Common peroneal nerve

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The common peroneal nerve, also known as common fibular nerve, forms the lateral part of the sciatic nerve and supplies the leg.

Summary

origin: one of two terminal branches of the sciatic nerve
course: diverges laterally to enter the lateral compartment of the leg
terminal branches
- deep peroneal nerve
- superficial peroneal nerve
motor supply: short head biceps femoris
sensory supply: cutaneous innervation of posterolateral leg

Gross anatomy

Origin

One of two terminal branches of the sciatic nerve, with the division, typically occurring in the lower-third of the thigh. It arises from the posterior division of the anterior rami of L4-S2 nerve roots in the sacral plexus.

Course

Diverges away from the sciatic nerve by sloping ~~medial~~lateral and downwards to ~~sit along~~lie laterally in the popliteal fossa, deep to biceps femoris ~~tendon where it passes through to the lateral aspect of the~~ ~~popliteal fossa~~. It It exits the popliteal fossa over the plantaris and lateral head of gastrocnemius. Here the common peroneal nerve remains subfascial as it winds its way around the fibula neck to enter the lateral compartment of the leg where it can be felt and rolled in the living. It divides into its terminal branches in the peroneus longus muscle - superficial and deep peroneal nerves.

Branches and supply

peroneal communicating nerve
- pierces roof of popliteal fossa, runs down in the subcutaenous fat, and joins the sural nerve below the gastrocnemius bellies
lateral sural cutaneous nerve - pierces the roof of the fossa over the lateral gastrocnemius head
superior and inferior genicular nerves - travel with the arteries of the same name and supply the lateral aspect of the knee capsule
recurrent genicular nerve
- arise in the substance of peroneus longus, perforates tibialis anterior (supplying its upper lateral fibres) and supplies the capsule of the knee joint and superior tibiofibular joint
muscular ~~twigs to the~~branches - short head of the biceps femoris
~~cutaneous branches: fibular communicating branch which joins the~~ ~~sural nerve, lateral sural cutaneous branch to innervate the posterolateral leg~~
terminal branches
- superficial peroneal nerve
- deep peroneal ~~nerve~~nerve

Relations

anterior / deep (on posterior aspect of the leg)
- plantaris
- lateral head of the gastrocnemius muscle
- knee joint capsule
- fibular origin of soleus
anterior / superficial (on anterior aspect of lower leg)
- peroneus longus

Function

cutaneous innervation
- lateral sural cutaneous nerve
  - supplies skin and deep fascia over the upper half of the peroneal and extensor compartments
- superficial peroneal nerve:
  - medial and intermediate dorsal cutaneous nerves supply the skin on the dorsum of the foot
- deep peroneal nerve
  - terminal branch gives dorsal digital nerve to supply adjacent sides of the 1st and 2nd toes
- peroneal communicating branch
  - joins medial sural cutaneous nerve (from tibial nerve) to form sural nerve that supplies posterolateral side of leg and dorsal aspect of lateral foot
motor supply
- deep peroneal nerve: muscles of extensor compartment
- superficial peroneal nerve: muscles of lateral compartment

Variants

the level of division from the sciatic nerve is variable ranging from high up in the pelvis to the distal femur
sural communicating branch of common peroneal - absent in 20%
arising from the sacral pelvis separate to the tibial nerve
arising through the piriformis
arising under the piriformis

-</ul><h4>Gross anatomy</h4><h5>Origin</h5><p>One of two terminal branches of the sciatic nerve, with the division, typically occurring in the lower-third of the thigh. It arises from the posterior division of the anterior rami of L4-S2 nerve roots in the <a href="/articles/sacral-plexus">sacral plexus</a>.</p><h5>Course</h5><p>Diverges away from the sciatic nerve by sloping medial and downwards to sit along the biceps femoris tendon where it passes through to the lateral aspect of the <a href="/articles/popliteal-fossa">popliteal fossa</a>. It exits the popliteal fossa over the plantaris and lateral head of gastrocnemius. Here the common peroneal nerve remains subfascial as it winds its way around the fibula neck to enter the lateral compartment of the leg where it can be felt and rolled in the living. It divides into its terminal branches - superficial and deep peroneal nerves.</p><h5>Branches and supply</h5><ul>
~~-<li>muscular twigs to the short head of biceps femoris</li>~~
~~-<li>cutaneous branches: fibular communicating branch which joins the <a href="/articles/sural-nerve">sural nerve</a>, lateral sural cutaneous branch to innervate the posterolateral leg</li>~~
+</ul><h4>Gross anatomy</h4><h5>Origin</h5><p>One of two terminal branches of the sciatic nerve, with the division, typically occurring in the lower-third of the thigh. It arises from the posterior division of the anterior rami of L4-S2 nerve roots in the <a href="/articles/sacral-plexus">sacral plexus</a>.</p><h5>Course</h5><p>Diverges away from the sciatic nerve by sloping lateral and downwards to lie laterally in the popliteal fossa, deep to biceps femoris. It exits the popliteal fossa over the plantaris and lateral head of gastrocnemius. Here the common peroneal nerve remains subfascial as it winds its way around the fibula neck to enter the lateral compartment of the leg where it can be felt and rolled in the living. It divides into its terminal branches in the peroneus longus muscle - superficial and deep peroneal nerves.</p><h5>Branches and supply</h5><ul>
+<li>peroneal communicating nerve <ul><li>pierces roof of popliteal fossa, runs down in the subcutaenous fat, and joins the sural nerve below the gastrocnemius bellies</li></ul>
+</li>
+<li>lateral sural cutaneous nerve - pierces the roof of the fossa over the lateral gastrocnemius head </li>
+<li>superior and inferior genicular nerves - travel with the arteries of the same name and supply the lateral aspect of the knee capsule</li>
+<li>recurrent genicular nerve <ul><li>arise in the substance of peroneus longus, perforates tibialis anterior (supplying its upper lateral fibres) and supplies the capsule of the knee joint and superior tibiofibular joint </li></ul>
+</li>
+<li>muscular branches - short head of the biceps femoris</li>
~~-<li><a href="/articles/deep-peroneal-nerve">deep peroneal nerve</a></li>~~
+<li>
+<a href="/articles/deep-peroneal-nerve">deep peroneal nerv</a>e</li>
+</ul>
+</li>
+</ul><h5>Relations</h5><ul>
+<li>anterior / deep (on posterior aspect of the leg)<ul>
+<li>plantaris </li>
+<li>lateral head of the gastrocnemius muscle</li>
+<li>knee joint capsule</li>
+<li>fibular origin of soleus</li>
+</ul>
+</li>
+<li>anterior / superficial (on anterior aspect of lower leg)<ul><li>peroneus longus </li></ul>
+</li>
+</ul><h5>Function</h5><ul>
+<li>cutaneous innervation<ul>
+<li>lateral sural cutaneous nerve<ul><li>supplies skin and deep fascia over the upper half of the peroneal and extensor compartments</li></ul>
+</li>
+<li>superficial peroneal nerve:<ul><li>medial and intermediate dorsal cutaneous nerves supply the skin on the dorsum of the foot</li></ul>
+</li>
+<li>deep peroneal nerve<ul><li>terminal branch gives dorsal digital nerve to supply adjacent sides of the 1st and 2nd toes </li></ul>
+</li>
+<li>peroneal communicating branch <ul><li>joins medial sural cutaneous nerve (from tibial nerve) to form sural nerve that supplies posterolateral side of leg and dorsal aspect of lateral foot </li></ul>
+</li>
+</ul>
+</li>
+<li>motor supply <ul>
+<li>deep peroneal nerve: muscles of extensor compartment</li>
+<li>superficial peroneal nerve: muscles of lateral compartment </li>
+</ul><h4>Variants </h4><ul>
+<li>the level of division from the sciatic nerve is variable ranging from high up in the pelvis to the distal femur</li>
+<li>sural communicating branch of common peroneal - absent in 20%</li>
+<li>arising from the sacral pelvis separate to the tibial nerve</li>
+<li>arising through the piriformis</li>
+<li>arising under the piriformis</li>