Interactive Transcript
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Let's tackle the tibial nerve, sometimes called
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the posterior tibial nerve.
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And we begin with a mnemonic.
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We've got our friends Tom, Dick, and
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there's Harry with Harry's muscle.
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Tibialis posterior, the flexor digitorum,
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and the flexor hallucis.
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But we also have Tom, Dick,
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and very nervous Harry.
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Very standing for vascular, we've got arteries and
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veins kind of mush-moshed together, and then here's
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nervous Harry, the nerve, and then there's Harry.
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So Tom, Dick, and very
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vascular, nervous nerve, Harry.
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Let's scroll and follow our nerve.
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There's our nerve.
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We're going up, now we're going down.
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And our nerve is splitting into two nerves.
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Let's blow it up a little bit.
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It's a little bit tricky to
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do online, but we can do it.
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Let's make it a little bit bigger.
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We've got two nerves now.
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The one in the front is the medial plantar nerve.
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It's also going to be, as we'll see in
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the coronal projection, a little higher up
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than the lateral plantar nerve.
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But that'll be a story for another day.
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So the medial plantar nerve crosses the lateral
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surface of the posterior tibial artery.
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So here's the posterior tibial artery.
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Here's its lateral surface right there.
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That's lateral.
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That's medial.
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There is the medial plantar nerve.
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We've got some veins kind of making a soup in the neighborhood.
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It will then cross anterior to a branch
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of the artery called the medial plantar artery.
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And then it courses proximally between the
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quadratus plantae and the abductor hallucis.
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And we're going to show you that
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in the more advanced sections.
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But right now I'd like you to follow
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the medial plantar nerve down.
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And you can see, here's the abductor hallucis,
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and if we followed it more distally, there's
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our quadratus plantae, so it is between the two,
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just as we have advertised, but you're
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going to appreciate that a lot better in the
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coronal projection and more advanced discussions.
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Distally, it's still going to be located
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between these two structures, the quadratus plantae
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and the abductor hallucis.
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And then it lies in very close proximity
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to something called Henry's master knot.
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So, let's go back up again to find it.
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There it is, medial plantar nerve.
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What's Henry's master knot, you say?
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It's where the flexor digitorum and flexor
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hallucis come together to form this knot.
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There's the knot, and there
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is your medial plantar nerve.
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Find the knot, find the nerve.
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More distally, it's going to course along
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the medial border of the flexor digitorum brevis muscle,
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which is this one down here.
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And we'll have to show you that in
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the coronal projection on another day.
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And then we'll divide that nerve into
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articular, muscular, and cutaneous branches.
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The articular branches supply the articulations
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of the tarsus and the metatarsus regions.
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The muscular supply is pretty broad.
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The abductor hallucis, which we see here.
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The flexor digitorum brevis, the flexor hallucis brevis,
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Also at the base of the first metatarsal bone,
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it will itself divide into
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medial and lateral terminal branches.
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And that will also be a story for another day.
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It provides medial plantar cutaneous sensation
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to the big toe.
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Remember, it's on the plantar side.
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On the dorsal aspect of the big toe
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between the big toe and the second toe,
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it's the deep peroneal nerve
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that's responsible for the sensory supply.
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The terminal lateral branch will pass along
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the border of the flexor digitorum brevis
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muscle, and becomes more superficial.
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And then it divides into some digital branches.
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And again, that's probably a little
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too advanced for us to discuss today.
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So the medial plantar nerve may become
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compressed as it passes deep to its
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retinaculum adjacent to Henry's master knot.
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So if we look at Henry's master knot,
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which is where these two come together.
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There's our medial plantar nerve,
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then we follow it down.
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There's Henry's master knot and right as it
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starts to course around Henry's master knot,
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it may get irritated, crushed, or compressed
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between it and the abductor hallucis,
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and this may lead to the syndrome or
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condition known as Jogger's Foot.
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