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The front of the leg extends from knee to ankle, between the tibial crest and anterior border of fibula.
It corresponds to the anterior compartment, containing muscles for dorsiflexion of ankle and extension of toes.
Supplied by the deep peroneal nerve and anterior tibial artery.
The skin is thin and tightly adherent over tibia but loose on the dorsum of foot.
Tibial crest: Subcutaneous from tibial tuberosity to medial malleolus.
Tibial tuberosity: Below patella; attachment of ligamentum patellae.
Head of fibula: Lateral prominence just below the knee.
Medial malleolus: Rounded projection on inner ankle.
Lateral malleolus: Posterior and lower than the medial malleolus.
Tendons (medial → lateral): Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus, Peroneus tertius.
Dorsalis pedis artery pulse: Felt lateral to extensor hallucis longus tendon.
Contains cutaneous veins, nerves, and lymphatics.
Tight over tibia, loose on dorsum and lateral leg.
Lymphatics drain medially to inguinal nodes, laterally to popliteal nodes.
Great saphenous vein: From medial dorsal venous arch → in front of medial malleolus → ascends along medial leg → femoral vein.
Small saphenous vein: From lateral dorsal venous arch → behind lateral malleolus → popliteal vein.
Dorsal venous arch: Connects both saphenous veins.
Saphenous nerve: Medial leg to great toe.
Superficial peroneal nerve: Lower anterolateral leg and most of dorsum.
Deep peroneal nerve: First web space.
Sural nerve: Posterolateral leg and lateral foot.
Common peroneal nerve: Around fibular neck, easily injured.
Dense fibrous sheath continuous with fascia lata.
Gives anterior and posterior intermuscular septa, forming compartments.
Thickened below as retinacula to bind tendons.
Fibrous band between tibia and fibula above ankle.
Structures deep to it (medial → lateral):
Tibialis anterior, Extensor hallucis longus, Anterior tibial artery, Deep peroneal nerve, Extensor digitorum longus, Peroneus tertius.
Y-shaped band from calcaneum to medial malleolus and medial cuneiform.
Upper limb encloses TA, EHL, artery, nerve; lower limb encloses EDL, PT.
Tibialis anterior: Dorsiflexes, inverts foot.
Extensor hallucis longus: Extends great toe, dorsiflexes.
Extensor digitorum longus: Extends lateral four toes.
Peroneus tertius: Dorsiflexes and everts foot.
Nerve: Deep peroneal nerve.
Continuation of popliteal artery through interosseous membrane.
Descends with deep peroneal nerve on interosseous membrane.
Branches: Posterior and anterior tibial recurrent, muscular, anterior medial & lateral malleolar arteries.
Continues as dorsalis pedis artery at ankle.
Branch of common peroneal nerve.
Descends with anterior tibial artery.
Muscular branches to anterior-compartment muscles.
Cutaneous branch → first web space.
Lesion causes foot drop.
Skin: Thin, mobile.
Superficial fascia: Dorsal venous arch, superficial nerves, lymphatics.
Muscles: Extensor digitorum brevis and Extensor hallucis brevis.
Artery: Dorsalis pedis artery.
Nerve: Deep peroneal (lateral terminal branch).
Continuation of anterior tibial artery.
Lies lateral to EHL tendon.
Branches: Medial & lateral tarsal, arcuate, first dorsal metatarsal, deep plantar.
Pulse felt in front of ankle lateral to EHL tendon.
Between anterior and posterior septa.
Muscles: Peroneus longus and Peroneus brevis.
Nerve: Superficial peroneal nerve.
Action: Eversion and plantarflexion.
Superior: From lateral malleolus → calcaneum, holds both tendons in common sheath.
Inferior: From calcaneum → inferior extensor retinaculum, tendons in separate sheaths.
Branch of common peroneal.
Supplies peroneus longus and brevis.
Pierces fascia in lower leg to supply skin of dorsum except first web space and lateral border.
Contains great saphenous vein and saphenous nerve anterior to medial malleolus.
Skin thin; tibial crest subcutaneous and often bruised.
Foot drop: Injury to deep peroneal or common peroneal nerve.
Anterior compartment syndrome: Compression under tight fascia → ischemia.
Shin splints: Overuse of tibialis anterior.
Avulsion of 5th metatarsal: Pull of peroneus brevis.
Dorsalis pedis pulse: Assesses peripheral circulation.
Varicose veins: Due to great saphenous valve incompetence.
Retinaculum contents: “Tom Has A Nervous Dog Pet.”
Branches of anterior tibial artery: “Pretty Arteries Make Legs Alive.”
Branches of dorsalis pedis artery: “Many Lovers Are Found Deep.”
Anterior-compartment muscles: “The Extra Energetic Person.”
Four dorsiflexor muscles in anterior compartment, all by deep peroneal nerve.
Dorsalis pedis artery continues from anterior tibial artery.
Great saphenous vein → anterior to medial malleolus; small saphenous → behind lateral.
Deep peroneal → first web space; superficial peroneal → dorsum of foot.
Peroneus longus maintains transverse arch.
Shin splints and anterior-compartment syndrome are important applied points.
Deep peroneal nerve injury → Foot drop + sensory loss in first web space.
Shin splints: Overuse of tibialis anterior.
Anterior compartment syndrome: Compression of artery and nerve → ischemia.
Avulsion of 5th metatarsal: By peroneus brevis.
Dorsalis pedis palpation: Just lateral to EHL tendon.
Peroneal tendon subluxation: Tear of superior peroneal retinaculum.
Nerve supply of dorsum of foot? → Deep and superficial peroneal nerves.
Pulse point of dorsalis pedis? → Lateral to EHL tendon.
Main action of anterior-compartment muscles? → Dorsiflexion.
Which muscle crosses sole obliquely? → Peroneus longus.
Site for venesection in leg? → Great saphenous vein, anterior to medial malleolus.
1. Which of the following arteries continues as the dorsalis pedis artery?
A. Posterior tibial artery
B. Popliteal artery
C. Anterior tibial artery
D. Peroneal artery
✅ Answer: C – Anterior tibial artery
→ It passes through the interosseous membrane and becomes the dorsalis pedis artery on the dorsum of foot.
2. The deep peroneal nerve supplies which area of skin on the foot?
A. Medial border of foot
B. First interdigital cleft
C. Lateral border of foot
D. Whole dorsum of foot
✅ Answer: B – First interdigital cleft
→ Cutaneous supply of deep peroneal nerve is restricted to the first web space.
3. All the following muscles are dorsiflexors of the ankle except:
A. Tibialis anterior
B. Extensor hallucis longus
C. Extensor digitorum longus
D. Peroneus longus
✅ Answer: D – Peroneus longus
→ Peroneus longus is an everter and plantarflexor, not a dorsiflexor.
4. The pulse of dorsalis pedis artery is felt:
A. Anterior to lateral malleolus
B. Posterior to medial malleolus
C. Lateral to tendon of extensor hallucis longus
D. Medial to tendon of tibialis anterior
✅ Answer: C – Lateral to tendon of extensor hallucis longus
→ This is the surface anatomy point used to palpate dorsalis pedis pulse.
5. The superficial peroneal nerve supplies:
A. Peroneus longus and brevis
B. Tibialis anterior and peroneus longus
C. Peroneus tertius and tibialis anterior
D. Extensor hallucis longus and brevis
✅ Answer: A – Peroneus longus and brevis
→ It is the nerve of the lateral (compartment of everters) muscles.
6. Eversion of foot is mainly produced by:
A. Tibialis anterior and posterior
B. Peroneus longus and brevis
C. Gastrocnemius and soleus
D. Flexor digitorum longus and hallucis longus
✅ Answer: B – Peroneus longus and brevis
→ They pull the foot laterally and downward.
7. Foot drop occurs due to injury of:
A. Tibial nerve
B. Superficial peroneal nerve
C. Deep peroneal nerve
D. Sural nerve
✅ Answer: C – Deep peroneal nerve
→ Paralysis of anterior compartment muscles causes loss of dorsiflexion.
8. The tendon inserted into the base of the fifth metatarsal is that of:
A. Peroneus brevis
B. Peroneus longus
C. Peroneus tertius
D. Tibialis posterior
✅ Answer: A – Peroneus brevis
→ It is often avulsed in inversion injuries.
9. The great saphenous vein passes:
A. Behind lateral malleolus
B. In front of medial malleolus
C. Behind medial malleolus
D. In front of lateral malleolus
✅ Answer: B – In front of medial malleolus
→ A reliable landmark for venesection.
10. The muscle helping to maintain the transverse arch of foot is:
A. Tibialis posterior
B. Peroneus longus
C. Flexor hallucis longus
D. Extensor hallucis longus
✅ Answer: B – Peroneus longus
→ Its tendon crosses the sole obliquely and supports the arch.
11. Which structure lies in the first interdigital cleft and is tested for deep peroneal nerve sensation?
A. Medial tarsal artery
B. Superficial peroneal nerve branch
C. Deep peroneal nerve cutaneous branch
D. Sural nerve
✅ Answer: C – Deep peroneal nerve cutaneous branch
12. The retinaculum which prevents bowstringing of extensor tendons is:
A. Flexor retinaculum
B. Peroneal retinaculum
C. Superior extensor retinaculum
D. Inferior peroneal retinaculum
✅ Answer: C – Superior extensor retinaculum
13. All muscles of anterior compartment are supplied by the deep peroneal nerve except:
A. Tibialis anterior
B. Extensor hallucis longus
C. Extensor digitorum longus
D. None of the above
✅ Answer: D – None of the above
→ All four (anterior compartment) receive branches from deep peroneal nerve.
14. The lateral compartment of leg is bounded anteriorly by:
A. Posterior intermuscular septum
B. Anterior intermuscular septum
C. Interosseous membrane
D. Deep fascia of leg
✅ Answer: B – Anterior intermuscular septum
15. Pain and swelling in the shin region of athletes is known as:
A. Plantar fasciitis
B. Anterior compartment syndrome
C. Shin splints
D. Tenosynovitis
✅ Answer: C – Shin splints
1. What is the main action of muscles in the anterior compartment of the leg?
→ Dorsiflexion of ankle and extension of toes.
2. Which nerve supplies the anterior compartment?
→ Deep peroneal nerve.
3. What is the cutaneous supply of the deep peroneal nerve?
→ First interdigital cleft (between great and second toe).
4. Name the main artery of the anterior compartment.
→ Anterior tibial artery.
5. Which artery continues as dorsalis pedis?
→ Anterior tibial artery.
6. Where is the dorsalis pedis pulse felt?
→ Lateral to the tendon of extensor hallucis longus in front of ankle.
7. Which muscles produce eversion of the foot?
→ Peroneus longus and peroneus brevis.
8. Which muscles cause inversion of the foot?
→ Tibialis anterior and tibialis posterior.
9. Which nerve supplies the peroneus longus and brevis?
→ Superficial peroneal nerve.
10. What are the contents deep to the superior extensor retinaculum (from medial to lateral)?
→ Tibialis anterior, Extensor hallucis longus, Anterior tibial artery, Deep peroneal nerve, Extensor digitorum longus, Peroneus tertius.
11. What are the actions of tibialis anterior?
→ Dorsiflexion and inversion of the foot.
12. What deformity results from paralysis of the deep peroneal nerve?
→ Foot drop.
13. What are shin splints?
→ Pain along tibia due to overuse of tibialis anterior.
14. What is the function of peroneus longus in the sole?
→ Maintains the transverse arch of foot.
15. Which vein passes anterior to the medial malleolus?
→ Great saphenous vein.
16. Which vein passes posterior to the lateral malleolus?
→ Small saphenous vein.
17. What are the signs of anterior compartment syndrome?
→ Pain, paresthesia, pallor, paralysis, pulselessness (5 Ps).
18. Which nerve is most commonly injured in fractures of the neck of fibula?
→ Common peroneal nerve.
19. Which artery supplies the dorsum of foot?
→ Dorsalis pedis artery.
20. What is the importance of the dorsalis pedis artery clinically?
→ Its pulse indicates patency of the anterior tibial artery and peripheral circulation
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