Compartments of the Leg, Talocrural Joint, and Foot Flashcards
What are the bones of the leg? What is the point of tibiofibular joint?
Fibula (medial side) and fibula (lateral side). Joins tibula and fibula at the posterior end of the leg. Prevents one from flexing over the other bone. So no true rotation. Note that tibula has tibial tuberosity and medial malleolus.
What joins fibula to femur?
Lateral meniscus
Name of heal bone. What sits on top of calcaneus?
Sustentaculum tali (sustains the foot from the LATERAL side)/CALCANEUS. Talus sits on top of calcaneus. Talus is covered by trochlea, which makes contact with tibula and fibula.
Describe flow of force throughout foot while walking.
Hindfoot –> midfoot –> forefoot. Note that bigtoe acts as a spring.
Difference between amount of phalanges in the foot and in the toe.
No difference in amount.
Anterior leg
Nerve supply:
Function:
Nerve supply: Deep fibular
Function: Foot dorsiflexion, digit extension
Lateral leg
Nerve supply:
Function:
Nerve supply: Superficial fibular
Function: Foot eversion
Superficial posterior leg
Nerve supply:
Function:
Nerve supply: Tibial
Function: Foot plantar flexion
Deep posterior leg
Nerve supply:
Function:
Nerve supply: Tibial
Function: Foot plantar flexion, digit flexion
What is the job of the crural fascia? What makes it dangerous for the leg?
Compartmentalizes the muscles in the leg. Note that compression of the muscles here further constricts them against each other. Helps with venous return, but if there was ever internal bleeding here, you would need to cut open the leg to remove the trapped blood and relieve compressed vessels and nerves.
What are symptoms to compartment syndrome? What is the source of pain in the leg in this syndrome? Treatment?
- Leg pain disproportional to the injury.
- Leg looks fine (no fracture or ligament damage) from the surface.
- Pain seems more severe than the injury suffered.
Note that the source of pain is from the irritated nerve and the ischemic muscles in the leg.
Treat with fasciotomy (cut leg wide open)
Anterior leg muscles:
Nerve:
Function:
Artery:
Anterior leg muscles: Tibialis anterior (chief dorsiflexor), extensor digitorum longus, extensor hallucis longus
Nerve: Deep fibular
Function: Foot dorsiflection, digit extension
Artery: Anterior tibial
Where is extensor retinaculum?
Anterior side of foot. Wraps around ankle
Lateral leg muscles:
Nerve:
Function:
Artery:
Lateral leg muscles: Fibularis longus, fibularis brevis
Nerve: Superficial fibular
Function: Foot eversion
Artery: Fibular
Where is the fibular retinacula?
Covers the LATERAL part of the foot
Superficial posterior leg muscles:
Nerve:
Function:
Artery:
Superficial posterior leg muscles: Gastrocnemius (has to heads, and attatched over the knee joint to the femur. ), soleus (Only crosses at ankle. Cannot flex the knee), plantaris (Deep to gastricnemius. Equivalent to palmaris longus. Used for grafting.)
Nerve: Tibial
Function: Foot plantar flexion, knee flexion.
Note that both gastroc and soleus link up to make achelese tendon.
Artery: Posterior tibial artery, fibular artery
Deep posterior leg muscles:
Nerve:
Function:
Artery:
Deep posterior leg muscles: Popliteus, tibialis posterior (PURELY plantar flexion), flexor hallucis longus, flexor digitorum longus
Nerve: Tibial
Function: Foot plantar flexion, digit flexion
Artery: Posterior tibial artery, fibular artery
Where is the flexor retinaculum?
On MEDIAL side of foot
From most anterior to most posterior, list the order of the tendons and nerves and arteries posterior to the medial malleolus (Tom, Dick, And Very Nervous Harry)
- Tibialis posterior
- Flexor digitorum Longus
- Posterior tibular artery
- Tibular nerve
- Flexor hallucis longus
What makes up the popliteal artery? Where does the peroneal (fibular) artery come off from?
Anterior tibial and posterior tibial. The fibular (peroneal) artery comes off the posterior tibial artery.
Where does the anterior tibial artery go? Why is the artery response important?
Goes to the dorsal pedis. The dorsal pedis artery is at the lowest point in the body. When lying down, the pulde you feel at the dorsal pedis artery should be the same as that in the brachial artery. If it is low, you may have blockage in the more superior regions for the leg.
What does the posterior fibular artery become when it reaches the foot?
Medial plantar artery and lateral plantar artery
Are the 3 joints of the ankle?
Talocrural (tight fit), subtalar, transverse tarsal
Which ankle joint allows for dorsiflexion/plantar flexion?
Talocrural joint
Which ankle joint allows for inversion/eversion?
Subtalar joint
What are the movements of the transverse tarsal joint?
Midfoot-Inversion and Eversion
Describe shoe heel upon excessive pronation (dorsiflexed, abducted, and everted) of the foot.
Inner heel sole wear
Describe shoe heel upon excessive supination (plantarflexed, adducted, and inverted) of the foot.
Outer heel sole wear
What 4 components support the ankle and foot?
- Medial collateral ligament
- Lateral collateral ligament
- Spring Ligament
- Plantar fascia
What is the job of the medial collateral ligament?
Resists eversion
What is the job of the lateral collateral ligament?
Resists inversion. And this is the most likely ligament to be torn if you sprain an ankle. know this. You have been warned.
What is the job of the spring ligament?
Supports the head of the taleus
What is the job of the plantar fascia?
Protects vascular structure and limits movement of the skin at the plantar surface of the foot.
What innervates the foot?
Dorsum –>
Motor: Deep fibular
Sensory: Superficial fibular (L5), Deep fibular (Great Toe Web Space. STEP 1 MATERIAL!!!)
Plantar Surface –>
Motor and Sensory: Medial/Lateral plantar (Tibial)
What are the dorsal nerves of the foot?
Superficial Fibular Nerve and deep fibular nerve
What are the plantar nerves of the foot?
Medial plantar nerve and lateral plantar nerve
