Anatomy- The posterior Leg and Sole of the Foot Flashcards
Name the 3 glutei muscles.
- Gluteus maximus. 2. Gluteus medius. 3. Gluteus minimus.
Where does gluteus maximus insert?
The iliotibial tract and the gluteal tuberosity of the femur.
What is the action of gluteus maximus?
Extension of the thigh.
What is the innervation of gluteus maximus?
Inferior gluteal nerve.
What is the action of gluteus medialis and minimus?
Abduction of the lower limb.
What is the innervation of gluteus medialis and minimus?
Superior gluteal nerve.
When do you abduct the hip joint?
When walking.
What is the usual function of the abductors of the hip joint?
They hold the pelvis level when you take one foot off the ground.
Where do gluteal vessels and nerves emerge from?
The greater sciatic foramen.
What are the nerve roots of the sciatic nerve?
L4-S3.
What does the sciatic nerve innervate?
The muscles of the posterior thigh and the hamstring part of adductor magnus.
What does the sciatic nerve bifurcate into?
The tibial and common peroneal (common fibular) nerves.
What 3 muscles make up the hamstrings?
- Biceps femoris (lateral). 2. Semimembranous (medial). 3. Semitendinous.
What is the action of the muscles in the posterior compartment of the thigh?
Extension at the hip and flexion at the knee.
When do the extensors of the hip joint act?
When climbing the stairs.
What is the innervation of the muscles in the posterior compartment of the thigh?
Sciatic nerve L4-S3.
Where does the biceps femoris tendon insert?
The head of the fibula.
What muscle forms the superiomedial border of the politeal fossa?
Semimembranosus muscle.
What muscle forms the superiolateral border of the politeal fossa?
Biceps femoris.
What muscle forms the inferiormedial border of the politeal fossa?
Medial head of the gastrocnemius.
What muscle forms the inferiorlateral border of the politeal fossa?
Lateral head of the gastrocnemius and plantaris.
What forms the roof of the popliteal fossa?
Fascia.
What are the contents of the popliteal fossa?
- Popliteal artery. 2. Popliteal vein. 3. Tibial nerve. 4. Common peroneal nerve.
How are the arteries, veins and nerves arranged in the popliteal fossa?
Usually NAV from lateral to medial. The nerve is always most superficial and the artery is always deepest.
How can you examine the hamstrings in the living?
Active flexion of the knee.
Name 4 muscles that insert on to the medial condyle of the tibia.
- Semitendinosus. 2. Semimembranosus. 3. Sartorious. 4. Gracilis.
How does the popliteal artery reach the popliteal fossa?
As the femoral artery through the adductor canal.
What superficial vein drains into the popliteal vein?
The great saphenous vein.
What is the surface marking of the sciatic nerve?
Lower medial quadrant of the buttock.
What is the effect of a complete transection of the sciatic nerve?
Loss of hamstring function and of muscles below the knee.
What is the origin of the long head of the biceps, semitendinosus and semimembranosus?
The ischial tuberosity.
What is the origin of the short head of the biceps?
Linea aspera.
Where does biceps femoris tendon insert?
The head of the fibula.
Which of the hamstrings muscles lies most lateral?
The biceps femoris.
How can you identify semitendinosus?
It has a very long tendon attaching to the medial condyle of the tibia.
Name 2 superficial muscles in the posterior compartment of the thigh.
Soleus and gastrocnemius.
How many heads does gastrocnemius have?
2 - medial and lateral. They form the inferior borders of the popliteal fossa.
What is the origin of gastrocnemius?
- Medial head: medial condyle of the femur. - Lateral head: lateral condyle of the femur.
What is the insertion of gastrocnemius?
It combines with soleus to form the calcaneal tendon which inserts onto the calcaneus.
What are the 2 actions of gastrocnemius?
Plantarflexion at the ankle and flexion at the knee.
What other muscle combines to form the calcaneal tendon with gastrocnemius?
Soleus.
What is the action of soleus?
Plantarflexion.
What is the innervation to the posterior compartment of the leg?
Tibial nerve.
In what compartment of thelower limb are the hamstrings located?
The posterior thigh.
Name 4 deep muscles in the posterior compartment of the leg.
- Popliteus. 2. Flexor digitorum longus. 3. Flexor hallucis longus. 4. Tibialis posterior.
How many tarsal bones are there?
7.
Which nerve winds around the neck of the fibula?
The common peroneal nerve.
Complete transection of the common peroneal nerve can cause what clinical sign?
Foot drop.
The muscles that form the calcaneus tendon are all supplied by which nerve?
Tibial nerve.
Does the long saphenous vein cross anterior or posterior to the medial malleolus?
Anterior.
What veins drain the superficial leg?
Short and long saphenous veins. The short saphenous vein drains the posterior leg.
How do the superficial and deep veins of the leg communicate?
Via perforators which pass through the deep fascia.
What area of the leg receives skin sensation from the superficial peroneal nerve?
Anterolateral inferior 1/3 of the leg.
What area of the foot receives skin sensation from the deep peroneal nerve?
Dorsum of the first web space.
What area of the leg receives skin sensation from the saphenous nerve?
Medial leg.
What area of the leg receives skin sensation from the posterior cutaneous nerve of the thigh?
Popliteal fossa.
What area of the foot receives skin sensation from the tibial nerve?
Medial sole of foot.
Describe compartment syndrome.
Bleeding, oedema or infection increase the pressure in a compartment. The increased pressure means blood flow will cease which results in ischemia.
How can you test tibialis anterior?
Dorsiflexion at the ankle.
How can you test extensor digitorum longus?
Extension of the toes.
How can you test extensor hallucis longus?
Extension of the great toe.
Which muscle compartment is supplied by the deep peroneal nerve?
Anterior leg.
Does the deep peroneal nerve innervate skin? If so, where?
Innervates the first dorsal web space.
What is the anterior tibial artery a branch of?
The popliteal artery. (Popliteal artery is a branch of the femoral artery).
Which artery is the dorsal pedis artery a branch of?
The anterior tibial artery.
When might the pulsation of the dorsal pedis artery be absent?
If the anterior tibial artery is blocked.
What are the actions of the peroneii muscles?
Eversion of the foot.
What muscles make up the peroneii muscles?
- Peroneal longus. - Peroneal brevis.
What nerve innervates the peroneii muscles?
Superficial peroneal nerve.
How can you test the peroneii muscles?
Eversion against resistance.
Which nerve injury will lead to paralysis of the peroneii muscles?
Superificial peroneal nerve or common peroneal nerve.
What muscles are paralysed by damage to the common peroneal nerve?
- Peroneal longus and brevis (lateral compartment). 2. Tibialis anterior, extensor longus digitorum and extensor longus hallucis (anterior compartment).
Describe the gait of a patient who has had complete teansection of the common peroneal nerve.
- Foot drop. - High steps to avoid stubbing toes.
Which leg bone has more muscle attached to it?
Fibula.
Why is the blood supply to the shaft of the tibia relatively poor?
The tibia has few muscles attached it. Attached muscles are responsible for supplying the majority of blood to a bone.
Why do fractures of the tibia take a long time to heal?
Poor blood supply.
How do you test the gastrocnemius?
Ask the patient to stand on their tip toes.
What is the fibular artery a branch of?
The posterior tibial artery.
Describe the ankle jerk reflex.
Tapping the achilles/calcaneal tendon acutely stretches the gastrocnemius. This results in a reflex contraction of the muscle.
Which segments of the spinal cord are you testing when you elicit the ankle jerk reflex?
S1,2.
Which segments of the spinal cord are you testing when you elicit the knee jerk reflex?
L2,3,4.
Which muscle compartment is supplied by the tibial nerve?
Posterior leg.
What are the structures in the tarsal tunnel deep to the retinaculum?
Tibial nerve.
Name 2 superficial muscles in the posterior compartment of the thigh.
Soleus and gastrocnemius.
How many heads does gastrocnemius have?
2 - medial and lateral. They form the inferior borders of the popliteal fossa.
What is the origin of gastrocnemius?
- Medial head: medial condyle of the femur. - Lateral head: lateral condyle of the femur.
What is the insertion of gastrocnemius?
It combines with soleus to form the calcaneal tendon which inserts onto the calcaneus.
What are the 2 actions of gastrocnemius?
Plantarflexion at the ankle and flexion at the knee.
What other muscle combines to form the calcaneal tendon with gastrocnemius?
Soleus.
What is the action of soleus?
Plantarflexion.
What is the innervation to the posterior compartment of the leg?
Tibial nerve.
In what compartment of thelower limb are the hamstrings located?
The posterior thigh.
Name 4 deep muscles in the posterior compartment of the leg.
- Popliteus. 2. Flexor digitorum longus. 3. Flexor hallucis longus. 4. Tibialis posterior.
How many tarsal bones are there?
7.
Which nerve winds around the neck of the fibula?
The common peroneal nerve.
Complete transection of the common peroneal nerve can cause what clinical sign?
Foot drop.
The muscles that form the calcaneus tendon are all supplied by which nerve?
Tibial nerve.
Does the long saphenous vein cross anterior or posterior to the medial malleolus?
Anterior.
What veins drain the superficial leg?
Short and long saphenous veins. The short saphenous vein drains the posterior leg.
How do the superficial and deep veins of the leg communicate?
Via perforators which pass through the deep fascia.
What area of the leg receives skin sensation from the superficial peroneal nerve?
Anterolateral inferior 1/3 of the leg.
What area of the foot receives skin sensation from the deep peroneal nerve?
Dorsum of the first web space.
What area of the leg receives skin sensation from the saphenous nerve?
Medial leg.
What area of the leg receives skin sensation from the posterior cutaneous nerve of the thigh?
Popliteal fossa.
What area of the foot receives skin sensation from the tibial nerve?
Medial sole of foot.
Describe compartment syndrome.
Bleeding, oedema or infection increase the pressure in a compartment. The increased pressure means blood flow will cease which results in ischemia.
How can you test tibialis anterior?
Dorsiflexion at the ankle.
How can you test extensor digitorum longus?
Extension of the toes.
How can you test extensor hallucis longus?
Extension of the great toe.
Which muscle compartment is supplied by the deep peroneal nerve?
Anterior leg.
Does the deep peroneal nerve innervate skin? If so, where?
Innervates the first dorsal web space.
What is the anterior tibial artery a branch of?
The popliteal artery. (Popliteal artery is a branch of the femoral artery).
Which artery is the dorsal pedis artery a branch of?
The anterior tibial artery.
When might the pulsation of the dorsal pedis artery be absent?
If the anterior tibial artery is blocked.
What are the actions of the peroneii muscles?
Eversion of the foot.
What muscles make up the peroneii muscles (lower lateral compartment of leg)?
- Peroneal longus. - Peroneal brevis.
What nerve innervates the peroneii muscles?
Superficial peroneal nerve.
How can you test the peroneii muscles?
Eversion against resistance.
Which nerve injury will lead to paralysis of the peroneii muscles?
Superificial peroneal nerve or common peroneal nerve.
What muscles are paralysed by damage to the common peroneal nerve?
- Peroneal longus and brevis (lateral compartment). 2. Tibialis anterior, extensor longus digitorum and extensor longus hallucis (anterior compartment).
Describe the gait of a patient who has had complete teansection of the common peroneal nerve.
- Foot drop. - High steps to avoid stubbing toes.
Which leg bone has more muscle attached to it?
Fibula.
Why is the blood supply to the shaft of the tibia relatively poor?
The tibia has few muscles attached it. Attached muscles are responsible for supplying the majority of blood to a bone.
Why do fractures of the tibia take a long time to heal?
Poor blood supply.
How do you test the gastrocnemius?
Ask the patient to stand on their tip toes.
What is the fibular artery a branch of?
The posterior tibial artery.
Describe the ankle jerk reflex.
Tapping the achilles/calcaneal tendon acutely stretches the gastrocnemius. This results in a reflex contraction of the muscle.
Which segments of the spinal cord are you testing when you elicit the ankle jerk reflex?
S1,2.
Which segments of the spinal cord are you testing when you elicit the knee jerk reflex?
L2,3,4.
Which muscle compartment is supplied by the tibial nerve?
Posterior leg.
What are the structures in the tarsal tunnel deep to the retinaculum?
Tibial nerve.
What is the blood supply to the posterior compartment of the leg?
Posterior tibial artery.
What is the innervation to the posterior compartment of the leg?
Tibial nerve.
