This is the lecture about anatomy of the posterior compartment of leg

1. Posterior Compartment of Leg
Dr. Zaheer Amjad
MBBS, DLO, PhD

2. Learning Objectives
At the end of lecture, you should be able to:
• Explain the boundaries of posterior compartment of leg
• Explain the subdivision of the posterior compartment
• Name the muscles, their attachments and functions in the posterior
compartment of the leg
• Discuss about the blood supply of the posterior compartment of leg
• State the nerve supply of the posterior compartment of leg

3. Muscles of Posterior Compartment of Leg
Superficial layer:
• Gastrocnemius
• Soleus
• Plantaris
Deep layer:
• Popliteus
• Flexor digitorum longus
• Flexor hallucis longus
• Tibialis posterior

4. Muscles of Posterior Compartment of Leg
Superficial layer:
• Gastrocnemius
• Soleus
• Plantaris
Deep layer:
• Popliteus
• Flexor digitorum longus
• Flexor hallucis longus
• Tibialis posterior
Triceps surae

5. Muscles of Posterior Compartment of Leg
Superficial layer:
• Gastrocnemius
• Soleus
• Plantaris
Deep layer:
• Popliteus
• Flexor digitorum longus
• Flexor hallucis longus
• Tibialis posterior

6. Muscles of Posterior Compartment of Leg
Superficial layer:
• Gastrocnemius
• Soleus
• Plantaris
Deep layer:
• Popliteus
• Flexor digitorum longus
• Flexor hallucis longus
• Tibialis posterior

7. Muscles of Posterior Compartment of Leg
Superficial layer:
• Gastrocnemius
• Soleus
• Plantaris
Deep layer:
• Popliteus
• Flexor digitorum longus
• Flexor hallucis longus
• Tibialis posterior

8. Origin:
• medial and lateral condyles of
femur.
Insertion:
• calcaneum via tendocalcaneus
Action:
• flexes knee joint and plantar
flexes foot at ankle joint.
Nerve supply:
• tibial nerve.
Gastrocnemius

9. Soleus
Origin:
• soleal line of tibia and upper third of
fibula
Insertion:
• calcaneum via tendocalcaneus.
Action:
• plantar flexes foot at ankle joint.
Nerve supply:
• tibial nerve.

10. Soleus
Origin:
• soleal line of tibia and upper third of
fibula
Insertion:
• calcaneum via tendocalcaneus.
Action:
• plantar flexes foot at ankle joint.
Nerve supply:
• tibial nerve.

11. Plantaris
Origin:
• Lateral supra condylar ridge of
femur.
Insertion:
• calcaneum
Action:
• flexes knee joint and plantar
flexes foot at ankle joint.
Nerve supply:
• tibial nerve.

14. Origin:
• Lateral surface of lateral condyle
of femur.
Insertion:
• Posterior surface of shaft of tibia.
Action:
• Flexes leg at knee joint, unlocks it
by lateral rotation of femur.
Nerve supply:
• Tibial nerve.
Popliteus

15. Popliteus
Origin:
• Lateral surface of lateral condyle
of femur.
Insertion:
• Posterior surface of shaft of tibia.
Action:
• Flexes leg at knee joint, unlocks it
by lateral rotation of femur.
Nerve supply:
• Tibial nerve.

16. Popliteus
Origin:
• Lateral surface of lateral condyle
of femur.
Insertion:
• Posterior surface of shaft of tibia.
Action:
• Flexes leg at knee joint, unlocks it
by lateral rotation of femur.
Nerve supply:
• Tibial nerve.

17. Flexor Digitorum Longus
Origin:
• Posterior surface of shaft of
tibia.
Insertion:
• Bases of distal phalanges of
lateral four toes.
Action:
• Flexes distal phalanges of
lateral four toes.
Nerve supply:
• Tibial nerve.

18. Flexor Digitorum Longus
Origin:
• Posterior surface of shaft of
tibia.
Insertion:
• Bases of distal phalanges of
lateral four toes.
Action:
• Flexes distal phalanges of
lateral four toes.
Nerve supply:
• Tibial nerve.

19. Flexor Hallucis Longus
Origin:
• Posterior surface of shaft of tibia.
Insertion:
• Base of distal phalynx of big toe.
Action:
• Flexes distal phalynx of big toe.
Nerve supply:
• Tibial nerve.

20. Flexor Hallucis Longus
Origin:
• Posterior surface of shaft of tibia.
Insertion:
• Base of distal phalynx of big toe.
Action:
• Flexes distal phalynx of big toe.
Nerve supply:
• Tibial nerve.

21. Tibialis Posterior
Origin:
• Posterior surfaces of shaft of tibia
and fibula.
Insertion:
• Navicular bone.
Action:
• Plantar flexes foot at ankle joint
• Inverts foot.
• Supports medial longitudinal arch
Nerve supply:
• Tibial nerve.

22. Tibialis Posterior
Origin:
• Posterior surfaces of shaft of tibia
and fibula.
Insertion:
• Navicular bone.
Action:
• Plantar flexes foot at ankle joint,
inverts foot.
Nerve supply:
• Tibial nerve.

24. Blood Supply of Posterior Compartment
Posterior tibial Artery:
• Large terminal branch of
popliteal artery.
• Also supplies lateral
compartment of leg & sole of
foot.

25. Course:
• Begins at lower border of
popliteus deep to
gastrocnemius.
• Enters back of leg by passing
deep to tendinous arch of
soleus.
• Terminates deep to flexor
retinaculum by dividing into
medial & lateral planter
arteries.
Blood Supply of Posterior Compartment

26. Course:
• Begins at lower border of
popliteus deep to
gastrocnemius.
• Enters back of leg by passing
deep to tendinous arch of
soleus.
• Terminates deep to flexor
retinaculum by dividing into
medial & lateral planter
arteries.
Blood Supply of Posterior Compartment

27. Course:
• Begins at lower border of
popliteus deep to
gastrocnemius.
• Enters back of leg by passing
deep to tendinous arch of
soleus.
• Terminates deep to flexor
retinaculum by dividing into
medial & lateral planter
arteries.
Blood Supply of Posterior Compartment

28. Branches of Posterior
Tibial Artery :
• Circumflex fibular artery
• Peroneal artery (largest
branch of posterior tibial
artery).
• Muscular branches.
• Nutrient artery to tibia
(largest nutrient artery)
Blood Supply of Posterior Compartment

29. Branches of Posterior
Tibial Artery :
• Circumflex fibular artery
• Peroneal artery (largest
branch of posterior tibial
artery).
• Muscular branches.
• Nutrient artery to tibia
(largest nutrient artery)
Blood Supply of Posterior Compartment

30. Branches of Posterior
Tibial Artery :
• Circumflex fibular artery
• Fibular (Peroneal) artery
(largest branch of posterior
tibial artery).
• Muscular branches.
• Nutrient artery to tibia
(largest nutrient artery)
Blood Supply of Posterior Compartment

31. Branches of Posterior
Tibial Artery :
• Malleolar branches-
anastomose with arteries
over medial malleolus
• Calcaneal branches-
anastomose with other
arteries in region.
• Terminal branches- medial
& lateral plantar arteries
Blood Supply of Posterior Compartment

32. Branches of Posterior
Tibial Artery :
• Malleolar branches-
anastomose with arteries
over medial malleolus
• Calcaneal branches-
anastomose with other
arteries in region.
• Terminal branches- medial
& lateral plantar arteries
Blood Supply of Posterior Compartment

33. Peroneal Artery
• Largest branch of posterior tibial
artery.
• Supplies posterior & lateral
compartments of leg.
• Starts 2.5cm below the lower
border of popliteus.
• Passes behind inferior tibiofibular
& ankle joints, medial to peroneal
tendon.
• Terminates by dividing into
number of lateral calcanean
branches.
Blood Supply of Posterior Compartment

34. Branches of Peroneal artery:
• Muscular branches to posterior &
lateral compartments.
• Nutrient artery to fibula.
• Anastomotic branches
• Perforating branch
• Communicating branch
• Calcaneal branch
Blood Supply of Posterior Compartment

36. Tibial Nerve
• Descends through the
popliteal fossa and posterior
compartment of leg.
• Terminates by dividing into
medial & lateral plantar
nerves.
• Crosses posterior tibial
artery from medial to lateral
side.

37. Branches of tibial nerve:
Muscular branches:
• Tibialis posterior.
• Flexor digitorum longus.
• Flexor hallucis longus.
• Soleus.
• Popliteus.
• Gastrocnemius
Tibial Nerve

38. Tibial Nerve
Branches of tibial nerve:
Cutaneous branches:
• Medial calcaneal nerve- supplies skin
on back & medial surface of heel.
• Sural nerve-supplies skin of calf, back
of leg, lateral border of foot and little
toe.
Articular branches:
• Ankle joint
• Knee joint

39. Branches of tibial nerve:
Cutaneous branches:
• Medial calcaneal nerve- supplies skin
on back & medial surface of heel.
• Sural nerve-supplies skin of calf, back
of leg, lateral border of foot and little
toe.
Articular branches:
• Ankle joint
• Knee joint
Tibial Nerve

40. Medial plantar nerve:
Cutaneous branch
• Supplies medial part of sole, medial
three and half toes, nail beds.
Muscular branches
• Abductor hallucis
• Flexor digitorum brevis
• Hallucis brevis
• First lumbrical
Tibial Nerve

41. Lateral plantar nerve:
Cutaneous branch:
• Supplies lateral part of sole, lateral
one and half toes, nail beds.
Muscular branches:
• Abductor digiti minimi
• Flexor digiti minimi brevis.
• Adductor hallucis.
• Interosseus.
• Second, Third, Fourth lumbricals.
Tibial Nerve