Posterior compartment

nerves

Cutaneous

· proximal supplied by termination of posterior femoral cutaneous nerve

· distal supplied by sural nerve

veins

Short saphenous vein

· drains lateral side of dorsal venous arch

· starts behind lateral malleolus

· passes upwards along midline of calf

· pierces deep fascia on roof of popliteal fossa

· enters popliteal vein

deep fascia

· attached to posterior border of tibia

Flexor retinaculum

· distal thickening of deep fascia

· between medial malleolus and calcaneus

· bridges deep flexor tendons and NV bundle

superficial muscles

Gastrocnemius

Origin

· medial head

· from medial condyle and popliteal surface

· by tendon that leaves pit

· lateral head

· from lateral surface of lateral condyle

· by tendon that leaves pit

· medial head more proximal than lateral head

Path

· heads converge

· aponeurosis deep to muscle

· lateral side blends with underlying soleus aponeurosis

· medial side separate proximally

· separated by plantaris

· blends at heel

· forms tendo Achilles at heel

Insertion

· smooth area on middle third of posterior calcaneus

· deep bursa lies between tendon and calcaneus

· superficial bursa lies between tendon and deep fascia more proximally

Plantaris

Origin

· shaft of femur next to lateral head of gastrocnemius

Path

· tendon runs deep to medial head of gastrocnemius

Insertion

· calcaneus medial to tendo Achilles

Soleus

Origin

· from tibia by soleal line

· from upper 1/4 of fibula

· joined by fibrous arch

· bridges over popliteal a and tibial n

Path

· aponeurosis on both surfaces

· blends with that of gastrocnemius

Insertion

· part of tendo Achilles

deep muscles

Flexor digitorum longus

Origin

· from posterior surface of tibia below soleal line

· lateral to vertical ridge

Path

· tendon lies medially in calf

· crosses superficial to FHL in sole

Insertion

· P3 of lateral 4 toes

Flexor hallucis longus

Origin

· middle 1/2 of fibula

Path

· lies lateral to PT

· crossed by FDL in sole

· tendon forms at lower end of tibia

Insertion

· base of P2 of great toe

Tibialis posterior

Origin

· from posterior surface of tibia below soleal line

· medial to vertical crest

· from posterior surface of fibula

· between medial crest and interosseous border

Path

· grooves back of medial malleolus

Insertion

· tuberosity of navicular

NEUROVASCULAr

Posterior tibial artery

· arises at bifurcation of popliteal artery

· at lower border of popliteus

· passes under fibrous arch of soleus

· runs down between FDL and FHL

· lies successively on

· TP

· FDL

· tibia

· passes behind medial malleolus

· ends under flexor retinaculum

· divides into medial and lateral plantar aa

Branches

Peroneal

· arises 2 cm below commencement of PT

· passes laterally across PT

· runs between TP and FHL

· ends by dividing into

· perforating branch which pierces IOM to enter extensor compartment

· lateral calcaneal branch

Nutrient

· to tibia

· enters between origins of TP and FHL

Muscular

· to soleus

Tibial nerve

· runs straight down calf

· under soleus

· lies between FDL and FHL

· proximally is medial to anterior tibial a

· then passes over it

· distally is lateral to anterior tibial a

· ends under flexor retinaculum

· supplies

· gastrocnemius

· soleus

· plantaris

· TP

· FHL

· FDL

· supplies heel by median calcanean branches