Triceps Surae: Difference between revisions
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It has been proposed that the plantaris muscle can either attach onto the calcaneus independently from the achilles tendon or may form a portion of the achilles tendon, accompany the tendon to insert onto the calcaneus. Interestingly, the plantaris tendon is commonly intact with rupture of the achilles tendon <ref name=":3" />. This plantaris muscle is proposed to be absent in 7-20% of the population <ref name=":3" />. | It has been proposed that the plantaris muscle can either attach onto the calcaneus independently from the achilles tendon or may form a portion of the achilles tendon, accompany the tendon to insert onto the calcaneus. Interestingly, the plantaris tendon is commonly intact with rupture of the achilles tendon <ref name=":3" />. This plantaris muscle is proposed to be absent in 7-20% of the population <ref name=":3" />. | ||
* Innervation | * Innervation - tibial nerve, nerve roots S1, S2 <ref name=":0" />. | ||
* Blood Supply | * Blood Supply - posterior tibial artery | ||
[[File:Gastrocnemius-Muscle.jpg|317x317px|thumb|Illustrating the origin and insertion of the ''medial & lateral heads of the gastrocnemius muscle'' ]] | |||
==== Gastrocnemius ==== | ==== Gastrocnemius ==== | ||
The gastrocnemius muscle consists of a lateral and medial head at it's origin, and make up the superficial portion of the triceps surae. Both the medial and lateral head insert into the calcaneus bone. | The gastrocnemius muscle consists of a lateral and medial head at it's origin, and make up the superficial portion of the triceps surae. Both the medial and lateral head insert into the calcaneus bone. | ||
The gastrocnemius traverses three joints including the knee, ankle and subtalar joints <ref>Cohen JC. [https://pubmed.ncbi.nlm.nih.gov/19857836/ Anatomy and biomechanical aspects of the gastrocsoleus complex]. Foot and ankle clinics. 2009 Dec 1;14(4):617-26.</ref>. | The gastrocnemius traverses three joints including the knee, ankle and subtalar joints <ref>Cohen JC. [https://pubmed.ncbi.nlm.nih.gov/19857836/ Anatomy and biomechanical aspects of the gastrocsoleus complex]. Foot and ankle clinics. 2009 Dec 1;14(4):617-26.</ref>. | ||
* Origin - posterosuperior region of the corresponding femoral condyle, specifically: | |||
* Medial head: arises from the posterior aspect of the femur, posterior to the medial supracondylar ridge and adductor tubercle. The medial head is thicker and wider than the lateral head <ref name=":2">Cohen JC. Anatomy and biomechanical aspects of the gastrocsoleus complex. Foot and ankle clinics. 2009 Dec 1;14(4):617-26.</ref>. | |||
** Lateral head: arises from the lateral aspect of the lateral femoral condyle. Proximal, we well as posterior, to the lateral epicondyle <ref name=":2" />. | ** Lateral head: arises from the lateral aspect of the lateral femoral condyle. Proximal, we well as posterior, to the lateral epicondyle <ref name=":2" />. | ||
Additionally, the lateral and medial heads of the gastrocnemius muscle further attachments from the oblique popliteal ligament as well as from the posterior capsule of the knee joint. | Additionally, the lateral and medial heads of the gastrocnemius muscle further attachments from the oblique popliteal ligament as well as from the posterior capsule of the knee joint. | ||
* Function - the gastrocnemius muscle produces flexion of the leg at the knee joint and plantarflexor of the foot at the talocrural joint (ankle mortise). Further, the gastrocnemius is most effective when the knee is in an extended position and the ankle plantarflexed <ref name=":2" />. | |||
[[File:Posterior leg muscles gastrocnemius soleus plantaris.png|317x317px|left|thumb|Illustrating the plantaris and soleus muscles, located deep to the gastrocnemius muscle (''(ateral & medial heads of the gastrocnemius muscle are cut)'']] | |||
Further, the gastrocnemius is most effective when the knee is in an extended position and the ankle plantarflexed <ref name=":2" />. | |||
==== Soleus ==== | ==== Soleus ==== | ||
The soleus muscle is situated deep to the gastrocnemius and crosses two joints including the ankle and subtalar joints <ref name=":2" /> | The soleus muscle is situated deep to the gastrocnemius and crosses two joints including the ankle and subtalar joints <ref name=":2" />. | ||
* Origin - posterior aspect of the fibular head, medial border of the tibia (soleal line) and the interosseous membrane <ref name=":2" />. | |||
* Function - soleus muscle is shown to be most effective with the ankle in plantarflexion (similar to the gastrocnemius muscle) but with the knee in flexion (opposite of the gastrocnemius) <ref name=":2" />. | |||
==== Plantaris ==== | ==== Plantaris ==== | ||
The plantaris muscle is made up of a small muscle that has a slim and long tendon, ranging from 7 to 13 cm long <ref name=":3">Spina AA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978447/ The plantaris muscle: anatomy, injury, imaging, and treatment]. The Journal of the Canadian Chiropractic Association. 2007 Jul;51(3):158.</ref>. | The plantaris muscle is made up of a small muscle that has a slim and long tendon, ranging from 7 to 13 cm long <ref name=":3">Spina AA. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978447/ The plantaris muscle: anatomy, injury, imaging, and treatment]. The Journal of the Canadian Chiropractic Association. 2007 Jul;51(3):158.</ref>. | ||
* Origin - superior & medial to the lateral head of the gastrocnemius on the lateral supracondylar femoral line. It also has an origin in the posterior aspect of the knee from the oblique popliteal ligament <ref name=":3" />. | |||
* Function - similar action as the gastrocnemius muscle however the plantaris muscle is considered an insignficant knee flexor and ankle plantarflexor <ref name=":3" />. Because the plantaris muscle consists of a "high density of muscle spindles", it is considered to be an "organ of proprioceptive function" for the more powerful plantarflexor muscles <ref name=":3" />. | |||
* | |||
== Clinical Significance == | == Clinical Significance == | ||
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Introduction[edit | edit source]
The triceps surae, also known as the muscle of the calf, is constructed by the soleus, the two-headed (medial & lateral) gastrocnemius and the plantaris muscles [1]. Research suggests that contracture of the triceps surae is correlated with various conditions that affect the forefoot and midfoot, therefore consideration of these muscles is valuable when evaluating and managing such conditions [2].
Anatomy[edit | edit source]
The muscles that comprise the triceps surae (gastrocnemius, soleus and plantaris) are part of the posterosuperficial compartment of the calf [1].
The soleus muscle and both heads of the gastrocnemius muscle, fuse to insert onto the calcaneus (heel bone) through the achilles tendon (also known as the calcaneal tendon). This structure is considered to be the strongest tendon in the human body [2].
It has been proposed that the plantaris muscle can either attach onto the calcaneus independently from the achilles tendon or may form a portion of the achilles tendon, accompany the tendon to insert onto the calcaneus. Interestingly, the plantaris tendon is commonly intact with rupture of the achilles tendon [3]. This plantaris muscle is proposed to be absent in 7-20% of the population [3].
- Innervation - tibial nerve, nerve roots S1, S2 [1].
- Blood Supply - posterior tibial artery
Gastrocnemius[edit | edit source]
The gastrocnemius muscle consists of a lateral and medial head at it's origin, and make up the superficial portion of the triceps surae. Both the medial and lateral head insert into the calcaneus bone.
The gastrocnemius traverses three joints including the knee, ankle and subtalar joints [4].
- Origin - posterosuperior region of the corresponding femoral condyle, specifically:
- Medial head: arises from the posterior aspect of the femur, posterior to the medial supracondylar ridge and adductor tubercle. The medial head is thicker and wider than the lateral head [5].
- Lateral head: arises from the lateral aspect of the lateral femoral condyle. Proximal, we well as posterior, to the lateral epicondyle [5].
Additionally, the lateral and medial heads of the gastrocnemius muscle further attachments from the oblique popliteal ligament as well as from the posterior capsule of the knee joint.
- Function - the gastrocnemius muscle produces flexion of the leg at the knee joint and plantarflexor of the foot at the talocrural joint (ankle mortise). Further, the gastrocnemius is most effective when the knee is in an extended position and the ankle plantarflexed [5].
Soleus[edit | edit source]
The soleus muscle is situated deep to the gastrocnemius and crosses two joints including the ankle and subtalar joints [5].
- Origin - posterior aspect of the fibular head, medial border of the tibia (soleal line) and the interosseous membrane [5].
- Function - soleus muscle is shown to be most effective with the ankle in plantarflexion (similar to the gastrocnemius muscle) but with the knee in flexion (opposite of the gastrocnemius) [5].
Plantaris[edit | edit source]
The plantaris muscle is made up of a small muscle that has a slim and long tendon, ranging from 7 to 13 cm long [3].
- Origin - superior & medial to the lateral head of the gastrocnemius on the lateral supracondylar femoral line. It also has an origin in the posterior aspect of the knee from the oblique popliteal ligament [3].
- Function - similar action as the gastrocnemius muscle however the plantaris muscle is considered an insignficant knee flexor and ankle plantarflexor [3]. Because the plantaris muscle consists of a "high density of muscle spindles", it is considered to be an "organ of proprioceptive function" for the more powerful plantarflexor muscles [3].
Clinical Significance[edit | edit source]
Calf Strain[edit | edit source]
A calf strain implies damage to either the muscle belly itself or to its tendons at the site of attachment
Resources[edit | edit source]
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References[edit | edit source]
- ↑ 1.0 1.1 1.2 Keith LM, Arthur FD, Anne MR. Clinically oriented anatomy. Clinically oriented anatomy. 2006.
- ↑ 2.0 2.1 Dalmau-Pastor M, Fargues-Polo B, Casanova-Martínez D, Vega J, Golanó P. Anatomy of the triceps surae: a pictorial essay. Foot and ankle clinics. 2014 Dec 1;19(4):603-35.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Spina AA. The plantaris muscle: anatomy, injury, imaging, and treatment. The Journal of the Canadian Chiropractic Association. 2007 Jul;51(3):158.
- ↑ Cohen JC. Anatomy and biomechanical aspects of the gastrocsoleus complex. Foot and ankle clinics. 2009 Dec 1;14(4):617-26.
- ↑ 5.0 5.1 5.2 5.3 5.4 5.5 Cohen JC. Anatomy and biomechanical aspects of the gastrocsoleus complex. Foot and ankle clinics. 2009 Dec 1;14(4):617-26.
