Jump to content

Tarsal tunnel: Difference between revisions

From Wikipedia, the free encyclopedia
Browse history interactively
← Previous edit
Content deleted Content added
VisualWikitext
DumZiBoT (talk | contribs)
212,289 edits
m Bot: Converting bare references, see FAQ
lowercase #article-section-source-editor
Tags: Mobile edit Mobile app edit iOS app edit
 
(45 intermediate revisions by 35 users not shown)
Line 1: Line 1:
{{short description|Canal in the ankle area}}
{{Infobox Anatomy |
{{Infobox anatomy
Name = {{PAGENAME}} |
Latin = |
| Name = Tarsal tunnel
| Latin = canalis tarsi
GraySubject = |
GrayPage = |
| Greek =
Image = Gray442.png |
| Image = Structures within the tarsal tunnel - with text.svg
Caption = The mucous sheaths of the tendons around the ankle. Medial aspect. |
| Caption = Medial view of the [[ankle]]. The structures within the tarsal tunnel are depicted.
Image2 = |
| Width =
| Image2 = Tarsal Tunnel by Sanjoy Sanyal 2018-06-03.webm
Caption2 = |
| Caption2 = Dissection video (1 min 55 s)
Precursor = |
System = |
| Precursor =
Artery = |
| System =
Vein = |
| Artery =
Nerve = |
| Vein =
Lymph = |
| Nerve =
MeshName = |
| Lymph =
MeshNumber = |
DorlandsPre = t_23 |
DorlandsSuf = 12832517 |
}}
}}
The '''tarsal tunnel''' (flexor retinaculum) is found along the inner leg behind the [[medial malleolus]].
The '''tarsal tunnel''' is a passage found along the inner [[leg]] underneath the [[Malleolus|medial malleolus]] of the [[ankle]].


==Structure==
The tarsal tunnel is made up of bone on the inside and the flexor retinaculum on the outside.
The roof of the tarsal tunnel is formed by the [[Flexor retinaculum of foot|flexor retinaculum of the foot]].<ref name=":1">{{Citation|last1=Lowe|first1=Whitney|title=Chapter 6 - Foot, ankle, and lower leg|date=2009-01-01|url=https://www.sciencedirect.com/science/article/pii/B9780443068126000064|work=Orthopedic Massage (Second Edition)|pages=77–115|editor-last=Lowe|editor-first=Whitney|place=Edinburgh|publisher=Mosby|language=en|doi=10.1016/b978-0-443-06812-6.00006-4|isbn=978-0-443-06812-6|access-date=2021-03-02|last2=Chaitow|first2=Leon|editor2-last=Chaitow|editor2-first=Leon}}</ref> The floor of the tarsal tunnel is formed by the [[medial malleolus]] and the [[calcaneus]].<ref name=":1" />
===Contents===
⚫
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 muscle|Tibialis posterior tendon]].<ref name=":0">{{Citation|last1=Minieka|first1=Michael|title=Chapter 54 - Entrapment Neuropathies|date=2005-01-01|url=https://www.sciencedirect.com/science/article/pii/B9780443066511500587|work=Essentials of Pain Medicine and Regional Anesthesia (Second Edition)|pages=426–432|editor-last=Benzon|editor-first=Honorio T.|place=Philadelphia|publisher=Churchill Livingstone|language=en|doi=10.1016/b978-0-443-06651-1.50058-7|isbn=978-0-443-06651-1|access-date=2021-02-21|last2=Nishida|first2=Takashi|editor2-last=Raja|editor2-first=Srinivasa N.|editor3-last=Molloy|editor3-first=Robert E.|editor4-last=Liu|editor4-first=Spencer S.}}</ref>
⚫
* [[Flexor digitorum longus muscle|Flexor digitorum longus tendon]].<ref name=":0" />
⚫
* [[Posterior tibial artery]].<ref name=":0" />
⚫
* [[Posterior tibial vein]].<ref name=":1" />
⚫
* [[Tibial nerve]].<ref name=":0" />
⚫
* [[Flexor hallucis longus muscle|Flexor hallucis longus tendon]].<ref name=":0" />


In the tunnel, the tibial nerve splits into three different paths.<ref name=":2">{{Citation|last=Kaufmann|first=Petra|title=Tibial Nerve|date=2003-01-01|url=https://www.sciencedirect.com/science/article/pii/B0122268709020542|encyclopedia=Encyclopedia of the Neurological Sciences|pages=537–539|editor-last=Aminoff|editor-first=Michael J.|place=New York|publisher=Academic Press|language=en|doi=10.1016/b0-12-226870-9/02054-2|isbn=978-0-12-226870-0|access-date=2021-03-02|editor2-last=Daroff|editor2-first=Robert B.}}</ref> The [[medial calcaneal branches of the tibial nerve]] continues to the heel, while the [[medial plantar nerve]] and the [[lateral plantar nerve]] continue on to the bottom of the [[foot]].<ref name=":2" />
==Nerve distribution==
⚫
The [[tibial nerve]], a major artery, veins, and tendons travel in a bundle along this pathway, through the tarsal tunnel.


==Clinical significance==
In the tunnel, the nerve splits into three different paths. One nerve ([[Medial calcaneal branches of the tibial nerve|calcaneal]]) continues to the heel, the other two ([[medial plantar nerve]] and [[lateral plantar nerve]]) continue on to the bottom of the foot.
⚫
===Tarsal tunnel syndrome===

==Contents of tunnel==
{{Main|Tarsal tunnel syndrome}}
[[Tarsal tunnel syndrome]] is the most commonly reported nerve entrapment of the ankle. It is analogous to [[carpal tunnel syndrome]] in the [[wrist]]. It is caused by compression of the [[tibial nerve]] underneath the [[Flexor retinaculum of foot|flexor retinaculum of the foot]].<ref name=":1" /> People with tarsal tunnel syndrome have pain in the plantar aspect of the foot mostly at night. Weight bearing increases pain and weakness is found on intrinsic foot muscles with positive [[Tinel sign]] at the tunnel. There is no tenderness present on the plantar foot, though this is typically the primary site of complaint.
* [[Tibialis posterior muscle]]
⚫
* [[Flexor digitorum longus muscle]]
⚫
* [[Posterior tibial artery]]
⚫
* [[Posterior tibial vein]]
⚫
* [[Tibial nerve]]
⚫
* [[Flexor hallucis longus muscle]]

One common mnemonic used to remember the contents is "[[Tom, Dick and Harry]]".<ref>http://www.orthoteers.com/content/content.aspx?article=80</ref><ref>[http://doctor.medscape.com/viewarticle/413587 Log In Problems<!-- Bot generated title -->]</ref><ref> {{MedicalMnemonics|1182|7||}}</ref> or alternatively "Tom, Dick ('''a'''nd '''v'''ery '''n'''ervous) Harry" if the '''a'''rtery, '''v'''ein, and '''n'''erve are included.

All three muscles are part of the [[posterior compartment of leg]].

⚫
== See also ==
⚫
* [[tarsal tunnel syndrome]]
⚫
* [[carpal tunnel]]


==Additional images==
==Additional images==
<gallery>
<gallery>
File:Sobo 1909 316.png|The mucous sheaths of the tendons around the ankle. Medial aspect. The [[Flexor retinaculum of foot|flexor retinaculum]] is labelled as laciniate lig.
Image:Gray357.png|Coronal section through right talocrural and talocalcaneal joints.
File:Slide2BER.JPG|Dissection image. Around the medial malleolus seeing from below.
Image:Gray439.png|Muscles of the back of the leg. Deep layer.
File:Tarsal tunnel by Majid Doroudi.webm|Dissection video (41 s)
Image:Gray551.png|The popliteal, posterior tibial, and peroneal arteries.
Image:Gray832.png|Nerves of the right lower extremity Posterior view.
Image:Gray444.png|Muscles of the sole of the foot. Second layer.
Image:Gray555.png|The plantar arteries. Deep view.
Image:Gray833.png|The plantar nerves.
</gallery>
</gallery>

⚫
== See also ==
{{Anatomy terms}}
* [[Tarsal tunnel syndrome]]
⚫
* [[Carpal tunnel]]


==References==
==References==
{{Reflist}}
<references/>


==External links==
==External links==
{{Commons category}}
* [http://physiotherapy.curtin.edu.au/resources/educational-resources/pgdissections/lower_limb/heel_pain_triad_2003/page8.cfm Description at curtin.edu.au]
* [http://physiotherapy.curtin.edu.au/resources/educational-resources/pgdissections/lower_limb/heel_pain_triad_2003/page8.cfm Description at curtin.edu.au]
* http://www.ithaca.edu/faculty/lahr/LE2000/ankle%20pics/5Asupmed.jpg
* http://www.ithaca.edu/faculty/lahr/LE2000/ankle%20pics/5Asupmed.jpg {{Webarchive|url=https://web.archive.org/web/20120212203142/http://www.ithaca.edu/faculty/lahr/LE2000/ankle%20pics/5Asupmed.jpg |date=2012-02-12 }}


{{Muscles of lower limb}}
{{anatomy-stub}}
{{Lower limb general}}


[[Category:Pelvic limb anatomy]]
[[Category:Lower limb anatomy]]

Latest revision as of 16:09, 9 March 2024

Tarsal tunnel
Medial view of the ankle. The structures within the tarsal tunnel are depicted.
Dissection video (1 min 55 s)
Details
Identifiers
Latincanalis tarsi
Anatomical terminology

The tarsal tunnel is a passage found along the inner leg underneath the medial malleolus of the ankle.

Structure

[edit]

The roof of the tarsal tunnel is formed by the flexor retinaculum of the foot.[1] The floor of the tarsal tunnel is formed by the medial malleolus and the calcaneus.[1]

Contents

[edit]

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:

In the tunnel, the tibial nerve splits into three different paths.[3] The medial calcaneal branches of the tibial nerve continues to the heel, while the medial plantar nerve and the lateral plantar nerve continue on to the bottom of the foot.[3]

Clinical significance

[edit]

Tarsal tunnel syndrome

[edit]
Main article: Tarsal tunnel syndrome

Tarsal tunnel syndrome is the most commonly reported nerve entrapment of the ankle. It is analogous to carpal tunnel syndrome in the wrist. It is caused by compression of the tibial nerve underneath the flexor retinaculum of the foot.[1] People with tarsal tunnel syndrome have pain in the plantar aspect of the foot mostly at night. Weight bearing increases pain and weakness is found on intrinsic foot muscles with positive Tinel sign at the tunnel. There is no tenderness present on the plantar foot, though this is typically the primary site of complaint.

Additional images

[edit]
  • The mucous sheaths of the tendons around the ankle. Medial aspect. The flexor retinaculum is labelled as laciniate lig.
    The mucous sheaths of the tendons around the ankle. Medial aspect. The flexor retinaculum is labelled as laciniate lig.
  • Dissection image. Around the medial malleolus seeing from below.
    Dissection image. Around the medial malleolus seeing from below.
  • Dissection video (41 s)

See also

[edit]
This article uses anatomical terminology.

References

[edit]
  1. ^ a b c d Lowe, Whitney; Chaitow, Leon (2009-01-01), Lowe, Whitney; Chaitow, Leon (eds.), "Chapter 6 - Foot, ankle, and lower leg", Orthopedic Massage (Second Edition), Edinburgh: Mosby, pp. 77–115, doi:10.1016/b978-0-443-06812-6.00006-4, ISBN 978-0-443-06812-6, retrieved 2021-03-02
  2. ^ a b c d e Minieka, Michael; Nishida, Takashi (2005-01-01), Benzon, Honorio T.; Raja, Srinivasa N.; Molloy, Robert E.; Liu, Spencer S. (eds.), "Chapter 54 - Entrapment Neuropathies", Essentials of Pain Medicine and Regional Anesthesia (Second Edition), Philadelphia: Churchill Livingstone, pp. 426–432, doi:10.1016/b978-0-443-06651-1.50058-7, ISBN 978-0-443-06651-1, retrieved 2021-02-21
  3. ^ a b Kaufmann, Petra (2003-01-01), "Tibial Nerve", in Aminoff, Michael J.; Daroff, Robert B. (eds.), Encyclopedia of the Neurological Sciences, New York: Academic Press, pp. 537–539, doi:10.1016/b0-12-226870-9/02054-2, ISBN 978-0-12-226870-0, retrieved 2021-03-02
[edit]
Wikimedia Commons has media related to Tarsal tunnel.
Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=Tarsal_tunnel&oldid=1212789430"