Lecture 13: Lower Extremity part 3 continued

Question 1

What muscle is in the superficial compartment of the leg?

Answer 1

Triceps surae (group of muscles incl. soleus, gastrocnemius, and soleus)

Question 2

What compartment are the flexors of the toes located in?

Answer 2

Deep posterior leg

Question 3

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Answer 3

Deep to gastrocnemius mm.
Does not cross knee – no action at knee
Plantar flexion @ ankle/foot

Question 4

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Answer 4

Origin as Tendinous Arch (hiatus for vessels and nerve) @ inferior popliteal fossa
Popliteal artery bifurcates as is travels inferior from popliteal fossa into terminal branches – anterior/posterior tibial arteries

Question 5

What tendon runs between soleus and gastroc mm.?

Answer 5

Plantaris m. tendon

Question 6

Calcaneal tendon is also called what?

Answer 6

“Achilles” tendon

Question 7

What do the triceps surae do?

Answer 7

Elevate heel

Question 8

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Answer 8

Bursa
SQ bursa between skin and tendon

Question 9

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Answer 9

Deep bursa between tendon & calcaneal tuberosity
Achilles tendonitis, calcaneal bursitis

Question 10

What may be the primary function of the plantaris muscle?

Answer 10

Proprioception

Question 11

1) What muscle is a small muscle with a long tendon?
2) What else is unique about this muscle?

Answer 11

1) Small muscle, Long tendon
2) Technically crosses 2 joints but can be used for tendon graft without disability
-Absent in 5-10% of folks

Question 12

What LE muscle is absent in 5-10% of folks?

Answer 12

Plantaris

Question 13

1) What clinical test examines the integrity of theAchilles tendonby squeezing the calf?
2) What does it identify?

Answer 13

1) TheThompson test
2) The presence of a complete Achilles rupture

Question 14

What does a Test of Triceps Surae involve?

Answer 14

Weight bearing, stand on toes, observe and palpate Triceps Surae (Achilles tendon)

Question 15

“Ankle Jerk” or Calcaneal Tendon Reflex (DTR) is what type of reflex? What nerves are involved?

Answer 15

S1-2 spinal cord reflex (tibial br. of sciatic n.)

Question 16

1) What muscle unlocks knee by rotating the femur laterally?
2) What muscle functions as arch support and flexes 4 toes?
3) Which functions as arch support and flexes the big toe?

Answer 16

1) Popliteus m.
2) Flexor digitorum longus(FDL)
3) Flexor hallucis longus (FHL)

Question 17

1) What does the Tibialis posterior (TP) do?
2) Where does it insert in relation to TA? What do both do?

Answer 17

1) Invertor of foot
2) TP posterior inserts posterior to TA, both stabilize and invert foot

Question 18

What 3 things does the TP (tibialis posterior) muscle do?

Answer 18

1) Primary plantar flexor of the ankle
2) Inverts foot
3) [supports] Medial longitudinal arch of foot

Question 19

List the 3 jobs of the FDL and FHL

Answer 19

1) FDL: flexes lateral 4 toes, plantar flexes ankle, arch support
2) FHL: flexes great toe, weak ankle plantarflex, arch support

Question 20

What muscle supports the medial longitudinal arch of foot and helps w static contraction during weight bearing stance?

Answer 20

TP

Question 21

What muscle acts as an inverter of foot along with TA when non weight bearing?

Answer 21

TP

Question 22

FHL, FDL, and TP muscles are found within what?

Answer 22

Synovial sheaths

Question 23

_________________ holds tendons so they don’t bow when flexing or extending

Answer 23

Retinaculum

Question 24

Femoral artery continues as what artery?

Answer 24

Popliteal

Question 25

What forms the geniculate arteries around the knee?

Answer 25

Femoral artery (branches)

Question 26

What divides into anterior tibial & posterior tibial arteries?

Answer 26

Popliteal artery

Question 27

What does the anterior tibial artery supply? What does it continue as?

Answer 27

Anterior compartment of the leg; Dorsalis pedis a.

Question 28

1) What artery supplies the posterior compartment of the leg?
2) What supplies the leg’s lateral compartment?

Answer 28

1) Posterior tibial artery
2) Fibular a. branch

Question 29

Where is the posterior tibial artery palpated?

Answer 29

Posterior to medial malleolus

Question 30

Posterior Tibial a. forms what two arteries?
2) What do those two arteries then form?

Answer 30

Medial and lateral plantar aa.
2) plantar arches
MT and Phalangeal aa.

Question 31

1) Where is the tibial nerve in the leg?
2) What action does it supply motor to?
3) Where is it in relation to the malleoli?

Answer 31

1) Posterior compartment
2) Plantar flexors of the foot
3) Posterior to medial malleolus

Question 32

What nerve divides into medial and lateral plantar n.?

Answer 32

Tibial nerve

Question 33

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Answer 33

Cutaneous sensory as the medial sural & sural nerves to posterior and lateral leg and lateral foot distally

Question 34

1) What supplies motor to the lateral compartment of the leg?
2) What do the muscles here do?

Answer 34

1) Superficial Fibular n.
2) Evert foot

Question 35

1) What innervation does the deep fibular nerve supply? (motor or sensory) To where?

Answer 35

1) Motor
2) Dorsiflexors of the foot anterior compartment of leg

Question 36

How does the common fibular nerve supply cutaneous sensory innervation? Where to?

Answer 36

As lateral sural nerve; lateral leg and dorsum of foot

Question 37

1) What nerve does the Achilles tendon reflex (ankle jerk) test?
2) What spinal cord segment is this?

Answer 37

1) Tibial nerve
2) S1-2

Question 38

1) What nerve does the Patella tendon reflex (knee jerk) test?
2) What spinal cord segment is this?

Answer 38

1) Femoral nerve
2) L2-4

Question 39

What is the action of the muscles of the anterior compartment of leg?
What nerves and arteries supply this area?

Answer 39

1) Dorsiflexors of ankle & extensors of toes
2) Deep fibular nerve; anterior tibial artery/vein

Question 40

What is the action of the muscles of the lateral compartment of leg? What nerves and arteries supply this area?

Answer 40

1) Evertor of foot
2) Superficial fibular nerve; perforating branches of
tibial and fibular arteries

Question 41

Posterior compartment of leg

Answer 41

Plantar flexor of ankle, flexors of toes; tibial nerve; posterior tibial & fibular artery/vein
Superficial
deep

Question 42

List the 3 functional parts of the foot and what bones make up each

Answer 42

1) Hindfoot: Talus and calcaneus
2) Midfoot: Navicular, cuboid, cuneiforms x 3
3) Forefoot: Metatarsals and phalanges

Question 43

Plantar aponeurosis (fascia) is an example of what?

Answer 43

Deep fascia

Question 44

What structure does the pathology “plantar fasciitis” affect?

Answer 44

Plantar aponeurosis (fascia)

Question 45

What are the two groups of plantar muscles?

Answer 45

Intrinsic and extrinsic

Question 46

What muscles flex/extend/invert/evert foot & toes?

Answer 46

Extrinsic muscles of foot

Question 47

1) How are the intrinsic muscles arranged?
2) How do they function primarily?

Answer 47

1) In 4 layers in 4 compartments
2) As a group during weight bearing to maintain the arches of the foot

Question 48

1) What do the intrinsic muscles do during weight bearing besides maintaining the arches?
2) What do they do when over uneven ground?

Answer 48

1) Stabilize or fix the foot, variable pressure vs. ground to maintain balance
2) Assist with pronation and supination