Origin and course
The tibial nerve (n. tibialis) passes through the popliteal fossa and the posterior compartment of the leg, and divides behind the medial malleolus into two branches: the medial and lateral plantar nerves.
The anatomical landmark for branching is the space between the tibialis posterior muscle (m. tibialis posterior) and the flexor digitorum longus muscle (m. flexor digitorum longus): here, the n. tibialis branches into n. plantaris medialis and n. plantaris lateralis.
Further, the resulting medial and lateral neurovascular bundles enter the calcaneal canal (canalis calcaneus) and course onto the sole. In the foot, the medial plantar vessels and nerve (a., v., n. plantares mediales) run within the medial intermuscular septum.
Topography and adjacent structures
In the medial retromalleolar region, the anatomical structures listed include n. tibialis, n. plantaris medialis, n. plantaris lateralis, a. tibialis posterior, retinaculum mm. flexorum, the calcaneal branches of the tibial neurovascular bundle, as well as synovial sheaths and tendons of the flexor digitorum longus, tibialis posterior, and flexor hallucis longus muscles.
In the deep layer of the sole, the structures listed include the medial plantar artery and nerve (a., n. plantaris medialis), the tendon of the flexor digitorum longus (tendo m. flexoris digitorum longi), and the quadratus plantae muscle (m. quadratus plantae).
Which muscles does it innervate?
The medial plantar nerve innervates the muscles of digit I, the flexor digitorum brevis, and the lumbrical muscles, as specified in the study materials.
- Flexor digitorum brevis (m. flexor digitorum brevis) — flexes the middle phalanges of digits II–V and forms the longitudinal arch of the foot.
- Abductor hallucis muscle (m. abductor hallucis) — abducts and flexes the proximal phalanx of the great toe, supports the medial arch.
- Flexor hallucis brevis muscle (m. flexor hallucis brevis) — the medial part is innervated by n. plantaris medialis; the muscle flexes the proximal phalanx of the great toe.
- Lumbrical muscles (mm. lumbricales) — the study materials indicate innervation of the first lumbrical muscle by the medial plantar nerve; innervation of the two medial lumbrical muscles is also specified.
Which skin areas does it innervate?
The medial plantar nerve innervates the skin of the medial part of the sole, the medial margin, and the center of the sole.
It gives rise to the common plantar digital nerves (nn. digitales plantares communes) and proper plantar digital nerves (nn. digitales plantares proprii / propriae). Area of cutaneous innervation: skin of digits I, II, III, and the medial half of digit IV.
Class and exam questions
Which nerve is the medial plantar nerve a branch of?
It is a branch of the tibial nerve (n. tibialis). The division occurs posterior to the medial malleolus.
Through which canal does the nerve enter the foot?
Following the division of the tibial nerve, the medial plantar nerve as part of the medial neurovascular bundle enters the calcaneal canal (canalis calcaneus) and then continues onto the sole.
Which toes of the foot does this nerve innervate?
The proper plantar digital nerves innervate the skin of digits I, II, III, and the medial half of digit IV.
What else to study on this topic
- Tibial nerve (n. tibialis)
- Lateral plantar nerve (n. plantaris lateralis)
- Medial plantar artery (a. plantaris medialis)
- Calcaneal canal (canalis calcaneus)
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