Flashcards in Tibial nerve Deck (12):
Arises at apex of popliteal fossa.
Within the popliteal fossa, it gives off branches to superficial posterior leg and branches that contribute to the sural nerve which innervates the posterolateral leg.
Descends posterior to tibia, supplying deep posterior leg.
At the foot, it passes posterior and inferior to medial malleolus through the tarsal tunnel. Within the tunnel, branches arise that supply cutaneous Innervation to heel.
Immediately distal to tarsal tunnel, the tibial nerve terminates by dividing into sensory branches that innervate the sole of the foot.
What is tarsal tunnel syndrome
Tibial nerve is compressed within the tarsal tunnel (posterior to medial malleolus)
Causes of tarsal tunnel syndrome
Post trauma ankle deformities
Presentation of tarsal tunnel syndrome
Paresthesia in ankle and sole of foot, which can radiate up the leg
It's aggravated by activity and relieved by rest
Treatment of tarsal tunnel syndrome
Anti Inflammatory drugs and changes in footwear.
If unsuccessful, flexor retinaculum can be surgically cut to release the pressure
Deep posterior leg - Popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior
Superficial posterior leg - plantaris, soleus, gastrocnemius
What branches give sensory Innervation to the sole of the foot
Medial calcaneal branches - arise within tarsal tunnel and innervates skin over heel
Medial plantar nerve - skin over plantar surface of medial 3.5 digits and associated sole
Lateral plantar nerve - skin over plantar surface of lateral 1.5 digits and associated sole
What forms the sural nerve
Cutaneous branches of tibial nerve that arise in the popliteal fossa combine with branches from the common fibular nerve
Sensory Innervation of sural nerve
Skin over posterolateral leg
Lateral side of foot
How does damage to tibial nerve occur
Entrapment through narrow space
Compression for long period