A: Leg + foot Flashcards
What movement is available at intertarsal joints?
Inversion/ eversion
What movement is available at MTP + IP joints
Flexion/extension + adduction/ abduction
Muscles in anterior compartment of leg
- Fibularis tertius
- Tibialis anterior
- Extensor digitorum longus
- Extensor hallucis longus (big toe)
What movement do the muscles in the anterior compartment of leg cause
Dorsi flexion
Superficial muscles in posterior compartment of leg + what movement do they cause
- Gastrocnemius
- Plantaris
- Soleus
Plantar flexion
Deep muscles in posterior compartment of leg
- Popliteus
- Flexor digitorum longus
- Tibialis posterior
- Flexor hallucis longus
Structures that pass behind medial malleolus + into flexor retinaculum
- Tibialis posterior
- Flexor digitorum longus
- Posterior tibial artery
- Posterior tibial vein
- Posterior tibial nerve
- Flexor hallicus longus
Tom Dick And Very Naughty Harry
Innervation of muscles in posterior compartment of leg
Tibial nerve
Lateral compartment muscles in leg + their movement
- Fibularis longus
- Fibularis brevis
These muscles cause eversion.
Fibularis longus + brevis pass behind the lateral malleolus and into the fibular retinacula
Common fibular nerve branches + innervations
Deep fibular nerve: supplies muscles in anterior compartment
Superficial fibular nerve: supplies muscles in lateral compartment.
Nerve supply to plantar muscles foot
All muscles in plantar aspect of foot are supplied by lateral plantar nerve except:
- Abductor hallucis
- Flexor hallucis brevis
- Flexor digitorum brevis
- 1st lumbrical.
These muscles are supplied by the medial plantar nerve.
Gastrocnemius
- Posterior aspect of lateral condyle of femur + superior to medial condyle
- Posterior surface of calcaneum via calcaneal tendon
- Plantar flexion of ankle joint, flexion of knee joint, main propulsive force in walking and running
- Tibial nerve
Soleus
- Upper parts of shafts of tibia + fibula and tendinous arch between the two bones
- Posterior surface of calcaneum via calcaneal tendon
- Plantar flexion of ankle joint, postural muscle
- Tibial nerve
Plantaris
- Lower part of femur
- Posterior surface of calcaneum via calcaneal tendon
- Plantar flexion of ankle joint, flexion of knee joint
- Tibial nerve
Tibialis anterior
- Upper part of shaft of tibia
- Medial cuneiform and base of first metatarsal
- Dorsiflexion of ankle, inverts foot, helps maintain medial longitudinal arch of foot
- Deep fibular nerve
Extensor digitorum longus
- Shaft of fibula
- Extensor hoods of lateral 4 toes
- Dorsiflexion at ankle, extends lateral 4 toes
- Deep fibular nerve
Extensor hallucis longus
- Shaft of fibula
- Base of distal phalanx of great toe
- Dorsiflexion at ankle, extends great toe
- Deep fibular nerve
Fibularis tertius
- Shaft of fibula
- Base of fifth metatarsal
- Dorsiflexion at ankle, everts foot
- Deep fibular nerve
Fibularis longus
- Lateral aspect of shaft of fibula
- Base of 1st metatarsal + medial cuneiform
- Everts foot, weakly plantarflexes ankle, prevents medial overbalancing at ankle joint, supports arches of foot
- Superficial fibular nerve
Fibularis brevis
- Lateral aspect of shaft of fibula
- Base of 5th metatarsal bone
- Everts foot, weakly plantarflexes ankle, prevents medial overbalancing at ankle joint supports lateral longitudinal arch
- Superficial fibular nerve
Extensor digitorum brevis
- Calcaneus
- Long extensor tendons of middle 3 digits
- Extends middle 3 digits
- Deep fibular nerve
Popliteus
- Lateral femoral condyle
- Posterior surface of proximal tibia
- Stabilizes knee joint, unlocks knee at start of flexion by lateral rotation of femur on fixed tibia
- Tibial nerve
Flexor digitorum longus
- Shaft of tibia
- Distal phalanges of lateral four toes
- Flexes lateral 4 toes, plantar flexes ankle, supports arch of foot
- Tibial nerve
Flexor hallucis longus
- Shaft of fibula
- Base of distal phalanx of great toe
- Flexes great toe, plantar flexes ankle, supports arch of foot
- Tibial nerve
Tibialis posterior
- Shafts of tibia + fibula + interosseous membrane
- Most of tarsal bones
- Plantar flexes ankle, inverts foot, supports medial arch of foot
- Tibial nerve
Muscles of sole of foot superficial
- Abductor hallucis
- Flexor digitorum brevis
- Abductor digiti minimi
Abductor hallucis
- Calcaneus
- Proximal phalanx great toe
- Abducts + flexes great toe at MTP joint
- Medial plantar
Flexor digitorum brevis
- Calcaneus
- Middle phalanx of 4 lateral toes
- Flexes 4 toes at PIP + MTP joints
- Medial plantar
Abductor digiti minimi
- Calcaneus
- Proximal phalanx little toe
- Abducts little toe at MTP joint
- Lateral plantar
Muscles of sole of foot second layer
- Accessory flexor
- Four lumbricals
Muscle of sole of foot third layer
- Flexor hallucis brevis
- Adductor hallucis
- Flexor digiti minimi brevis
Muscles of sole of foot fourth layer
- Four dorsal interossei
- Three plantar interossei
What does the deep fibular nerve supply?
- All muscles in anterior compartment
- Extensor digitorum brevis
- Skin between great + second toe
What does the superficial fibular nerve supply?
- All muscles of lateral compartment
- Skin of anterior leg
- Skin of dorsum of foot (except skin between great + second toe) and lateral side of little toe
Accessory flexor
- Calcaneus
- Each of tendons of flexor digitorum longus
- Aids long flexor tendon to flex lateral 4 toes
- Lateral plantar nerve
Four lumbricals
- Tendons of flexor digitorum longus
- Dorsal hoods of lateral four toes
- Extends toes at IP joints, flexion of MTP joints
- First lumbrical: medial plantar. Remainder: lateral plantar
Flexor hallucis brevis
- Plantar aspect of tarsal bones
- Proximal phalanx of great toe
- Flexes MTP joint of great toe
- Medial plantar
Adductor hallucis
- Plantar aspect of metatarsal bones
- Proximal phalanx of great toe
- Adducts great toe
- Lateral plantar
Flexor digiti minimi brevis
- 5th metatarsal
- Proximal phalanx of little toe
- Flexes MTP joint of little toe
- lateral plantar
Four dorsal interossei
- Adjacent sides of metatarsals
- Extensor hoods of 2nd, 3r, 4th toes
- Abducts toes
- Lateral plantar
Three plantar interossei
- Sides of metatarsals
- Extensor hoods 3rd, 4th, 5th toes
- Adducts toes
- Lateral plantar
Following a motor collision, a man has difficulty walking. Examination reveals that he is unable to dorsiflex or plantar-flex his foot. You suspect a nerve injury. Your diagnosis is confirmed by a loss of sensation in which area?
Below the knee, lateral leg, lateral dorsum of foot, plantar aspect of foot.
Spinal cords for calcaneal tendon reflex?
S1, S2
List the bones which form the medial longitudinal arch.
Calcaneus, talus, navicular, 3 cuneiforms, 3 medial metatarsals.
Muscles in the leg that prevent overbalancing forwards
Soleus, Gastrocnemius, Plantaris, Flexor hallucis longus, Flexor digitorum longus, Tibialis posterior.
Terminal branches of posterior tibial artery?
Posterior Tibial artery divides into medial and lateral plantar arteries, deep to the flexor retinaculum, posterior to the medial malleolus.
Sural nerve?
Cutaneous branch of tibial nerve
Passes around lateral malleolus + enters foot
Innervates skin of postero-lateral aspect of leg and lateral aspect of foot & little toe.
Where can you find the pulse of the posterior tibial artery
Midway between medial malleolus + heel
What are the results of injuring tibial nerve?
Weakness in plantarflexion
Weakness in flexion of toes
Diminished sensation over sole of foot (medial & lateral plantar nerves)
Diminished sensation over postero-lateral aspect of leg and lateral aspect of foot and little toe (sural nerve)
Injury to common fibular nerve
- Impaired sensation over anterolateral surface of leg + dorsum of foot
- Paralysis of muscles in anterior compartment + extensor digitorum brevis –> cannot dorsi flex ankle. Plantar flexors are unopposed = footdrop.
- Paralysis of muscles in lateral compartment - cannot evert foot.
Where can you find the dorsalis pedis artery pulse?
Midway between medial + lateral malleoli on dorsum of foot.
Articulations in knee joint
- Two articulations between condyles of femur and condules of tibia.
- Articulation between patella + lower end of shaft of femur
Anterior drawer test
When knee joint is flexed at right angles, tibia cannot normally be pulled anteriorly bc it is held in place by ACL.
Posterior drawer test
When knee joint is flexed at right angles, tibia cannot normally be pushed posteriorly because its held in place by PCL.
Menisci attachments
Both are attached at their anterior and posterior ends to the intercondylar area of tibia.
Medial = attached to capsule of joint + tibial collateral ligament
To locate great saphenous vein, where should skin be incised?
Anterior + superior to medial malleolus
Where is the common fibular nerve liable to injury?
As it winds around lateral surface of the neck of fibula.
Proximal tibiofibular joint
Plane synovial
Head of fibula + lateral condyle of tibia
Slight gliding movement
Distal tibiofibular joint
Fibrous joint
Subtalar
Inferior surface of talus and superior surface of calcaneus
Synovial
Stabilized by talocalcaneal ligaments
Joint where majority of inversion and eversion take place
Talo-calcaneo-navicular joint
Strengthened by spring ligament
Inversion/eversion
