L16: Anatomy of the leg and foot (Theme 2)

Question 1

what is the function of the foot

Answer 1

Support body weight

Stability/standing

Locomotion/propulsion (lever)

Shock absorption

Question 2

what are the bones of the leg

Answer 2

fibula

tibia

check the slide 3

Question 3

divisions for the bones of the foot

Answer 3

• tarsals
• metatarsals
• Phalanges

slide 4

Question 4

what are the movements of the foot

Answer 4

Dorsiflexion/extension

Plantarflexion/flexion

Eversion

Inversion

Supination

Pronation

• (feet together – inversion/adduction of front of foot)
• feet apart – eversion/abduction of front of foot)

Question 5

what are the joints of theterph foot

Answer 5

ankle joint - dorsiflexion/plantar flexion

intertarsal joints-invert/evert, supinate/pronate

metatarsophalangeal joints :
extension/flexion
limited abduction/adduction

interphalangeal joints-

extension/flexion

Question 6

what type of joint is the ankle

Answer 6

• Articulation between the talus and tibia/fibula

- Synovial hinge joint

Question 7

clinical importance of stabilizing collateral ligaments to ankle

Answer 7

Clinical: Injury to lateral ligament (usually anterior talofibular ligament)

Question 8

describe the subtalar joint

Answer 8

Between talus and calcaneus (+ navicular)

Allows inversion/eversion during locomotion

Question 9

describe movements of transverse tarsal joint

Answer 9

Allows eversion/inversion and pronation/supination

• Important for standing on uneven ground

Question 10

what is the plantar aponeurosis

Answer 10

Thickening of deep fascia

Protects underlying structures

Supports longitudinal arch

Clinical – Plantar fasciitis (inflammation due to overuse)

Question 11

describe importance of the arches of the foot

Answer 11

Longitudinal and transverse arches

Function:
Shock absorbers during locomotion

Act as springboards

Distribution of weight (to calcaneus + ball of foot)

Question 12

describe the importance of longitudinal arches

Answer 12

-Supported by long tendons, intrinsic plantar muscles, intrinsic ligaments and plantar
aponeurosis

-Clinical: Fallen medial longitudinal arch can lead to pes planus (flat feet)

Question 13

what is the transverse arch supported by

Answer 13

Supported by long tendons (mainly fibularis longus)

Question 14

what are the muscle compartments of the leg

Answer 14

anterior: extend/invert foot
(deep fibular nerve )

posterior : flex/ invert foot (tibial nerve )

lateral : evert foot -superficial fibular nerve

Question 15

muscles in the anterior leg

Answer 15

Three muscles
Extend (dorsiflex) and invert foot

Tibialis anterior
(extends/inverts foot)

Extensor digitorum longus
(extends lateral 4 toes)

Extensor hallucis longus
(extends great toe)

Question 16

where do the tendons of the anterior muscles insert

Answer 16

Extensor digitorum longus
- Middle + distal phalanges

Tibialis anterior
- Medial cuneiform + 1st metatarsal

Extensor hallucis longus
- Distal phalanx of great toe

Question 17

what are the muscles in the posterior superficial group

Answer 17

Superficial group
- Flex (plantar flex) foot and leg

Plantaris
Origin: femur

Soleus
Origin: tibia + fibula

Gastrocnemius
Origin: condyles of femur

aponeurosis -Tendo calcaneus

Question 18

what are the muscles in the Posterior compartment of leg- deep group

Answer 18

Deep group
- Flex (plantar flex) and invert foot + flex toes

Flexor digitorum longus
(flexor of lateral 4 toes)

Tibialis posterior
(Inverter of foot)

Flexor hallucis longus
(flexor of great toe)

Origin: tibia + fibula

Question 19

where do the posterior deep muscles insert

Answer 19

Flexor digitorum longus
- Distal phalanges

Flexor hallucis longus
- Distal phalanx of great toe

Tibialis posterior
- Medial cuneiform + navicular

Question 20

what are the muscles of the lateral compartment of the leg

Answer 20

Evert foot

Fibularis longus
(everts and plantar flexes foot)

Fibularis brevis

Question 21

where do the muscles of the lateral compartment insert into

Answer 21

Fibularis longus
- Medial cuneiform + 1st metatarsal

Fibularis brevis
- 5th metatarsal

Question 22

what keeps the anterior compartment tendons stable

Answer 22

Extensor retinaculum

Question 23

what keeps the posterior compartment tendons stable

Answer 23

Flexor retinaculum

Question 24

what keeps the posterior compartment

Answer 24

Fibular retinaculum

Question 25

what are the long tendons of the foot

Answer 25

Extensor digitorum longus Extensor hallucis longus Tibialis anterior posterior: Tibialis posterior Flexor hallucis longus Flexor digitorum longus

Question 26

what are the intrinsic muscles of the foot

Answer 26

Many layers - Dorsal extensors – 1 layer - Plantar flexors/abductors/adductors – 4 layers

Question 27

what are the dorsal intrinsic muscles

Answer 27

Extensor digitorum brevis Extensor hallucis brevis

Question 28

what are the plantar intrinsic muscles

Answer 28

layer 1 : Abductor digiti minimi Flexor digitorum brevis Abductor hallucis Layer 2: Quadratus plantae Lumbricals layer 3: Adductor hallucis Flexor digiti minimi brevis Flexor hallucis brevis layer 4: Plantar interossei - Adduct (PAD) Dorsal interossei - Abduct (DAB)

Question 29

what is the blood supply of the posterior compartment

Answer 29

- Popliteal artery - Anterior tibial artery - Posterior tibial artery - Fibular artery

Question 30

what are the contents of the tarsal tunnel

Answer 30

- Tibialis posterior - Flexor digitorum longus post tibial artery/vein: Tibial nerve Flexor hallucis longus clinical -pulse

Question 31

what are the medial/ lateral plantar arteries made up of

Answer 31

Posterior tibial artery divided into 2: 1-Lateral plantar artery 2-Medial plantar artery and forms :deep plantar arch

Question 32

what do the Dorsalis pedis artery supply

Answer 32

Anterior tibial artery: forms the... Dorsalis pedis Anastomosis with deep plantar arch

Question 33

what is the nerve supply to the leg

Answer 33

Tibial - Posterior compartment Deep fibular - Anterior compartment Superficial fibular - Lateral compartment

Question 34

what does the tibial nerve supply

Answer 34

Motor: posterior compartment of leg + plantar Intrinsic muscles Clinical – Tarsal tunnel syndrome

Question 35

what does the common fibular nerve supply

Answer 35

Motor: Deep – anterior compartment of leg + dorsal intrinsic muscles Superficial – lateral compartment of leg Clinical – Trauma to common fibular nerve (foot drop)

Question 36

what are the cutaneous nerves

Answer 36

Common fibular nerve Superficial fibular nerve Deep fibular nerve Sural nerve (tibial nerve) Saphenous nerve (femoral nerve) Medial/Lateral plantar nerves (tibial) supply sole of foot