Tarsal tunnel: Difference between revisions

Tarsal tunnel
Tarsal tunnel
	Medial view of the ankle. The structures within the tarsal tunnel are depicted.
	Dissection video (1 min 55 s)
Details
Identifiers
Latin	canalis tarsi
	Anatomical terminology [edit on Wikidata]

Browse history interactively

← Previous edit

Content deleted Content added

VisualWikitext

Inline

Latest revision as of 16:09, 9 March 2024

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

Structure

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]

Clinical significance

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

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 video (41 s)

References

^ ^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
^ ^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
^ ^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

External links

Description at curtin.edu.au
http://www.ithaca.edu/faculty/lahr/LE2000/ankle%20pics/5Asupmed.jpg Archived 2012-02-12 at the Wayback Machine

[:1-1] 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

[:0-2] 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

[:2-3] 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

[1]

[2]

[3]

@@ Line 2: / Line 2: @@
 {{Infobox anatomy
 | Name        = Tarsal tunnel
-| Latin       = Canalis tarsi
+| Latin       = canalis tarsi
 | Greek       =
 | Image       = Structures within the tarsal tunnel - with text.svg
@@ Line 16: / Line 16: @@
 | Lymph       =
 }}
-The '''tarsal tunnel''' is found along the inner leg posterior to the [[Malleolus|medial malleolus]].
+The '''tarsal tunnel''' is a passage found along the inner [[leg]] underneath the [[Malleolus|medial malleolus]] of the [[ankle]].
 ==Structure==
+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" />
-The tarsal tunnel is made up of bone on the inside and the [[Flexor retinaculum of foot|flexor retinaculum]] on the outside.
-==Function==
 ===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 antero-medial to postero-lateral:
+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>
-* [[Tibialis posterior muscle|Tibialis posterior tendon]]
-* [[Flexor digitorum longus muscle|Flexor digitorum longus tendon]]
+* [[Flexor digitorum longus muscle|Flexor digitorum longus tendon]].<ref name=":0" />
-* [[Posterior tibial artery]]
+* [[Posterior tibial artery]].<ref name=":0" />
-* [[Posterior tibial vein]]
+* [[Posterior tibial vein]].<ref name=":1" />
-* [[Tibial nerve]]
+* [[Tibial nerve]].<ref name=":0" />
-* [[Flexor hallucis longus muscle|Flexor hallucis longus tendon]]
+* [[Flexor hallucis longus muscle|Flexor hallucis longus tendon]].<ref name=":0" />
-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.
+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" />
 ==Clinical significance==
 ===Tarsal tunnel syndrome===
 {{Main|Tarsal tunnel syndrome}}
-[[Tarsal tunnel syndrome]] is the most commonly reported nerve entrapment of the ankle and is analogous to the carpal tunnel of the wrist.  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.
+[[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.
 ==Additional images==
@@ Line 56: / Line 54: @@
 {{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://www.ithaca.edu/faculty/lahr/LE2000/ankle%20pics/5Asupmed.jpg{{deadlink}}
+* 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}}