lecture 20 Flashcards
Thigh foot and leg
what is the subcutaneous tissue of the thigh and leg?
superficial fascia and this lies deep to the skin
what is the deep fascia of the lower limb?
fascia lata and the crural fascia
what is the fascia fata?
deep fascia of the thigh separated into three compartments
what the three components of the the fascia lata is divided into?
anterior, medial, and posterior
what is the function of the fascia lata?
this encloses the large thigh muscles and thickens laterally reinforced by the iliotibial tract that attaches to the anterolateral tubercle of the tibia (Gerdy tubercle)
describe the iliotibial tract
aponeurosis of tensor fasciae latae and gluteus maximus
what is the anterolateral tubercle of the tibia also known as?
Gerdy tubercle
Crural fascia is the deep fascia of the leg, T/F?
True
what are the three compartments of the crural facia?
anterior
lateral
posterior
what movements are noted for each of the 3 compartments of the crural fascia?
anterior - dorsiflexor
lateral - fibular
posterior - plantarflexor
how are the compartments of the lower limb seen as useful?
they contain groups of muscles contributing to a common action
how are the compartments of the thigh organized?
anterior, medial, posterior
what are the functions in each of the thigh compartments?
anterior - extend leg at knee joint, flex thigh at hip joint
medial - adduct thigh
posterior - flex leg at knee joint, extend thigh at hip joint
since we know that the leg compartments are divided into anterior, lateral and posterior, how would you describe the function of each of the compartments?
anterior - dorsiflexion and invert the foot
lateral - evert the foot
posterior - plantarflexion
term for part of the foot directed superiorly?
dorsum of the foot
term for part of the contacting the ground?
sole or plantar region
what is the term for part of the foot underlying the calcaneus?
the heel
what is the term for the part underlying the heads of the medial two metatarsals?
ball of the foot
medical term the 1st toe called?
great toe
medical term for the 5th toe?
little toe
describe the skin of the dorsum of the foot
thin with loose subcutaneous tissue
what medical condition can happen to the skin of the dorsum of the foot?
edema
what is the plantar fascia?
holds the foot together, protects the sole and helps support the longitudinal arches
what is the plantar aponeurosis?
runs from the calcaneus to the fibrous digital sheaths where it forms the superficial transverse metatarsal ligament.
the fibrous septa found in the sole of the foot divide creating this?
shock absorbing pads and the fibrous septa also serve as good anchors
where are the foot compartments located in the foot? how many are there?
mid foot and forefoot; 5
this septa forms 3 compartments of the foot?
vertical intermuscular septa
where is the fourth compartment located?
surrounded by the plantar and dorsal interosseous fascias
what is the fourth compartment of the foot called?
Interosseous compartment of the foot
where is the fifth compartment of the foot located?
lies between the dorsal fascia of the foot and the tarsal bones and the dorsal interosseous fascia of the midfoot and forefoot
what is the fifth compartment called?
Dorsal compartment of the foot
what plexus supplies the gluteal region and the thigh compartments?
lumbosacral plexus
what is the general innervation for the following?
Anterior compartment
Medial compartment
Posterior compartment
Anterior compartment (femoral nerve) Medial compartment (obturator nerve) Posterior compartment (sciatic nerve)
what is the innervation to the gluteal region?
Superior and inferior gluteal nerves
the anterior compartment of the thigh is the largest of the three compartments, T/F?
T
what locomoters are found in the anterior compartment?
flexors of the hip and extensors of the knee
what muscles are found in the anterior compartment?
Flexors of the hip joint: pectineus, iliopsoas, sartorius
Extensors of the knee: quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius)
describe the shape of the pectineus
Flat quadrangular muscle, located in the superomedial anterior thigh
what muscles combine to form the Iliopsoas?
Merger of the psoas major and iliacus
this muscle of the anterior compartment is the most superficial and passes obliquely over across the thigh
sartorius
when acting bilaterally, this muscle of the anterior compartment puts limb in the cross legged sitting position
sartorius
what comprises the medial compartment muscles?
Adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus
what is the medial compartment of the thigh innervated by?
obturator nerve
this is the largest adductor in the medial compartment? what is it comprised of?
adductor magnus; adductor part and hamstrings
name the muscle that is formed from each of the three thigh compartments forming a common tendinous insertion into the superior part of the medial surface of the tibia?
pes anserinus
*what is the femoral triangle?
is a wedge-shaped depression in the upper thigh inferior to the inguinal ligament
*a subfascial formation bound by muscles of the upper thigh and is a useful landmark in dissection and in understanding relationships in the groin
what are the boundaries that comprise the femoral triangle?
borders, floor, and roof
what are the borders of the femoral triangle, name the structures found in them?
Superior - Inguinal ligament
Medial - Adductor longus muscle
Lateral - Sartorius muscle
what structures are found in the floor of the femoral triangle?
Iliopsoas laterally and pectineus medially
what structures are found in the roof of the femoral triangle?
Fascia lata, subcutaneous tissue and skin
what contents can we find in the femoral triangle?
Femoral nerve, femoral artery, femoral vein, deep inguinal lymph nodes
what are the thigh muscles of the posterior compartment?
Semitendinosus
Semimembranosus
Biceps femoris long head
Biceps femoris short head
of the following thigh muscles in the posterior compartment, which three are the hamstring muscles?
Biceps femoris (LH), semitendinosus, and semimembranosus
what is the criteria for hamstrings?
- Proximal attachment to the ischial tuberosity
- Span and act on two joints (producing extension at hip and flexion at knee)
- Innervation by the tibial division of sciatic nerve (L5, S1, S2)
in the posterior compartment, this muscle is half tendinous and is part of the pes anserinus formation
semitendinous
this muscle of the posterior compartment is a broad muscle with a flattened membranous part?
semimembranosus
this muscle of the posterior compartment is a two headed muscle with a common tendon attaching to the head of the fibula
biceps femoris
what compartments is the leg divided into?
anterior, posterior, lateral
what locomotors can be found in the anterior compartment of the leg?
dorsiflexors of the ankle joint and extensors of the toes
what are the boundaries of the anterior compartment of the leg?
anteriorly by the deep fascia of the leg and skin
between the lateral surface of the tibia and medial surface of the fibula
posteriorly by the interosseous membrane
T/F the small anterior compartment found in the anterior compartment of the leg is confined and most susceptible to compartment syndromes?
T
what does the deep fascia of the anterior compartment of the leg form?
the superior and inferior extensor retinacula
what are the muscles found in the anterior compartment of the leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius
what is the vasculature of the anterior compartment of the leg?
anterior tibial artery
what is the innervation of the anterior compartment of the leg?
Deep fibular (peroneal) nerve
Name this artery based on the following for the supply to the anterior compartment of the leg:
- A terminal branch of the popliteal artery
- Becomes the doralis pedis artery at the ankle joint
anterior tibial artery
what are the locomoters found in the lateral compartment of the leg?
evertors of the foot
how is the lateral compartment of the leg bounded?
Bounded anteriorly by the deep fascia of the leg and skin, located between the lateral surface of the fibula and the anterior and posterior intermuscular septa
where does the lateral compartment of the leg end?
inferiorly at the superior fibular retinaculum which is between the fibula and calcaneus.
the lateral compartment of the leg is the smallest of the leg, T/F?
T
what are the muscles found in the lateral compartment of the leg?
fibularis longus and fibularis brevis and no artery coursing through it
what is the vasculature of the lateral compartment of the leg?
Perforating branches of the anterior tibial artery
Perforating branches of the fibular artery
what innervates the lateral compartment of the leg?
Superficial fibular (peroneal) nerve
with respect to the vasculature of the lateral compartment of the leg, these penetrate septums, which ones do these arteries penetrate?
Perforating branches of the anterior tibial artery – penetrate the anterior intermuscular septum
Perforating branches of the fibular artery – penetrate the posterior intermuscular septum
in the posterior compartment of the leg, what locomotors can be find here?
Muscles produce plantarflexion at the ankle, inversion of the foot and flexion of the toes
the posterior compartment further subdivided, T/F? if so, what are they?
Divided into superficial and deep subcompartments by the transverse intermuscular septum
how are the subcompartments of the posterior leg bounded?
The superficial subcompartment is bounded by deep fascia of the leg and the transverse intermuscular septum.
The deep subcompartment is bounded by the interosseous membrane and transverse intermuscular septum.
where does the divider, transverse intermuscular septum, of the posterior compartment of the leg end?
flexor retinaculum
what are the muscles of the superficial compartment in the posterior compartment of the leg?
Superficial
Gastrocnemius
Soleus
Plantaris
what are the muscles of the deep compartment in the posterior compartment of the leg?
Deep
Popliteus
Flexor hallucis longus
Flexor digitorum longus
Tibialis posterior
what is the vasculature in the posterior compartment of the leg?
Posterior tibial artery
a) Fibular artery
1) Nutrient artery of fibula
b) Nutrient artery of tibia
c) Circumflex fibular artery
what is the innervation of the posterior compartment of the leg?
tibial nerve
the superficial or deep subcompartment muscles of the posterior compartment for the prominence associated with the calf?
superficial
this muscle in the superficial subcompartment of the posterior legs a short belly muscle with a long tendon and can be absent in 5-10% of people
plantaris, the long slender tendon can be mistaken for a nerve and can be removed for grafting without causing weakness in plantarflexion
the foot is distal or proximal to the ankle joint?
distal
how does the foot provide a platform for the body?
the platform is used to support the body while standing
how many tarsals, metatarsals, and phalanges comprise the foot?
Skeleton of the foot consists of 7 tarsals, 5 metatarsals and 14 phalanges.
what are the zones of the foot?
Hindfoot: talus and calcaneus
Midfoot: navicular, cuboid, and cuneiforms
Forefoot: metatarsals and phalanges
how many muscles of the foot?
20 individual muscles of the foot
14 plantar
2 dorsal
4 intermediate
how many layers are the four muscles of the sole arranged in?
4 layers within four compartments
what is the function of the plantar muscles?
resist forces that stress (attempt to flatten) the arches of the foot
when do the planter muscles become most active?
They become most active during push off of the foot and refining supination and pronation allowing the foot to adjust to uneven ground
what muscles are in the 1st layer?
abductor digiti minimi
flexor digitorum brevis
abductor hallucis
what muscles are in the 2nd layer?
lumbricals and quadratus plantae
what muscles are in the 3rd layer?
flexor hallucis brevis
flexor digiti minimi brevis
what muscles are in the 4th layer?
plantar interossei and dorsal interossei
