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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
In the Master Knot of Henry, FHL lies
dorsal (superior) to FDL
26
In the Master Knot of Henry, FDL lies
plantar (inferior) to FHL
27
The Master Knot of Henry lies
Inferior to the Navicular Tuberosity
28
Tibialis Posterior characteristics
Deepest muscle of the deep posterior compartment | Tendon is palpable around medial malleolus
29
Origin of Tibialis Posterior
Posterior tibia (inf to soleal line) Posterior aspect of fibula (ant to medial crest) Interosseus membrane
30
Insertion of Tibilias Posterior
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
31
Path of the Tibialis Posterior
Post to tibia (in a groove with FDL) Inf to medial malleolus (through Flex Retinaculum) Superior to sustentaculum tali
32
Innervation to Posterior Tibialis
Tibial Nerve
33
Blood supply to Posterior Tibialis
Posterior Tibial artery | Fibular artery
34
Function of Posterior Tibialis
Invert and adduct fot | Supinate subtalar and midtarsal joint
35
All proximal synovial tendon sheaths of the deep compartment pass
within the flexor retinaculum | laciniate ligament
36
FHL Sheath (Proximal)
Begins at distal tip of med malleolus | Ends at knot of Henry
37
FHL Sheath (Proximal) surrounds
Tendon posterior to medial malleolus and inferior to sustentaculum tali
38
FHL Sheath (Distal) surrounds
Tendon from hallux met head to proximal phalanx
39
FDL Sheath (Proximal)
Begins posterior to med malleolus (little prox to FHL sheath) Ends proximal to Master Knot of Henry
40
FDL Sheath (Distal)
all 4 tendons of digits m2-5 from MTP joint to midlde phalanges
41
Tibialis Posterior Sheath
Begins 4 cm proximal to tip of medial malleolus | Ends at porta pedis
42
FHL Proximal Sheath begins and ends
most distally
43
Tibialis Posterior Sheath begins and ends
most proximally
44
Tibial nerve root level
L4-S3
45
Tibial nerve characteristics
Passes deep to tendinous arch of soleus
46
Tibial nerve provides innervation to all
Posterior compartment muscles
47
Tibial nerve gives off what nerves/branches
Medial sural cutaneous (S1, S2) Muscular branches Medial calcaneal branches terminal branches
48
Medial sural cutaneous nerve joins with
Fibular communicating | Forms Sural nerve
49
The medial calcaneal branches off posterior tibial nerve
Pierce through flex retinaculum (laciniate ligament) | Supply skin in medial calcaneal region
50
The terminal branches of posterior tibial nerve are
Medial Plantar nerve | Lateral Plantar nerve
51
Popliteal artery is a continuation of
Femoral artery | deep in the popliteal fossa
52
Popliteal artery supplies
Knee joint and surrounding musculature
53
Popliteal artery passes into the posterior leg compartment how?
Deep through the fibrous arch of the soleus
54
What the 6 branches off popliteal artery?
``` Superior Lat Gen Superior Mid Gen Sural Arteries Middle Gen Inferior Lat Gen Inferior Med Gen ```
55
Superior Lat Genicular artery path
Passes deep to biceps femoris
56
Superior Med Genicular artery
Passes deep to medial hamstring muscles/adductor magnus | Above medial femoral condyle
57
Sural arteries supply
Gastrocnemius Soleus Plantaris
58
Middle Genicular artery path
Pierces oblique popliteal ligament | Supplies internal knee structures
59
Inferior Lat Genicular artery path
Passes deep to Gastroc/Plantaris Superficial to Popliteus Passes around LATERAL tibial condyle
60
Inferior Med Genicular artery path
Along superior border of Popliteus toward MEDIAL tibial condyle
61
What are the two terminal branches of popliteal artery?
Anterior Tibial Artery | Posterior Tibial Artery
62
Anterior Tibial Artery path
Branches off popliteal near inf border of popliteus | passes through superior opening of IO membrane into Anterior compartment
63
Anterior Tibial artery branches into
Posterior Tibial Recurrent | Anterior Tibial Recurrent
64
Posterior Tibial recurrent branch of Ant Tibial Artery path
Branches off before entering Anterior compartment | Passes deep to Popliteus to join with genicular anastomosis
65
Anterior Tibial recurrent branch of Ant Tibial Artery path
Branches right after passing through superior opening of IO membrane Passes superiorly to anastomose with INFERIOR genicular arteries
66
Posteror Tibial Artery is found in
Deep posterior compartment
67
Posterio Tibial artery branches into
Circumflex Fibular | Fibular Artery
68
Circumflex Fibular branch of Post Tibial Artery path
wrap around neck of Fibula | Joints with Inferior Genicular arteries
69
Fibular (artery) branch of Posterior Tibial Artery path
Descends posterior to Fibula
70
Venous pathway of Posterior Leg
Anterior Tibial to Post Tibial to Popliteal to Femoral
71
Posterior Tibial Artery path
Between FHL and FDL Superficial to tibialis posterior (in deep compartment) Passes posterior to MEDIAL malleolus
72
Posterior Tibial pulse is felt
Between medial malleolus and achilles tendon
73
Posterior tibial artery branches into its terminal branches
Posterior to medial malleolus | Tarsal tunnel
74
Branches of the Posterior Tibial Artery include
``` 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
Nutrient artery of tibia
Lies inferior to soleal line
76
Both medial and lateral plantar arteries are
Terminal branches of posterior tibial
77
Fibular (peroneal) artery path
descends between FHL and TP | Posterior to LATERAL malleolus
78
Branches of the Fibular Artery
``` Muscular branches Nutrient artery of Fibular Perforating branch of fibular artery Fibular communicating artery Posterior lateral malleolar arteries Lateral calcaneal arteries ```
79
Nutrient artery of fibula
Found around mid shaft
80
Perforating branch of fibular artery path
Passes through inferior opening of IO membrane (5cm superior to lateral malleolus) Enters anterior ankle regions
81
Fibular communicating artery
Joins with posterior tibial | posterior and very inferior leg
82
Flexor retinaculum AKA
Laciniate ligament (thickening of crural fascia)
83
Flexor Retinaculum
Attaches to distal and posterior medial malleolus and medial calcaneus Anchors flexor tendons
84
How do tendons pass through flexor retinaculum?
Separate compartments surrounded by synovial sheaths
85
Tarsal tunnel
Located in posteromedial ankle (prox flex retinaculum to porta pedis) Passageway between post leg and plantar foot
86
Tarsal tunnel is divided into 4 compartments
``` 3 tendon (surrounded by synovial sheath) 1 neruovascular bundle ```
87
Boundaries of flexor retinaculum
Medial (Flex ret and abductor hallucis) | Lateral (Calcaneus, post talotibial ligament, calcaneotibial ligament)
88
Contents of Flexor retinaculum (ant to post/med to lat)
``` Tibialis posterior tendon Flexor digitorum tendon Posterior tibial art/vein Tibial nerve Flexor hallucis longus tendon (inf to sustenaculum tali) ```
89
Inside tarsal tunnel (others)
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
Muscles in Posterior leg (medial to lateral)
FDL TP FHL
91
Muscles in Tarsal tunnel, post to medial malleolus (medial to lateral)
TP FDL FHL
92
Muscles distal to Master Knot of Henry
TP FHL FDL
93
Flexor Digitorum Accessorius Longus
``` Accessory muscle (3-12% of time) Content of tarsal tunnel IF present ```
94
Origin of FDL Accessorius Longus
Tibia or Fibula Crural fascia Proximal FDL
95
Inserion of FDL Accessorius Longus
FDL tendon around Master Knot of Henry or Quadratus Plantae
96
Blood/Nerve to FDL Accessorius Longus
Same as muscles of posterior compartment
97
FDL Accessorius Longus pathology
Crowding of tarsal tunnel Tarsal tunnel syndrome FHL tenosynovitis
98
Porta Pedis
Canal formed by the abductor hallucis muscle and calcaneus
99
Porta pedis acts as passageway for
Medial and lateral plantar arteries, veins, and nerves | To and from medial ankle
100
Porta pedis is a potential site of
Entrapment

Lower Extremity Anatomy (9 decks)

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