‫بسم هللا الرحمن الرحيم‬

AL AZHAR UNIVERSITY
Faculty of Medicine for Girls
Year 1-Semester II
Academic year: 2020 / 2021
Module Name: Musculoskeletal and skin
Course code: IMP 07- 10212
Credit hours: 8 crh

Anatomy department
Lower Limb(lateral side of leg)
 OBJECTIVES
• At the end of the lecture, students should be able to:

1- Describe anatomy of the muscles of lateral side of leg.

2-Identify anatomy of the nerve supply of lateral side of legs.
The lateral compartment of the leg
A) Cutaneous innervation of the posterlateral portion of the leg
by sural nerve
B) Muscles of the Lateral Compartment of the Leg:
- It contains 2 muscles:
1-Peroneus longus muscle (long tendon)
2- Peroneus brevis (short tendon)
• Both of them arise from lateral Surface of fibula
• Both of them are inserted in foot
• Both of them are supplied by musculocutaneous nerve
• (superficial peroneal nerve).
• Both of them produce:
• Eversion
• Plantar flexion
• Supports the lateral longitudinal arch of foot.
Peroneus Longus
Origin: Upper 2/3 of lateral surface of fibula.
Insertion:
1)its tendon passes behind the lateral malleolus to be held by the
superior peroneal retinacula
2)and lateral surface of the calcaneus where it is held by inferior
peroneal retinacula
3)then enters the sole of the foot (in the 4th layer) where it passes
from lateral to medial in a groove on the cuboid bone
4)to be inserted into the lateral surfaces of the base of the
first metatarsal bone and the medial cuneiform bone.
2. Peroneus Brevis
• Origin: Lower 2/3 of lateral surface of fibula.
• Insertion: It passes below the lateral malleolus on the lateral
surface of the calcaneus deep to the inferior peroneal retinaculum
to reach the tuberosity of the base of the 5th metatarsal bone.
• Nerve Supply 0f both muscles:
• Innervated by the superficial peroneal nerve.
Action of both
muscles produced :
1-Plantar flexion of the foot
(ankle joint).
2-Eversion of the foot by talo-
calcaneo-navicular joint (sub-
talar joints).
3- Maintenance of the lateral
longitudinal and transverse
arches of the foot are produced
by peroneus longus.While,
Maintenance of the lateral
longitudinal arch of the foot by
the peroneous brevis.
Retinacula of the ankle
1)The superior peroneal retinaculum
• It is a thickened band of deep fascia that extends from the lateral malleolus
to
• the lateral surface of the calcaneum.
• The tendons of the peroneus longus and brevis pass deep to the retinaculum.
2) The inferior peroneal retinaculum
• Thick Y-shaped band of deep fascia in front of the ankle joint
• Attachment: The lateral end (the stem of Y): attached to the anterior part
• of upper surface of calcaneus
• Medially: The upper band: is attached to the medial malleolus.
• The lower band: passes to the medial side of the foot & fuses with the deep
• fascia of sole.
• Function: Keep the tendons of the peroneal muscles in position during their
• contraction

Synovial sheath of peroneal tendons

• It begins 5cm above the tip of the lateral malleolus.
• 1- At first it surrounds the tendons of the peroneus longus and brevis.
• 2- at the lateral surface of the calcaneum: it divides into 2 sheaths for the 2
• tendons. Each sheath reaches almost to the insertion of the muscle.
• B- Musculocutaneous (superficial peroneal) Nerve
• It is the smaller of the 2 terminal branches of the common peroneal nerve
• It begins: lateral to the neck of the fibula in the peroneus longus as one of the 2 terminal branches of common peroneal nerve
• Course and relations
• It descends in the lateral compartment of the leg:
• At first in the substance of peroneus longus, Then between peroneous longus and peroneus brevis and finally, between
peroneus brevis and extensor digitorum longus.
• At the junction of the middle and lower 1/3 of the front of the leg:
• The superficial peroneal nerve pierces the deep fascia to become
• cutaneous and descends in the superficial fascia to reach the dorsum of the
• foot.
• Branches
• A- muscular branches:
• 1- Peroneus longus
• 2- Peroneus brevis
• B- Cutaneous branches: to supply the skin of
• 1- Lower 1/3 of the lateral surface of the leg.
• 2- The skin of dorsum of foot (by the lateral &medial terminal
• branches) except:
• a-Cleft between 1st and 2nd toes "by deep peroneal nerve.
• b-Medial border of the foot "is supplied by saphenous nerve.
• c- Lateral border of the foot "is supplied by sural nerve.
• N.B. The medial terminal branch gives: - Medial branch to medial side of
• the big toe
• Results of common peroneal nerve injury
The common site of injury at the neck of the fibula:
A- Motor changes
• -Foot drop (plantar flexion and inversion of the foot):
• It is due to loss of the power of dorsiflexion and eversion of
the foot due
• to paralysis of:
• 1- Peroneus longus and brevis muscles (superficial
peroneal nerve)
• 2- Extensors of the foot (deep peroneal nerve)
B- Sensory changes
• - Loss of sensation on the skin of:
• 1- upper 2/3 of the back of the leg (sural communicating
nerve)
• 2- lateral side of the front of the leg (lateral cutaneous nerve
of the calf and
• superficial peroneal nerve)
• 3- middle part of the dorsum of the foot( superficial peroneal
nerve)
• 4- dorsum of toes (superficial and deep peroneal nerves)
except the lateral
• side of the little toe (sural nerve) and the dorsum of the
terminal
• phalanges (medial and lateral plantar nerves).
• References:

• Allam, H.N. : Synopsis of Human Embryology.

Devi, V.S. (2018):“Inderbir Singh’s Human Embryology”.11th ed. The Health
Sciences Publisher, New Delhi, London Panama.
Drake, R. A. Wayne Vogl, W. and Mitchell, A. (2017): Gray's Anatomy for
Students. Elsevier.
Kadasne, D.K. (2011):“Kadasne’s Textbook of Embryology”.1st ed. Jaypee
Brothers Medical Publishers.
Moore, K. L.; Persaud, T.V.N.; Torchia, M. G. (2013):“The Developing
Human”. Clinically Oriented Embryology. 8th ed. Saunders Elsevier.
Philadelphia.
Moore, K. L.; Dalley, A. F. and Agur, A. M. R. (2010): Clinically Oriented
Anatomy.6th Edition, Lippincott Williams & Wilkins, Philadelphia.
Romanes, G. J.: Cunning hams Manual of Practical Anatomy.13th ed. London,
Oxford University Press. New York, Bombay.
Ronald W. Dudek, R. W. (2014):“BRS Embryology”. 6th ed. Lippincott
Williams & Wilkins.
Sadler, T. W. (2019): “Langman´s Medical Embryology”.9th ed. Lippincott
Williams& Wilkins. Philadelphia, New York, London, Hong Kong,
Sydney, Tokyo. pp. 298-301.
Singh, V. (2017): “Textbook of Clinical Embryology”.2nd ed. Elsevier, Relx
India Pvt. Ltd.
Snell, R.S. (2008): “Clinical Anatomy by Regions”. 8th ed. Lippincott
Williams& Wilkins. Philadelphia, New York, London, Hong Kong,
Sydney, Tokyo. P. 253
Thanks for listening and attention
Wish you best luck