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Y1 - LEA Quiz- 9/10 > 9-2. Posterior Compartment Overview > Flashcards

9-2. Posterior Compartment Overview Flashcards

1
Q

What are the boundaries of the (entire) posterior compartment of the leg?

A

Anterior: posterior surface of tibia, interosseous membrane, posterior medial and posterior lateral surfaces of fibula, posterior intermuscular septum
Lateral/Posterior/Medial: deep fascia of the leg (crural fascia)

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2
Q

What separates the deep and superficial posterior compartments of the leg?

A

Deep transverse intermuscular septum

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3
Q

What are the general contents of the posterior muscular compartment?

A
  • Knee flexors
  • Ankle plantarflexors
  • Foot invertors
  • Digit plantarflexors
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4
Q

What nerve innervates all of the muscles of the posterior compartment?

A

Tibial nerve*

**In SUPERFICIAL posterior compartment, the nerve segments are always S1,S2; in the DEEP posterior compartment the nerve segments vary.

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5
Q

What are the proximal and distal attachments for Gastrocnemius?

A

Proximal:

  • lateral head= lateral aspect of lateral femoral condyle
  • medial head= superior to medial femoral condyle; popliteal surface of femur

Distal:
posterior surface of calcaneus via calcaneal/Achilles tendon

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6
Q

What are the proximal and distal attachments for Soleus?

A

Proximal:

  • Posterior head and superior 1/4 of posterior surface of fibula
  • Soleal line and middle 1/3 of medial border of tibia
  • tendinous arch between bony attachments

Distal:
posterior surface of calcaneus via calcaneal/Achilles tendon

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7
Q

What are the proximal and distal attachments for Plantaris?

A

Proximal:

  • Inferior end of lateral supracondylar line
  • Oblique popliteal ligament

Distal:
Inserts on calcaneus medial to Achilles tendon or can join Achilles tendon

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8
Q

What muscles are found in the superficial posterior compartment?

A
  • Gastrocnemius
  • Plantaris
  • Soleus
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9
Q

What muscles are found in the deep posterior compartment?

A
  • Popliteus
  • Flexor hallucis longus
  • Flexor digitorum longus
  • Tibialis posterior
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10
Q

What actions does Gastrocnemius have?

A
  • Flexes knee joint
  • Plantarflexes ankle when knee is extended
  • Contributes to inversion
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11
Q

What actions does Soleus have?

A
  • Plantarflexes ankle regardless of knee position

- Contributes to inversion

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12
Q

What actions does Plantaris have?

A
  • Weakly flexes knee

- Weakly plantarflexes ankle

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13
Q

What muscles together are referred to as Triceps Surae?

A

Gastrocnemius and Soleus

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14
Q

What are the notable differences between the two heads in Gastrocnemius?

A
  • medial head tends to be larger than the lateral head

- the possible sesamoid/cartilage known as “fabella” is more commonly found in the lateral head

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15
Q

Where is a Baker’s cyst usually found?

A

Between the medial head of gastrocnemius and the semi-membranosus tendon

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16
Q

What is the clinical significance of a possible “accessory soleus” muscle?

A

Its distal belly is located medial to the calcaneal tendon–> its presence can cause tarsal tunnel syndrome

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17
Q

What is the clinical significance of the plantaris muscle?

A

It is very small in humans and has a minor role–> can be removed and used for tendon grafts without any adverse effect on limb funciton

18
Q

What are the proximal and distal attachments for Popliteus?

A

Proximal:

  • lateral surface of lateral femoral condyle
  • lateral meniscus

Distal:
posterior surface of tibia, above soleal line

19
Q

What are the proximal and distal attachments for Flexor hallucis longus?

A

Proximal:

  • inferior 2/3 of posterolateral surface of fibula
  • inferior part of interosseous membrane
  • *most lateral origin of the deep post. compartment muscles

Distal:
base of distal hallucal phalanx

20
Q

What are the proximal and distal attachments for Flexor digitorum longus?

A

Proximal:

  • posterior surface of tibia inferior to soleal line
  • by a broad tendon to fibula

Distal:
base of distal phalanges of lateral digits

21
Q

What are the proximal and distal attachments for Tibialis posterior?

A

Proximal:

  • interosseous membrane
  • posterior surface of tibia inferior to soleal line
  • posteromedial surface of fibula

Distal:

  • all tarsals, except talus
  • bases of MT 2-4
22
Q

What is the segmental innervation of popliteus?

A

Tibial nerve (L4-S1)

23
Q

What is the segmental innervation of FHL?

A

Tibial nerve (S2, S3)

24
Q

What is the segmental innervation of FDL?

A

Tibial nerve (S2, S3)

25
Q

What is the segmental innervation of TP?

A

Tibial nerve (L4, L5)

26
Q

What actions does Popliteus have?

A
  • weakly flexes knee and unlocks it by rotating femur 5* on a fixed tibia (closed chain kinetics)
  • medially rotates tibia on an unplanted limb (open chain kinetics)
27
Q

What actions does FHL have?

A
  • plantarflexes hallux

- assists in inversion

28
Q

What actions does FDL have?

A
  • plantarflexes lateral digits

- assists in inversion

29
Q

What actions does TP have?

A
  • plantarflexes ankle

- inverts foot

30
Q

What is unique about popliteus in regards to its location?

A

It is the only posterior compartment muscle that does NOT cross the ankle

31
Q

How does popliteus contribute to stabilization of the knee?

A

When knee is partially flexed, popliteus may assist PCL in checking anterior displacement of femur on tibial plateau (ex- when walking downhill).

32
Q

What activity is happening in the posterior compartment during foot flat in the gait cycle?

A

Loading response:

  • eccentric contraction of triceps surae moderates ankle dorsiflexion
  • TP, FHL, FDL support the medial longitudinal arch as foot pronates
33
Q

What activity is happening in the posterior compartment during midstance in the gait cycle?

A
  • triceps surae continues to control ankle dorsiflexion

- TP, FHL, FDL support restoration of medial longitudinal arch as foot begins to prepare for supination

34
Q

What activity is happening in the posterior compartment during terminal stance in the gait cycle?

A
  • concentric contraction of triceps surae producing heel-up/heel-off
  • TP, FHL, FDL support medial longitudinal arch and stabilize forefoot for propulsion during toe-off
35
Q

At toe-off, where is the GRF line in relation to the ankle, knee, and hip?

A

Ankle: anterior
Knee: posterior
Hip: posterior

36
Q

Knowing where the GRF line is during toe-off, what muscle groups will be recruited at the hip/knee/ankle to offset the effect of the GRF and to keep body moving forward?

A

Ankle: plantarflexors
Knee: extensors
Hip: flexors

37
Q

Weakness of the ankle plantarflexors can result in insufficient propulsion. There is no toe-off, instead the entire foot will leave the ground at once.

What is this compensatory gait?

A

Apropulsive/Calcaneal gait

38
Q

In apropulsive/calcaneal gait, what happens to the plantarflexors at midstance?

A

Plantarflexors will not be able to moderate the passive dorsiflexion that takes place at the ankle as body weight is transferred forward.

39
Q

How might a patient with an apropulsive/calcaneal gait try to compensate for the unmoderated passive dorsiflexion at the ankle as their body weight is transferred forward at midstance?

A

To counteract this ankle movement, the patient will often rotate the foot as far externally as possible to allow for push-off to occur at the midfoot.

40
Q

What structures form the tarsal tunnel?

A

Medial malleolus, calcaneal tuberosity, flexor retinaculum

41
Q

What are the contents of the tarsal tunnel?

A

Tom, Dick, (Very) And Very Nervous Harry

  • Tibialis Posterior
  • Flexor Digitorum Longus
  • Posterior Tibial Artery/Veins
  • Tibial Nerve
  • Flexor Hallucis Longus

Y1 - LEA Quiz- 9/10 (13 decks)

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