Anatomy of leg and foot Flashcards
Tibiofibular joint
Superior and inferior
- Connects tibia to fibula
Tarsal bones
Calcaneus (heel bone)
- Biggest
- Contains tuberosity and substentaculum tail
Talus (ankle bone)
Cuboid
Navicular
Cuneiforms (medial, intermediate and lateral)
Seasmoid bones
Act like pulleys, providing a smooth surface for tendons to slide over
On the greater toe
- between the metatarsal and proximal phalanx
Patella
Eversion and Inversion
The tipping of the sole of the feet
- Away from midline= eversion
- Towards midline= inversion
Supination and pronation of the feet
Supination
- Feet together
- Weight shifted laterally by sole turning inwardly
Pronation
- Feet apart
- Weight shifted medially by turning sole outwardly
Ankle joint
- Description
- Type
- Actions
Articulation between talus and tibia/fibula
Type- synovial hinge joint
Actions
- Dorsi flexion
- Plantar flexion
Ankle ligaments
- Types
- Attachement
- Function
- Injury
Lateral collateral
- From lateral malleolus of fibula
- To talus/ calcaneus
- Limits inversion of feet
- More commonly injured in sprains [anterior talofibular]
Medial collateral
- From medial malleolus of tibia - To talus/ calcaneus/ navicular
- Limits eversion of feet.
Subtalar joints
- Description
- Actions
Intertarsal joint- Articulation between talus and calcaneus (+navicular)
Actions
- Inversion + eversion
Transverse tarsal joint
- Description
- Actions
- Importance
Compound intarsal of 2 joints
- Between cuboid and calcaneus
- Between Talus and navicular
Actions
- Eversion/inversion
- Pronation/ supination
Importance
- Divides hind foot from mid-foot
- Important for standing on uneven ground.
Plantar aponeurosis
- Description, including attachment
- Function
Thickening of deep fascia in the plantar side of the foot
- From calcaneus to longitudinal bands into the toes
Function
- Protects underlying tendons
- Supports longitudinal arch
Plantar fasciitis
Inflammation of the plantar aponeurosis, due to overuse
- Commonly seen in runners.
Arches of the foot
- Types
- Function
Longitudinal and transverse arches
- Supported by long tendons, intrinsic plantar muscles, intrinsic ligaments and plantar aponeurosis.
Functions
- Shock absorption during locomotion
- Act as spring for propulsion
- Distribution of weight to calcaneus and ball of foot
Longitudinal arch of the foot
Lateral
- less defined
- Along calcaneus, cuboid and lateral metatarsal (5th)
Medial
- More defined, fallen in pes planus
- Line along medial metatarsals, cuneiforms, navicular and calcaneus bone
Transverse arch of the foot
Line along the cuneiforms and cuboid bone on the posterior surface
Is supported by long tendons, mainly fibularis longus
Anterior muscles of the leg
- Muscles
- Action
- Innervation
3 Muscles- tendons pass under extensor retinalculum
- Tibialis anterior
- Extensor digitorium longus
- Extensor hallucis longus
Function
- Dorsiflexion
- Inversion of foot
Innervation
- Deep fibular nerve
Posterior muscles of the leg
- Muscles
- Action
- Innervation
Muscles- tendons pass under flexor retinaculum
- Superficial: gastrocnemius, soles, plantaris
- Deep: Flexor digitorium longus, tibialis posterior, flexor hallucis longus.
Action
- Plantarflexion
- Inversion
- Deep muscles flexes toes
Innervated by tibial nerve
Lateral muscles of the leg
- Muscles
- Action
- Innervation
[2] Muscles- tendons pass under fibular retinaculum
- Fibularis longus
- Fibularis brevis
Action
- Eversion of foot
Innervation
- Superficial fibular nerve
Tibialis anterior
- Origin and insertion
- Action
- Innervation
Origin- Tibia + adjacent interosseous membrane
Insertion- cuneiform and base of 1st metatarsal
Action
- Dorsiflexion/ extension
- Inversion
Innervation
- Deep fibular nerve
Extensor digitorium longus
- Origin and insertion
- Action
- Innervation
Origin- Tibia and fibula
Insertion
- Into extensor hoods
- Middle and distal phalanges of toes 2-5
Action
- Dorsiflexion/ extension
- Inversion
Innervation
- Deep fibular nerve
Extensor hallucis longus
- Origin and insertion
- Action
- Innervation
Origin
- Fibula and adjacent interosseous membrane
Insertion
- Distal phalanx of great toes
Action
- Dorsiflexion/ extension of foot
- Extension of great toe
Innervation
- Deep fibular nerve
Gastrocnemius
- Origin and insertion
- Action
- Innervation
Most superficial posterior muscle of the leg
Two heads- medial and lateral
- forms inferior border of popliteal fossa
Origin
- Medial and lateral condyle of femur
Insertion
- Via tendo calcaneus (Achilles tendon)
- Into posterior calcaneus bone
Action
- Plantar flexion of foot
- Flexion at knee
Innervation
- Tibial nerve
Soleus
- Origin and insertion
- Action
- Innervation
Deep to gastrocnemius, lateral to leg
Origin
- Tibia and fibula
Insertion
- Via tendo calcaneus into posterior calcaneus
Action
- Plantar flexion of foot
Plantaris
- Origin and insertion
- Action
- Innervation
Posterior muscle of the leg
Origin
- Femur
Insertion
- Via tendo calcaneus into posterior calcaneus bone
Action
- Plantar flexion of the foot
- Flexion at the knee
Innervation
- Tibial nerve
Flexor digitorium longus
- Origin and insertion
- Action
- Innervation
Deep muscle of the posterior leg
Origin
- Tibia
Insertion
- Tendons crosses tibialis posterior in flexor retinaculum (medially)
- Base of distal phalanges of lateral 4 toes
Action
- Flexes lateral 4 toes
Innervation
- Tibial nerve
Tibialis posterior
- Origin and insertion
- Action
- Innervation
Deep muscle of the posterior leg
- Slightly deep to FDL and FHL
Origin
- Tibia
- Fibula
- Adjacent interosseous membrane
Insertion
- Medial cuneiform
- Navicular bone
Action
- Inversion
- Plantar flexion
- Supports medial longitudinal arch
Innervation
- Tibial nerve
Flexor hallicus longus
- Origin and insertion
- Action
- Innervation
Deep posterior muscle of the leg
Origin
- Fibular and adjacent interosseous membrane
Insertion
- Distal phalanx of greater toe
Action
- Flexion of great toe
Innervation
- Tibial nerve
Fibularis longus
- Origin and insertion
- Action
- Innervation
Lateral muscle of the leg
Origin
- Fibula
Insertion
- Medial cuneiform
- Base of metatarsal 1
Action
- Eversion of foot
- Plantar flexion of foot
- Supports lateral and transverse arches
Innervation
- Superficial fibular nerve
Fibularis brevis
- Origin and insertion
- Action
- Innervation
Lateral muscle of the leg
Origin
- Fibula
Insertion
- Tuberosity at the base of metatarsal 5
Action
- Eversion of the foot
Innervation
- Superficial fibular nerve
Extensor retinaculum
Located at the dorsum of the foot, anterior to ankle joint.
Prevents the bowing of extensor tendons:
- Extensor digitorium longus
- Extensor hallucis longus
- Tibialis anterior
Fibular retinaculum
Located lateral to foot, to lateral malleous
Prevents the bowing of lateral muscle tendons
- Fibularis longus
- Fibularis brevis
Flexor retinaculum
Located medially in the foot, inferior to medial malleolus
Prevents the bowing of flexor muscle tendons
- Flexor digitorium longus
- Tibialis posterior
- Flexor hallucis longus
Intrinsic muscles of the foot
Dorsal extensors
- 1 layer
Plantar flexors/ abductors/ adductors
- 4 layers
Blood supply to leg
Arises from the popliteal artery division
Anterior tibial
- To anterior compartment
Posterior tibial and fibular- within deep flexors
- Supplies posterior and lateral compartment
Tarsal tunnel
Contents within the flexor retinaculum of the foot
- Location of posterior tibial artery pulse
Contents [TOM DICK AND HARRY]
- Tibialis [TOM] posterior
- Flexor digitorium [DICK] longus
- Posterior tibial artery/vein [A]
- Tibial nerve [ND]
- Flexor hallicus [HARRY] longus
Plantar arteries
Medial, lateral and posterior
– From posterior tibial
Forms deep plantar arch
Dorsalis pedis artery
From anterior tibial artery
- sits lateral to extensor hallucis longus tendon
Anastomosis with deep plantar arch
Tibial nerve
From sciatic nerve
Supplies motor
- Posterior leg
- Plantar intrinsic muscles [medial and lateral plantar nerves]
Common fibular nerve
Branch of sciatic nerve
- Supplies cutaneous to anterior/lateral/superior leg
Divides into deep and superficial fibula
Deep
- Motor; Anterior leg, Dorsal intrinsic muscles
- Cutaneous; between first and second toes
Superficial
- Motor=Lateral leg
- Cutaneous= anterio lateral/ inferior leg
Foot drop
Damage to common fibular nerve
- Cannot dorsiflex foot
Sural nerve
Branch of tibial nerve
Sensory
- Posterior/lateral leg and hind foot
medial and lateral plantar nerves
From tibial nerve
- Supplies sole of feet
