Anterolateral Leg

Question 1

Crural Fascia

Answer 1

Deep fascia of the leg continuous with fascia late
Covers leg muscles
Part of proximal attachment of underlying muscles
Thickens distally to form extensor retinaculum

Question 2

Anterior Compartment muscles

Answer 2

Dorsiflexor/extensor Muscles
Anterior to interosseous membrane
1. Tibialis anterior
2. Extensor hallucis longus
3. Extensor digitorum longus
4. Fibularis tertius

Question 3

Deep Fibular Nerve

Answer 3

One of two terminal branches of the common fibular nerve
-begins between fibula and fibularis longus
-runs inferomedially with anterior tibial vessels between tibias anterior and extensor hallucis longus. Ends in medial and lateral terminal branches on dorm of foot
Supplies:
-anterior compartment muscles
-ankle joint and metacarpal phalangeal joints
-dorsal intrinsic foot muscles
-skin between first and second digits

Question 4

Anterior Tibial Artery

Answer 4

Arises from popliteal artery
Begins near inferior border of popliteus muscle
-tibial tuberosity is where it divides into anterior and posterior tibial arteries
Passes anteriorly over interosseous membrane
Descends on anterior surface of interosseus membrane between EHL and TA muscles with deep fibular nerve
Ends at ankle between malleoli to become doornails pedis artery

Question 5

Cuboid

Answer 5

Most lateral bone in distal row of tarsus
Articulates with:
-posteriorly=calcaneus
-anteriorly=4th and 5th metatarsals
-medially=navicular and lateral cuneiform
Cuboid sulcus- groove for fibularis longus

Question 6

Superficial Fibular nerve

Answer 6

One of the two terminal branches of the common fibular nerve
Begins between fibulas longus and fibula
Descends between fibular muscles and lateral to extensor digitorum longus
Becomes superficial in distal third of leg to supply:
-anteroinferior leg
-dorsal surface of foot and digits

Question 7

Common fibular nerve

Answer 7

Most commonly injured lower extremity nerve
Paralysis of all anterior and lateral crural muscles
“Foot Drop”
Difficult to achieve heel strike
Has stepping, waddling or swing out gait
Foot falls with a “clop”
Loss of sensation along anterolateral leg and dorsal of foot

Question 8

Crural Fascia Clinical correlations

Answer 8

Leg compartmental syndromes
Trauma may lead to hemorrhage, edema and inflammation
Intracompartmental pressure may lead to ischemia and permanent injury
Fasciotomy may be performed to relieve pressure

Question 9

Shin splints

Answer 9

Due to repetitive microtrauma to tibialis anterior
Induces small tears to periosteum over tibia
And/or tears to overlying deep fascia
Mild form of compartmental syndrome. (Swelling of tibialis anterior due to repetitive ground reaction force)