Final Exam: Lecture 18-19 (Study Other Decks Too) Flashcards
Which muscles plantarflex the foot?
Gastrocnemius + Soleus
What is the peroneal (fibular) retinaculum? Where does each retinaculum attach?
A pair of two lateral ligaments that hold the peroneus longus and brevis in place to prevent tendon subluxation
Superior peroneal retinaculum: Runs inferior/posterior from lateral malleolus to calcaneus
Inferior peroneal retinaculum: Runs inferior/posterior from inferior extensor retinaculum to calcaneus
Which muscles perform toe flexion?
Flexor hallucis longus, flexor digitorum longus
Which nerve innervates the posterior compartment of the lower leg?
Tibial nerve (via sciatic)
Which artery supplies blood to the posterior compartment of the lower leg? Which structure does it pass through in the ankle?
Posterior tibial artery (via popliteal artery)
It passes through the tarsal tunnel
The tibial nerve splits into which nerves when it reaches the foot?
Medial and lateral plantar nerves
Where does the gastrocnemius originate and insert? Action? Innervation? Blood Supply?
Origin: Medial and lateral heads of the femoral condyles
Insertion: Calcaneus (via achilles tendon)
Action: Plantar flexion and Knee flexion
Innervation: Tibial nerve (S1-S2)
Blood supply: Posterior tibial artery
Where does the plantaris originate and insert? Action? Innervation? Blood Supply?
Origin: Lateral supracondylar line
Insertion: Calcaneus (via achilles tendon)
Action: Plantar flexion + Knee flexion
Innervation: Tibial nerve (S1-2)
Blood supply: Posterior tibial artery
(Not present in 10% of people)
Where does the soleus originate and insert? Action? Innervation? Blood Supply?
Origin: Posterior tibia (soleal line), and posterior fibular head
Insertion: Calcaneus (via achilles tendon)
Action: Plantarflexion
Innervation: Tibial nerve (S1-S2)
Blood supply: Posterior tibial artery
What are the deep muscles of the posterior compartment?
- Tibialis posterior
- Flexor digitorum longus
- Flexor hallucis longus
Which structures pass below the medial malleolus via the tarsal tunnel? List the structures in order from closest to furthest using the medial malleolus as the reference point
Tom: Tibialis Posterior
Dick: Flexor Digitorum Longus
And: Posterior Tibial Artery
Very: Posterior Tibial Vein
Nervous: Tibial Nerve
Harry: Flexor Hallucis Longus
Which structures lie within the distal tibial groove?
Tibialis posterior and flexor digitorum longus
Which structure lies within the groove of the posterior talus?
Flexor hallucis longus
Where does the flexor digitorum longus originate and insert? Action? Innervation? Blood Supply?
Origin: Posterior tibia
Insertion: Plantar distal phalanges
Action: Toe flexion and plantarflexion
Innervation: Tibial nerve (S1-S2)
Blood supply: Posterior tibial artery
Where does the posterior tibialis originate and insert? Action? Innervation? Blood Supply?
Origin: Posterior tibia, fibula, IO membrane
Insertion: Navicular tuberosity and medial cuneiform
Action: Inversion + Plantarflexion
Innervation: Tibial nerve (S1-S2)
Blood supply: Posterior tibial artery
Where does the flexor hallucis longus originate and insert? Action? Innervation? Blood Supply?
Origin: Middle 1/3 of posterior tibia
Insertion: Distal phalanx of digit 1
Where does the anterior tibialis originate and insert? Action? Innervation? Blood Supply?
Origin: Proximal 2/3 of anterior tibia and IO membrane
Insertion: Medial and inferior medial cuneiform and base of MT 1
Action: Dorsiflexion + Inversion
Innervation: Deep peroneal nerve (L4-L5)
Blood supply: Anterior tibial artery
Which muscle looks like a 7?
Adductor hallucis
Where does the Flexor hallucis longus originate and insert? Action? Innervation? Blood Supply?
Origin: Middle 1/3 of fibula
Insertion: Distal phalanx of digit 1
Action: Flexion of metatarsophalangeals (MTP) and interphalangeal (IP)
Innervation: Tibial nerve (S1-S2)
Blood supply: Posterior tibial artery
What is the flexor retinaculum?
The ligament that runs from the calcaneus to medial malleolus and holds Tom Dick And Very Nervous Harry in place
(Also forms the tarsal tunnel)
What is tarsal tunnel syndrome?
When the posterior tibial artery or tibial nerve becomes compressed by the flexor retinaculum
Where does the popliteus originate and insert? Action? Innervation? Blood Supply?
Responsible for the reverse screw home mechanism which locks and unlocks the knee
Origin: Lateral femoral condyle/meniscus
Insertion: Proximal posterior tibia (soleal line)
Action: Internal rotation (unlocks knee) and Knee flexion
Innervation: Tibial nerve (L5-S1)
Blood supply: Popliteal artery
Which nerve innervates the medial lower leg?
Saphenous nerve
Which nerve innervates the anterior lateral lower leg?
Superficial peroneal nerve
Which nerve innervates the lateral knee?
Lateral sural cutaneous nerve
Which nerve innervates the posterior lateral leg?
Sural cutaneous (a branch from the tibial nerve and a branch from common peroneal nerve that meets up and runs lateral to achilles tendon)
Which vein runs down the medial thigh and lower leg and is also considered the longest vein in the human body? Where does it drain into?
Great saphenous vein
drains blood into femoral vein
Where is the short saphenous vein? what does it drain into?
Runs down the back of the leg (with sural nerve)
Drains blood into the popliteal vein
Name all the bones of the foot
Calcaneus, Talus, Cuboid, Navicular, Cuneiforms (3), Metatarsals, Phalanges
Describe the talus?
Articulates with tibia/fibula and navicular
Contains a groove for flexor hallucis longus (FHL)
What is the talocrural joint? Which motions can it perform?
The joint between the talus and foot that connects the talus and tibia
Can perform plantarflexion, dorsiflexion, abduction, adduction
What is the subtalar joint?
The joint between the talus and calcaneus
Which muscles go above and below the fibular/peroneal tubercle?
Above: Peroneus Brevis
Below: Peroneus Longus
(Peroneus longus runs over brevis before they cross at the medial malleolus)
Describe the calcaneus
- Lateral process is the origin of abductor digiti minimi
- Medial process is the origin of the abductor hallucis
- ## Contains the susentaculum tali with the FHL groove underneath
What is ankle mortise?
Upper ankle joint (Talocrural)
What is the primary action of the talocrural joint?
Plantarflexion and dorsiflexion
What is the transverse tarsal joint (TTJ)?
Both the talonavicular joint, and calcaneocuboid joint (together they allow for flexibility/mobility of the forefoot)
What are the actions of the transverse tarsal joint (TTJ)
Supination:
- Combination of plantarflexion, inversion, and adduction
Pronation:
- Combination of dorsiflexion, eversion, and abduction
Which tarsometatarsal bones align with one another?
- Medial cuneiform and MT 1
- Intermediate cuneiform and MT 2
- Lateral cuneiform and MT 3
- Cuboid and MT 4-5
Abduction and adduction of the toes are based around which toe?
2nd toe
Which actions take place at the metatarsophalangeal joint (MTP)?
- Flexion/extension
- Abduction/Adduction
What does PIP stand for?
Proximal Interphalangeal joint
What does DIP stand for?
Distal Interphalangeal joint
T or F? There is no PIP or DIP of the big toe
True, only an interphalangeal joint
T or F? The interphalangeal joint can only perform abduction/adduction
False, only flexion/extension
What are the 3 foot arches?
Medial longitudinal arch, Lateral longitudinal arch, and transverse arch
Which bones make up the medial longitudinal arch?
Calcaneus, talus, navicular, cuneiforms (3), Metatarsals 1-3
Which bones make up the lateral longitudinal arch?
Calcaneus (laterally), Cuboid, Lateral 2 metatarsal bones
Which bones make up the transverse arch?
Tarsometatarsal joints
What is Pes Cavas? What is Pes Planus?
Pes Cavas is an excessive arch while Pes Planus is a flat foot with minimal arch
❗️What are the lateral collateral ligaments of the ankle? What is their function?
Anterior Talofibular (ATFL), Posterior Talofibular (PTFL), Calcaneofibular (CFL)
Function: Resist inversion
What is the weakest ligament of the foot?
Anterior Talofibular Ligament (ATFL)
Which motions does the anterior talofibular ligament (ATFL) resist?
Plantarflexion and Inversion
Which test do you use to distinguish whether or not you have a ruptured ATFL?
Anterior drawer test of ankle
❗️What are the medial collateral ligaments (deltoid) of the ankle? What is their function?
Anterior tibiotalar, Posterior tibiotalar, Tibionavicular, Tibiocalcaneal
Function: Resist eversion
What is plantar fascia? Where does it run to and from?
Fascia that runs on the bottom of the foot from the calcaneus to the head of metatarsals
Function: Supports the bottom of the foot and medial longitudinal arch
What is the long plantar ligament?
The ligament that runs from the calcaneal tuberosity to the bases of metatarsals 2-5
- Supports longitudinal arch
- Forms a tunnel for the peroneus longus
What is the short plantar ligament?
Ligament that runs from calcaneal tubercle to the cuboid
What is the full name of the spring ligament?
Plantar Calcaneonavicular
Describe the calcaneonavicular (spring) ligament
- Runs from the sustentaculum tali to the plantar surface of the navicular
- Connects the calcaneus to navicular
- Partially maintains the medial longitudinal arch of the foot
What
What are the ligaments of the toe?
Collateral ligament
- Resist Abduction and adduction of MTP/IP joints
Plantar ligament
- Resist hyperextension
Deep transverse ligament (between metatarsal heads)
- Resists splaying of MT
Which nerve innervates the dorsum of the foot (top of foot)?
Deep peroneal nerve
Which nerve innervates the intrinsic muscles of the foot?
Lateral/Medial plantar nerves (via tibial nerve)
Which artery supplies the dorsum of the foot (top of the foot)?
dorsalis pedis (via anterior tibial artery)
Which artery supplies the intrinsic foot muscles (plantar side)?
Lateral/Medial Plantar artery (via posterior tibial artery)
Ankle dorsiflexion and plantarflexion in the sagittal plane mainly occur at which of the following joints?
- Talocrural
- Subtalar
- Mid-tarsal
- Talofibular
Talocrural
Ankle inversion/eversion in the frontal plane mainly occurs at which of the following joints?
- Talocrural
- Subtalar
- Mid-tarsal
- Talofibular
Subtalar
Which motion occurs at the mid-tarsal joint?
- Abduction/adduction
- Inversion/eversion
- Dorsiflexion/plantarflexion
- Supination/pronation
Supination/pronation
Which of the following statements regarding the ligaments of the foot is correct?
- ATFL is the strongest ligament of the lateral collateral ligaments
- The lateral collateral ligament resists subtalar inversion
- The lateral collateral ligaments is also called the deltoid ligament
- The plantar fascia distally attaches to the base of the metatarsals
The lateral collateral ligament resists subtalar inversion
The insertion of tibialis anterior is at…
- Medial and inferior medial cuneiform and the first metatarsal base
- Cuboid and the 5th metatarsal tuberosity
- Lateral calcaneus
- Navicular process
Medial and inferior medial cuneiform and the first metatarsal base
The motor innervation to the anterior compartment of the leg is provided by the…
- Superficial fibular nerve
- Deep fibular nerve
- Tibial nerve
- Common fibular nerve
- Deep fibular nerve
The arterial supply to the posterior compartment of the leg is provided by the…
- Anterior tibial artery
- Posterior tibial artery
- Fibular artery
- Inferior lateral genicular artery
Posterior tibial artery
The fibularis brevis can generate which of the following actions?
- Ankle dorsiflexion
- Ankle plantarflexion
- Ankle eversion
- Ankle inversion
- A and D
- B and C
B and C… Ankle plantarflexion and eversion
The lateral compartment of the leg is innervated by the…
- Deep fibular nerve
- Superficial fibular nerve
- Tibial nerve
- Sural nerve
Superficial fibular nerve
Which of the following muscles does not attach to the fibula?
- Tibialis posterior
- Flexor digitorum longus
- Flexor hallucis longus
- Fibularis longus
Flexor digitorum longus
The posterior compartment of the leg is innervated by the…
- Deep fibular nerve
- Superficial fibular nerve
- Tibial nerve
- Femoral nerve
Tibial nerve
Which of the following structures pass through the tarsal tunnel?
- Deep fibular nerve
- Tibialis anterior tendon
- Flexor hallucis longus tendon
- Fibular artery
Flexor hallucis longus tendon
The arterial supply to the posterior compartment of the lower leg is provided by the…
- Anterior tibial artery
- Posterior tibial artery
- Fibular artery
- Popliteal artery
Posterior tibial artery
T or F? The great saphenous vein drains into the popliteal vein
False
Which of the following structures does not go through the adductor canal?
- Femoral artery
- Femoral nerve
- Saphenous nerve
- All of the above go through the adductor canal
All of the above go through the adductor canal
The gracilis inserts at the…
Pes anserinus (medial tibia)
The vastus lateralis is innervated by the…
- Obturator nerve
- Femoral nerve
- Superior gluteal nerve
- Inferior gluteal nerve
Femoral nerve
The arterial supply to the posterior compartment of the thigh is from…
- Obturator artery
- Deep femoral artery
- Superior Gluteal artery
- Iliolumbar artery
- Deep femoral artery
During knee extension, the patella moves which direction?
Superior and lateral
Which ligament resists anterior translation of the tibia in relation to the femur?
Anterior cruciate ligament (ACL)
Which artery supplies the cruciate ligaments?
Middle genicular artery
What is a Jones fracture?
A fracture of the 5th metatarsal
What are the superficial veins of the lower leg?
- Great saphenous vein
- Small saphenous vein
What is the tarsal tunnel?
A narrow opening on the medial ankle formed by the flexor retinaculum
What is the tarsal tunnel?
A narrow opening on the medial ankle formed by the flexor retinaculum
The tibia has grooves for which tendons?
Posterior tibial and flexor digitorum longus
Where is the groove for flexor hallucis longus
Posterior talus
Where does posterior tibialis originate and insert?
Origin: posterior tib and fib
Insertion: navicular tuberosity and medial cuneiform
Where does the flexor digitorum longus originate and insert?
Origin: posterior tib
Insertion: plantar distal phalanges
Where does the flexor hallucis longus originate and insert?
Origin: middle 1/3 of fibula
Insertion: distal phalanx of digit 1
Where does the anterior tibialis originate and insert?
Origin: proximal 2/3 of anterior tibia
Insertion: medial cuneiform + base of MT1
Which artery supplies the dorsum of the foot?
Dorsalis pedis (via anterior tib artery)
Which artery supplies the intrinsic foot muscles?
Lateral + Medial plantar arteries
Which nerve innervates the dorsum of foot?
Deep peroneal nerve
Which nerve innervates the intrinsic foot muscles?
Lateral + Medial plantar nerves
In a closed chain movement, hip internal rotation causes…
Ankle eversion
In a closed chain movement, hip external rotation causes…
Ankle inversion
Which ligament holds peroneus brevis and longus in place?
- Superior peroneal retinaculum
- Inferior peroneal retinaculum
Which ligament holds tom dick Harry in place?
Flexor retinaculum (makes the tarsal tunnel) CONFIRMED
