18. Anatomy of the Leg and Foot Flashcards
What are the two main joints of the leg?
Superior tibiofibular
Inferior Tibiofibular
What supports the superior tibiofibular joint?
Ligament of fibular head - has anterior and posterior
What type of joint is the superior tibiofibular?
What type of movement is permitted?
Synovial plane joint
Limited gliding movement allowed
What type of joint is the inferior tibiofibular joint?
Fibrous syndesmosis - limited movement allowed
What supports the inferior tibiofibular joint in place?
Tibiofibular ligaments (anterior and posterior)
Inferior transverse tibiofibular ligament
Interosseous tibiofibular ligament
What is a syndesmosis?
A fibrous joint where the bones are bound together by ligaments or membrane
Which has more movement? The superior or inferior tibiofibular joint?
Superior
What is the name of the ankle joint?
The talocrural joint
What type of joint is the talocrural joint?
Synovial hinge
What terms means that the toes point (a) up and (b) down?
(a). Dorsiflexion
(b). Plantarflexion
What ligaments support the talocrural joint?
Lateral ligaments of ankle (Anterior and posterior talofibular, calcaneofibular)
Medial ligaments of ankle (anterior and posteior tibiotalar, tibiocalcaneal & tibionavicular)
What type of joint is found betwen the tarsals?
Synovial joints
- Subtalar (i.e. talus & calcaneous) = Plane
- Transverse tarsal (calcaneocuboid, talonavicular) = Saddle joint
What is the name of the joint between the tarsals and metatarsals?
Tarsometatarsal joint
What type of joint is the tarsometatarsal joint?
Synovial plane
What is another name for the tarsometatarsal joints?
Lisfranc joints
What is the name of the joint between the metatarsals and phalanges?
What type of joint is this?
Metatarsophalangeal joint
Synovial ellipsoid
What is the name of the joint between the phalanges?
What type of joint is this?
Interphalangeal joint
Synovial hinge uniaxial joint
What does the talus sit within in the foot?
The malleolar mortice
What type of muscles are found in the anterior compartment of the leg?
Dorsiflexors
Which muscles are found in the anterior compartment of the leg?
Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus
Fibularis Tertius
What is the action of the muscles of the anterior compartment of the leg?
All - dorsiflex the foot
EDL & EHL - extend digits
TA - inverts foot at subtalar joint
What is the blood supply to the anterior compartment of the leg?
Anterior tibial artery
What is the innervation to the anterior compartment of the leg?
Deep fibular nerve (L4-S1)
Cutaneous = saphenous and lateral sural nerves
What does fibularis tertius contribute to in terms of movement?
Eversion of the foot as well as dorsiflexion
What is the function of the muscles in the lateral compartment of the leg?
Evertors of the foot at the subtalar joint
Which two muscles are found in the lateral compartment of the leg?
Fibularis longus
Fibularis brevis
Which retinaculum are found in the anterior compartment of the leg?
Superior Extensor Retinaculum
Inferior Extensor Retinaculum
What is another name for fibularis longus & brevis?
Peroneus longus & brevis
What is the blodo supply to the lateral compartment of the leg?
Fibular artery perforating branches
Does not have its own artery - instead uses perforating branches
What is the innervation to the lateral compartment of the leg?
Superficial fibular nerve (L5-S2)
Cutaneous - lateral sural and sural nerves
Which artery does the fibular artery arise from?
The posterior tibial artery
What separates the lateral comparment from other compartments?
Intermuscular septa (anterior and posterior)
Which retinaculum is found in the lateral compartment of the leg?
The fibular retinacula
Which nerve supplies the web space between the big toe and the second toe?
Deep fibular nerve
What is the innervation of fibularis longus?
Superficial fibular nerve
What is the action of fibularis longus?
Eversion of foot
Plantarflexion of foot
Supports the arches of the foot
What is the innervation of fibularis brevis?
Superficial fibular nerve
What is the function of fibularis brevis?
Eversion of the foot
What is the posterior compartment of the leg divided into?
Superficial and Deep compartments
Which muscles are found in the superior compartment of the posterior leg?
Gastrocnemius
Soleus
Plantaris
Which muscles are found in the deep compartment of the posterior leg?
Flexor digitorum longus
Flexor hallucis longus
Tibialis posteior
Popliteus
What separates the posterior compartment of the leg from other compartments?
Transverse intermuscular septum
What reticulum is found in the posterior compartment of the leg?
What passes underneath it?
Flexor retinaculum
Tarsal tunnel
What is the main function of the posterior compartment leg muscles?
Plantarflexion
Which muscles in the posterior compartment of the leg are responsible for flexion of the digits?
Flexor digitorum longus
Flexor hallucis longus
Which muscle of the posterior compartment of the leg is also responsible for inversion of the foot at the subtalar joint?
Tibialis Posterior
What is another name for the subtalar joint?
Talocalcaneal joint
What gives blood supply to the superficial posterior compartment of the leg?
Posterior tibial artery
What gives blood supply to the deep posterior compartment of the leg?
Fibular artery
Which nerves provides innervation to both the superficial and deep posterior compartments of the leg?
Tibial nerve
Sural & saphenous nerves - cutaneous supply
What percentage of the population do not have a plantaris muscle?
10%
Which three muscles insert on the calcaneus to form the achilles tendon?
Gastrocnemius
Soleus
Plantaris
Which muscles of the posterior leg compartment crosses the knee and can help to flex the knee joint?
Gastrocnemius
Plantaris
Which muscle of the posterior leg makes up the floor of the popliteal fossa?
Popliteus
What separates the superficial and deep compartments of the posterior leg?
Transverse intermuscular septum
What is the main function of the popliteus muscle?
Unlocks the knee & stabilises the knee joint
What is the innervation of Gastrocnemius?
Tibial nerve
What is the function of gastrocnemius?
Plantarflexion of the foot
Flexion of the knee
What is the innervation of plantaris?
Tibial nerve
What is the function of plantaris?
Plantarflexion of the foot
Flexion of the knee
What is the innervation of soleus?
Tibial nerve
What is the action of soleus?
Plantarflexion of the foot
What is the innervation to popliteus?
Tibial nerve
What is the action of the popliteus muscle?
Unlocks the knee joint (laterally rotates femur on a fixed tibia)
Stabilises the knee joint (resists lateral rotation of tibia on femur)
What is the innervation of flexor hallucis longus and brevis?
Tibial nerve
What is the action of flexor hallucis longus?
Flexes the great toe
What is the action of flexor digitorum longus?
Flexes the lateral four toes
What is the innervation of tibialis posterior?
Tibial nerve
What is the action of tibialis posterior?
Inversion and plantarflexion of the foot
Supports the medial arch of the foot during walking
Which two muscles are found in the dorsum of the foot?
Extensor digitorum brevis
Extensor hallucis brevis
Which two muscles are found in the dorsum of the foot?
Extensor digitorum brevis
Extensor hallucis brevis
What is the innervation of muscles of the dorsum of the foot?
Deep fibular nerve
What is the innervation of muscles of the dorsum of the foot?
Deep fibular nerve
What is the cutaneous nerve supply to the dorsum of the foot?
Mostly superficial fibular - 2nd to 4th webspaces
1st webspace = deep fibular
What does the great saphenous vein drain into?
Femoral vein
What does the small saphenous vein arise from?
The lateral aspect of the dorsal venous arch
What does the great saphenous vein arise from?
Medial
Which arteries arise from the dorsalis pedis artery?
Arcuate artery
Lateral tarsal artery
Deep plantar artery
Where is the great saphenous vein found in relation to the medial malleolus?
Anterior
Where is the small saphenous vein found in relation to the medial malleolus?
Posterior
What is the action of extensor digitorum brevis?
Extension of toes 2-4
What is the action of extensor hallucis brevis?
Extension of metatarsophalangeal joint of the great toe
What forms the most superficial layer of the plantar foot?
Plantar fascia and thickened plantar aponeurosis
How is the plantar foot subdivided?
Into four muscle layers
How is innervation of the plantar foot divided?
Into superficial (1st and 2nd layers) and deep (3rd and 4th) sections
Which illness is important clinically that involves the plantar foot?
Plantar fasciitis
Which muscles are found in the first layer of the plantar foot?
Abductor hallucis
Flexor digitorum brevis
Abductor digiti minimi
What is the blood supply to abductor hallucis?
Medial plantar artery
What is the blood supply to flexor digitorum brevis and abductor digiti minimi?
Lateral plantar artery
Which muscles in the first layer of the plantar foot are innervated by the medial plantar nerve?
Abductor hallucis
Flexor digitorum brevis
Which muscle in the first layer of the plantar foot is innervated by the lateral plantar nerve?
Abductor digiti minimi
Which nerve do the medial and lateral plantar nerves arise from?
Tibial nerve in posterior leg
What does the tibial nerve travel through before it divides into the medial and lateral plantar nerves?
Plantar tunnel
Which main artery in the posterior leg travels through the tarsal tunnel and divides into medial and lateral tarsal arteries?
Posterior tibial
Which main artery in the posterior leg travels through the tarsal tunnel and divides into medial and lateral tarsal arteries?
Posterior tibial
What is the function of abductor hallucis?
Abduction and flexion of great toe
What is the function of flexor digitorum brevis?
Flexes the lateral four toes at the PIP joint
What is the function of flexor digitorum brevis?
Flexes the lateral four toes at the PIP joint
What is the function of abductor digiti minimi?
Abducts the little toe at the metatarsophalangeal joint
Which muscles are found in the second layer of the plantar foot?
Quadratus plantae
Lumbricals
What is the action of quadratus plantae and the lumbricals?
Flexion of the digits
What is the blood supply to the second layer of the plantar foot (quadrantus plantae and lumbricals)?
Lateral plantar artery
What is the blood supply to the second layer of the plantar foot (quadrantus plantae and lumbricals)?
Lateral plantar artery
What is the innervation of the second layer of the plantar foot (quadratus plantae and lumbricals?)
1st lumbrical = Medial plantar nerve
Quadratus plantae & 2-4th lumbricals = Lateral plantar nerve
Which muscles are found in the third layer of the plantar foot?
Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis
What is the blood supply to the flexor hallucis brevis and adductor hallucis muscles in the third plantar layer of the foot?
Medial plantar artery
What is the blood supply to flexor digiti minimi brevis in the third layer of the plantar foot?
Lateral plantar artery
What is the innervation to the third layer of the plantar foot?
Flexor hallucis brevis = medial plantar nerve
Adductor hallucis & Flexor digiti minimi brevis = lateral plantar nerve
What is the function of the muscles in the 3rd layers of the plantar foot?
Flexion of digit
Adduction of hallux
Which muscles are found in the fourth layer of the plantar foot?
Plantar interossei
Dorsal interossei
What are the functions of the planter and dorsal interossei?
PAD & DAB
Plantar - adduction
Dorsal - abduction
What is the axis point for abduction of the toes?
Second toe
Where are the interossei of the foot found?
In the webspaces
Where are the interossei of the foot found?
In the webspaces
What is the blood supply to the interossei of the foot?
Lateral plantar artery
What is the innervation to the interossei of the foot?
Lateral plantar nerve
Deep fibular nerve (1st and 2nd dorsal interossei)
What are the arches of the foot?
Longitudinal arches - medial and lateral
Transverse
Which bones make up the medial longitudinal arch?
Talus (keystone)
Calcaneus
Navicular
Cuniforms x3
Metatarsals 1-3
Which bones make up the lateral longitudinal arch?
Calcaneus, cuboid, metatarsal V
Which bones make up the transverse arch?
Cuboid, cuneiforms x3
Why do we have arches in the foot?
Shock absorption
Adaption for uneven ground
Balance
Propulsion
Which tendons provide dynamic support to the medial arch of the foot?
Flexor hallucis longus
Flexor digitorum longus
Tibialis anterior
Fibularis longus
Which tendons provide dynamic support to the transverse arch of the foot?
Fibularis longus
Tibialis posterior
What is the difference between tendon support and ligament support in the foot?
Tendon support = dynamic support
Ligament support = passive support
Which ligaments in the foot give passive support?
Plantar aponeurosis
Long & short plantar ligaments
Spring (plantar calcaneonavicular) ligament
What passes through the tarsal tunnel?
Tom Dick And Very Nervous Harry
Tibialis posterior
flexor Digitorum Longus
Artery (posterior tibial)
Veins (venae commitantes)
Nerve (tibial)
flexor Hallucis Longus