Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

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Atlas of Human Anatomy in Cross Section: Section 7. Lower Limb

Plate 7.29

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Upper Left Quadrant	Lower Left Quadrant	Lower Right Quadrant	Upper Right Quadrant
1. Tendon m. tibialis anterior 2. Great saphenous v. and saphenous nerve	3. Tendon m. tibialis posterior 4. Tendon m. flexor digitorum longus 5. Posterior tibial a. and v. 6. Tibial nerve 7. Tendon m. plantaris 8. Fat pad 9. Subcutaneous calcaneal bursa 10. Calcaneal (Achilles) tendon (mm. gastrocnemius and soleus)	11. Flexor hallucis longus m. 12. Small saphenous v. and sural nerve 13. Intermuscular fascial septum 14. Peroneus brevis m. 15. Tendon m. peroneus longus 16. Lateral calcaneal a. and v.	17. Tibiofibular syndesmosis 18. Inferior extensor retinaculum and anterior tibiofibular ligament 19. Tendons m. extensor digitorum longus 20. Tendon m. extensor hallucis longus

This section passes through the lower tibiofibular syndesmosis (17) about one cm above the talus. The subcutaneous calcaneal bursa (9) is seen. The bursa tendinis calcanei lies between the tendon of Achilles and the upper part of the back of the calcaneus.

Synovial tendon sheaths forming the bursa of the ankle and foot are similar to those in the wrist and hand. A number of these are associated with the muscle tendons of this region: (a) The synovial sheath of the tendon of flexor digitorum longus (vaginae tendinum m. flexoris digitorum longi) extends from the back of the lateral malleolus to the place where it crosses the tendon of flexor hallucis longus below the navicular bone. (b) The bursa of flexor hallucis longus (vagina synovalis m. flexor hallucis longi) surrounds the tendon from the back of the medial malleolus to the crossing of the tendon of flexor digitorum longus. Another sheath surrounds the tendon from the middle of the first metatarsal to its insertion. (c) The bursa of tibialis posterior (vagina tendinis m. tibialis posterioris) surrounds the muscle tendon from a region proximal to the medial malleolus to the insertion of the tendon. (d) The bursa of tibialis anterior (vagina tendinis m. tibialis anterioris) surrounds the muscle tendon from above the superior extensor retinaculum to the talonavicular Joint. (e) The synovial sheath of extensor hallucis longus (vagina tendinis m. extensoris halluci longi) begins above the proximal arm of the inferior retinaculum and ends near the tarsometatarsal Joint beneath a band-like thickening of the dorsal fascia of the foot. (f ) The common bursa of peronei longus and brevis (vagina synovalis mm. peroneorum communis) lies behind the lateral malleolus. The synovial sheath sends processes along each tendon proximally above the malleolus and distally on the lateral surface of the calcaneus.

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