Anterior and Lateral Leg, Foot Flashcards
Distally, the tibia forms the _______ malleolus and the fibula forms the ________ malleolus.
Tibia - medial malleolus
Fibula - lateral malleolus
What is the interosseus membrane?
Dense CT that connects the tibia and fibula throughout the length of both.
What are the four compartments of the leg?
- Anterior
- Lateral
- Superficial posterior
- Deep posterior
Which nerve supplies the posterior leg compartment?
The tibial (medial) division of the sciatic nerve
What nerve supplies the anterior compartment of the leg?
The deep peroneal nerve (a division of the common fibular peroneal nerve from the sciatic that occurs after the peroneal crosses the lateral fibular head).
What nerve supplies the lateral compartment of the leg?
The superficial peroneal nerve (division of the common fibular peroneal from the sciatic)
What happens to the popliteal artery distal to the popliteal fossa?
It divides to form the anterior and posterior tibial arteries.
The anterior tibial artery ends at the ankle where it becomes the dorsalis pedis artery.
The posterior tibial artery gives rise to the peroneal (fibular) artery which travels to the foot and ends by dividing into the medial and lateral plantar arteries that supply the foot.
What are the four muscles of the anterior leg compartment?
- Tibialis anterior
- Extensor hallucis longus
- Extensor digitorum longus
- Peroneus tertius
What are the extensor retinacula and what do they do?
Transverse strands of CT fibers that hold the extensor tendons of the anterior compartment close to the ankle joint - keeps them from bowing outwards
After the deep peroneal nerve travels distally from the anterior leg compartment, what does it do?
It emerges as a cutaneous nerve in the first web space between the big and second toe.
What muscles are in the lateral leg compartment?
Peroneus longus and peroneus brevis
What supplies the lateral leg compartment with blood?
The peroneal and anterior tibial arteries.
After the superficial peroneal nerve travels distally from the lateral leg compartment, what does it do?
Emerges as the major cutaneous nerve of the dorsum of the foot and ends in the distal digital nerves.
How can a fibular neck fracture cause foot drop?
This injury can injure the common fibular (peroneal) nerve, which supplies the anterior compartment and is involved in dorsiflexion of the foot. That is accompanied by loss of sensation of the inferolateral half of the leg and most of the dorsum of the foot.
The gastrocnemius arises from ______ heads, medial and lateral, from their respective ______ ________.
two heads from their respective femoral condyles
Gastrocnemius from the Greek “gaster” meaning belly and “kneme” meaning leg
condyle from the Greek “kondylos” meaning knuckle
What muscles are in the superficial posterior compartment of the leg?
Gastrocnemius and soleus
What is the name of the common tendon of the gastrocnemius and soleus muscles? Where does it insert?
Calcaneal tendon inserts into the calcaneus bone.
The calcaneal tendon is also referred to as the achilles tendon
What supplies the superficial posterior compartment of the leg with blood?
The posterior tibial artery and inferior vessels of the genicular anastamosis
What muscles are included in the deep posterior compartment of the leg?
- Popliteus
- Flexor digitorum longus
- Tibialis posterior
- Flexor hallucis longus
The popliteus muscle is important in ________ the knee joint. (What’s its action?)
unlocking
In other words, it is important in initiating flexion at the knee by medially rotating the tibia with respect to the femur, “unlocking” the joint.
What is anterior tibial compartment syndrome?
Ischemic necrosis of the anterior compartment leg muscles due to compression of the anterior tibial artery and its branches.
The compression usually due to swollen muscles of the anterior compartment following excessive exertion.
Which muscle is primarily involved in shin splints?
The tibialis anterior muscle.
What is claudication?
A poor blood supply to the leg muscles caused by smoking and atherosclerosis can cause a type of pain called “claudication”.
Most commonly affected muscles are the calf, hammys, and quads
What is intermittent claudication?
Limping caused by ischemia of lower limb muscles, mostly the calf muscles. Caused by occlusion of arteries, esp. the popliteal.
What nerve does the medial plantar nerve arise from? What does the medial plantar nerve innervate?
Arises from the tibial nerve. Medial plantar nerve innervates four muscles in the sole of the foot.
What is Pes planus?
Flatfoot
What is a saphenous cutdown?
When an incision is made anterior to the medial malleolus to expose the great saphenous vein to administer blood and other products.
What is a Pott’s fracture? What causes it?
Fracture of the distal fibula, often accompanied by fracture of the medial malleolus or deltoid ligament ruptures. Caused by forced eversion (pronation).
What is Hallux valgus?
Lateral deviation of the big toe. Called “hammertoe” in lay terms. Often accompanied by a bunion (swelling) on the medial side of the first metatarso-phalangeal joint.
Note that hallux varus would be a medial deviation.
What is a trimalleolar fracture?
Fracture of the ankle that involves the lateral malleolus, medial malleolus, and distal posterior aspect of the tibia. Can be accompanied by ligament damage and dislocation.
Does damage to the superficial peroneal nerve cause foot drop?
No, just loss of eversion (pronation) of the foot.
Which nerve roots does the calcaneal tendon reflex (hitting the Achilles tendon) test? In what areas of the lower limbs are these nerves responsible for cutaneous sensation?
S1 and S2 - they are responsible for cutaneous sensation of the posterior thigh, legs, and buttocks.
What is the tuberosity of the 5th metatarsal, and what is it for?
It is a rough patch on the base of the 5th metatarsal, where the peroneus brevis muscle inserts.
What is the sustentaculum tali?
A horizontal eminence from the upper medial surface of the calcaneum. The flexor hallucis longis tendon travels around it.
What causes a Charley horse (muscle cramp)?
Muscle fatigue, overexertion, dehydration and depletion or imbalance of salt and minerals such as calcium, sodium and potassium.
What type of joint is the ankle? What bones form the ankle joint?
Hinge-type
Tibia and fibula superiorly, trochlea of the talus inferiorly
What can cause tarsal tunnel syndrome?
Fracture of the adjacent bone, nearby edema, venous stasis (as from varicose veins), and other compressive pathology can result in pressure on the tibial nerve. It’s just like carpal tunnel, but in the ankle.
What are the two muscles involved in inversion of the foot?
Tibialis anterior and posterior
compartment syndrome
fluid is trapped, veins are compressed and leads to necrosis
superficial posterior compartment (3)
- gastrocnemius
- soleus
- plantaris
superficial posterior compartment nerve
tibial nerve
deep posterior compartment [4]
- popliteus
- flexor hallucis longus
- flexor digitorum longus
- tibialis posterior
deep posterior compartment nerve
tibial nerve
popliteus crosses the
knee joint
Tom, Dick an(d) Harry went around the medial malleolus
Tibialis posterior flexor Digitorum longus posterior tibial Artery tibial Nerve flexor Hallucis longus
does the common peroneal nerve is found in the popliteal fossa?
no! it runs laterally to it
anterior comparment of the leg
tibialis anterior
extensor digitorum
extensor hallucis
anterior comparment of the leg nerve
deep peroneal nerve
peroneus tertius
usually an extension of the extensor digitorum
lateral compartment of the leg [2]
Peroneus Longus
Peroneus Brevis
lateral compartment of the leg nerve
superficial peroneal nerve
