2.6.5. ANAT LAB - Posterior Leg Compartments Flashcards
Name the muscles in the anterior compartment of the leg. (4)
What is this group of muscles called (i.e. what is their function)?
1) Tibialis anterior
2) Extensor digitorum longus
3) Extensor hallucis longus
4) Fibularis tertius
These muscles are referred to as the long extensors.
Name the muscles in the lateral compartment of the leg. (2)
What is this group of muscles called (i.e. what is their function)?
1) Fibularis longus
2) Fibularis brevis
These muscles are called the evertors
What are the two subcompartments of the posterior compartment of the leg called?
What separates them?
Deep and superficial
They are separated by the transverse intermuscular septum
Name the muscles of the superficial posterior compartment. (3)
What is this group of muscles called?
1) Gastrocnemius
2) Soleus
3) Plantaris
The muscles of the posterior compartment are called the long flexors
Name the muscles of the deep posterior compartment. (4)
What is this group of muscles called?
1) Popliteus
2) Flexor hallucis longus
3) Flexor digitorum longus
4) Tibialis posterior
The muscles of the posterior compartment of the leg are called the long flexors
In what compartment of the leg would you be most worried about compartment syndrome, and why?
The deep posterior compartment because the muscles are tightly compacted; swelling in this area can cause compartment syndrome.
List the structures that transit the space under the flexor retinaculum to the foot. (6)
1) Tibialis posterior tendon
2) flexor Digitorum posterior tendon
3) posterior tibial Artery
4) posterior tibial Vein(s)
5) tibial Nerve
6) flexor Hallucis longus tendon
(Tom, Dick, and A Very Nervous Harry)
Which part of the foot is made up by the tarsus?
List the bones of the tarsus. (7)
The tarsus is the posterior/proximal foot.
1) Talus
2) Calcaneus
3) Cuboid
4) Navicular
5,6,7) Cuneiforms
List three awesome facts about the talus bone.
1) The talus is gripped by two malleoli (the distal heads of the tibia and fibula)
2) The talus receives the weight of the body from the tibia
3) The talus is the ONLY tarsal bone with no muscular or tendinous attachments
What bone is gripped by the malleoli of the distal heads of the tibia and fibula?
The talus
Which bone receives the weight of the body from the tibia?
How and where does it transmit the weight after it is received from the tibia?
The talus receives the weight of the body from the tibia.
The talus transmits the weight to the calcaneus (heel) and the fore foot via an osseoligamentous hammock.
Name the only tarsal bone with no muscular or tendinous attachments.
The talus
The body of the talus rests on which bone?
The calcaneus
Which is the largest, strongest bone in the foot?
The calcaneus
Name the weight bearing prominence of the calcaneus.
The calcaneus tuberosity
How many tubercles does the calcaneus have?
Which is the only one contacting the ground when standing?
3 tubercles - medial, lateral and anterior
The medial tubercle is the only one contacting the ground when standing.
Name the bones of the midfoot. (5)
1) Navicular
2) Cuboid
3,4,5) Cunieform bones
What is an important site for tendon attachments to help hold the medial foot (arch) off the ground?
Navicular tuberosity
What is the most lateral bone of the distal tarsus bones?
Which tendon goes through the groove on the lateral and inferior surfaces of this bone?
The cuboid bone
The tendon of the fibularis longus muscle runs through the groove on the cuboid
Which cuneiform bone articulates with the cuboid?
The lateral (third) cuneiform
All cuneiform bones articulate with the _____1______ posteriorly and the base of its appropriate ______2_______ anteriorly.
1) Navicular
2) Metatarsal
How many metatarsals are in a foot?
How are they numbered?
Which is the longest?
Shortest?
There are 5 metatarsals (but I made you think for a second, didn’t I?)
They are numbered from the medial side
The 2nd metatarsal is the longest
The 1st metatarsal is the shortest
Where are the medial and lateral sesamoid bones located on the 1st metatarsal?
On the plantar surface of the head of the 1st metatarsal (they are embedded in the tendons passing along the plantar surface)
What part of the foot are the tarsals in?
What part of the foot are the metatarsals and phalanges in?
The tarsals are in the posterior foot
The metatarsals & phalanges are in the anterior foot
Each metatarsal has three parts. What are they?
The base, the shaft, and the head
What separates the posterior foot from the anterior foot?
The oblique tarsometatarsal line formed by the tarsometatarsal joints.
How many phalanges are there in a foot?
Each phalange has three parts. What are they?
You have 14 (exact same setup as the hand; thumb = great toe)
Each phalange has a base, shaft, and head.
Name the specific parts of the bones involved in the tibiofibular joint.
What surrounds the joint?
The flat facet on the fibular head and a similar facet located posterolaterally on the lateral tibial condyle
The joint is surrounded by a tense joint capsule
Communication between what two structures can allow inflammation to migrate from the popliteal joint to the tibiofibular joint?
How common is this communication?
Communication between the popliteal bursa and the synovial cavity of the tibiofibular joint
This happens about ~20% of the time.
What is the tibiofibular syndesmosis?
A compound fibrous joint (fibrous union of the tibia and fibula via the interosseus membrane and the anterior, interosseus, and posterior tibiofibular ligaments (latter three make up the inferior tibiofibular joint)
What forms the principal connection between the tibia and fibula?
The Interosseus tibiofibular ligament
What is the function of the malleolar mortise?
What forms its three walls?
The Malleolar mortise is a square socket for the trochlea of the talus.
posterior wall - inferior transverse tibiofibular ligament
lateral wall - lateral malleolus
medial wall - medial malleolus
What is another name for the ankle joint?
This joint is located between which bones (specific parts)?
The ankle joint is also known as the talocrural articulation
It is located between the distal heads of the tibia and fibula and the superior part of the talus
How many ligaments stabilize the lateral side of the ankle joint?
Name & describe them.
3 separate ligaments
1) Anterior talofibular ligament - flat weak band that extends anteromedially from the lateral malleolus to the neck of the talus
2) Posterior talofibular ligament - thick, fairly strong band that runs horizontally medially and slightly posteriorly from the malleolar fossa to the lateral tubercle of the talus
3) Calcaneofibular ligament - a round cord that passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
How many ligaments stabilize the medial side of the ankle joint?
Name & describe.
Just one! It is called the deltoid ligament. It has 4 parts.
The deltoid ligament attaches proximally to the medial malleolus, from where it fans out, attaching distally to the talus, calcaneus, and navicular via four adjacent and continuous parts:
1) tibionavicular part
2) tibiocalcaneal part
3) anterior tibiotalar part
4) posterior tibiotalar part
What muscles effect dorsiflexion, plantar flexion, inversion, and eversion of the ankle?
Dorsiflexion - anterior compartment of the leg
Plantar Flexion - posterior compartment of the leg, lateral compartment (weakly)
Inversion - tibialis anterior
Eversion - fibularis tertius (weakly), lateral compartment of the leg
Describe the talar joint both anatomically and clinically.
What movement does it allow? (2)
What nerves provide motor ability? (2)
Anatomically - single synovial joint between the inferior talus and superior calcaneus
Clinically - compound joint of the subtalar joint and the talocalcaneonavicular joint, which are separated by the interosseus talocalcaneal ligament, but cannot function independently of one another
Movements - inversion and eversion of the foot
Motor - 1) plantar aspect: medial or lateral plantar nerve
2) dorsal aspect: deep fibular nerve
Describe the transverse tarsal joint.
What movement does it allow? (2)
Compound joint formed by two separate joints aligned transversely, the talonavicular part of the talocalcaneonavicular joint and the calcaneocuboid joint
Movement - augment the eversion and inversion of the hindfoot by allowing extra rotation at the mid and forefoot
What movement does the calcaneocuboid joint allow? (3)
Movement - inversion and eversion of the foot, circumduction
Explain the springboard action of the lateral and medial arches of the foot.
The lateral and medial arches of the foot are stretched out slightly when the foot lands, which causes tension in the “ropes” of the foot, giving you the spring in your step that helps to reduce the energy needed for each step/stride (important for long distance running)
Explain the general venous drainage of the foot.
Superficial veins form a plantar venous network either drain around the medial border of the foot or the lateral border:
- medial - medial marginal vein, which become the great saphenous vein
- lateral - lateral marginal vein, which becomes the small saphenous vein
Explain the general lymphatic drainage of the foot.
Begins in subcutaneous plexi
The collecting vessels are the superficial and deep lympatic vessels, which follow the superficial veins and major vascular bundles, respectively
Medial are larger than lateral, and converge on the great saphenous vein, accompanying it to the superficial inguinal lymph nodes (around the saphenous’ termination, then to the deep inguinal lymph nodes along the proximal femoral vein
Lateral accompany the small saphenous vein to the popliteal fossa, where they enter the popliteal lymph nodes
Deep vessels follow the main blood vessels and drain into the popliteal lymph nodes, which form lymph vessels that follow the femoral vessels to the deep inguinal lymph nodes
ALL lymph from the lower limb passes deep to the _____ ligament to ______ lymph nodes
Inguinal ligament
Iliac lymph nodes
Expalin the cutaneous innervation of the foot:
Medially
Superiorly
Inferiorly
Laterally
Posteriorly
Medially by the saphenous nerve, extending to the head of the 1st metatarsal
Superiorly (dorsum) by the superficial (mainly) and deep fibular nerves
Inferiorly by the medial and lateral plantar nerves in a manner similar to the palm of the hand
Laterally by the sural nerve, including part of the heel
Posteriorly (heel) by medial and lateral calcaneal branches of the tibial and sural nerves
Plantar (Babinski) Reflex:
What nerve roots does it test?
What is a normal sign?
What is an abnormal sign? What does this indicate?
From nerve roots L4, 5 and S1, 2
Normal = flexion of the toes
Abnormal = Babinski sign = dorsiflexion of the great toe and slight fanning of the other four toes
The abnormal sign is indicative of brain injury or cerebral disease, except in infants ages 0-4 years (then a normal toe flexion would be bad)
What is the normal reaction for a calcaneal tendon reflex?
If the reflex is absent, what does that indicate?
Normal reaction is plantar flexion.
Absent, or virtually absent reflex may be caused by compressed or injured S1 nerve
What is the most common joint injury?
Which ligament in the joint is most vulnerable?
Most common injury is the ankle sprain, which occurs when fibers of ligaments are torn
The lateral ligament is typically injured because it is much weaker than the medial ligament
The specific lateral ligament that is most vulnerable is the anterior talofibular ligament
Severe ankle sprains can also result in a fracture of which part of which bone?
The lateral malleolus of the fibula
_______ injuries fracture the lateral malleolus of the fibula superior to the ankle joint;
________ injuries fracture the lateral malleolus of the fibula inferior to the ankle joint.
Shearing injuries
Avulsion injuries
Identify the following:
- Gastrocnemius - medial head
- Plantaris
- Gastrocnemius - lateral head
Identify the following:
- Soleus
- Gastrocnemius (cut & reflected)
- Plantaris
Identify the following:
- Tibialis posterior tendon
- Flexor digitorum longus tendon
- Posterior tibial artery
- Tibial nerve
- Flexor hallucis longus muscle
Identify the following:
- Head of fibula
- Fibular border for interosseous membrane
- Lateral malleolus
- Tibial border for interosseous membrane
- Anterior border of tibia
- Medial malleolus
Identify the following:
- Medial condyle
- Lateral condyle
- Intercondylar eminence
Identify the following:
- Medial tibial plateau
- Intercondylar eminence
- Lateral tibial plateau
Identify the following:
- Calcaneus
- Intermediate (middle) cuneiform bone
- Tuberosity of the calcaneous
- Cuboid bone
- 5th metatarsal bone
- Proximal phalanx
- Distal phalanx
- Talus
- Navicular bone
- Lateral cuneiform bone
Identify the following:
- Sustenaculum tali
- Talus
- Navicular bone
- Calcaneus
- Metatarsal bone
- Proximal phalanx
- Medial cuneiform bone
Identify the following:
- Distal phalanx
- Tuberosity of calcaneus
- Navicular
- Cuboid
- Lateral cuneiform
- Intermediate cuneiform
- Medial cuneiform
- Metatarsals
- Proximal phalanx
