3 - Zill - Leg and Dorsum of Foot

Question 1

Retinaculum

Answer 1

Hold tendons in place, prevent bowstringing

Question 2

Sprained Ankle

Answer 2

Excessive Inversion

Question 3

How is body weight transfered through the thigh and leg?

Answer 3

Hip

Femur

Tibia (no fibula)

Talus

Calcaneus/First Metatarsal (sesamoid bones x2)

Question 4

Posterior Compartment of Leg

Action:

Nerve:

Artery:

Answer 4

A: Plantar Flex Foot, Flex Toes, Invert Foot

Inn: Tibial Nerve

Artery: Posterior Tibial Artery

Question 5

Lateral Compartment of Leg

Action:

Nerve:

Artery:

Answer 5

A: Evert Foot

Inn: Superficial Peroneal Nerve

Artery: Posterior Tibial Artery (lateral branch)

Question 6

Anterior Compartment of Leg

Action:

Nerve:

Artery:

Answer 6

A: Dorsiflex Foot, Extend Toes, Invert Foot

Inn: Deep Peroneal Nerve

Artery: Anterior Tibial Artery

Question 7

Gastrocnemius

Answer 7

Keeps you upright!

O - Femur

I - Achilles Tendon

A - Plantar Flex Foot

Tendo Calcaneus (Achilles) is largest tendon in body

Question 8

Fabella

Answer 8

Sesamoid bone sometimes found in the lateral head of the Gastrocnemius

Can be mistaken for a fractur

Question 9

Soleus

Answer 9

Sits beneath gastrocnemius

O - Tibia (soleal line)

I - Tendo Calcaneus (Achilles)

Act: Plantar flex foot

Question 10

Achilles Tendon Tap

Answer 10

Test

S1, S2

Question 11

Plantaris

Answer 11

Can be absent, very small belly, long thin tendon used for grafts

Question 12

Posterior Deep Group muscle actions?

Answer 12

Plantar Flex Foot

Invert Foot

Flex Toes

Question 13

What divides the posterior deep and superficial compartments?

Answer 13

Tibial Nerve, Posterior Tibial Artery

Question 14

Flexor Hallucis Longus

Answer 14

HARRY

O: Fibula

I: Distal phalanx of big toe

Lateral in posterior compartment, tendon passes deep on medial ankle

Runs between two sesamoid bones on sole of foot

Question 15

Sustentaculum Tali

Answer 15

Part of calcaneus, acts as pulley for flexor hallucis longus

Question 16

Tibialis Posterior

Answer 16

TOM

O: Tibia, Fibula, Interosseus Membrane

I - Navicular bone, cuneiform, cuboid, metatarsals 2-4 (branches on bottom of foot)

A: Inverter of foot

Question 17

Flexor Digitorum Longus

Answer 17

DICK

O: Tibia

I: Distal phalanges lateral four toes

Origin is medial to lateral at insertion

A: Plantar Flex lateral four toes, Plant flex foot

Question 18

Tom, Dick, ANd Harry

(anterior to posterior)

Answer 18

T = Tibialis Posterior

D = Flexor Digitorum Longus

A = Posterior Tibial Artery

N = Tibial Nerve

H = Flexor Hallucis Longus

Question 19

Flexor Retinaculum and Tarsal Tunnel Syndrome

Answer 19

Tendons of deep muscles pass beneath flexor reticulum on medial side of joint and are covered by synovial sheaths under retinaculum

Tarsal Tunnel Syndrome is swelling on synovial sheaths, can compress Tibial Nerve–numbness of sole of foot, toes, and weakened flexion of toes

Question 20

Peroneus Longus

Answer 20

O: Fibula

I: Base of metatarsal 1 (BIG toe)

A: Plantar Flexion, Eversion of foot

Also supports arch

Inn: Superficial Peroneal Nerve

Question 21

Peroneal Brevis

Answer 21

O: Fibula

I: Lateral side of Little Toe

A: Plantar Flexion, Eversion of Foot

Inn: Superficial Peroneal Nerve

Question 22

Common Action of Peroneus Longus and Peroneus Brevis?

Answer 22

Evert foot

Question 23

Action of Anterior Compartment?

Answer 23

Dorsiflex Ankle

Question 24

Anterior Leg Syndrome

Answer 24

Muscles of the anterior compartment can swell, and compress Deep Peroneal Nerve

May present as Foot Drop

Question 25

Tibialis Anterior

Answer 25

**Major inverter of foot** O: Tibia I: First metatarsal, medial cuneiform A: Dorsiflex ankle, **invert** foot **Crosses from lateral to medial** **Opposite of peroneus longus**

Question 26

Extensor Hallucis Longus

Answer 26

O: Fibula and Interosseus Membrane I: Distal Phalanx **Big Toe** A: Dorsiflex Ankle, Extend Big Toe

Question 27

Extensor Digitorum Longus

Answer 27

O: Tibia and Interosseus Membrane I: Distal Phalanges (**other toes**) A: Dorsiflex Ankle, Extend toes

Question 28

Extensor Expansions

Answer 28

Connective tissue that spreads of **dorsal surface of toes**, prevents **bowstringing** Acts like a **retinacum**

Question 29

Peroneus Tertius

Answer 29

part of **Extensor Digitorum Longus** that ends on 5th metatarsal

Question 30

Extensor Digitorum Brevis

Answer 30

O - Calcaneus I - Phalanges toes 2-4 Inn - Deep peroneal nerve Action - Extend toes

Question 31

Main Inverters of Foot?

Answer 31

Tibialis Anterior Tibialis Posterior

Question 32

Main Everters of Foot?

Answer 32

Peroneus Longus Peroneus Brevis (Peroneus Tertius)

Question 33

Damage to Common Peroneal Nerve?

Answer 33

Can result from blow to top of **fibula** Major symptom is **foot drop**

Question 34

What does the common peroneal nerve divide into?

Answer 34

1. Superficial Peroneal Nerve (Lateral Compartment) 2. Deep Peroneal Nerve (Anterior Compartment)

Question 35

Damage to what two nerves can result in foot drop?

Answer 35

1. Common Peroneal Nerve (damage to top of fibula) 2. Deep Peroneal Nerve (sweeling of anterior compartment)

Question 36

Sensory Innervation to Dorsum of Foot

Answer 36

Superficial - entire top of foot, except 1/2 big, 1/2 2nd toe Deep Peroneal - 1/2 big, 1/2 2nd toe

Question 37

Where does the Popliteal Artery end? What does it branch to? What does it further branch to?

Answer 37

Ends when the **Ant. Tibial Artery** dives to anterior - - - Branches to: 1. Posterior Tibial Artery (**A**Nd) 2. Peroneal Artery (fibular) - - - Posterior Tibial Artery branches to: 1. Medial Plantary Artery 2. Lateral Plantar Artery

Question 38

Intermittent Claudication

Answer 38

Narrowing of **_posterior tibial artery_** due to **arteriosclerosis** Painful cramps when walking, but **subsides after rest**

Question 39

Clinical Presentation: Painful crampus when walking, but go away with rest

Answer 39

**Intermittent Claudication** Narrowing of **_posterior tibial artery_ due to arteriorsclerosis**

Question 40

Pulse location on the leg?

Answer 40

**Pulse of Posterior Tibial Artery:** Between medial malleolus and tendo calcaneus **Pulse of Dorsalis Pedis Artery:** Dorsum of foot, between medial and lateral malleoli

Question 41

Genu Valgus vs Genu Varus

Answer 41

VaLgus = knock kneed Infants 3-5 Varus = bow legged Infants 0-3 - - - Va**L**gus = **L**eft **L**eg makes an **"L"**

Question 42

Blood Supply to Talus

Answer 42

Anterior Tibial Artery Posterior Tibial Artery **Blood supply enters DISTALLY** Fracture of talus can interrupt blood supply and produce necrosis of talus