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The posterior border presents a broad groove, the malleolar sulcus, directed obliquely downward and medially, and occasionally double; this sulcus lodges the tendons of the tibialis posterior and flexor digitorum longus. The summit of the medial malleolus is marked by a rough depression behind, for the attachment of the deltoid ligament. The ...
[1] [2] The tarsal tunnel is found along the inner leg behind the medial malleolus (bump on the inside of the ankle). The posterior tibial artery, tibial nerve, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles travel in a bundle through the tarsal tunnel.
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]
The tibial malleolar sulcus, also known as the malleolar groove, is the smooth, vertical depression found on the posterior aspect of the medial malleolus. [1] [2] [3] This groove is traversed by the tendons of the tibialis posterior and flexor digitorum longus muscles. [1] [4] There are two malleolar sulci, medial and lateral. [2]
The flexor retinaculum of the foot extends from the medial malleolus above, to the calcaneus below. [1] This converts a series of bony grooves into canals for the passage of the tendons of the flexor muscles and the posterior tibial vessels and tibial nerve into the sole of the foot, known as the tarsal tunnel.
The tendon of the tibialis posterior muscle (sometimes called the posterior tibial tendon) descends posterior to the medial malleolus. [2] It terminates by dividing into plantar, main, and recurrent components. The main portion inserts into the tuberosity of the navicular bone. [2]
The deltoid ligament (or medial ligament of talocrural joint) is a strong, flat, triangular band, attached, above, to the apex and anterior and posterior borders of the medial malleolus. The deltoid ligament supports the ankle joint and also resists excessive eversion of the foot. [1] The deltoid ligament is composed of 4 fibers:
Its tendon runs between those of the soleus and gastrocnemius and is embedded in the medial end of the calcaneus tendon. [32] In the deep layer, the tibialis posterior has its origin on the interosseus membrane and the neighbouring bone areas and runs down behind the medial malleolus.