Common peroneal nerve
|Common peroneal nerve|
Nerves of the right lower extremity Posterior view. (Common peroneal labeled at center right.)
|From||sacral plexus via sciatic nerve (L4-S2)|
|To||Deep fibular nerve and Superficial fibular nerve|
|Innervates||Anterior compartment of leg, lateral compartment of leg, extensor digitorum brevis|
|Latin||Nervus fibularis communis,
Nervus peronaeus communis
|Anatomical terms of neuroanatomy|
The common peroneal nerve (common fibular nerve; external popliteal nerve; lateral popliteal nerve) is a nerve in the lower leg that provides sensation and motor function to parts of the lower leg. When damaged or compressed, it can cause foot drop.
It descends obliquely along the lateral side of the popliteal fossa to the head of the fibula, close to the medial margin of the biceps femoris muscle. Where the common peroneal nerve winds round the head of the fibula, it is palpable.
It lies between the tendon of the biceps femoris and lateral head of the gastrocnemius muscle, winds around the neck of the fibula, between the peroneus longus and the bone, and divides beneath the muscle into the superficial peroneal nerve and deep peroneal nerve.
Previous to its division it gives off articular and lateral sural cutaneous nerves.
- The articular branches are three in number:
- Two of these accompany the superior and inferior lateral genicular arteries to the knee; the upper one occasionally arises from the trunk of the sciatic nerve.
- The third (recurrent) articular nerve is given off at the point of division of the common peroneal nerve; it ascends with the anterior recurrent tibial artery through the tibialis anterior to the front of the knee.
- The lateral sural cutaneous nerve supplies the skin on the posterior and lateral surfaces of the leg.
- The motor branches:
- As the common peroneal nerve exits the popliteal fossa, it courses around the lateral aspect of the leg just below the head of the fibula. Here it is apposed with fibula and gives off two branches, the superficial peroneal branch and deep peroneal branch.
- The superficial peroneal nerve supplies the muscles of the lateral compartment of the leg namely: peroneus longus and peroneus brevis. These two muscles assist with eversion and plantarflexion of the foot.
- The deep peroneal nerve innervates the muscles of the anterior compartment of the leg which are: tibialis anterior, extensor hallucis longus, extensor digitorum longus, and the peroneus tertius. Together these muscles are responsible for dorsiflexion of the foot and extension of the toes.
- The deep peroneal nerve also innervates intrinsic muscles of the foot including the extensor digitorum brevis and the extensor hallucis brevis.
The common peroneal nerve innervates the short head of the biceps femoris muscle via a motor branch that exits close to the gluteal cleft. The remainder of the peroneal-innervated muscles are innervated by its branches, the deep peroneal nerve and superficial peroneal nerve.
It provides sensory innervation to the skin over the upper third of the lateral aspect of the leg via the lateral cutaneous nerve of the calf. It gives the peroneal communicating nerve which joins the sural nerve in the midcalf.
Chronic peroneal neuropathy can result from, among other conditions, bed rest of long duration, hyperflexion of the knee, peripheral neuropathy, pressure in obstetric stirrups, and conditioning in ballet dancers. The most common cause is habitual leg crossing that compresses the common peroneal nerve as it crosses around the head of the fibula. Transient trauma to the nerve can result from peroneal strike.
Damage to this nerve typically results in foot drop, where dorsiflexion of the foot is compromised and the foot drags (the toe points) during walking; and in sensory loss to the dorsal surface of the foot and portions of the anterior, lower-lateral leg. A common yoga kneeling exercise, the Vajrasana, has been linked to a variant called yoga foot drop.
Surgical procedures involving the nerve involve:
- Peroneal nerve decompression
- Deep peroneal nerve decompression
- In the surgical treatment of deep peroneal nerve entrapment in the foot, a ligament from the extensor digitorum brevis muscle that crosses over the deep peroneal nerve, putting pressure on it and causing pain, is released.
- Tam, Michael (2006-03-30). "Nerves of the Lower Limb". Medical student's retreat - Michael Tam's anatomy notes for medical students. Archived from the original on 2007-12-13. Retrieved 2010-05-08.
- Katirji, Bashar (2007). Electromyography in Clinical Practice: A Case Study Approach, 2nd ed. Mosby Elsevier. p. 146. ISBN 9780323028998.
- Bradley, Walter G.; et al. (2004). Neurology in Clinical Practice (4th ed.). Philadelphia: Butterworth-Heinemann. pp. 453–454. ISBN 0-7506-7469-5.
- Joseph Chusid (August 9, 1971). "Yoga Foot Drop". JAMA, The Journal of the American Medical Association. 271 (6): 827–828. doi:10.1001/jama.1971.03190060065025. Retrieved November 19, 2012.
- William J. Broad (January 5, 2012). "How Yoga Can Wreck Your Body". The New York Times Magazine. Retrieved August 29, 2012.
- "Peroneal Nerve Injury (Foot Drop)", Neurology and Neurosurgery, Johns Hopkins School of Medicine, 2013-12-18, retrieved 2013-12-18
- "Peroneal Nerve Entrapment at the Fibular Head", Department of Neurosurgery, NYU Langone Medical Center, 2013-12-18, retrieved 2013-12-18
- About us, Dellon Institutes for Peroneal Nerve Surgery, 2013-12-18, retrieved 2013-12-18
- Dellon Institutes Peroneal Nerve Compression Surgical Treatment (pdf), Dellon Institutes for Peroneal Nerve Surgery, 2006-02-20, retrieved 2013-12-18
- Anatomy photo:14:st-0501 at the SUNY Downstate Medical Center
- Peroneal_nerve at the Duke University Health System's Orthopedics program
- latleg at The Anatomy Lesson by Wesley Norman (Georgetown University)
- arteries-nerves%20LE/nerves4[dead link] at the Dartmouth Medical School's Department of Anatomy
- Overview at okstate.edu