Clinical Anatomy of the Lower Limb III Flashcards
Ankle joint
synovial in type and
involves articulation between the talus
bone of the foot and the tibia and
fibula of the leg
Tibiotalar joint
allows hinge-like
dorsiflexion and plantar flexion of
the foot on the leg
Subtalar joint
allows for inversion and
eversion
ankle joint is stabilized by ;
medial (deltoid) and lateral ligaments
what 3 ligaments make up the lateral ligament :
-anterior talofibular -posterior talofibular -calcaneofibular
what 4 ligaments make up the medial ligament :
- tibionavicular
- tibiocalcanea
- plantar calcaneonavicular
- sustentaculum tali
what does the inversion injury tear :
anterior talofibular and calcaneofibular
what is the medial tarsal tunnel
the gateway to the foot
Found on the posteromedial side of the
ankle. Structures from the posterior leg
enter the plantar foot.
what are the contents of tarsal tunnel :
Tom -tibialis posterior Dick -flexor digitorum longus And- posterior tibial artery Very- posterior tibial vein Very- posterior tibial vein Nervous- tibial nerve Harry flexor- hallucis longus
what are the bones of the foot
-7 Tarsal bones
-5 metatarsal
bones
-14 Phalanges
why does the foot have arches
Arches absorb and distribute downward forces from the body during standing and moving on different surfaces.
what ligaments support the arches :
β plantar calcaneonavicular
β plantar calcaneocuboid
β long plantar ligaments
β plantar aponeurosis
what muscles provide dynamic support for the foot arches
β tibialis anterior
β tibialis posterior
β fibularis longus
Hallux Valgus
a foot deformity in which there is lateral deviation of the great toe in the transverse plane. It is caused by pressure from the footwear and degenerative joint disease.
Hallux Varus
is a foot deformity in which there is medial deviation of the great toe in the transverse plane. It is caused by excessive recession of a bunion.
abductor digiti minim
abducts the little
toe
β’ lateral plantar
nerve
abductor
hallucis
abducts the big
toe
β’ medial plantar
nerve
flexor digitorum brevis
flexes the digits
β’ medial plantar
nerve
plantar aponeurosis
β’ supports the longitudinal arch of the foot β’ protects deeper structures in the sole
Lumbricals
- flexion at the MTP and extension at IP
- 1st : medial plantar
- 2nd-4th :lateral plantar
Flexor digiti minimi brevis
flexes little toe
β’ lateral plantar
nerve
Flexor hallucis brevis
β’ flexes big toe β’ medial plantar nerve
Adductor hallucis
β’ adducts the
big toe
β’ lateral plantar
nerve
how many plantar interossei
Adductors do we have
3
how many dorsal interossei
Abductors do we have
4
Lymphatic drainage of lower limb -Superficial drainage:
β lateral foot + postero-lateral leg -popliteal lymph
nodes
- antero-medial foot,antero-medial leg,thigh-vertical group of
superficial inguinal lymph nodes
Lymphatic drainage of lower limb -Deep drainage
β’ leg and foot to popliteal nodes, then to
deep inguinal
β’ thigh to deep inguinal nodes
β’receives tributaries from the superficial
groups and eventually drain into the
external iliac nodes
valves in veins:
assist with venous return by preventing
retrograde flow
β’ prevent flow from deep veins to
superficial veins
superficial veins
are outside deep fascia β not
exposed to compression forces when muscles
contract
superficial veins
are outside deep fascia β not
exposed to compression forces when muscles
contract
deep veins-
pressure rises when muscles contract = muscular pump
varicose vein
Superficial veins and perforating branches with
insufficient valves
venous ulcers
When large numbers of superficial vein valves become insufficient β there is continuous excess flow through superficial veins (from deep to superficial) β pressure in the superficial veins rises leading to mechanical injury of small vessels, inflammation and fibrosis
Chronic venous insufficiency
pigmentation, fibrosis, ulcerations
Dermatomes-βL1
over the inguinal ligament
Dermatomes-βL2
lateral side of the thigh
Dermatomes-βL3
lower medial side of the thigh
Dermatomes-βL4
medial side of the great toe (digit I
Dermatomes-βL5
β medial side of digit II
Dermatomes-S1
little toe (digit V)
Dermatomes-βS2
back of the thigh
skin over the gluteal fold
Dermatomes-βS3
skin over the gluteal fold