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Anatomy > Ankle And Foot Muscles > Flashcards

Ankle And Foot Muscles Flashcards

1
Q

What are the four compartments that the lower leg is divided into?

What are they divided by?

A

Anterior compartment
Posterior, deep and superficial compartments
Lateral compartment

Divided by - interosseous membrane
Two intermuscular septa (pass between fibula and deep fascia surround)
Direct attachment of the deep fascia to the periosteum of the anterior and medial borders of the tibia

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2
Q

What muscles make up the anterior compartment of the lower leg?

What are the innovated by?
Blood supply:

A

Tibias anterior
Extensor hallucis Longus
Extensor digitorium longus
Peroneus tertius (fibularous tertius)

Deep peroneal nerve (L4-S1) - dorsiflexors
Anterior tibial artery

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3
Q

What will happen if muscles of the anterior compartment are not innovated?

A

Foot drop

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4
Q

Anterior compartment
Tibialis anterior:

A

Proximal - upper 2/3’s lateral shaft of tibia
Adjacent Interosseous membrane

Distal - medial and inferior surfaces of medial cuneiform and base of metatarsal I

Never supply - deep peroneal nerve (L4/5)
Actions - dorsiflexion of the foot
Inversion of foot (intertarsal joint)
Dynamic support of medial arch of foot

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5
Q

Anterior compartment
Extensor hallucis longus -

A

Proximal - middle one half medial surface of fibula
Adjacent surface interosseous membrane

Distal - dorsal surface of base of distal phalanx of great toe

Nerve supply - deep peroneal nerve (L5/S1)
Actions - extension of great toe
Dorsiflexion of foot

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6
Q

Anterior compartment
Extensor digitorium longus -

A

Proximal - proximal one half medial surface fibula and related surface of lateral tibial condyle

Distal - via dorsal expansions into bases of distal and middle phalanges of lateral four toes

Nerve supply - deep peroneal nerve (L5/S1)
Actions - extension of lateral four toes
Dorsiflexion of foot

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7
Q

Extensor hoods -
What makes up an extensor hood? What ligaments are involved? And main function of it -

A

Tendons of extensor digitorium longus, extensor digitiorium brevis and extensor hallucis longus pass into dorsal aspect of the digits and expand over the proximal phalanges to form extensor hoods

Each is triangular in shape, apex attaches to the distal phalanx
Corners of the hoods attach mainly to the deep transverse metatarsal ligaments

Many intrinsic muscles of foot insert into extensor hood which allows forces of these muscles to be disrupted over the toes to cause flexion of the metatarsal phalangeal joints, simultaneously with extension of the inter-phalangeal joints

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8
Q

Anterior compartment
Peroneus (fibularis) tertius -

A

Proximal - distal part of medial surface of fibula
Distal - dorsomedial surface of base of metatarsal V

Nerve supply - deep peroneal nerve (L5/S1)
Actions - dorsiflexion of foot
Eversion of foot

*this muscle is so small that it can be considered a part of extensor digitorium longus.

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9
Q

What muscles make up the superficial posterior compartment ?
Function and nerve innovation -

A

Gastrocnemius
Soleus
Plantaris

All Innervation by tibial nerve S1-2
All plantarflex the foot
All insert into calcaneus via calcaneal tendon (Achilles).

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10
Q

Superficial posterior compartment
Gastrocnemius -

A

Proximal: medial head - posterior aspect of medial femoral condyle
Lateral head - posterior aspect of lateral femoral condyle

Distal - via calcaneal tendon to posterior surface of calcaneus

Nerve supply - tibial nerve S1-2
Actions - plantarflexion of the foot
Flexion of the knee

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11
Q

Superficial posterior compartment
Soleus -

A

Large flat muscle deep to gastroc
Proximal - soleal line and medial border of tibia
Posterior aspect fibula head and adjacent surfaces of neck and proximal shaft
Tendinous arch between tibial and fibular attachments

Distal - via calcaneal tendon to posterior surface of calcaneus

Nerve supply - tibial nerve S1-2
Action - plantarflexion of foot. Active when - knee flexion and go onto tip toes
Cannot palpate

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12
Q

Superficial posterior compartment
Plantaris -

A

Small muscle belly and long, thin tendon
Proximal - inferior part of lateral supracondylar line of femur
Oblique popliteal ligament of knee

Distal - via calcaneal tendon to posterior surface of calcaneus

Nerve supply - tibial nerve S1-2

Actions - plantarflexion of foot
Flexion of knee

Often used as a graft in surgeries as its so small

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13
Q

What muscles make up the deep posterior compartment of the lower leg?
Innervation and action -

A

Popliteus (acts on knee)
Flexor hallucis longus
Flexor digitorium longus
Tibialis posterior

Innervation by tibial nerve L4-S3
All expect poplietus contribute to plantarflexion of the foot

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14
Q

Deep posterior compartment
Popliteus -

A

Smallest and most deep
Proximal - lateral femoral condyle
Distal - posterior surface of proximal tibia about soleal line

Nerve supply - tibial nerve L4-S1
Actions - stabilises knee joint (resits lateral rotation of tibia on femur)
Unlocks knee joint (laterally rotates femur on fixed tibia) to begin movement

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15
Q

Deep posterior compartment
Flexor hallucis longus -

A

Proximal - lower 2/3’s posterior surface of fibula and adjacent interosseous membrane
Distal - plantar surface of base of distal phalanx of great toe

Nerve supply - tibial nerve S2/3
Actions - flexes great toe
Contributes to plantarflexion of the foot at ankle joint

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16
Q

Deep posterior compartment
Flexor digitorium longus -

A

Proximal - medial side of posterior surface of tibia
Distal - divides into four tendons which go to plantar surfaces of bases of distal phalanges of the lateral four toes

Nerve supply - tibial nerve S2/3
Actions - flexes lateral four toes
Contributes to plantarflexion at ankle joint
Contributes to gripping the ground

17
Q

Deep posterior compartment
Tibialis posterior -

A

Proximal - posterior surface of tibia and fibula and interosseous membrane
Distal - tuberosity of navicular and adjacent region of medial cuneiform

Nerve supply - tibial nerve L4/5
Actions - inversion and plantarflexion of foot
Support of medial arch of foot during walking

18
Q

What muscles make up the lateral compartment of the lower leg?
Innervation by -

A

Peroneus longus
Peroneus brevis - both of these perform eversion
NOTE, Peroneus used interchangeably with fibularis

Innervated by surperfical peroneal nerve L5-S2

19
Q

Lateral compartment
Peroneus longus -

A

Proximal - upper lateral surface of fibula
Head of fibula

Distal - under surface and lateral sides of medial cuneiform and base of metatarsal I

Nerve supply - superficial peroneal nerve L5-S2
Actions - eversion and plantarflexion of foot
Supports arches of foot

20
Q

Lateral compartment
Peroneus brevis -

A

Sits deep to Peroneus tertius
Proximal - lower 2/3’s of lateral surface of shaft of fibula
Distal - lateral tubercle at base of metatarsal V

Nerve supply - superficial peroneal nerve L5-S2
Actions - eversion of the foot

21
Q

Intrinsic muscles - dorsum of the foot (top)
Extensor digitorium brevis -

A

Proximal- superolateral surface of the calcaneus
Distal - lateral sides of tendons of extensor digitorium longus of toes II and Iv via extensor hoods

Nerve supply - deep peroneal nerve S1/2

Actions - extension of toes

22
Q

What are the other intrinsic muscles to be aware of?

A

Lumbricals - muscle bellies sitting between flexor digitorium longus
Abductor hallucis
Interossi dorsal and plantar

23
Q

Contents of the tarsal tunnel: (from top to bottom)

A

Located on medial side of foot
Tibialis posterior
Flexor digitorium longus
Tibial artery and vein
Tibial nerve
Flexor hallucis longus

24
Q

Attachments of the flexor retinaculum -

A

Proximal - medial malleollus
Distal - inferno medial margin of calcaneus

25
Q

Superior and inferior extensor retinaculums attachments -

A

Superior - anterior borders of tibia and fibula
Inferior - base - lateral sides of upper surface of calcaneus. Crosses medially and one arm attaches to medial malleollus, other arms attaches to medial side of plantar aponeurosis

Both prevent tendon bowing

26
Q

Name the two longitudinal arches of the foot -
Clinical relevance -

A

Medial longitudinal arch
Lateral longitudinal arch

Clinical - arch height can vary across ethnicities

27
Q

What ligaments support the longitudinal arches -

A

Plantar calcaneonavicular (spring ligament)
Plantar calcaneocuboid (short plantar ligament)
Long plantar ligament
Plantar aponeurosis

28
Q

Muscle support for transverse ligament -

A

Provides dynamic support
Tibialis anterior and posterior
Peroneus longus

29
Q

Muscle support of the medial arch -

A

Tibialis anterior and Tibialis posterior
Flexor hallucis longus
Abductor hallucis and flexor digitorium brevis

30
Q

Muscle support of lateral arch -

A

Peroneus longus, brevis and tertius
Flexor digitorium longus - 4th and 5th toes
Flexor digitorium brevis - lateral 1/2
Abductor digiti minimi

31
Q

What is the plantar aponeurosis and its clinical relevance ?

A

Thickening of deep fascia in sole of foot
Supports longitudinal arch and protects deeper structures in the foot

Clinical relevance - plantar faciopathy - pain on bottom of foot and heel.

32
Q

Name the pulses of the ankle and foot -

A

Posterior tibial pulse (just superior to medial malleollus)

Dorsal is pedis pulse - on dorsum of foot

Anatomy (9 decks)

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