93 - Bones, Muscles and Fascia of the Leg and Foot Flashcards

1
Q

Landmarks of the tibia

1-5

A
  • Condyles
  • Intercondylar eminence
  • Tibial tuberosity
  • Soleal line
  • Medial malleolus
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2
Q

Shape of tibia

A

Roughly triangular (apex is on anterior face)

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3
Q

Is the tibia or fibula more lateral?

A

Fibula

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4
Q

Tibial tuberosity

A

On anterior surface of tibia, just below tibial plateau.

Site of muscle attachment

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5
Q

Location of tibial line of epiphysis

A

Below tibial plateau, runs through tibial tuberosity anteriorly

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6
Q

Soleal line location and structures around it

A

Attachment of soleus.
On posterior aspect of tibia.
Runs from superior tibio-fibular joint to medial mid-tibia.

Above soleal line is where popliteus attaches.

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7
Q

Malleli

A

Medial mallelus is part of the tibia.

Lateral mallelus is part of the fibula.

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8
Q

Attachments of tibia to fibula

A

Attaches superiorly and inferiorly with facet joints

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9
Q

Borders of fibula

A

Sharp border is where interosseus membrane attaches.

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10
Q

Most proximal muscle insertion to the fibula

A

Biceps femoris

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11
Q

Compartments of the leg
1
2
3

A

Anterior (dorsiflexors, inverters)
Lateral (everters)
Posterior (superficial and deep parts, divided by deep fascia, plantarflexors and inverters)

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12
Q

Examples of inverters

A

Tibialis anterior and posterior

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13
Q

Aspects of fascia of leg

A
  • Thick
  • Continuous with:
  • Fascia lata superiorly
  • Periosteum of tibia anteriorly
  • Intermuscular septa (deep)
  • Ankle retinaculae inferiorly
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14
Q

Structures formed by deep fascia at ankle

A

Ankle retinaculae
Bind tendons.
One flexor retinaculum, two extensor retinaculae, two fibular retinaculae.

These create the tarsal tunnels (anterior and posterior)

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15
Q

Location of retinaculae of ankle

A

Flexor retinaculum on medial foot, attaching to hell (calcaneus)
Superficial and inferior fibular retinacula superior to ankle joint, on anterior surface.
Extensor retinaculum on lateral foot, dorsal surface

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16
Q

Part of foot that stores elastic energy

A

Particularly Achilles tendon, plantar aponeurosis and TFL

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17
Q

Muscles of anterior leg

1-4

A

Tibialis anterior
Extensor hallucis longus (EHL)
Extensor digitorum longus (EDL)
Fibularis tertius

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18
Q

Innervation of muscles of anterior leg

A

Deep fibular nerve (from L4, L5)

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19
Q

Foot slap

A

When tibialis anterior is not functioning properly (EG L4, L5 damage), can’t control heel-toe part of walking, so foot slaps on ground

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20
Q

Shin splints

A

Microtrauma at attachment of tibialis anterior to tibia.

From running on hard surfaces repeatedly.

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21
Q

Role of fibularis tertius

A

Vestigial.

Attaches to dorsum of fifth metatarsal, at the base.

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22
Q

Attachment of extensor hallucis longus

A

Most-distal phalange of big toe (hallux)

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23
Q

Tendons attaching to the talus

A

None

24
Q

Mnemonic for muscles of the anterior leg

A
Timothy (tibialis anterior)
Has (extensor Hallucis longus)
A very nasty (neurovascular)
Dirty (extensor Digitorum)
Toe (fibularis Tertius)
25
Q

Muscles of the lateral leg
1
2

A

Fibularis longus

Fibularis brevis

26
Q

Innervation of fibularis longus and brevis

A

Superficial fibular nerve (L4, L5)

27
Q

Insertion of fibularis brevis

A

Dorsum of fifth metatarsal, inserts onto fibularis tubercle, or peroneal tubercle).

28
Q

Clinical significance of fibularis brevis insertion

A

In severe inversion sprains, it is possible for attachment to be avulsed at the peroneal tubercle (5th metatarsal).

29
Q

Muscles of the posterior leg, superficial compartment

1-3

A

Gastrocnemius
Plantaris (vastigial, not very useful)
Soleus

30
Q

Nerve supply of superficial posterior muscles of the leg

A

Tibial nerve (S1, S2)

31
Q

Role of soleus

A

High concentration of slow-twitch muscle fibres.

Mostly an antigravity muscle, prevents body falling forward.

32
Q

Role of gastrocnemius

A

Higher concentration of fast-twitch muscle fibres.

Involved in power activities, such as running.

33
Q

Location of lower limb venous sinuses

A

In soleus

34
Q

What form the Achilles tendon

A

Gastrocnemis and soleus

35
Q

Morphology of gastrocnemius

A

Crosses knee and ankle joints

36
Q

What protects the Achilles tendon?

A

A paratenon.

Doesn’t have synovial sheaths, like other tendons travelling across ankle joint have.

37
Q

Muscles of deep posterior leg

A

Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Popliteus

38
Q

Direction of tendons of flexor digitorum longus

A

Travels from medial to lateral, to four phalanges

39
Q

Direction of tendons of flexor hallucis longus

A

Travels from lateral to medial, to attach to big toe

40
Q

Innervation of deep compartment of posterior leg

A

Tibial nerve, S1, S2

41
Q

Mnemonic for tendons crossing underneath medial mallelus

A

Tom (tibialis posterior)
Dick (flexor Digitorum longus
And very naughty (neurovascular)
Harry (flexor Hallucis longus)

42
Q

Role of popliteus

A

Unlocks knee.

43
Q

Intrinsic muscles of the dorsum of the foot
1
2

A

Extensor hallucis brevis

Extensor digitorum brevis

44
Q

Toes that are extended by extensor digitorum brevis

A

Phalanges 2, 3 and 4 (not big or little toes)

45
Q

Intrinsic muscles of the sole of the foot, layer 1 (most superficial)
1
2
3

A

Abductor Hallucis
Flexor Digitorum Brevis
Abductor Digiti Minimi

Stabilise foot during locomotor activities

46
Q

Intrinsic muscles of the sole of the foot, layer 2

A
Lumbricals (four)
Flexor accessorius (quadratus plantae)
47
Q

Role of quadratus plantae

A

Straightens pull of flexor digitorum longus on the toes.

48
Q

Intrinsic muscles of the sole of the foot, layer 3
1
2
3

A

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi

49
Q

Intrinsic muscles of the sole of the foot, layer 4 (deepest)

A
Interossei
Four dorsal (these abduct, DAB)
Three plantar (these are adductors, to the second metatarsal, PAD)
50
Q

Arches of the foot shape

A

Between three weight bearing points:

Medial, lateral longitudinal arches, and a transverse arch between the longitudinal arches

51
Q

Role of arches of foot

A

Provide stability when standing.

Dynamic springs in locomotion

52
Q

Why do pathologies of the arches of the foot arise?

A

Poor bony support.
In standing, ligaments provide support for the arches, and in dynamic activity muscles provide support.

Doing too much standing or dynamic activity can damage/alter the ligaments or muscles.

53
Q

Important muscle in maintaining arches of foot

A

Flexor hallucis longus (tendon follows entire length of medial longitudinal arch).

54
Q

Plantar aponeurois

A
  • Between calcaneus and metatarsal heads - binds skin of foot for grip & protection
  • Maintains longitudinal arches of foot
55
Q

Pathology of plantar aponeurosis

A

Plantar fascitis with or without a bony spur