Tibial nerve (L4–S3)
Main branches · L4 L5 S1 S2 S3
Larger terminal division of the sciatic. Runs vertically through the popliteal fossa as the most superficial neurovascular structure, passes deep to the soleal arch with the posterior tibial vessels, descends between the superficial and deep posterior compartments and passes behind the medial malleolus in the tarsal tunnel to end as the medial and lateral plantar nerves.
Traced from the start
Detail
- Motor
- Gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus; intrinsic foot muscles via the plantar nerves
- Sensory
- Medial sural cutaneous nerve (to the sural), medial calcaneal branch (heel), sole via the plantar nerves
- Tarsal tunnel, anterior to posterior
- Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, Vein, tibial Nerve, flexor Hallucis longus — Tom, Dick ANd Harry
- Reflex
- Ankle jerk (S1)
When it goes wrong
Tarsal tunnel syndrome: compression under the flexor retinaculum by a ganglion, tenosynovitis, pes planus or old fracture
Burning pain and paraesthesia in the sole and heel, worse at night and after standing, Tinel's sign behind the medial malleolus, late wasting of the intrinsic foot muscles
Injury in the popliteal fossa (knee dislocation, laceration) or high in the calf
Cannot plantarflex or stand on tiptoe, weak inversion and toe flexion, absent ankle jerk, numb sole, clawed toes from unopposed extensors
Practise this structure
1 question in the bank tagged Leg Compartments.