ANTERIOR COMPARTMENT OF THE LEG

MUSCLES, ARTERIES, NERVES

BOUNDARIES
Anterior: Deep fascia of the leg.
Medial: Lateral surface of the shaft of the tibia.
Lateral: Anterior intermuscular septum.
Posterior: Interosseous membrane.

CONTENTS

Muscles: 4 muscles (tibialis anterior, extensor hallucis longus, extensor

digitorum longus, and peroneus tertius).
Artery: Anterior tibial artery.
Nerve: Deep peroneal nerve (anterior tibial nerve).

MUSCLES OF THE ANTERIOR COMPARTMENT OF

THE LEG
With the exception of the Tibialis anterior which appears from tibia, all the
muscles of the anterior compartment of the leg originate from the Fibula.
All are supplied by the deep peroneal nerve and dorsiflex.

ORIGIN, INSERTION, AND ACTIONS OF THE MUSCLES

OF THE ANTERIOR COMPARTMENT OF THE LEG
 Insertion
Muscle Origin from Actions
into

1. Upper 2/3rd of the

lateral surface of the
1. Dorsiflexion of the
tibia
1. Medial surface of the ankle
2. Adjacent part of the
Tibialis anterior (it medial cuneiform 2. Inversion of the
interosseous membrane
has spindle-shaped 2. Adjoining medial foot
3. Its own covering deep
multipennate belly) surface of the base of 3. Maintenance of the
fascia
the 1st metatarsal medial longitudinal
3. Distal part of the
arch of the foot
lateral condyle of the
tibia

1. Middle 2/4th
1. Extension of the
(posterior part) of the
Base (dorsal surface) of phalanges of the big
Extensor hallucis medial surface of the
the distal phalanx of the toe
longus shaft of fibula
big toe 2. Dorsiflexion of the
2. Adjacent part of the
foot
interosseous membrane

1. Dorsiflexion of the
Whole of the upper
Middle and distal foot
1/4th and medial part of
Extensor digitorum phalanges of the lateral 2. Extension of MP*,
the middle 2/4th of the
longus four toes by four PIP**, and DIP***
anterior surface of the
tendons joints of the lateral
fibula
four toes

1. Lower 1/4th of the

1. Dorsiflexion of the
anterior surface of the Dorsal surface (medial
foot
Peroneus tertius fibula part) of the base of the
2. Eversion of the
2. Adjacent part of the 5th metatarsal bone
foot
interosseous membrane
* MP: metatarsophalangeal, ** PIP = proximal interphalangeal, *** DIP =
distal interphalangeal.

TIBIALIS ANTERIOR
Its a spindle-shaped multipennate muscle. Its the most medial and
superficial dorsiflexor of the foot, which is located against the lateral surface
of the tibia.
Origin

It appears from:

Upper 2/3rd of the lateral surface of the tibia and adjoining part of the
lateral condyle of the tibia.
Adjoining part of the interosseous membrane.
Overlying deep fascia of the leg.

Insertion

The muscle fibres converge below to create a tendon that is related to the
lower 1/3rd of the lateral surface of the tibia. It pierces the medial part of
superior extensor retinaculum and the upper group of inferior extensor
retinaculum. Now it enters medially underneath the inferior group of inferior
extensor retinaculum to be added on to the inferomedial side of the base of
the very first metatarsal bone and adjacent part of the medial cuneiform.

Nerve Supply

By the deep peroneal nerve.

Actions

Its the leader dorsiflexor of the foot in the ankle joint.

It keeps the medial longitudinal arch.
It functions as an inverter of the foot at the midtarsal and subtalar
joints.

Clinical testing

To analyze tibialis anterior medically, request the patient to stand on heels

or dorsiflex the foot against resistance. If normal, its tendon can be viewed
and palpated.

Clinical significance

Anterior tibial compartment syndrome/shin splints (Freshers

syndrome): It happens because of overexertion of the muscles of the
anterior compartment particularly when the untrained men who lead a
sedentary life are requested to walk or run for long distances. Shin
splints also appear in trained runners who dont warm up.
Muscles of the compartment swell inside a tight compartment because
of unexpected overuse that might impede venous return resulting in
accumulation of more fluid in the compartment with unyielding walls.
The pressure tends to compress the anterior tibial artery, and reducing
the blood supply to the muscles, resulting in ischemia and pain. Its
often viewed in freshers (example, recently accepted medical
students/ recently recruited military employees) who are made to run
excessively. Therefore, this condition is also called military freshers
syndrome.

ANTERIOR TIBIAL ARTERY

The anterior tibial artery is the key artery of the anterior compartment of the
leg. It corresponds to the posterior interosseous artery of the forearm. The
blood supply to the anterior compartment of the leg is bolstered by the
perforating branch of peroneal artery. Hence, the size of peroneal artery is
inversely proportional to that of the anterior tibial artery.

The anterior tibial artery is escorted by 2 venae comitantes.

The anterior tibial artery descends through the anterior compartment on the
interosseous membrane. In the distal leg, it lies between the tendons of the
tibialis anterior and extensor hallucis longus muscles. It leaves the leg by
passing anterior to the distal end of the tibia and ankle joint and continues
onto the dorsal aspect of the foot as the dorsalis pedis artery.

In the proximal leg, the anterior tibial artery has a recurrent branch, which
connects with the anastomotic network of vessels around the knee joint.
DEEP PERONEAL NERVE (ANTERIOR TIBIAL
NERVE)
Its the nerve of the anterior compartment of the leg and dorsum of the
foot. It corresponds to the posterior interosseous nerve of the forearm.

The nerve associated with the anterior compartment of the leg is the deep
fibular nerve. This nerve originates in the lateral compartment of the
leg as one of the two divisions of the common fibular nerve.

The deep fbular nerve passes anteromedially through the intermuscular

septum that separates the lateral from the anterior compartments of the leg
and then passes deep to the extensor digitorum longus. It reaches the
anterio interosseous membrane where it meets and descends with the
anterior tibial artery.

The deep fibular nerve innervates all muscles in the anterior compartment
then continues into the dorsal aspect of the foot where it innervates the
extensor digitorum brevis, contributes to the innervation of the first two
dorsal interossei muscles, and supplies the skin between the great and
second toes.