![]() Loss of sensation occurs from the plantar aspect of the foot. In a pure tibial nerve injury, the hock joint is dropped when the animal walks or supports weight ( Figure 5-6). In most animals, tibial nerve lesions occur in association with peroneal nerve injuries, and a mixture of neurologic signs occurs. ![]() It provides cutaneous sensory innervation to the plantar surface of the foot and the caudal surface of the limb. The tibial nerve supplies the muscles that extend the hock and flex the digits. Marc Kent DVM, BA, DACVIM, in Handbook of Veterinary Neurology (Fifth Edition), 2011 Tibial Nerve The lateral plantar nerve supplies sensation to the lateral 2–3 toes on the plantar surface of the foot. Entrapment of this branch is thought by some to be a cause of intractable heel pain. It is also called the inferior calcaneal nerve or Baxter's nerve. The first branch of the lateral plantar nerve supplies the abductor digiti quinti muscle. The medial plantar nerve supplies sensation to the medial 2–3 toes on the surface of the foot. The medial calcaneal nerve generally branches off the tibial nerve at or above the tarsal tunnel and supplies sensation to the medial and plantar surfaces of the heel. These branches are the medial plantar nerve and the lateral plantar nerve. The tibial nerve divides into its two main branches in the region of the tarsal tunnel. The tibial nerve runs posterior to the tibial artery. The tibial artery and vein, as well as the tibialis posterior and the flexor digitorum tendons, also travel in this space. The tibial nerve travels under the flexor retinaculum, which lies between the medial malleolus and the Achilles tendon. Weiss MD, FAAPMR, FAANEM, in Easy Injections, 2007 Local Anatomy The nerve descends down the middle of the calf and provides sensory innervation to the posterior aspect of the distal leg and lateral aspect of the foot. It is composed of sensory fibers arising from the tibial nerve at the popliteal fossa, supplemented by fibers from the common peroneal nerve. The sural nerve provides the remainder of the sensory innervation of the distal leg. The sensory supply to the fourth toe is variable and is often derived from the medial, but occasionally from the lateral, plantar nerves ( Figure 2). The lateral plantar nerve supplies sensation to the fifth toe. The medial plantar nerve supplies sensation to the first, second, and third toes. Both plantar nerves terminate at the toes by dividing into interdigital sensory branches. The sensory portions of the medial and lateral plantar nerves provide innervation of the soles. The lateral plantar nerve innervates the abductor and flexor digiti minimi, the adductor hallucis, and the interossei muscles ( Figure 1). The medial plantar nerve innervates the abductor hallucis, flexor digitorum brevis, and flexor hallucis brevis muscles. The motor fibers innervate the small intrinsic muscles of the foot. The medial and lateral plantar nerves carry both motor and sensory fibers. The medial and lateral calcaneal branches are purely sensory and supply the heel area of the sole ( Fig. The sensory supply to areas under the fourth toe is variable and is often derived from the medial, but occasionally from the lateral, plantar nerves. The lateral plantar nerve supplies sensation to the plantar aspects of the fifth or little toe. The sensory fibers of the medial plantar nerve supply sensation to the area of the great toe and the second and third toes. The lateral plantar nerve passes between the flexor digitorum brevis and quadratus plantae muscles to innervate the abductor and flexor digiti minimi, the adductor hallucis, and the interossei. The medial plantar nerve travels to the sole of the foot under the bony attachment of the abductor hallucis to innervate that muscle and the flexor digitorum brevis and flexor hallucis brevis. The medial and lateral plantar nerves carry motor and sensory fibers.
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