dorsum of foot and ankle

Dorsum

dorsal structures

· Tom (tibialis anterior TA)

· Had (extensor hallucis longus EHL)

· A (anterior tibial artery)

· Night (deep peroneal nerve)

· Down (extensor digitorum longus EDL)

· Town (peroneus tertius PT)

superficial peroneal nerve

· divides above ankle into medial and lateral branches

· medial branch supplies

· medial dorsum of hallux

· 2-3 cleft

· lateral branch supplies

· 3-4 cleft

· 4-5 cleft

· deep peroneal nerve supplies 1-2 cleft

· sural nerve supplies lateral little toe

deep peroneal nerve

· crosses dorsum of ankle

· lateral to artery

· supplies

· 1-2 cleft

· EDB

· periosteum and joint capsules

superior extensor retinaculum

· thickening of deep fascia

Origin

· laterally from anterior border of fibula

Insertion

· medially to anterior border of tibia

Structures

· encloses tibialis anterior

· with synovial sheath

· other structures pass deep to it

inferior extensor retinaculum

Origin

· by stem

· from upper calcaneum

· from lateral edge of sinus tarsi

Insertion

· upper stem

· to medial malleolus

· lower stem

· across dorsum of foot

· to plantar aponeurosis under medial longitudinal arch

Structures

· dorsal tendons slung in retinaculum

· enclosed in synovial sheaths

extensor digitorum brevis

Origin

· upper surface of calcaneus

· behind bifurcate ligament

· stem of inferior extensor retinaculum

Insertion

· 4 slips

· medial slip

· called extensor hallucis brevis

· inserts into base of proximal phalanx

· lateral 3 slips

· into toes 2,3,4

· deep to tendons of EDL

· into extensor expansions

dorsalis pedis artery

· passes forwards

· lies between

· tendon of EHL medially

· digital branch of deep peroneal n laterally

· crossed by tendon of EHB

· runs to base of 1-2 intermetatarsal space

· passes into sole

· joins lateral plantar a to form plantar arch

· three branches

Lateral tarsal artery

· runs laterally beneath EDB

· supplies EDB and tarsal bones

Arcuate artery

· runs laterally beneath tendons of EDB

· over bases of MTs

· gives off dorsal MT aa to supply lateral 3 clefts

· each dorsal MT a gives off perforating branch to communicate with plantar arch

1st dorsal metatarsal artery

· continuation of dorsalis pedis

· supplies 1st cleft

deep peroneal nerve

· passes forwards

· lateral to artery

· supplies 1st cleft

· gives off branch to EDB

Lateral aspect

sural nerve

· runs with short saphenous nerve

· passes behind lateral malleolus

· ends on lateral aspect of 5th toe

peroneal tendons

· peroneus brevis

· broad tendon

· lies behind and grooves lateral malleolus

· peroneus longus

· narrow tendon

· lies on tendon of brevis

· does not contact lateral malleolus

· tendons pass forwards on peroneal trochlea

· peoneus brevis above

· peroneus longus below

· peroneus brevis inserted into styloid process on base of 5th MT

peroneal retinaculae

Superior

· binds tendons behind lateral malleolus

· thickening of deep fascia

· from lateral surface of calcaneus

· to tip of lateral malleolus

Inferior

· binds tendons at peroneal trochlea

· upper part continuous with stem of inferior extensor retinaculum

· lower part attaches to

· lateral calcaneus (above and below tendons)

· peroneal trochlea (between tendons)

Medial aspect

structures

· Tom (tibialis posterior TP)

· Dick (flexor digitorum longus FDL)

· A (posterior tibial artery)

· N (tibial nerve)

· Harry (flexor hallucis longus FHL)

flexor retinaculum

· thickening of deep fascia

· from medial malleolus to calcaneus

· bridges tendons and neurovascular bundle