Tibial nerve Flashcards Preview

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Flashcards in Tibial nerve Deck (12):
1

Anatomical course

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.

2

What is tarsal tunnel syndrome

Tibial nerve is compressed within the tarsal tunnel (posterior to medial malleolus)

3

Causes of tarsal tunnel syndrome

Osteoarthritis,
Rheumatoid arthritis,
Post trauma ankle deformities

4

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

5

Treatment of tarsal tunnel syndrome

Anti Inflammatory drugs and changes in footwear.
If unsuccessful, flexor retinaculum can be surgically cut to release the pressure

6

Motor Innervation

Deep posterior leg - Popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior
Superficial posterior leg - plantaris, soleus, gastrocnemius

7

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

8

What forms the sural nerve

Cutaneous branches of tibial nerve that arise in the popliteal fossa combine with branches from the common fibular nerve

9

Sensory Innervation of sural nerve

Skin over posterolateral leg
Lateral side of foot

10

Nerve roots

L4-S3

11

How does damage to tibial nerve occur

Rare
Direct trauma
Entrapment through narrow space
Compression for long period

12

Consequences of damage

Loss of plantar flexion and flexion of toes
Weakened inversion (tibialis anterior still inverts foot)

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