Anatomy dissection notes 4

Question 1

What/where is the popliteal fossa ?

Answer 1

It is the space behind the knee joint

Question 2

What are the boundaries of the popliteal fossa ?

Answer 2

• Superomedially - semitendinous and semimembranous
• Superolaterally - Biceps femoris
• Inferiorly - medial and lateral heads of gastrocnemius

Question 3

The popliteal fossa is the main conduit for neurovascualr structures leaving and entering the leg, what are the contents of the popliteal fossa ?

Answer 3

From medial to lateral:

• Popliteal artery
• Popliteal vein (popliteal lymph nodes are found along this)
• Tibial nerve
• Common fibular nerve

Question 4

Describe the route of the tibial nerve

Answer 4

Arises as a branch of the sciatic nerve, then descends vertically through the popliteal fossa into the posterior compartment of the leg where it courses through the compartment deep to the soleus

Question 5

Describe the route of the common fibular nerve

Answer 5

• Arises from the sciatic nerve, follows the medial border of the biceps femoris, running in a lateral and inferior direction, over the lateral head of the gastrocnemius.
• The nerve wraps around the neck of the fibula, splitting into the superficial and deep fibular branches which then go to there respective compartments they supply

Question 6

What do the sural cutnaneous branches supply ?

Answer 6

They supply the skin and fascia on the posterolateral aspect of the leg and foot

Question 7

From what does the sural nerves arise from ?

Answer 7

The tibial nerve in the popliteal fossa gives rise to medial sural cuntaneous branch

and the common fibular nerve gives rise to the lateral sural cuntaneous branch

Question 8

Appreciate that there is frequent communication between the medial and lateral sural cutaneous nerves

Answer 8

appreciate this

Question 9

What forms the sural nerve ?

Answer 9

The medial sural cuntaneous nerve and communicating fibres from the lateral sural cutaneous nerve

Question 10

When is the common fibular nerve vulnerable to compression ?

Answer 10

Vulnerable to compression injury against the neck of the fibula (e.g. a tight plaster cast)

Can also be damaged in fractures of the fibular neck.

Question 11

The posterior compartment of the leg is split into two groups (superifical and deep) what are the superficial muscles of the leg ?

Answer 11

• Gastrocnemius
• Soleus
• Plantaris
• Popliteus

(Girls Suck Plenty Penis)

Question 12

What are the deep muscles of the posterior compartment of the leg ?

Answer 12

• Flexor hallucis longus (FHL)
• FLexor digitorum longus (FDL)
• Tibialis posterior (TP).

Question 13

What nerve is the posterior compartment of the leg supplied by ?

Answer 13

Tibial nerve

Question 14

What is the main function of the muscles of the posterior compartment of the leg?

Answer 14

To plantar flex the ankle and toes

Question 15

What is the acronym Tom, Dick ANd Harry used to remember ?

Answer 15

The tendons of Tibialis posterior and flexor Digitorum longus, the posterior tibial Artery, the tibial Nerve and the tendon of flexor Hallucis longus leave the compartment to reach the sole of the foot by passing posterior to the medial malleolus and deep to the flexor retinaculum.

Question 16

Describe the attachements of the gastrocnemius muscles and therefore there function

Answer 16

Attach distally to the calcaneus via achillies tendon and proximally to the femoral chondyles

This means that they cross both the ankle and knee joint giving it weak knee flexor and powerful ankle plantar-flexor (push off phase in walking/running).

Question 17

Describe the appearance of the soleus and its attachments

Answer 17

• Soleus has a flat shape
• Attaches to the neck of the fibula and distally to the calcaneus via the achillies tendon

Question 18

Describe the ankle jerk reflex and what it confirms

Answer 18

• Have the knee flexed, foot dorsiflexed with gastrocnemius and soleus relaxed
• Hammer hit against the achillies tendon (calcaneal) causes the ankle to plantar flex

Positive test confirms functioning of the muscles, and tibial nerve and the central connections at spinal cord level (reflex arc) and above

Question 19

Immediately after the popliteal fossa the popliteal artery branches into what ?

Answer 19

Into the anterior and posterior tibial arteries and the fibular artery

Question 20

Match the artery to the compartment of the leg it supplies:

• Anterior tibial artery
• Posterior tibial artery
• Fibular artery

Anterior, posterior, lateral compartmeant

Answer 20

• Anterior tibial artery - anterior compartment
• Posterior tibial artery - posterior compartment
• Fibular artery - lateral compartment

Question 21

Describe the route of the posterior tibial artery

Answer 21

It passes out of the posterior compartment of the leg, posteriorly to the medial mallelous and then branches into the medial and lateral plantar arteries

Question 22

What are the attachments of the deep posterior muscles of the leg?

Answer 22

• All three attach proximally to tibia, mid-shaft of the fibula and the interosseous membrane.
• The tendons of all three pass into the sole of the foot to attach to medial tarsal bones (TP), distal phalanges of lateral four toes (FDL) and distal phalanx of great toe (FHL).

Think flexor so they are on the sole of the foot then in relation to where they attach