3 - Zill - Leg and Dorsum of Foot Flashcards
106B - 169B
Retinaculum
Hold tendons in place, prevent bowstringing
Sprained Ankle
Excessive Inversion
How is body weight transfered through the thigh and leg?
Hip
Femur
Tibia (no fibula)
Talus
Calcaneus/First Metatarsal (sesamoid bones x2)
Posterior Compartment of Leg
Action:
Nerve:
Artery:
A: Plantar Flex Foot, Flex Toes, Invert Foot
Inn: Tibial Nerve
Artery: Posterior Tibial Artery
Lateral Compartment of Leg
Action:
Nerve:
Artery:
A: Evert Foot
Inn: Superficial Peroneal Nerve
Artery: Posterior Tibial Artery (lateral branch)
Anterior Compartment of Leg
Action:
Nerve:
Artery:
A: Dorsiflex Foot, Extend Toes, Invert Foot
Inn: Deep Peroneal Nerve
Artery: Anterior Tibial Artery
Gastrocnemius
Keeps you upright!
O - Femur
I - Achilles Tendon
A - Plantar Flex Foot
Tendo Calcaneus (Achilles) is largest tendon in body
Fabella
Sesamoid bone sometimes found in the lateral head of the Gastrocnemius
Can be mistaken for a fractur
Soleus
Sits beneath gastrocnemius
O - Tibia (soleal line)
I - Tendo Calcaneus (Achilles)
Act: Plantar flex foot
Achilles Tendon Tap
Test
S1, S2
Plantaris
Can be absent, very small belly, long thin tendon used for grafts
Posterior Deep Group muscle actions?
Plantar Flex Foot
Invert Foot
Flex Toes
What divides the posterior deep and superficial compartments?
Tibial Nerve, Posterior Tibial Artery
Flexor Hallucis Longus
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
Sustentaculum Tali
Part of calcaneus, acts as pulley for flexor hallucis longus
Tibialis Posterior
TOM
O: Tibia, Fibula, Interosseus Membrane
I - Navicular bone, cuneiform, cuboid, metatarsals 2-4 (branches on bottom of foot)
A: Inverter of foot
Flexor Digitorum Longus
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
Tom, Dick, ANd Harry
(anterior to posterior)
T = Tibialis Posterior
D = Flexor Digitorum Longus
A = Posterior Tibial Artery
N = Tibial Nerve
H = Flexor Hallucis Longus
Flexor Retinaculum and Tarsal Tunnel Syndrome
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
Peroneus Longus
O: Fibula
I: Base of metatarsal 1 (BIG toe)
A: Plantar Flexion, Eversion of foot
Also supports arch
Inn: Superficial Peroneal Nerve
Peroneal Brevis
O: Fibula
I: Lateral side of Little Toe
A: Plantar Flexion, Eversion of Foot
Inn: Superficial Peroneal Nerve
Common Action of Peroneus Longus and Peroneus Brevis?
Evert foot
Action of Anterior Compartment?
Dorsiflex Ankle
Anterior Leg Syndrome
Muscles of the anterior compartment can swell, and compress Deep Peroneal Nerve
May present as Foot Drop
Tibialis Anterior
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
Extensor Hallucis Longus
O: Fibula and Interosseus Membrane
I: Distal Phalanx Big Toe
A: Dorsiflex Ankle, Extend Big Toe
Extensor Digitorum Longus
O: Tibia and Interosseus Membrane
I: Distal Phalanges (other toes)
A: Dorsiflex Ankle, Extend toes
Extensor Expansions
Connective tissue that spreads of dorsal surface of toes, prevents bowstringing
Acts like a retinacum
Peroneus Tertius
part of Extensor Digitorum Longus that ends on 5th metatarsal
Extensor Digitorum Brevis
O - Calcaneus
I - Phalanges toes 2-4
Inn - Deep peroneal nerve
Action - Extend toes
Main Inverters of Foot?
Tibialis Anterior
Tibialis Posterior
Main Everters of Foot?
Peroneus Longus
Peroneus Brevis (Peroneus Tertius)
Damage to Common Peroneal Nerve?
Can result from blow to top of fibula
Major symptom is foot drop
What does the common peroneal nerve divide into?
- Superficial Peroneal Nerve (Lateral Compartment)
- Deep Peroneal Nerve (Anterior Compartment)
Damage to what two nerves can result in foot drop?
- Common Peroneal Nerve (damage to top of fibula)
- Deep Peroneal Nerve (sweeling of anterior compartment)
Sensory Innervation to Dorsum of Foot
Superficial - entire top of foot, except 1/2 big, 1/2 2nd toe
Deep Peroneal - 1/2 big, 1/2 2nd toe
Where does the Popliteal Artery end?
What does it branch to?
What does it further branch to?
Ends when the Ant. Tibial Artery dives to anterior
Branches to:
- Posterior Tibial Artery (ANd)
- Peroneal Artery (fibular)
- - -
Posterior Tibial Artery branches to:
- Medial Plantary Artery
- Lateral Plantar Artery
Intermittent Claudication
Narrowing of posterior tibial artery due to arteriosclerosis
Painful cramps when walking, but subsides after rest
Clinical Presentation: Painful crampus when walking, but go away with rest
Intermittent Claudication
Narrowing of posterior tibial artery due to arteriorsclerosis
Pulse location on the leg?
Pulse of Posterior Tibial Artery: Between medial malleolus and tendo calcaneus
Pulse of Dorsalis Pedis Artery: Dorsum of foot, between medial and lateral malleoli
Genu Valgus vs Genu Varus
VaLgus = knock kneed
Infants 3-5
Varus = bow legged
Infants 0-3
VaLgus = Left Leg makes an “L”
Blood Supply to Talus
Anterior Tibial Artery
Posterior Tibial Artery
Blood supply enters DISTALLY
Fracture of talus can interrupt blood supply and produce necrosis of talus