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Lower Extremity Anatomy > 3) Posterior Leg Part II > Flashcards

3) Posterior Leg Part II Flashcards

1
Q

The muscles of the Deep compartment of the are separated from superficial by

A

Deep transverse IM septum

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2
Q

Popliteus characteristics

A

Partially intracapsular and extracapsular

Covered by fascia derived from semimembranosus

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3
Q

Origin of Popliteus

A

Lateral FEMORAL condyle (popliteal groove)

Posterior aspect of lateral meniscus

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4
Q

Inertion of Popliteus

A

Posterior aspect of proximal Tibia

Superior to soleal line

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5
Q

Innervation to Popliteus

A

Tibial nerve

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6
Q

Blood supply to Popliteus

A

Posterior tibial and medial inferior genicular

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7
Q

Function of Popliteus

A

UNLOCK knee
by laterally rotating femur on tibia
OR
medially rotating tibia on femur

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8
Q

Flexor Hallucis Longus characteristicss

A

Most lateral muscle in the DEEP posterior compartment

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9
Q

Origin of Flexor Hallucis Longus

A

Inferior 2/3 of Post Fibula
IM Septum
Deep fascia

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10
Q

Insertion of Flexor Hallucis Longus

A

Plantar aspect of base of distal phalanx of Hallux

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11
Q

Path of Flexor Hallucis Longus

A

Passes through groove on Post Tibia and Talus

Passes Inferior to Sustentaculum Tali through flexor retinaculum

Passes between the fibular and tibial sesamoids to insert on the plantar aspect of the base of the distal phalanx of the hallux

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12
Q

Innervation to the Flexor Hallucis Longus

A

Tibial nerve

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13
Q

Blood supply to the Flexor Hallucis Longus

A

Posterior tibial artery

Fibular artery

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14
Q

Function of the Flexor Hallucis Longus

A

Plantarflex hallux at IP and MTP joint

Helps plantarflex and INVERT foot

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15
Q

Flexor Hallucis Longus is important during

A

Push off of gait

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16
Q

Flexor Digitorum Longus characteristics

A

Most medial deep compartment muscle

Tendon is palpable around malleolus

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17
Q

Origin of Flexor Digitorum Longus

A

Posterior tibia

inferior to soleal line

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18
Q

Insertion of Flexor Digitorum Longus

A

Plantar aspect of the bases of distal phalanges

Digits 2-5

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19
Q

Path of Flexor Digitorum Longus

A

Through tibial groove
Medial to sustentaculum tali, through flex retinaculum
Passes to plantar footand splits into 4 slips at area of cuneiforms
Slips pass along the plantar surface of lesser mets and phalanges to insertion

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20
Q

Innervation to Flexor Digitorum Longus

A

Tibial Nerve

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21
Q

Blood supply to Flexor Digitorum Longus

A

Posterior Tibial Artery

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22
Q

Function of Flexor Digitorum Longus

A

Plantarflex digits, distal and proximal IP joints and MTPs

Help with ankle plantarflexion

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23
Q

FDL tendon crosses ________ to FHL tendon in sole of the foot

A

Superficial

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24
Q

The Master Knot of Henry is

A

connective tissue connection between FHL and FDL

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25
Q

In the Master Knot of Henry, FHL lies

A

dorsal (superior) to FDL

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26
Q

In the Master Knot of Henry, FDL lies

A

plantar (inferior) to FHL

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27
Q

The Master Knot of Henry lies

A

Inferior to the Navicular Tuberosity

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28
Q

Tibialis Posterior characteristics

A

Deepest muscle of the deep posterior compartment

Tendon is palpable around medial malleolus

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29
Q

Origin of Tibialis Posterior

A

Posterior tibia (inf to soleal line)
Posterior aspect of fibula (ant to medial crest)
Interosseus membrane

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30
Q

Insertion of Tibilias Posterior

A

Navicular tuberosity
Plantar aspect of ALL cuneiforms
Base of mets 2-4
Can also insert into plantar aspect of cuboid and 1st and 5th met bases

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31
Q

Path of the Tibialis Posterior

A

Post to tibia (in a groove with FDL)
Inf to medial malleolus (through Flex Retinaculum)
Superior to sustentaculum tali

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32
Q

Innervation to Posterior Tibialis

A

Tibial Nerve

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33
Q

Blood supply to Posterior Tibialis

A

Posterior Tibial artery

Fibular artery

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34
Q

Function of Posterior Tibialis

A

Invert and adduct fot

Supinate subtalar and midtarsal joint

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35
Q

All proximal synovial tendon sheaths of the deep compartment pass

A

within the flexor retinaculum

laciniate ligament

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36
Q

FHL Sheath (Proximal)

A

Begins at distal tip of med malleolus

Ends at knot of Henry

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37
Q

FHL Sheath (Proximal) surrounds

A

Tendon posterior to medial malleolus and inferior to sustentaculum tali

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38
Q

FHL Sheath (Distal) surrounds

A

Tendon from hallux met head to proximal phalanx

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39
Q

FDL Sheath (Proximal)

A

Begins posterior to med malleolus (little prox to FHL sheath)
Ends proximal to Master Knot of Henry

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40
Q

FDL Sheath (Distal)

A

all 4 tendons of digits m2-5 from MTP joint to midlde phalanges

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41
Q

Tibialis Posterior Sheath

A

Begins 4 cm proximal to tip of medial malleolus

Ends at porta pedis

42
Q

FHL Proximal Sheath begins and ends

A

most distally

43
Q

Tibialis Posterior Sheath begins and ends

A

most proximally

44
Q

Tibial nerve root level

45
Q

Tibial nerve characteristics

A

Passes deep to tendinous arch of soleus

46
Q

Tibial nerve provides innervation to all

A

Posterior compartment muscles

47
Q

Tibial nerve gives off what nerves/branches

A

Medial sural cutaneous (S1, S2)
Muscular branches
Medial calcaneal branches
terminal branches

48
Q

Medial sural cutaneous nerve joins with

A

Fibular communicating

Forms Sural nerve

49
Q

The medial calcaneal branches off posterior tibial nerve

A

Pierce through flex retinaculum (laciniate ligament)

Supply skin in medial calcaneal region

50
Q

The terminal branches of posterior tibial nerve are

A

Medial Plantar nerve

Lateral Plantar nerve

51
Q

Popliteal artery is a continuation of

A

Femoral artery

deep in the popliteal fossa

52
Q

Popliteal artery supplies

A

Knee joint and surrounding musculature

53
Q

Popliteal artery passes into the posterior leg compartment how?

A

Deep through the fibrous arch of the soleus

54
Q

What the 6 branches off popliteal artery?

A 
Superior Lat Gen
Superior Mid Gen
Sural Arteries
Middle Gen
Inferior Lat Gen
Inferior Med Gen
55
Q

Superior Lat Genicular artery path

A

Passes deep to biceps femoris

56
Q

Superior Med Genicular artery

A

Passes deep to medial hamstring muscles/adductor magnus

Above medial femoral condyle

57
Q

Sural arteries supply

A

Gastrocnemius
Soleus
Plantaris

58
Q

Middle Genicular artery path

A

Pierces oblique popliteal ligament

Supplies internal knee structures

59
Q

Inferior Lat Genicular artery path

A

Passes deep to Gastroc/Plantaris
Superficial to Popliteus
Passes around LATERAL tibial condyle

60
Q

Inferior Med Genicular artery path

A

Along superior border of Popliteus toward MEDIAL tibial condyle

61
Q

What are the two terminal branches of popliteal artery?

A

Anterior Tibial Artery

Posterior Tibial Artery

62
Q

Anterior Tibial Artery path

A

Branches off popliteal near inf border of popliteus

passes through superior opening of IO membrane into Anterior compartment

63
Q

Anterior Tibial artery branches into

A

Posterior Tibial Recurrent

Anterior Tibial Recurrent

64
Q

Posterior Tibial recurrent branch of Ant Tibial Artery path

A

Branches off before entering Anterior compartment

Passes deep to Popliteus to join with genicular anastomosis

65
Q

Anterior Tibial recurrent branch of Ant Tibial Artery path

A

Branches right after passing through superior opening of IO membrane
Passes superiorly to anastomose with INFERIOR genicular arteries

66
Q

Posteror Tibial Artery is found in

A

Deep posterior compartment

67
Q

Posterio Tibial artery branches into

A

Circumflex Fibular

Fibular Artery

68
Q

Circumflex Fibular branch of Post Tibial Artery path

A

wrap around neck of Fibula

Joints with Inferior Genicular arteries

69
Q

Fibular (artery) branch of Posterior Tibial Artery path

A

Descends posterior to Fibula

70
Q

Venous pathway of Posterior Leg

A

Anterior Tibial to Post Tibial to Popliteal to Femoral

71
Q

Posterior Tibial Artery path

A

Between FHL and FDL
Superficial to tibialis posterior (in deep compartment)
Passes posterior to MEDIAL malleolus

72
Q

Posterior Tibial pulse is felt

A

Between medial malleolus and achilles tendon

73
Q

Posterior tibial artery branches into its terminal branches

A

Posterior to medial malleolus

Tarsal tunnel

74
Q

Branches of the Posterior Tibial Artery include

A 
Circumflex Fibular (sometimes)
Muscular branches
Nutrient Artery of Tibia
Fibular artery
Posterior medial malleola
Artery to Tarsal canal
Medial Plantar artery
Lateral Plantar Artery
75
Q

Nutrient artery of tibia

A

Lies inferior to soleal line

76
Q

Both medial and lateral plantar arteries are

A

Terminal branches of posterior tibial

77
Q

Fibular (peroneal) artery path

A

descends between FHL and TP

Posterior to LATERAL malleolus

78
Q

Branches of the Fibular Artery

A 
Muscular branches
Nutrient artery of Fibular
Perforating branch of fibular artery
Fibular communicating artery
Posterior lateral malleolar arteries
Lateral calcaneal arteries
79
Q

Nutrient artery of fibula

A

Found around mid shaft

80
Q

Perforating branch of fibular artery path

A

Passes through inferior opening of IO membrane (5cm superior to lateral malleolus)
Enters anterior ankle regions

81
Q

Fibular communicating artery

A

Joins with posterior tibial

posterior and very inferior leg

82
Q

Flexor retinaculum AKA

A

Laciniate ligament (thickening of crural fascia)

83
Q

Flexor Retinaculum

A

Attaches to distal and posterior medial malleolus and medial calcaneus
Anchors flexor tendons

84
Q

How do tendons pass through flexor retinaculum?

A

Separate compartments surrounded by synovial sheaths

85
Q

Tarsal tunnel

A

Located in posteromedial ankle (prox flex retinaculum to porta pedis)
Passageway between post leg and plantar foot

86
Q

Tarsal tunnel is divided into 4 compartments

A 
3 tendon (surrounded by synovial sheath)
1 neruovascular bundle
87
Q

Boundaries of flexor retinaculum

A

Medial (Flex ret and abductor hallucis)

Lateral (Calcaneus, post talotibial ligament, calcaneotibial ligament)

88
Q

Contents of Flexor retinaculum (ant to post/med to lat)

A 
Tibialis posterior tendon
Flexor digitorum tendon
Posterior tibial art/vein
Tibial nerve
Flexor hallucis longus tendon (inf to sustenaculum tali)
89
Q

Inside tarsal tunnel (others)

A

Tibial nerve into med/lat plantar nerves
Post tibial artery into med/lat plantar
Medial calcaneal nerve/art also possible (some pierce flexor retinaculum)

90
Q

Muscles in Posterior leg (medial to lateral)

91
Q

Muscles in Tarsal tunnel, post to medial malleolus (medial to lateral)

92
Q

Muscles distal to Master Knot of Henry

93
Q

Flexor Digitorum Accessorius Longus

A 
Accessory muscle (3-12% of time)
Content of tarsal tunnel IF present
94
Q

Origin of FDL Accessorius Longus

A

Tibia or Fibula
Crural fascia
Proximal FDL

95
Q

Inserion of FDL Accessorius Longus

A

FDL tendon around Master Knot of Henry or Quadratus Plantae

96
Q

Blood/Nerve to FDL Accessorius Longus

A

Same as muscles of posterior compartment

97
Q

FDL Accessorius Longus pathology

A

Crowding of tarsal tunnel
Tarsal tunnel syndrome
FHL tenosynovitis

98
Q

Porta Pedis

A

Canal formed by the abductor hallucis muscle and calcaneus

99
Q

Porta pedis acts as passageway for

A

Medial and lateral plantar arteries, veins, and nerves

To and from medial ankle

100
Q

Porta pedis is a potential site of

A

Entrapment

Lower Extremity Anatomy (9 decks)

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