2.6.3. ANAT LAB - Anterior and Lateral Leg Dorsum Foot

Question 1

In the lower leg what bone supports the weight of the body?

Answer 1

Tibia

Question 2

What is the fibula’s primary purpose?

Answer 2

Muscle attachment and stabilization during standing and locomotion It supports essentially no weight

Question 3

What are the three anatomical compartments in the leg?

Answer 3

Anterior, lateral, and posterior

Question 4

What nerve supplies the muscles of the anterior compartment?

Answer 4

Deep fibular (peroneal) nerve

Question 5

What are the subdivisions of the posterior compartment?

Answer 5

Superficial and deep

Question 6

What are the muscles of the anterior compartment?

Answer 6

Tibialis anterior (TA) Extensor digitorum longus (EDL) Extensor hallucis longus (EHL) Fibularis tertius

Question 7

What artery is important in the anterior compartment?

Answer 7

Anterior tibial artery (a branch of the popliteal) supplies the anterior compartment of the leg and the dorsum of the foot

Question 8

What does the anterior tibial artery become?

Answer 8

Dorsalis pedis artery (after it reaches the foot)

Question 9

What is clinically important about the extensor digitorum brevis?

Answer 9

Contusion and tearing of the muscle fibers and associated blood vessels result in a hematoma in extensor digitorum brevis, producing edema anteromedial to the lateral malleolus Most people who have not seen this inflamed muscle assume they have a severely sprained ankle

Question 10

What does the superficial fibular nerve innervate?

Answer 10

Muscles of the lateral compartment of the leg, which are essentially involved in eversion of the foot

Question 11

What does the deep fibular nerve innervate?

Answer 11

Muscles of the anterior compartment of the leg and muscles on the dorsum of the foot These muscles are essentially dorsiflexors of the foot at the ankle and extensors of the toes

Question 12

What is the most commonly injured nerve of the lower limb

Answer 12

The COMMON fibular nerve (vulnerable to compression injury, usually from direct trauma) where it wraps around the head of the fibula

Question 13

What do patients present with when they have injured their common fibular nerve?

Answer 13

Footdrop (inability to dorsiflex at the ankle) and an inability to evert the foot

Question 14

Which arteries are involved in the anastomosis at the ankle?

Answer 14

Malleolar, tarsal, and arcuate arteries

Question 15

Posterior tibial pulse

Answer 15

Felt b/w the medial malleolus and the calcaneal tendon

Question 16

Dorsalis pedis artery

Answer 16

A continuation of the anterior tibial artery Palpated on the dorsum of the foot just lateral to the tendon of the extensor hallucis longus as it emerges from the extensor retinaculum

Question 17

Path of the posterior tibial artery

Answer 17

A continuation of the popliteal artery. Below the knee, it gives rise to the fibular (peroneal) artery, which courses deep to the flexor hallucis longus muscles. As the posterior tibial artery passes inferiorly to the medial malleolus and enters the sole of the foot, it divides into medial and lateral plantar arteries

Question 18

What nerve accompanies the posterior tibial artery along most of its course?

Answer 18

The tibial nerve

Question 19

What is the Q angle?

Answer 19

The angle created by the femur (normally diagonal) and the tibia (normally vertical) Assessed by drawing a line from the ASIS to the middle of the patella and extrapolating a second (vertical) line passing through the middle of the patella and tibial tuberosity

Question 20

Is the Q angle normally wider in males or females?

Answer 20

Females because they have a wider pelves

Question 21

What is genu varum?

Answer 21

Q-angle is abnormally small Bowleg

Question 22

What happens because of genu varum?

Answer 22

Unequal weight bearing results in arthrosis (destruction of knee cartilage), and an overstressed fibular collateral ligament

Question 23

What is genu valgum?

Answer 23

Q-angle is large (lateral angulation of the leg in relation to the thigh) Knock-knee

Question 24

What happens because of genu valgum?

Answer 24

Excess stress and degeneration of the lateral structures of the knee joint

Question 25

What are the medial and lateral tibial plateaus?

Answer 25

Clinical terms that refer to the cartilage-capped medial and lateral condyles

Question 26

Where is a Tibial fracture most common?

Answer 26

The tibia is narrowest at the junction of its middle and inferior thirds (most frequent site of a fracture) This area also has the poorest blood supply

Question 27

What type of fracture is most commonly seen in the tibia?

Answer 27

Because the anterior surface is subcutaneous, a compound fracture is typically seen

Question 28

Where does a Fibular fracture commonly occur?

Answer 28

Fibular fractures commonly occur 2-6 cm proximal to the distal end of the lateral malleolus and are associated with fracture-dislocations of the ankle join

Question 29

Talk about the etiology of an Epiphyseal plate fracture and who tends to get them most

Answer 29

Epiphysis dislocations commonly occur in children 10-17 years old. The epiphysis of the femoral head slips away from the femoral neck because of a weakened epiphyseal plate. This is caused by acute trauma or repetitive microtrauma.

Question 30

Tendons vs. Ligaments

Answer 30

Tendons attach muscles to bones Ligaments attach bone to bone

Question 31

Muscles of the lateral compartment?

Answer 31

Fibularis brevis (FB) Fibularis longis (FB)

Question 32

Muscles of the posterior compartment?

Answer 32

Flexor hallucis longus (FHL) Soleus (SOL) Plantaris (P) Tibialis posterior (TP) Flexor digitorum longus (FDL)

Question 33

What is compartment syndrome?

Answer 33

Compartment syndrome is a serious condition that involves increased pressure in a muscle compartment. It can lead to muscle and nerve damage and problems with blood flow.

Question 34

Describe location of the Fibular artery

Answer 34

Largest branch of the tibial artery and arises inferior to the distal border of the popliteus and the tendinous arch of the soleus Descends obliquely toward the fibula and passes along the medial side usually with the flexor hallucis longus. It branches to the nutrient artery of the fibula. Distally, it branches into the terminal lateral malleolar and calcaneal branches

Question 35

Tibial nerve - Where is it and what does it innervate?

Answer 35

This is the larger of two terminal branches of the sciatic nerve. It runs vertically through the popliteal fossa with the popliteal artery passing through the heads of the gastrocnemius. It supplies all muscles in the posterior compartment of the leg

Question 36

What happens to the tibial nerve at the ankle?

Answer 36

At the ankle, the nerve lies between the FHL and FDL. It then divides into the medial and lateral plantar nerves inferior and posterior to the medial malleolus.

Question 37

What is the posterior intermuscular septum?

Answer 37

Fascia which separates the lateral compartment of the leg from the posterior compartment

Question 38

What is the transverse intermuscular septum?

Answer 38

transversely placed, intermuscular septum between superficial and deep muscles of the back of the leg

Question 39

What muscles are in the Posterior superficial compartment

Answer 39

Gastrocnemius Soleus Plantaris

Question 40

What do the gastrocnemius and soleus share?

Answer 40

A common tendon (calcaneal tendon) which attaches to the calcaneus

Question 41

What exists in the Posterior deep compartment

Answer 41

Popliteus FDL FHL Tibialis posterior

Question 42

What is intermittent claudication?

Answer 42

Intermittent claudication (claudicare is latin for limp) occurs if there is a anatomical obstruction, such as atherosclerosis of the superficial femoral artery and the popliteal artery and its branches begin to hurt during walking or stair-climbing. This occurs since the circulation can’t meet the metabolic demands . The patient limps and must wait until the lactic acid is washed out of the muscles.

Question 43

What is the triceps surae

Answer 43

The muscle pair consisting of the gastrocnemius and soleus

Question 44

Characteristics of veins in the leg

Answer 44

The lower limb has superficial and deep veins: the superficial veins are in the subcutaneous tissue and run independent from named arteries; the deep veins are beneath the deep fascia and accompany all major arteries. Superficial and deep veins have valves, which are more numerous in deep veins. Valves are flaps that permit blood flow to the heart only.

Question 45

2 major superficial veins in the lower limb

Answer 45

Great and small saphenous veins

Question 46

Deep veins of the leg

Answer 46

Anterior tibial vein Medial/lateral plantar veins Posterior tibial veins Fibular vein Popliteal vein Femoral vein Profunda femoris vein

Question 47

Characteristics of lymphatic vessels in the lower limb

Answer 47

The lower limb has superficial and deep lymphatic vessels. The superficial lymphatic vessels converge on and accompany the saphenous veins and their tributaries. The lymphatic vessels accompanying the great saphenous vein end in the vertical group of superficial inguinal lymph nodes. Some also pass to the deep inguinal lymph nodes under the deep fascia on the medial aspect of the femoral vein. The lymph vessels accompanying the small saphenous vein enter the popliteal lymph nodes surrounding the popliteal vein. Deep lymphatic vessels from the leg accompany deep veins and enter popliteal lymph nodes. Most lymph from these nodes ascend to the deep inguinal lymph nodes.

Question 48

Ski boot syndrome

Answer 48

compression of the fibular nerve results in pain in the dorsum of the foot and radiates to the web space between the first and second toe

Question 49

Describe the etiology and result of a Tibial nerve injury

Answer 49

injury here is uncommon because it is deep and protected in the popliteal fossa Those with a tibial nerve injury are unable to plantar-flex their ankle or flex their toes. Also, there is a loss of sensation on the sole of the foot.

Question 50

What does the calcaneal tendon reflex test?

Answer 50

AKA the achilles tendon Tests S1 and S2 nerve roots

Question 51

Origin and insertion for the tibialis anterior

Answer 51

Origin: Lateral condyle and proximal half of the lateral tibia Insertion: Medial cunelform and the first metatarsal

Question 52

Action of the tibialis anterior

Answer 52

Dorsiflexion and Inversion of the foot

Question 53

Origin and Insertion for the extensor hallucis longus

Answer 53

Origin: Middle third of the medial fibula Insertion: 1st toe

Question 54

Action of Extensor Hallucis longus

Answer 54

Extends the big toe and assists in dorsiflexion of the foot at the ankle.

Question 55

Origin and Insertion of the Extensor Digitorum longus

Answer 55

Origin - Head and Anterior border of the fibula and the lateral tibial condyle Insertion - 2nd - 5th toes

Question 56

Action of the extensor digitorum longus

Answer 56

extension of 4 toes and dorsiflexion of ankle

Question 57

Origin and Insertion for the fibularis tertius

Answer 57

Origin: anterior surface of the distal fibula Insertion: dorsal shaft of the 5th metatarsal

Question 58

Action of the fibularis tertius

Answer 58

dorsiflexion and eversion of the foot

Question 59

Origin and insertion for the extensor digitorum brevis

Answer 59

Origin is the calcaneus. Wraps around laterally to insert on the 2nd - 4th toes at the bases and middle phalanges

Question 60

Extensor Hallucis brevis origin and insertion

Answer 60

Origin - Calcaneus Insertion 1st toe at the proximal phalanx

Question 61

Action of the extensor digitorum brevis

Answer 61

Extension of the MTP and PIP joints of the 2nd - 4th toes

Question 62

Action of the extensor hallucis brevis

Answer 62

Extension of the MTP joint of the 1st toe

Question 63

Origin and Insertion for the fibularis longus

Answer 63

Origin is on the head and proximal two thirds of the lateral fibula Insertion is on the medial cuneiform and the base of the 1st metatarsal

Question 64

Action of the fibularis longus

Answer 64

plantarflexion, eversion, support arches

Question 65

Fibularis Brevis Origin and insertion

Answer 65

Origin is the distal half of the lateral fibula Insertion is on the 5th metatarsal

Question 66

Action of the fibularis brevis

Answer 66

Plantarflexion, eversion

Question 67


Answer 67

1. Tibialis anterior 2. Extensor Digitorum Longus 3. Fibularis Tertius 4. Extensor Hallucis Longus

Question 68


Answer 68

1. Superficial Fibular Nerve 2. Tibialis Anterior

Question 69


Answer 69

1. Extensor Digitorum Brevis 2. Extensor Hallucis Brevis

Question 70


Answer 70

1. Deep Fibular Nerve (blue band) 2. Dorsalis Pedis Artery (red band)

Question 71


Answer 71

1. Fibularis Longus Muscle 2. Fibularis Brevis Muscle Note that the fibularis longus is superfical to the fibularis brevis

Question 72


Answer 72

1. Great Saphenous Nerve

Question 73


Answer 73


Question 74


Answer 74

Fibular Head

Question 75


Answer 75

Lateral malleolus

Question 76

What is this large bump called? 

Answer 76

Tibial tuberosity

Question 77


Answer 77

Medial Tibial condyle

Question 78


Answer 78

Lateral tibial condyle

Question 79


Answer 79

Medial malleolus

Question 80


Answer 80

Intercondylar eminence

Question 81


Answer 81

Talus

Question 82


Answer 82

Calcaneus

Question 83


Answer 83

Sustenaculum Tali

Question 84


Answer 84

Navicular

Question 85


Answer 85

Cuboid

Question 86


Answer 86

Medial (1st) cuneiform

Question 87


Answer 87

Intermediate (2nd) cuneiform

Question 88


Answer 88

Lateral (third) cuneiform

Question 89


Answer 89

Metatarsals

Question 90

What comes more distally to the metatarsals? (Toe bones)

Answer 90

Phalanges