את ?
- Fibularis longus m.
- Fibularis brevis m.
superficial peroneal nerve branches :
Intermediate dorsal cutaneous nerve of foot
Branches:
dorsal digital nerves
מספק את?
- contiguous sides of the third and fourth, and of the fourth and fifth toes
(interdigital spaces). - It also supplies the skin of the lateral side of the
foot and ankle, and communicates with the sural nerve - supply the skin of the dorsal surfaces of 3rd 4th and 5th toes (just medial half of the 5th)
Deep plan – lateral compartment
superficial peroneal nerve branches :
Medial dorsal cutaneous nerve of foot
Branches:
dorsal digital nerves (2 branches)
מספקים את?
- the medial side of the great toe, and the adjacent side of the second
and third toes (interdigital space). - It also supplies the integument of the medial side of the foot and ankle, and communicates with the saphenous nerve, and with the deep peroneal nerve
מי מספק את המדור הלטרלי של הרגל?
למדור הלטרלי אין עורק משלו. הוא מקבל דם מ- branches perforating
ומתנקז מה-
:שלהם satellite veins
החלק הפרוקסימלי מסופק על ידי
perforating branches of anterior tibial artery
החלק הדיסטלי מסופק על ידי
perforating branches of fibular artery.
posterior region of the Leg
ה- superficial plan
מתחת העור מכיל את ה:
- Great saphenous vein and its branches
- Small saphenous vein and its branches
- Superficial lymph vessels
- Saphenous nerve
- Lateral sural cutaneous nerve
- Medial sural cutaneous nerve
- Sural communicating branch
- Sural nerve
מי נתונים בשכבה כפולה של ה-
posterior aponeurosis
medial sural cutaneous N. -ה
צמוד ל
small saphenous vein
שניהם נתונים בשכבה כפולה של
posterior aponeurosis
העצב עמוק מהווריד ואנטריורי
ולטרלי לו
posterior region
מחולק לשני מדורים :
- Superficial posterior compartment
- Deep posterior compartment
posterior compartment – superficial lodge
אילו שרירים מכיל?
- Gastrocnemius m.
- Plantaris m.
- Soleus m.
deep plan - posterior compartment -Transvers intermuscular septum
מה הם היחסים האנטומים?
posteriorly : soleus m.
Anteriorly : FDL FHL , posterior
tibial vasculo-nervous package
Medially : medial margin of the
tibia
Lateraly : lateral margin of the
fibula
deep plan - posterior compartment – deep lodge
אילו סטרוקטורות נמצאות באזור ?
- Posterior tibial artery & veins
- Tibial nerve
- Flexor digitorum longus
- Flexor hallucis longus
- Fibular artery & veins
- Tibialis posterior m.
מה הוא מסלול ה-
Posterior tibial artery & veins
- the posterior tibial artery is the larger of the tow tibial arteries.
- coursing from the inferior margin of the popliteus muscle up to the medial malleolus.
- under the tendinous arch of the soleus m. the popliteal artery divides into an anterior tibial artery and a tibio peroneal trunk (3 to
4 cm long).
4 .the trunk divides into post tibial & peroneal arteries.
Posterior tibial artery & veins
יחסים אנטומים
- At the leg, the artery is : post. To
TP m; Lat. To FDL,
Med. To FHL. - at the distal part of the leg the artery passes behind the tibia and
the ankle joint. - In the lower third of the leg,
where it is more superficial, it
is covered only by the
integument and
fascia, and runs parallel with
the medial border of the
tendo calcaneus. - it continues distally deep to the
flexor retinaculum, accompanied
by, from medial to lateral: TP,
FDL tendons, (tibial artery &
veins), tibial nerve, FHL tendon
-It then traverses the tarsal
tunnel, deep to the flexor
retinaculum, entering the
plantar compartment of
the foot. - The tibial nerve crosses
the posterior side of the
artery’s origin and is
located lateral to the
artery along its course. - the tibial artery is
found posterior to
the veins
Posterior tibial artery & veins
ענף אחרון
The terminal bifurcation of
the posterior tibial artery
(medial & lateral plantar
arteries) is located deep to
the abductor hallucis muscle
The posterior tibial artery has 10 branches in total
מה הם הענפים?
- circumflex fibular
- Fibular
- Nutrient
- Muscular
- Perforating
- Communicating
- medial malleolar
- Calcaneal
- lateral plantar
- medial plantar arteries
Posterior tibial artery & V. branches
The circumflex fibular artery
מספק את
- Proximal fibula
- Soleus m.
- Knee joint
deep plan - posterior compartment – deep lodge
Posterior tibial artery & V. branches
fibular artery
מספק את?
The fibular artery arises approximately 2.5 cm after
the posterior tibial artery arises, distal to the
popliteal muscle (but it may occasionally arise up to
8 cm distal to the popliteus), where it descends
along the medial aspect of the fibula
Posterior tibial artery & V. branches
Nutrient artery of tibia
מספק את
arises distally to the circumflex fibular artery. It enters the tibia below the solear line, being the main vessel that supplies this bone.
הזנה לעצם הטיביה.
Posterior tibial artery & V. branches
muscular branches
מספקים את ?
- soleus muscle
- Popliteus
- FHL m.
- FDL m.
- TP m.
Posterior tibial artery & V. branches
perforating branches
מספקים את ?
skin and fascia of the posterior leg.
Posterior tibial artery & V. branches
communicating branch
It anastomoses with the communicating branch of
the fibular artery.
- emerges above
the distal end of
tibia (post) deep
to flexor hallucis
longus muscle.
Posterior tibial artery & V. branches
medial malleolar branches
מספקים את ?
Contribute to the medial malleolar vascular
network (formed by : medial malleolar, medial
tarsal & medial plantar arteries) , via which they supply the skin & the medial structures of the medial aspect of the ankle.
Posterior tibial artery & V. branches
The calcaneal branches
מספקים את ?
- Contribute to the supply of the calcaneus bone,
Achilles tendon, calcaneal bursa, cutaneous tissue of the heel. - Supply muscles of the medial part of the sole of the foot.
- They anastomose with medial malleolar arteries and calcaneal branches of the fibular artery.
Posterior tibial artery & V. branches
Medial & lateral plantar arteries
The terminal bifurcation of the posterior tibial artery
(medial & lateral plantar arteries) is located deep to
the abductor hallucis m. in the origin of the
sustentaculum tali.
מה הוא המקור הספינלי של
Tibial nerve
L4-S3
The Tibial nerve (L4-S3)
מה מסלול העצב ?
oblique inferior medial
1. As the nerve approaches the The
distal aspect of the popliteal
fossa, it becomes medial to
the popliteal vessels and
passes deep to heads of the
gastrocnemius muscle/
2. Then it runs below the tendinous
arch formed by the heads of the
soleus muscle to enter the deep
posterior compartment of the leg
(in front of the transvers septum)
3.Here it descends on the post.
surface of TP muscle, along with
the posterior tibial vessels, as a
neurovascular bundle
4.It then traverses the tarsal
tunnel, deep to the flexor
retinaculum, entering the
plantar compartment of
the foot.
5.The tibial nerve crosses
the posterior side of the
artery’s origin and is
located lateral to the
artery along its course.
The Tibial nerve (L4-S3)
יחסים אנטומים
- At the leg, the
nerve is : post. To TP m; Lat. To FDL,
Med. To FHL - at the distal part of the leg the nerve passes behind the tibia and
the ankle joint. - In the lower third of the leg,
where it is more superficial, it
is covered only by the
integument and fascia, and runs parallel with the medial border of the tendo calcaneus.
סטרקטורל ממדיאל ללטרל ב-
tarsal tunnel
Tom, Dick And Very Nervous Harry
Tibialis posterior .1
Digitorum longus (flexor) .2
Artery (post. Tibial) .3
Vein (post. Tibial) .4
Nerve (tibial) .5
Hallucis longus (flexor) .
The Tibial nerve branches
muscular branches
מספקים את ?
GC, plantaris, soleus, popliteus mm.
TP, FDL, FHL mm.
The Tibial nerve branches
articular branches
מספקים את ?
- Knee joint
- Proximal & distal tibiofibular joints
- Ankle joint
The Tibial nerve branches
Cutaneous branches (2 br.)
מה הם שני הענפים?
- sural nerve
2.medial laterl calcaneal nerve?
sural nerve
מה מסלולו?
The sural nerve passes between the lateral
malleolus and the calcaneus and into the foot.
Here, it gives rise to lateral calcaneal branches
and the lateral dorsal cutaneous nerve which
provide cutaneous innervation to the lower
posterolateral surface of the leg and the lateral
side of the foot and little toe.
Supply :
Cutaneous innervation to the posterior and
lateral aspect of the leg and ankle
Cutaneous innervation to the lateral aspect of
the foot
medial calcaneal nerve
arises from the tibial nerve close to the ankle and
runs onto the medial aspect of the calcaneus.
Supply :
The skin on the medial surface and sole of the
heel.
