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Tri 3 - Gross Anatomy II > Exam 4B > Flashcards

Exam 4B Flashcards

1
Q

cutaneous innervation of the leg

anterior surface

A

superolateral: lateral sural cutaneous nerve
inferolateral: superficial fibular (peroneal) nerve
medially: saphenous nerve

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2
Q

cutaneous innervation of the leg

posterior surface

A

superolateral: lateral sural cutaneous nerve
inferolateral: sural nerve
medially: saphenous nerve

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3
Q

superior extensor retinaculum

A

attaches to distal parts of anterior borders of tibia and fibula

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4
Q

inferior extensor retinaculum

A

Y-shaped: stem of “Y” is directed laterally and attaches to superior surface of calcaneus, upper limb of “Y” attaches to medial malleolus, lower limb of “Y” reaches medial border of foot, becomes continuous with deep fascia of sole of foot

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5
Q

flexor retinaculum

A

located on medial side of ankle; extends from medial malleolus to medial surface of calcaneus (runs posteriorly and inferiorly)

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6
Q

superior fibular retinaculum

A

extends from lateral malleolus to lateral surface of calcaneus (runs posteriorly and inferiorly)

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7
Q

inferior fibular retinaculum

A

attaches at both ends to lateral surface of calcaneus

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8
Q

muscles of the posterior compartment

superficial group

A

gastrocnemius
soleus
plantaris

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9
Q

muscles of the posterior compartment

deep group

A

flexor digitorum longus
flexor hallucis longus
tibialis posterior
popliteus

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10
Q

muscles of the posterior compartment

A

superficial and deep separated by transverse inter muscular septum; all supplied by tibial nerve

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11
Q

gastrocnemius origin

A

medial head: popliteal surface, above medial condyle

lateral head: lateral surface of lateral condyle and distal end of lateral supracondylar line

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12
Q

gastrocnemius insertion

A

both heads join a common tendon (together with soleus), calcaneal tendon (Achilles tendon), inserts into posterior surface of calcaneus

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13
Q

gastrocnemius innervation

A

tibial nerve

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14
Q

gastrocnemius action

A

plantar flexion of foot at ankle joint

assists with flexion of leg at knee joint

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15
Q

soleus origin

A

soleal line and medial border of tibia, posterior surfaces of head and shaft of fibula and tendinous arch between tibial and fibular attachments

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16
Q

soleus insertion

A

posterior surface of calcaneus via calcaneal tendon

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17
Q

soleus innervation

A

tibial nerve

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18
Q

soleus action

A

plantar flexion of foot at ankle joint

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19
Q

plantaris origin

A

lateral supracondylar line of femur, immediately above origin of lateral head of gastrocnemius

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20
Q

plantaris insertion

A

tendon passes inferiorly and medially between gastrocnemius and soleus, descends along medial border of calcaneal tendon, inserts into posterior surface of calcaneus (plantaris tendon may fuse with calcaneal tendon)

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21
Q

plantaris innervation

A

tibial nerve

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22
Q

plantaris action

A

assists with plantar flexion of foot at ankle joint and flexion of leg at knee joint

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23
Q

flexor digitorum longus

A

most medially located of deep posterior muscles

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24
Q

flexor digitorum longus origin

A

posterior surface of shaft of tibia, inferior to soleal line

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25
Q

flexor digitorum longus insertion

A

tendon passes posterior to medial malleolus, under flexor retinaculum; enters sole of foot and divides into 4 tendons for lateral 4 toes
tendons pass through openings in corresponding tendons of flexor digitorum brevis; insert into bases of distal phalanges of lateral 4 toes (similar to flexor digitorum profundus in hand)

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26
Q

flexor digitorum longus innervation

A

tibial nerve

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27
Q

flexor digitorum longus action

A

flexion of lateral 4 toes (distal, middle and proximal phalanges); plantar flexion of foot at ankle joint

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28
Q

flexor hallucis longus

A

most laterally located of deep posterior muscles

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29
Q

flexor hallucis longus origin

A

posterior surface of shaft of fibula

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30
Q

flexor hallucis longus insertion

A

tendon passes posterior to medial malleolus, under flexor retinaculum; it grooves posterior process of talus (divides it into medial and lateral tubercles) and inferior aspect of sustentaculum tali and runs anteriorly in sole of foot to insert into base of distal phalanx of great toe

tendons of flexor hallucis longus and flexor digitorum longus cross each other on medial side of sole of foot (FDL tendon passes superficial [inferior] to FHL tendon)

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31
Q

flexor hallucis longus innervation

A

tibial nerve

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32
Q

flexor hallucis longus action

A

flexion of big toe (distal and proximal phalanges)

plantar flexion of foot at ankle joint

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33
Q

tibialis posterior

A

most deeply placed muscle of deep posterior group

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34
Q

tibialis posterior origin

A

posterior surface of shaft of tibia (inferior to soleal line), posterior surface of shaft of fibula and interosseous membrane

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35
Q

tibialis posterior insertion

A

in lower leg its tendon passes anterior (deep) to flexor digitorum longus; passes posterior and directly in contact with medial malleolus, under flexor retinaculum; inserts into tuberosity of navicular, and via small tendinous slips it also inserts into cuboid, cuneiforms and bases of 2nd to 4th metatarsals

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36
Q

tibialis posterior innervation

A

tibial nerve

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37
Q

tibialis posterior action

A

plantar flexion of foot at ankle joint

inversion of foot at subtalar and transverse tarsal joints

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38
Q

popliteus origin

A

within capsule of knee joint, from lateral surface of lateral condyle of femur (a few fibers also originate from lateral meniscus of knee joint)

39
Q

popliteus insertion

A

emerges from knee joint and passes inferiorly and medially; inserts into posterior surface of shaft of tibia, superior to soleal line

40
Q

popliteus innervation

A

tibial nerve

41
Q

popliteus action

A

medial rotation of tibia (if foot is off ground) or lateral rotation of femur (if foot is on ground)
this action occurs at beginning of flexion from a fully extended (“locked”) knee joint
referred to as “unlocking” knee joint

42
Q

posterior tibial artery

A

terminal branch of popliteal artery

begins at lower border of popliteus muscle

runs inferiorly in deep part of posterior compartment of leg accompanied by posterior tibial veins and tibial nerve

passes posterior to medial malleolus, under flexor retinaculum; at this point it is only covered by skin and fasciae; its pulse can be palpated approximately halfway between heel and medial malleolus

terminates by dividing into medial and lateral plantar arteries, deep to flexor retinaculum

43
Q

posterior tibial artery branches

A 
fibular artery
circumflex fibular artery
muscular branches to posterior leg
posterior medial malleolar
medial calcaneal branch
medial and lateral plantar arteries
44
Q

fibular artery

A

originates from proximal part of posterior tibial artery and it is its largest branch
descends posterior to fibula, within flexor hallucis longus or between it and tibialis posterior
supplies muscles in posterior and lateral compartments of leg
ends distally giving off branches to arterial anastomosis around ankle (posterior lateral malleolar branch) and to heel (lateral calcaneal branches)
it also gives off a perforating branch that pierces lower part of interosseous membrane to enter anterior compartment of leg and anastomose with a branch of anterior tibial artery

45
Q

circumflex fibular artery

A

passes around neck of fibula; participates in arterial anastomosis around knee joint (may originate from anterior tibial artery)

46
Q

posterior medial malleolar branch

A

participates in arterial anastomosis around ankle

47
Q

medial calcaneal branches

A

supply medial aspect of heel

48
Q

tibial nerve

A

terminal branch of sciatic nerve in lower ⅓ of posterior thigh
descends through popliteal fossa and passes under tendinous arch of soleus
runs inferiorly in deep part of posterior compartment of leg accompanied by posterior tibial artery and veins
passes posterior to medial malleolus, under flexor retinaculum
terminates by dividing into medial and lateral plantar nerves under flexor retinaculum

49
Q

tibial nerve branches

A

muscular branches to soleus, flexor digitorum longus, flexor hallucis longus and tibialis posterior
medial calcaneal branches: supply skin over medial and inferior aspects of heel
articular branch to ankle joint
medial and lateral plantar nerves (terminal branches)

50
Q

muscles of the anterior compartment

A 
tibialis anterior
extensor digitorum longus
extensor hallucis longus
fibularis tertius
deep fibular nerve
51
Q

tibialis anterior

A

superficial and medially located in anterior compartment

52
Q

tibialis anterior origin

A

lateral condyle of tibia, lateral surface of shaft of tibia and interosseous membrane

53
Q

tibialis anterior insertion

A

tendon passes under extensor retinacula, inserts into medial cuneiform and base of 1st metatarsal

54
Q

tibialis anterior innervation

A

deep fibular nerve

55
Q

tibialis anterior action

A

dorsiflexion of foot at ankle joint

inversion of foot at subtalar and transverse tarsal joints

56
Q

extensor digitorum longus

A

superficial and laterally located in anterior compartment

57
Q

extensor digitorum longus origin

A

lateral condyle of tibia, medial surface of shaft of fibula and interosseous membrane

58
Q

extensor digitorum longus insertion

A

tendon passes under extensor retinacula and divides into 4 tendons (for lateral 4 toes); each tendon divides into 3 slips; central slip inserts into base of middle phalanx; 2 lateral slips join and insert into base of distal phalanx (similar to extensor digitorum in hand)

59
Q

extensor digitorum longus innervation

A

deep fibular nerve

60
Q

extensor digitorum longus action

A

extension of lateral 4 toes (distal, middle and proximal phalanges), dorsiflexion of foot at ankle joint

61
Q

extensor hallucis longus

A

its upper part is deeply located, covered by tibialis anterior and extensor digitorum longus muscles  in lower leg it becomes superficial

62
Q

extensor hallucis longus origin

A

medial surface of shaft of fibula and interosseous membrane

63
Q

extensor hallucis longus insertion

A

tendon passes under extensor retinacula and inserts into base of distal phalanx of great toe

64
Q

extensor hallucis longus innervation

A

deep fibular nerve

65
Q

extensor hallucis longus action

A

extension of great toe (distal and proximal phalanges)

dorsiflexion of foot at ankle joint

66
Q

fibularis tertius

A

it is essentially a lateral slip of extensor digitorum longus, from which it is rarely completely separated

67
Q

fibularis tertius origin

A

medial surface of shaft of fibula and interosseous membrane

68
Q

fibularis tertius insertion

A

tendon passes under extensor retinacula and inserts into dorsal aspects of shaft and base of 5th metatarsal

69
Q

fibularis tertius innervation

A

deep fibular nerve

70
Q

fibularis tertius action

A

dorsiflexion of foot at ankle joint

eversion of foot at subtalar and transverse tarsal joints

71
Q

anterior tibial artery

A

terminal branch of popliteal artery
begins at lower border of popliteus muscle, passes forward, into anterior compartment of leg, through an opening in upper part of interosseous membrane
in upper ⅔ of leg is deeply located, descends on interosseous membrane covered by muscles of anterior compartment
in distal ⅓ of leg is superficial, passes anterior to distal end of tibia, covered only by skin and fasciae
at ankle, it is crossed anteriorly (from lateral to medial) by tendon of extensor hallucis longus
distal to ankle, it continues on dorsum of foot as dorsalis pedis artery
along its course, it is accompanied by anterior tibial veins and deep fibular nerve (nerve is lateral to artery)

72
Q

anterior tibial artery branches

A

muscular branches: supply muscles of anterior and lateral compartments of leg
anterior tibial recurrent artery: participates in arterial anastomosis around knee joint
branches that participate in arterial anastomosis around ankle joint (anterior medial and anterior lateral malleolar arteries)

73
Q

deep fibular nerve

A

terminal branch of common fibular nerve
begins deep to fibularis longus muscle, lateral to neck of fibula (in lateral compartment of leg)
pierces anterior intermuscular septum, which separates anterior and lateral compartments, and enters anterior compartment of leg
in anterior compartment, it descends with anterior tibial artery and veins (lateral to them)
continues onto dorsum of foot (does not change name like artery does)

74
Q

deep fibular nerve branches

A

muscular branches: supply muscles of anterior compartment of leg
articular branch: ankle joint

75
Q

muscles of the lateral compartment

A

fibularis longus
fibularis brevis
superficial fibular nerve

76
Q

fibularis longus

A

superficial muscle of lateral compartment

77
Q

fibularis longus origin

A

lateral surfaces of head and shaft of fibula

78
Q

fibularis longus insertion

A

tendon passes posterior to lateral malleolus (under superior fibular retinaculum), runs anteriorly and inferiorly on lateral surface of calcaneus (under inferior fibular retinaculum), curves around cuboid and enters a groove on its inferior surface (groove is transformed into an osteofibrous tunnel by long plantar ligament), crosses sole of foot from lateral to medial, inserts into medial cuneiform and base of 1st metatarsal

79
Q

fibularis longus innervation

A

superficial fibular nerve

80
Q

fibularis longus action

A

plantar flexion of foot at ankle joint

eversion of foot at subtalar and transverse tarsal joints

81
Q

fibularis brevis

A

lies deep to fibularis longus muscle

82
Q

fibularis brevis origin

A

lateral surface of shaft of fibula

83
Q

fibularis brevis insertion

A

tendon passes posterior and directly in contact with lateral malleolus (under superior fibular retinaculum), runs anteriorly and inferiorly on lateral surface of calcaneus (under inferior fibular retinaculum), inserts into tuberosity (styloid process) of base of 5th metatarsal

84
Q

fibularis brevis innervation

A

superficial fibular nerve

85
Q

fibularis brevis action

A

plantar flexion of foot at ankle joint

eversion of foot at subtalar and transverse tarsal joints

86
Q

avulsion fracture of the tuberosity of the 5th metatarsal

A

when foot is suddenly and forcibly inverted, tuberosity of 5th metatarsal may be avulsed (torn away) by tendon of fibularis brevis
common in basketball and tennis players
associated with severely sprained ankle
causes pain, edema and bruising at base of 5th metatarsal

87
Q

blood supply of the lateral compartment

A

no major artery passes vertically through lateral compartment of leg
main sources of blood supply: anterior tibial and fibular arteries
branches of anterior tibial artery perforate anterior intermuscular septum to supply lateral compartment
branches of fibular artery perforate posterior intermuscular septum to supply lateral compartment

88
Q

superficial fibular nerve

A

terminal branch of common fibular nerve
begins deep to fibularis longus muscle, lateral to neck of fibula (in lateral compartment of leg)
lies at first deep to fibularis longus and then descends between fibularis longus and brevis and extensor digitorum longus
in lower leg pierces deep fascia and becomes superficial

89
Q

superficial fibular nerve branches

A

muscular branches: supply fibularis longus and fibularis brevis muscles
medial and intermediate dorsal cutaneous nerves: supply skin of inferolateral part of anterior leg, dorsum of foot and dorsal surfaces of toes, except adjacent sides of great and 2nd toes (supplied by deep fibular nerve) and lateral side of little toe (supplied by lateral dorsal cutaneous nerve, continuation of sural nerve)

90
Q

structures that pass anterior to the ankle, superficial to the inferior extensor retinaculum

A

saphenous nerve
great saphenous vein
branches of superficial fibular nerve

91
Q

structures that pass anterior to the ankle, deep or through the inferior extensor retinaculum

A 
tendon of tibialis anterior
 tendon of extensor hallucis longus
 tendons of extensor digitorum longus
 tendon of fibularis tertius
 anterior tibial artery and veins
 deep fibular nerve
92
Q

structures that pass posterior to the medial malleolus, deep to the flexor retinaculum AM - PL

A 
tendon of Tibialis posterior
 tendon of flexor Digitorum longus
 posterior tibial Artery and veins
 tibial Nerve
 tendon of flexor Hallucis longus
Tom Dick And Nervous Harry
93
Q

structures that pass posterior to the lateral malleolus, superficial to the superior fibular retinaculum

A

sural nerve

small saphenous vein

94
Q

structures that pass posterior to the lateral malleolus, deep to the superior fibular retinaculum

A

tendon of fibularis brevis

tendon of fibularis longus

Tri 3 - Gross Anatomy II (20 decks)

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