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Anatomy - Lower limb > L17: Musculo-neuro-vascular systems of the anterior and posterior compartments of the leg and popliteal fossa > Flashcards

L17: Musculo-neuro-vascular systems of the anterior and posterior compartments of the leg and popliteal fossa Flashcards

1
Q

popliteal fossa

A

diamond shaped region at back of knee

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2
Q

popliteal fossa - boundaries

A
  • semimembranosus
  • biceps femoris (long head)
  • gastrocnemius (medial and lateral head)
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3
Q

popliteal fossa - floor + roof

A

floor:
- popliteal surface of femur
- oblique popliteal ligament
- popliteus and popliteal fascia

roof:
- skin and fasciae lata

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4
Q

popliteal fossa - contents

A

Superficial:
- small saphenous vein - drains the lateral superficial leg and joints the popliteal vein
Intermediate:
- tibial nerve
- common fibular [peroneal] nerve
Deep:
-popliteal artery
- popliteal vein
Fat
Lymphatic tissue

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5
Q

fascia of the leg

A

leg muscles and bones are covered by crural fascia
- it is continuous superiorly with fascia lata of thigh
- attached around knee to patellar ligament, tibial tuberosity, tibial condyles and head of fibula
- anteriorly blends with periosteum covering shin (tibia)

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6
Q

three compartments of leg

A
  • anterior compartment
  • lateral compartment
  • posterior compartment
    • superficial
    • deep
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7
Q

the leg is divided into 3 compartments by :

A
  • anterior intramuscular septa
  • posterior intramuscular septa
  • interosseous membrane
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8
Q

compartment syndrome

A
  • excessive swelling or bleeding within a compartment
  • usually after an injury
  • exerts pressure on anything within that compartment: nerves, muscles, arteries, and veins
  • can cause irreversible damage to all tissues in compartment
  • treated with emergency fasciotomy
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9
Q

anterior compartment muscles 4

A
  1. tibialis anterior
  2. extensor digitorum longus
  3. extensor hallucis longus
  4. fibularis [peroneus] tertius
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10
Q

anterior compartment muscles
action

A
  • dorsiflexion of foot
  • extension of toes
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11
Q

anterior compartment innervation

A

deep fibular nerve - is a branch of common fibular [peroneal] nerve

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12
Q

extensor retinacula of anterior compartment

A

these are thickened bands of crural fascia

superior extensor retinaculum: passes between distal tibia and fibula

inferior extensor retinaculum: y-shaped retinaculum, attached to: calcaneus and medial malleolus + planter aponeurosis

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13
Q

tibialis anterior; origin

A

tendon of tibialis anterior is prominent on dorsum of foot close to ankle

origin:
-lateral tibial condyle
-antero-supero-lateral surface of tibia
-interosseous membrane

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14
Q

tibialis anterior ; insertion

A

-medial and inferior surface of medial cuneiform
-base of 1st metatarsal

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15
Q

tibialis anterior; innervation + action

A

innervation: deep fibular nerve

actions: dorsiflexes ankle joint + inverts foot at subtalar joint

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16
Q

extensor digitorum longus; origin

A
  • lateral tibial condyle
  • superior 3/4 of anterior fibular and adjacent interosseous membrane
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17
Q

extensor digitorum longus; insertion

A
  • divides into 4 slips
  • slips insert into middle and distal phalanges via extensor expansions (digit 2-5)
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18
Q

extensor digitorum longus; innervation + actions

A

innervation: deep fibular nerve

actions: extends digits 2-5, dorsiflexes ankle

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19
Q

extensor expansions

A
  • triangular shaped expansions
  • over metatarsal phalangeal [MTP] joints
  • extensor digitorum longus [EDL], foot lumbricals and foot interossei insert into extensor expansions
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20
Q

extensor hallucis longus; origin

A
  • middle 1/2 of anterior fibula
  • adjacent interosseous membrane
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21
Q

extensor hallucis longus; insertion

A

dorsal aspect if base of distal phalanx of digit 1 [big toe]

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22
Q

extensor hallucis longus; innervation + action

A

innervation; deep fibular nerve

actions: extends digit 1 + dorsiflexes ankle

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23
Q

fibularis tertius; origin

A

aka peroneus tertius

origin:
- inferior 1/3 of anterior fibula
- adjacent interosseous membrane

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24
Q

fibularis tertius; insertion

A

dorsal surface of base of 5th metatarsal

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25
Q

fibularis tertius; innervation + actions

A

innervation: deep fibular nerve

actions: dorsiflexes ankle + aids with foot eversion

26
Q

posterior compartment - superficial muscles 3

A
  1. gastrocnemius
  2. soleus
  3. plantaris
27
Q

posterior compartment - superficial muscles - innervation + actions

A
  • all innervated by tibial nerve, a branch of popliteal nerve
  • all insert into achilles tendon
    -all plantarflex ankle
  • triceps sura: gastrocnemius and soleus
28
Q

gastrocnemius; orgin

A

most superficial muscle in the posterior leg, it has 2 muscle bellies which unite at their tendon

origin:
-lateral head - lateral condyle of femur
-medial head - popliteal surface if femur, above medial condyle

29
Q

gastrocnemius; insertion

A

calcaneus via achilles tendon

30
Q

gastrocnemius; innervation + actions

A

innervation: tibial nerve
actions: plantar flexes ankle, raises heel during walking, flexes knee

31
Q

soleus; origin

A

lies deep to gastrocnemius

origin:
- fibular: posterior head and proximal 1/4 of posterior fibula
- soleal line and middle 1/3 of medial border of tibia

32
Q

soleus; insertion

A

calcaneus via achilles tendon

33
Q

soleus; innervation + actions

A

innervation: tibial nerve
actions: plantar flexes ankle independent of knee position + stabilises leg on foot

34
Q

plantaris; origin

A

lies between gastrocnemius and soleus, vestigial muscle- absent in 5-10% of people

origin;
- lateral supracondylar line of femur
- oblique popliteal ligament

35
Q

plantaris; insertion

A

calcaneus via achilles tendon

36
Q

plantaris; innervation + actions

A

innervation: tibial nerve
actions: weakly assists with plantar flexion of ankle and flexion of knee

37
Q

flexor retinaculum of posterior compartment

A
  • runs from medial malleolus to calcaneus
  • encloses the tarsal tunnel, a space between flexor retinaculum and bones underneath it
  • permits passage of plantar flexor tendons, nerves and vessels to sole of foot
38
Q

muscles of deep posterior compartment 4

A
  1. popliteus
  2. tibial posterior
  3. flexor digitorum
  4. flexor hallucis longus

all innervated by tibial nerve, a branch of the popliteal nerve

39
Q

Tom, Dick And Very Nervous Harry (from medial to lateral)

A

Tibialis posterior
flexor Digitorum longus
tibial Artery
tibial Vein
flexor Hallucis longus

40
Q

popliteus; origin

A

lateral femoral condyle and lateral meniscus

41
Q

popliteus; insertion

A

posterior tibial surface, superior to soleal line

42
Q

popliteus; innervation + actions

A

innervation: tibial nerve
actions: weakly flexes knee, ‘‘unlocks’’ a fully extended knee to permit flexion, contraction externally rotates femur by ~5* on tibial plateau to permit flexion

43
Q

tibialis posterior; origin

A

-Posterior tibia, inferior to soleal line
-Posterior fibula
- Adjacent interosseous membrane

44
Q

tibialis posterior; insertion

A

-Inferior surface of navicular
-Cuneiforms
-Cuboid
-Sustentaculum tali of calcaneus
-Bases of metatarsals 2-4

45
Q

tibialis posterior; innervation + actions

A

innervation: tibial nerve
actions: inverts foot

46
Q

flexor digitorum longus; origin

A

medial part of posterior tibial surface, inferior to soleal line

47
Q

flexor digitorum longus; insertion

A

base of distal phalanges 2-5

48
Q

flexor digitorum longus; innervation + actions

A

innervation: tibial nerve
actions: flexes digits 2-5, plantarflexes ankle, supports longitudinal arches of foot

49
Q

flexor hallucis longus; origin

A

-inferior 2/3 of posterior fibula
-adjacent interosseous membrane

50
Q

flexor hallucis longus; insertion

A

base of distal phalanx of great toe [hallux]

51
Q

flexor hallucis longus; innervation + action

A

innervation: tibial nerve
actions: flexes digit 1 at all joints, weakly plantarflexes ankle, supports medial longitudinal arch of foot

52
Q

surface anatomy of posterior leg

A

popliteal fossa, gastrocnemius muscle [medial and lateral heads], soleus muscle, calcaneal [achilles] tendon, medial malleolus of tibia, lateral malleolus of fibula, calcaneus

53
Q

popliteal artery divided into:

A

anterior and posterior tibial arteries

54
Q

arterial supply to the anterior leg

A

anterior tibial artery supplies anterior compartment of leg
- it reaches anterior compartment by passing through a gap in the superior interosseus membrane
- it descends between tibialis anterior and extensor hallucis longus
- descends deep to extensor retincula
- after passing inferior extensor retinaculum, becomes known as dorsalis pedis artery

55
Q

arterial supply to the posterior leg, 2

A
  1. posterior tibial
    - passes through posterior compartment of leg and through tarsal tunnel
    - distal to tarsal tunnel it divides into medial and lateral plantar arteries
    - supplies posterior and lateral compartments of leg
  2. fibular artery
    - descends in posterior compartment
    - supplies posterior compartment, perforating branches also supply lateral compartment
56
Q

arterial pulses of lower limb

A

proximal to distal:
- femoral artery
- popliteal artery
- posterior tibial artery
- dorsalis pedis

57
Q

venous drainage of the superficial leg

A

medial: great saphenous system, drains into femoral vein
lateral: small saphenous system, drains into popliteal vein

58
Q

venous drainage of the deep leg

A

anterior tibial vein: accompanies anterior tibial artery, drains anterior compartment, drains into popliteal vein

posterior tibial vein: accompanies posterior tibial artery, drains posterior compartment, drains into popliteal vein

fibular vein: accompanies fibular artery, drains into popliteal vein

59
Q

varicose veins

A

failure of valves in superficial venous systems
-great saphenous area
-small saphenous area

blood collects in superficial veins
can cause:
- pain, itching, swelling, bleeding can occur

60
Q

sensory innervation of leg

A
  • saphenous nerve - branch of femoral nerve
  • lateral sural cutaneous nerve - branch of fibular nerve
  • medial sural cutaneous nerve - branch of tibial nerve

Anatomy - Lower limb (9 decks)

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