Tibial nerve

TIBIAL NERVE

• Larger terminal branch of the sciatic nerve. 
• It is the nerve of posterior compartment of leg & the sole of foot.

BRANCHES:

A. Branches in popliteal fossa

1. Three articular fossa (genicular) nerves: Superior medial genicular, middle genicular, inferior medial genicular,

2. Five muscular branches: medial head of gastrocnemius, lateral head of gastrocnemius, soleus & plantaris.

3. Single cutaneous:

• Sural nerve supplies the skin of lower  half of back if leg & whole of lateral border of foot till the hip of great toe.
• Sural nerve runs along with short saphenous vein behind lateral malleolus.

B. Branches in calf

1. Four muscular branches: Soleus (deep foot), tibialis posterior, flexor hallusis longus & flexor digitorum longus.
2. Medial calcaneal branches: Supply skin of back & lower surface of heel.
3. Articular: Ankle joint
4. Terminal branches: Medial plantar & lateral plantar nerves. 

• Behind the medial malleolus, beneath the flexor retinaculum the tibial nerve divides into medial and lateral plantar branches.

1. Medial plantar nerve

• The medial plantar nerve supplies: the abductor hallucis, the flexor digitorum brevis, the flexor hallucis brevis and the first lumbrical.
•  Cutaneous distribution of the medial plantar nerve is to the medial sole and medial three and one half toes, including the nail beds on the dorsum (like the median nerve in the hand).

2. Lateral plantar nerve 

• The lateral plantar nerve supplies quadratus plantae, flexor digiti minimi, adductor hallucis, the interossei, three lumbricals (2nd, 3rd & 4th), and abductor digiti minimi. 
• Cutaneous innervation is to the lateral sole and lateral one and one half toes (like the ulnar nerve).